Many people with BPD have a profound fear of being abandoned or left by those they care for. In the relationships that matter to them most, they may become sensitive to signs of rejection. This sensitivity may lead them to perceive that they’re at risk of being abandoned even in situations where that is not likely to occur. In order to avoid the pain of being left, they might behave in uncharacteristic behavior in a desperate attempt to remain in relationship with those they care about or avoid being left. For example, they might call someone excessively to reestablish contact with them or break up with someone in order to avoid being broken up with.

For those with BPD, relationships can be quite rocky. And it tends to be the case that the closer and more intimate a relationship becomes, the more intense and rocky the connection grows.

In many relationships, partners learn to grow and trust one another over time and feel more at ease. However, BPD is likely to get in the way of an individual developing this trust, ease, and sense of stability in a relationship over time.

Those with BPD may notice that they experience themselves and those closest to them in binary ways — at times they might experience their partner as loving and kind and at others they might experience them as frightening and untrustworthy. It is difficult to have a stable, consistent relationship when one’s partner appears to be so drastically different from one moment to the next.

People with BPD tend to experience themselves in more extreme, fluctuating ways. Often, these changes in self image might be caused by perceived rejection or acceptance by others. For example, if someone gets a compliment from a co-worker, they might experience themselves as beautiful, cool, and likable. Conversely, if they feel rejected or judged by someone, they might experience themselves as stupid, a loser, and unloveable. While all people are influenced by compliments and rejection, for those of us with BPD, these external influences are unmooring and cause us to experience more extreme fluctuations in our perception of who we are.

Impulsive behavior in BPD is often an attempt at stabilizing mood. For example, if someone with BPD is feeling upset or rejected, they might impulsively turn to sex as a means of making themselves feel better. Considering how intensely folks with BPD experience their emotions, it’s understandable that they might turn to risky behaviors in an attempt to manage how they feel.

Folks with BPD might have a history of recurrent suicidal thoughts, gestures, and/or attempts. This can often lead to psychiatric hospitalization. Self-harm — such as cutting oneself, burning oneself, or hitting oneself — are also common. We can understand that these behaviors are frequently done in an effort to manage the intense and changing emotions associated with BPD.

People with BPD are likely to experience strong, frequently changing emotions that are often triggered by their interactions with other people. Their moods are reactive to the environment around them, as well as to their own thoughts and internal experiences. For example, a person might miss the bus and then criticize themselves harshly in their own mind and think “I’m such a loser, I never do anything right.” This, in turn, might send a person into intense feelings of sadness and shame that could last a few hours, but typically no more than a few days.

Because folks with BPD present with mood instability, they are frequently misdiagnosed with Bipolar Disorder. A trained clinician can help make an informed differential diagnosis to help gain a clearer understanding of the root cause of a person’s mood instability. This is important because it will help steer a person in the direction of appropriate and effective treatment.

Some people with BPD describe a sense of emptiness at the core of their being. Some might say that it’s always there, while others might experience this feeling more fleetingly.

Some other ways that people describe this feeling include: purposelessness, pointlessness, nothingness, numbness, or blankness.

Folks with BPD might have intense experiences of anger that they describe as feeling more like rage. Typically, this intense anger gets expressed most frequently (or solely) in the context of their closest relationships.

Often, folks with BPD feel remorse, shame, or embarrassment after they’ve expressed their intense anger or rage towards others, because they may have said or done things that are uncharacteristic of them at other times or not in keeping with their values.

When under stress, folks with BPD can experience paranoia that tends to be short-lived and is not typical for them in other moments of their lives. Although paranoia can take on many different forms, one common way it manifests is having a feeling of certainty that someone is trying to hurt or malign you. A person might feel overly convinced that someone is “out to get them,” and experience intense worry and fear in response to this conviction. As stress subsides, this certainty and worry tends to fade away and become less intense.

Dissociation is a broad category of experiences that put distance between oneself and reality. Someone might feel as if they aren’t a real person or as if they were watching their life happen from the outside (depersonalization). Life might not feel real (derealization). One might have patches of time that they can’t recall, or find themselves in a new location without any sense of how they arrived there (amnesia). Dissociation can also cause changes in one’s visual perception — colors might fade or the world might seem cloudy or hazy. You might have problems latching on to the words a person is saying to you while in conversation.

Dissociation can feel confusing and unsettling, and because of this, be hard to talk about. Dissociation tends to happen automatically and in response to emotional stress. When it happens recurrently, it can cause a person to feel disconnected and as if they are missing out on life.