Borderline personality disorder diagnosis is a process that happens in multiple stages, and can take some time to reach a diagnosis from your initial GP appointment. It’s important to be aware that this may not be an easy, or quick, process.
The first step in diagnosis is to see your GP, if you’re concerned that you have borderline personality disorder (BPD). They may ask about your symptoms and how they’re affecting your quality of life. They may order some tests to rule out other possible causes, and to make sure there is no immediate risk to your health.
Community Mental Health Team (CMHT)
If your GP suspects that you may have borderline personality disorder, you will most likely be referred to your local community mental health team (CMHT) to be assessed in more detail.
What is a community mental health team? Different mental health professionals work together in a CMHT – this may include psychiatric nurses, psychologists and psychiatrists, but can also include social workers, mental health support workers and occupational therapists.
You may like to ask the CMHT if they have experience of working with personality disorders.
The CMHT will go into your symptoms, and how they affect you, in more detail. It’s important to be as honest as you can, because the more they know, the more they can help you.
In some areas, there are complex needs services which may be better placed to help you – the CMHT can advise on services available to you.
Your assessment will usually be carried out by a specialist in personality disorder – usually a psychologist or psychiatrist with training in personality disorders.
You may receive an assessment from another member of the CMHT before you see the specialist.
Your assessment will include a discussion about your symptoms and how they affect you, your health history (mental and physical) and about any signifcant events or traumas that may have impacted your mental health.
Internationally recognised criteria
There are also recognised criteria that the specialist will look for – a diagnosis is usually made if you can answer ‘yes’ to 5 or more of the following questions (these are also listed on the NHS website).
- Do you have an intense fear of being left alone, which causes you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody (but not including self-harming or suicidal behaviour)?
- Do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they’re wonderful to hating that person and thinking they’re terrible?
- Do you ever feel you do not have a strong sense of your own self and are unclear about your self-image?
- Do you engage in impulsive activities in 2 areas that are potentially damaging, such as unsafe sex, drug misuse or reckless spending (but not including self-harming or suicidal behaviour)?
- Have you made repeated suicide threats or attempts in your past and engaged in self-harming?
- Do you have severe mood swings, such as feeling intensely depressed, anxious or irritable, which last from a few hours to a few days?
- Do you have long-term feelings of emptiness and loneliness?
- Do you have sudden and intense feelings of anger and aggression, and often find it difficult to control your anger?
- When you find yourself in stressful situations, do you have feelings of paranoia, or do you feel like you’re disconnected from the world or from your own body, thoughts and behaviour?