Searching for answers about borderline personality disorder (BPD) can feel overwhelming. While there’s no single test, understanding the diagnostic process can bring clarity and hope.
If you’ve been struggling with intense emotions that feel impossible to control, relationships that swing between extremes, or impulsive behaviors you later regret, you may be asking yourself: “Is there a test that can tell me if I have borderline personality disorder?”Â
Perhaps you’ve noticed patterns — sudden shifts between feeling deeply connected to someone and then feeling completely abandoned, moments when your sense of self feels unclear, or emotional reactions that seem disproportionate to what’s happening around you. These experiences can be confusing, exhausting, and deeply painful.
Or maybe you’re here because someone you love is struggling. You’ve watched them cycle through intense relationships, react with extreme emotion to situations that seem minor, or engage in self-destructive behaviors that leave you feeling helpless and afraid. You might notice them viewing people as either all good or all bad, with little middle ground. You see their pain and also feel the impact of their struggles on your relationship with them. What’s happening? Is this BPD? How can I help?
Whether you’re seeking clarity about your own experiences or trying to better understand a loved one, you’re taking an important step. The questions themselves — Is there a test? How is this diagnosed? What comes next? — reflect a desire for understanding, and that’s where healing begins.
Understanding Borderline Personality Disorder
Borderline personality disorder is a mental health condition characterized by patterns of instability in mood, self-image, and interpersonal relationships, combined with marked impulsivity. People with BPD often experience intense emotional reactions, fear of abandonment, and difficulty maintaining stable relationships.
BPD can develop from a combination of genetic, neurological, and environmental factors. Many people with the disorder have experienced trauma, particularly during childhood. The symptoms typically emerge in adolescence or early adulthood and can significantly impact daily functioning, relationships, work, and overall quality of life.
BPD affects approximately 1.4% to 2.7% of adults in the United States1 — which means millions of individuals navigate these challenges every day.
How Is BPD Diagnosed?
Unlike physical health conditions that can be identified through laboratory tests or imaging, BPD is diagnosed through a comprehensive clinical evaluation. Mental health professionals at treatment facilities — such as Clearview Treatment Programs in California — use specific diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
According to the DSM-5, a diagnosis of BPD requires that a person display a pervasive pattern of instability in relationships, self-image, and emotions, along with marked impulsivity. This pattern must be present across different situations and begin by early adulthood. Specifically, individuals must meet at least five of the following nine criteria:
- Frantic efforts to avoid real or imagined abandonment
- A pattern of unstable and intense interpersonal relationships alternating between extremes of idealization and devaluation
- Identity disturbance — a markedly unstable self-image or sense of self
- Impulsivity in at least two areas that are potentially self-damaging (such as spending, substance use, reckless driving, or binge eating)
- Recurrent suicidal behavior, gestures, threats, or self-harming behavior
- Affective instability due to marked reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
- Transient, stress-related paranoid ideation or severe dissociative symptoms
The diagnostic process involves gathering extensive information about your symptoms, personal history, relationships, and behavioral patterns. Your mental health provider may conduct structured or semi-structured clinical interviews to ensure all relevant symptoms are thoroughly assessed.
Screening Tools + Assessment Instruments
While there’s no single “BPD test,” mental health professionals use validated screening instruments to help identify potential cases of borderline personality disorder. These tools don’t provide a diagnosis on their own, but they help clinicians determine whether a more comprehensive evaluation is warranted.
One of the most widely used screening tools is the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). This self-report questionnaire consists of 10 yes-or-no items based on DSM-5 criteria. Research shows that a score of seven or more on this instrument demonstrates good sensitivity and specificity for identifying BPD.2 The McLean instrument is beneficial because it’s brief, easy to administer, and can be completed in just a few minutes.
Other assessment tools include the Diagnostic Interview for Borderlines-Revised (DIB-R), the Structured Clinical Interview for DSM Disorders (SCID-II), and the International Personality Disorder Examination (IPDE). These instruments are more comprehensive and are typically administered by trained clinicians during the diagnostic process.
It’s important to note that these screening tools are just one piece of the puzzle. A positive result on a screening instrument indicates that further evaluation is needed — it doesn’t mean you definitely have BPD. Similarly, screening tools can sometimes miss cases or produce false positives, which is why a thorough clinical assessment by a qualified professional is essential.
Why Accurate Diagnosis Matters
Getting an accurate diagnosis of borderline personality disorder is crucial for several reasons. First, it helps you understand what you’re experiencing. Many people with BPD have spent years feeling confused about their emotional reactions and relationship patterns. A diagnosis can bring clarity and validation — you’re not “crazy,” and what you’re experiencing has a name and effective treatments.
