Borderline Personality Disorder (BPD) is a complex mental health condition that affects how someone thinks, feels and interacts with others. Getting a diagnosis can be a turning point – not just for treatment but also for making sense of past struggles.
In this post, we’ll walk you through what the process of diagnosing BPD usually looks like. Whether you’re seeking help for yourself or supporting someone else, knowing what to expect can make things feel a little less overwhelming.
Table of Contents:
When should you seek help?
You might feel overwhelmed by your emotions. Maybe your relationships feel hard to manage. Or you find yourself reacting in ways you don’t fully understand. If that sounds familiar, it could be a good time to get support. You don’t have to wait until things feel worse.
If something feels off, it’s okay to talk to someone. A mental health professional can help you understand what’s going on. They can also guide you towards the right kind of support. Even if it’s not BPD, starting the conversation can really help.
Step 1: Talking to your GP
In the UK, the first step is usually to book an appointment with your GP. This can feel scary, but GPs are trained to help you.
Try to be open and honest about what you’re experiencing—emotionally, mentally and in your relationships.
Tips for your GP appointment
- Write down your symptoms. This might include mood swings, emotional reactions, struggles with identity, impulsive actions or self-harm.
- Mention any patterns. BPD usually shows up as ongoing patterns, not just one-off events.
- Be specific about how symptoms affect your work, studies or relationships.
Your GP might refer you to a mental health service. This could be a local NHS team or a specialist personality disorder service.
Step 2: Referral to a mental health professional
Once referred, you might see a psychologist, psychiatrist or community mental health worker. Waiting times vary, but try not to lose hope. This step is important to get the right support.
What professionals look for
Mental health workers use diagnostic guides like the ICD-11 (used by the NHS) or DSM-5 (more common internationally). You don’t need to know these yourself—they just help structure the process.
To be diagnosed with BPD, several signs usually need to be present, such as:
- Unstable emotions and self-image
- Intense, unstable relationships
- Fear of abandonment
- Impulsive or self-harming behaviours
- Recurrent suicidal thoughts or actions
- Feeling empty or disconnected
- Intense anger or trouble controlling it
- Stress-related paranoia or dissociation
These symptoms need to have been present for a while and across different parts of your life, not just in one situation.
Step 3: The assessment
This is where the diagnosis really begins. It usually involves one or more in-depth interviews. Some places also use questionnaires or other tools.
Things you’ll be asked
- Your background: Early life, family, past mental health
- Current feelings and reasons for seeking help
- How you relate to others and any recurring problems
- How you handle strong emotions and cope
- Whether you have a stable sense of self or it changes a lot
Try to be honest, even if it’s hard. The professionals are there to help, not judge you.
Assessments can be tiring or emotional—that’s normal. Take breaks if you need them.
Step 4: Ruling out other conditions
BPD can look like other mental health issues such as bipolar disorder, complex PTSD or ADHD. It’s also common to have more than one diagnosis.
Your assessor will ask about:
- When symptoms started
- How long they’ve lasted
- How symptoms affect different parts of your life
- Any trauma, substance use or physical health issues
This helps make sure the diagnosis fits or if something else explains what’s going on better.
Step 5: Getting the diagnosis
If your symptoms match the criteria, the professional will explain the diagnosis. This can be a big moment. Some people feel relief or clarity. Others may feel scared or confused.
It’s okay to have mixed feelings
Being told you have a personality disorder can feel heavy. But it doesn’t define you. A diagnosis is a tool to get help, not a label that limits you.
If you’re unsure how to feel, ask your clinician:
- Why do you think this diagnosis fits?
- What support or treatment can I get?
- How can I explain this to others if I want to?
Step 6: After the diagnosis
You should be offered a treatment plan. This might include:
- Talking therapies: Dialectical Behaviour Therapy (DBT) is the main treatment for BPD, but others like Mentalisation-Based Therapy (MBT) or Schema Therapy can also help.
- Medication: There’s no medicine for BPD itself, but some drugs may help with symptoms like anxiety or depression.
- Crisis planning: If self-harm or suicidal thoughts are a concern, your team can help you plan how to stay safe.
- Peer support: Meeting others with similar experiences can be really helpful.
Resources vary by area. If something isn’t available locally, ask about other options or self-referral.
What if you’re not diagnosed with BPD?
Sometimes the assessment shows you don’t meet full criteria for BPD. That doesn’t mean your struggles aren’t real.
You might be offered other explanations, like traits of BPD, complex trauma, anxiety or mood disorders. The goal is always to find the right support for you.
Final thoughts: How BPD is diagnosed
Getting diagnosed with BPD can feel like a new chapter. Things might start to make sense. The process can take time and feel hard, but it’s worth it. It opens the door to support, self-understanding and healing.
Be kind to yourself. You’re not alone, and help is available. Diagnosis is just the beginning, not the end of your story.
