....ginamarina's world....

Diagnostic Criteria for Borderline Personality Disorder
"Annotated" by a group of recovering friends
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) is the source of these diagnostics, which is used by mental health professionals. It is not all-encompassing, and is used to hoard "symptoms" into categories in order to find some commonality of treatment options. Sometimes they use words that sound ambiguous and weird. They may also be used in different ways than standard English. I have tried to annotate this version to make it more understandable.

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

This basically boils down to lack of coping skills. Relationship problems, lack of self-esteem and unhealthy thinking patterns are what becomes of this lack of coping skills. (Lots of people lack proper coping skills). 

(1) frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

"Frantic efforts" include panic, threats to yourself, or to the other person. This is not a conscious manipulative effort, it is a terrifying fear of losing something, an obsessive reaction to some "clue" that may or may not even exist. Unfortunately this often makes a partner assume you are distrusting, and if the relationship is already in a bad place, chances are you will push that person farther away with being so clingy or demanding.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

Here is where we begin the concept of Black and White thinking. Idealization means that one puts someone on a pedestal where they can do no wrong. The borderline sufferer will go out of their way to protect this person for the can do no wrong. Devaluation means the opposite - that everything that person does is wrong. It is suggested that this is a behavior adapted from childhood when one sees only extremes - black and white, no grey area.

(3) identity disturbance: markedly and persistently unstable self-image of sense of self

People who suffer from borderline disorder don't have a stable internal sense of self. They tend to feel the need to live in someone else's life because they don't know how to have their own. They only feel safe with others' reassurance. Again, black and white thinking applies: an outside person can control if a person with borderline is feeling like they are a bad person or a good one. There is seldom a middle ground. Not knowing who you is a persistent pattern.

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

Distractions can fill the voids that a borderline suffer feels within themselves. And of course, any period when they hate themselves they are more likely to do something harmful.

(5) recurrent suicidal behaviors, gestures, or threats, or self-mutilating behavior

Suicidal behaviors are not always "suicide threats" or "suicide attempts" that everyone knows about. People with borderline disorder often are so devastated by abandonment that they feel no will to live, and it hurts to feel. This is not always publicly displayed. Adrenaline and other brain hormones can be stimulated by the pain response, which is a coping skill, not a healthy one, but one that works. Most people with borderline disorder do not want to die, they just don't want to feel the pain of living anymore.

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

Thought patterns that are very unstable. An untreated sufferer of borderline has extreme emotionally driven reactions. They will panic, rage, silence, or suffer from severe depression and/or anxiety.

(7) chronic feelings of emptiness

These feelings are paralyzing. They are not a "pull yourself up by your bootstraps" type of feeling. Sufferers of borderline disorder lack self esteem and self image. It tends to feel like you will never be complete and that life is simply too difficult. Oversensitive to everything around, the world is entirely overwhelming.

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Rage, either internally or externally can be triggered by the slightest things. Because one is already suffering within, it takes very little to upset the person. It's as if every painful thing in life is stored up and appended, and when the trigger strikes, the blow falls in a manner that may be completely inappropriate for the situation.

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

Dissociation and paranoia occur because of heavy stress. Whether the stress is understandable by the outside world or it is within the person, it is just as real. Dissociation is leaving reality for a period of time. Many abuse cases use this form of coping with heavy stress, and it can also cause a loss of time perception in the victim. Paranoia is similar, it is the mind going into "overdrive" and potentially creating thoughts and situations that are not actually there, which can easily create a situation that is too paralyzing for the person to cope with.