Second, an accurate diagnosis guides professional treatment planning. BPD responds well to specific therapeutic approaches, particularly dialectical behavior therapy (DBT), which was specifically developed for this condition. Other evidence-based treatments include mentalization-based therapy and schema-focused therapy. Without an accurate diagnosis, you might receive treatment for other conditions — such as depression or anxiety — that don’t fully address the core issues of BPD.
Third, diagnosis affects prognosis and recovery. Research indicates that with appropriate treatment, many people with BPD experience significant improvement in symptoms over time. Understanding your diagnosis empowers you to seek the most effective interventions and gives you hope for recovery.
The Importance of Professional Evaluation
If you’re concerned that you or a loved one might have borderline personality disorder, the most crucial step is to seek evaluation from a qualified mental health professional. While online screening tools can provide some initial insights, they cannot replace a comprehensive clinical assessment. Here’s why professional evaluation is essential:
Complexity of Symptoms
BPD symptoms often overlap with those of other mental health conditions, including bipolar disorder, depression, anxiety disorders, and post-traumatic stress disorder. In fact, research shows that individuals with BPD frequently have co-occurring conditions — 83% have lifetime mood disorders, 85% have anxiety disorders, and 78% have substance use disorders.3 A trained clinician can differentiate between these conditions and identify whether BPD is present.
Contextual Understanding
Mental health professionals assess not just your current symptoms, but also your developmental history, relationship patterns over time, and the broader context of your life. They consider whether your symptoms are persistent and pervasive or whether they might be related to a specific situation or life event.
Comprehensive Assessment
Clinicians use multiple sources of information during evaluation, including structured interviews, behavioral observations, and sometimes input from family members or other people who know you well. This comprehensive approach increases diagnostic accuracy.
Treatment Planning
A professional evaluation doesn’t just result in a diagnosis; it leads to a personalized treatment plan tailored to your specific needs, goals, and circumstances.
What to Expect During a BPD Evaluation
If you decide to pursue an evaluation for borderline personality disorder, knowing what to expect can help ease anxiety about the process. Typically, the assessment involves one or more appointments with a mental health professional. During these sessions, you can expect:
Detailed Questions About Symptoms
Your clinician will ask about your emotional experiences, relationship patterns, impulse control, self-image, and any self-harming behaviors. They’ll want to know how long you’ve experienced these symptoms and how they affect your daily life.
Personal + Family History
You’ll discuss your childhood, family relationships, significant life events, and any history of trauma. Your clinician will also ask about mental health conditions in your family, as genetic factors can play a role in BPD.
Medical History
Your provider will review your general health, medications, substance use, and any medical conditions that might contribute to psychiatric symptoms.
Assessment of Co-occurring Conditions
Because BPD often occurs alongside other mental health conditions, your clinician will screen for depression, anxiety, substance use disorders, eating disorders, and other concerns.
Use of Screening Instruments
You may be asked to complete questionnaires or screening tools, such as the MSI-BPD, to supplement the clinical interview.
The evaluation process is collaborative. Your honesty and openness help your clinician develop an accurate understanding of your experiences. Remember that mental health professionals are there to help, not to judge. Everything you share is confidential and protected by privacy laws.
Moving Forward with Hope
If you’re struggling with symptoms that might indicate borderline personality disorder, it’s essential to understand that seeking help is a sign of strength and self-regard, not weakness. BPD can be a challenging condition, but it’s also highly treatable. Research consistently shows that people with BPD can and do recover, especially when they engage in evidence-based treatment.
At Clearview Treatment Center’s Women’s Mental Health Program in Venice, California, we offer nationally recognized, comprehensive care specifically designed for individuals identifying as women who struggle with borderline personality disorder and emotional dysregulation.
Our program centers on dialectical behavior therapy (DBT), the gold-standard, evidence-based treatment proven most effective for BPD. With a team of highly trained DBT therapists providing individual sessions, skills training groups, phone coaching, and round-the-clock support, we help clients develop the skills needed to regulate emotions, improve relationships, and build lives worth living.
If you or someone you love is struggling with BPD, know that lasting recovery is possible with the proper treatment. Contact our compassionate admissions team today to learn more about how our specialized program can help.
References
- Trull, T. J., Jahng, S., Tomko, R. L., Wood, P. K., & Sher, K. J. (2010). Revised NESARC personality disorder diagnoses: Gender, prevalence, and comorbidity with substance dependence disorders. Journal of Personality Disorders, 24(4), 412-426.
- Zanarini, M. C., Vujanovic, A. A., Parachini, E. A., Boulanger, J. L., Frankenburg, F. R., & Hennen, J. (2003). A screening measure for BPD: The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD). Journal of Personality Disorders, 17(6), 568-573.
- Ellison, W. D., Rosenstein, L. K., Morgan, T. A., & Zimmerman, M. (2018). Community and clinical epidemiology of borderline personality disorder. Psychiatric Clinics of North America, 41(4), 561-573.
