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Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Symptoms of BPD are outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM) and include

• desperate attempts to prevent real or imagined abandonment;
• unstable and intense relationships with others that alternate between seeing the other person as flawless and as worthless;
• highly unstable self-image;
• potentially self-damaging impulsive behaviors, like drug abuse or reckless driving;
• repeated suicidal thoughts or behaviors, or self-mutilation (for example, cutting or burning themselves);
• unstable emotional states, usually lasting a few hours to a few days;
• persistent feelings of emptiness;
• inappropriately intense anger or trouble controlling anger;
• short-lived episodes of paranoia (extreme suspiciousness) or dissociation (disconnecting from sense of self and reality) that are caused by stress.

Of the above symptoms, mood instability and impulsivity (the tendency to act without thinking) tend to be the most specific to BPD. These two symptoms are thought to be the driving force behind the unstable relationships and chronic suicidal thoughts that are hallmarks of this disorder. In men, BPD tends to include more explosive anger and co-occur with substance abuse and antisocial personality disorder, while in women, this disorder more often co-occurs with eating disorders, as well as mood and anxiety disorders. People who suffer from a number of the above symptoms but not enough to qualify for having BPD are described as having borderline personality traits.

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