Transient, stress-related paranoid or severe dissociative symptoms.Overall, the most distinguishing symptoms of BPD are pervasive patterns of instability in interpersonal relationships and self-image, alternating between extremes of idealization and devaluation of others, along with varying moods and difficulty regulating strong emotional reactions. Dangerous or impulsive behavior is also correlated with the disorder. Other symptoms may include feeling unsure of ones identity, morals, and values; having paranoid thoughts when feeling stressed; depersonalization; and, in moderate to severe cases, stress-induced breaks with reality or psychotic episodes. Individuals with BPD often have comorbid conditions, such as depressive and bipolar disorders, substance use disorders, eating disorders, post-traumatic stress disorder, and attention-deficit/hyperactivity disorder. Emotions
People with BPD may feel emotions with greater ease and depth and for a longer time than others do. A core characteristic of BPD is affective instability, which generally manifests as unusually intense emotional responses to environmental triggers, with a slower return to a baseline emotional state. According to Marsha Linehan, the sensitivity, intensity, and duration with which people with BPD feel emotions have both positive and negative effects. People with BPD are often exceptionally enthusiastic, idealistic, joyful, and loving, but may feel overwhelmed by negative emotions (anxiety, depression, guilt/shame, worry, anger, etc. ), experiencing intense grief instead of sadness, shame and humiliation instead of mild embarrassment, rage instead of annoyance, and panic instead of nervousness. Studies have shown that borderline patients experience chronic and significant emotional suffering and mental agony.People with BPD are also especially sensitive to feelings of rejection, criticism, isolation, and perceived failure.
Many adolescents experience these symptoms without going on to develop BPD, but those who experience them are 9 times as likely as their peers to develop BPD. They are also more likely to develop other forms of long-term social disabilities.BPD is recognised as a valid and stable diagnosis during adolescence. The diagnosis of BPD (also described as "personality disorder: borderline pattern qualifier") in adolescents is supported in recent updates to the international diagnostic and psychiatric classification tools including the DSM-5 and ICD-11. Early diagnosis of BPD has been recognised as instrumental to the early intervention and effective treatment for BPD in young people. Accordingly, national treatment guidelines recommend the diagnosis and treatment of BPD among adolescents in many countries including Australia, the United Kingdom, Spain, and Switzerland.The diagnosis of BPD during adolescence has been controversial. Early clinical guidelines encouraged caution when diagnosing BPD during adolescence. Perceived barriers to the diagnosis of BPD during adolescence included concerns about the validity of a diagnosis in young people, the misdiagnosis normal adolescent behaviour as symptoms of BPD, the stigmatising effect of a diagnosis for adolescents, and whether personality during adolescence was sufficiently stable for a valid diagnosis of BPD. Psychiatric research has since shown BPD to be a valid, stable and clinically useful diagnosis in adolescent populations. However, ongoing misconceptions about the diagnosis of BPD in adolescence remain prevalent among mental health professionals.