4 Early Signs of Borderline Personality Disorder in Young Adults

Four early signs of borderline personality disorder in young adults are intense fear of abandonment with unstable relationships, rapid and intense mood shifts, an unstable sense of self, and impulsive or self-harming behavior. Seeing one of these signs does not mean someone has BPD. A pattern that lasts, causes distress and affects daily life deserves a professional evaluation.

This article is for young adults who recognize themselves in these patterns, and for parents, partners and friends in Texas who are worried about someone in their late teens or twenties. It is education, not a way to diagnose yourself or anyone else.

What is borderline personality disorder?

Borderline personality disorder (BPD) is a mental health condition that affects how a person manages emotions, sees themselves and relates to other people. The National Institute of Mental Health (NIMH) says BPD severely impacts a person's ability to regulate their emotions.

NIMH also notes that BPD is usually diagnosed in late adolescence or early adulthood, which is why young adults and their families are often the first to notice the patterns described below. MedlinePlus explains that the cause of personality disorders is unknown, though genes and childhood experiences may play a role.

Sign 1: Why are relationships so intense and unstable?

Relationships can feel intense and unstable in BPD because fear of being left, whether real or imagined, drives strong reactions. NIMH lists efforts to avoid real or perceived abandonment, and a pattern of intense and unstable relationships, among the symptoms.

What this can look like:

• Seeing someone as wonderful one week and as hurtful or untrustworthy the next.
• Jumping quickly into or out of friendships or romantic relationships.
• Panic or anger over a late reply, a cancelled plan or a perceived slight.
• High sensitivity to rejection and frequent feelings of being alone.

Many young adults have rocky relationships at times. The difference is a repeated pattern that causes real distress and keeps disrupting school, work or family life.

Sign 2: What do intense mood shifts look like?

Intense mood shifts in BPD are strong emotions that rise quickly and can change within hours. The National Institute of Mental Health describes intense and highly variable moods, with episodes lasting from a few hours to a few days.

• Going from calm to furious, panicked or hopeless after a small trigger.
• Anger that feels out of proportion and is hard to control.
• Long-lasting feelings of emptiness between emotional storms.
• Feeling cut off from yourself or your surroundings during high stress.

These shifts are different from the longer episodes of mania or depression seen in bipolar disorder. Telling them apart is a job for a clinician.

Sign 3: What does an unstable sense of self mean?

An unstable sense of self means a person's identity, values or goals change often and sharply, and they may not feel they know who they are. NIMH lists a distorted and unstable self-image or sense of self among BPD symptoms.

• Frequently changing majors, career plans, friend groups or beliefs.
• Strong swings between feeling worthless and feeling fine.
• Taking on the opinions or style of whoever they are closest to.

Exploring identity is a normal part of early adulthood. The concern is when changes feel driven by inner chaos rather than curiosity, and leave the person distressed. Our article on quarter-life crisis or anxiety looks at other reasons this stage can feel unsettled.

Sign 4: When do impulsive or self-harming behaviors matter?

Impulsive or self-harming behaviors matter most when they are used to escape overwhelming emotion and they put the person at risk. NIMH lists self-harming behavior, such as cutting, and recurring thoughts of suicide or suicidal behavior among BPD symptoms.

• Binge spending, reckless driving or unsafe sex during emotional distress.
• Binge eating or substance use to numb feelings.
• Self-harm, or talking about hurting oneself.

This sign needs prompt attention. NIMH states that anyone thinking of harming themselves or attempting suicide needs help right away, and that comments about self-harm or suicide should be taken seriously.

How are these signs different from normal growing pains?

The signs of borderline personality disorder differ from normal growing pains in how intense, frequent and long-lasting they are, and in how much they disrupt life. Most young adults have breakups, mood dips and identity questions. Fewer have all of these repeatedly, across many relationships and settings, over a long stretch of time.

Questions that can help you think it through:

• Has this pattern lasted many months, rather than a few weeks?
• Does it show up with friends, family, partners and at school or work, not just one place?
• Is the person distressed by it, or are they getting hurt?
• Are there periods of self-harm, suicidal thoughts or dangerous impulsive acts?

Other conditions, such as depression, anxiety, trauma-related disorders, bipolar disorder and substance use, can look similar and can also occur alongside BPD. NIMH notes that a licensed mental health professional is the right person to sort this out.

Step by step: what to do if you notice these signs

If you notice signs of borderline personality disorder in yourself or someone close to you, a calm, step-by-step approach usually works better than a confrontation. The goal is to get an evaluation, not to settle on a label at home.

1. Check safety first. If there is talk of suicide or recent self-harm, call or text 988 now, or 911 for immediate danger.
2. Write down patterns you have noticed, with examples and how long they have been happening.
3. Choose a quiet time to talk, not in the middle of an argument.
4. Lead with care, focusing on how the person is feeling rather than on their behavior.
5. Suggest an evaluation with a licensed mental health professional.
6. Offer practical help, such as finding appointments or going to the first visit.
7. Get support for yourself, whether from a therapist, support group or trusted friend.

Writing a mental health safety plan together can also help before things feel urgent.

What to say to a young adult you are worried about

What you say matters less than saying it with warmth, without labels and without blame. NIMH encourages loved ones to offer emotional support, validation, understanding, patience and encouragement. Examples you can adapt:

• "I've noticed things have felt really intense for you lately. I care about you and want to understand."
• "You don't have to figure this out alone. Would you be open to talking with someone?"
• "I'm not trying to diagnose you. I just want you to have support."
• "If you ever feel like hurting yourself, I want you to tell me, and we'll get help together."

The 988 Suicide and Crisis Lifeline notes that anyone can contact 988 for guidance when they are worried about someone else. If the young adult has gone quiet, our article on a college student who won't answer texts may help.

How is borderline personality disorder diagnosed and treated?

Borderline personality disorder is diagnosed by a licensed mental health professional through a careful interview about symptoms, history and daily functioning. There is no blood test or scan for it. NIMH notes that a minor is occasionally diagnosed if symptoms are severe and long-lasting.

Talk therapy is the main treatment. The University of Washington's Behavioral Research and Therapy Clinics explains that dialectical behavior therapy (DBT) was originally developed for chronically suicidal people with BPD and, in its standard form, combines individual therapy, a skills group, phone coaching and a consultation team for therapists. Medication may be used for specific symptoms. Our comparison of CBT and DBT explains the differences.

NIMH states that evidence-based treatments have been shown to help many people with BPD, and that improvement takes time.

What should Texas families know about getting help?

Texas families can reach 24/7 crisis support through 988 and through their county's local mental health authority, and can seek outpatient evaluation through private practices or community clinics. Texas Health and Human Services lists crisis lines for each county's local mental health authority.

The U.S. Department of Health and Human Services explains that health information generally cannot be used or shared without written permission unless the law allows it. For an adult child, that usually means parents need the young adult's permission before clinicians can discuss their care. Rules for minors' consent and record access vary by state and situation, so ask the clinic how it handles family involvement.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area, and Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit. All Lyte Psychiatry services are available in Spanish.

Most new patients are seen within 1–2 business days. Weekend appointments are limited. Availability, insurance and clinician fit require confirmation, including whether a specific therapy approach is offered. Learn about therapy and coordinated therapy and psychiatry, or contact the practice. Lyte Psychiatry is an outpatient practice. It does not provide inpatient care, crisis or after-hours coverage, medically supervised detox, or intensive outpatient or partial hospitalization programs.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.