People with borderline personality disorder initially have difficulty feeling and classifying their emotions. They don't even realize that they are angry or sad about something. This creates inner tension. Even minimal occasions are then enough, and the emotional state changes. From one moment to the next, those affected are suddenly overwhelmed by overwhelming anger, fear, panic attacks or complete despair. You are unable to control these rapidly changing sensations and their impulses. Your mood swings are extreme.

The pent-up inner tension can be discharged immediately without considering the possible consequences, for example in violent aggression and tantrums for seemingly minimal reasons. A spilled coffee or a wrong word is enough and an emotional outburst follows. This impulsive behavior has a strange and irritating effect on those around them. Those affected are seen as aggressive, moody and unpredictable. But when are they actually borderline symptoms and not just a somewhat eccentric, short-tempered personality? The level of suffering makes the difference, say experts: conspicuous behavior in eccentrics often has something to do with gaining pleasure. This is not the case for people with borderline personality.

People with borderline syndrome suffer from their disorder, many of them so much that they use drastic means to relieve the unbearable inner tension. They injure themselves, for example repeatedly cutting ("scratching") their forearm with a knife or razor blade. Or they stub out lit cigarettes on their skin, hit themselves. Such self-injury is a kind of "emergency solution" of the organism, an attempt to bring the tormenting emotional chaos under control, to feel oneself again. Sometimes, however, self-injurious behavior is also a hidden cry for help to friends and family. Quite a few of those affected also endanger or harm themselves in other ways. They use drugs, drive too fast, drink too much alcohol, engage in risky sex or dangerous sports. Many suffer from other mental disorders such as eating disorders, depression, addictions or ADHD. Some find life with BPD unbearable, even contemplating suicide. Without timely therapy, more than five percent of those affected die by suicide.

Das Krankheitsbild von Borderline ist sehr unterschiedlich. Der Arzt ordnet die Persönlichkeitsstörungen nach der ICD-10-Klassifikation ein. Die Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme (ICD-10) wurde von der Weltgesundheitsorganisation (WHO) erstellt. Die Abkürzung ICD steht för International Statistical Classification of Diseases and Related Health Problems, die Ziffer 10 bezeichnet die 10. Revision der Klassifikation.

This is a personality disorder with a clear tendency to act out impulses without considering the consequences, combined with an unpredictable and moody mood. There is a propensity for emotional outbursts and an inability to control this impulsive behavior. There is also a tendency towards argumentative behavior and conflict with others, especially when impulsive actions are thwarted or impeded.

Two manifestations of the emotionally unstable personality disorder are distinguished: An impulsive type, mainly characterized by emotional instability and lack of impulse control. And a borderline type, further characterized by disturbances in self-image, goals, and inner preferences, a chronic sense of emptiness, intense but volatile relationships, and a tendency toward self-destructive behavior involving parasuicidal acts and suicide attempts.

The main character traits are emotional instability and lack of impulse control. Outbursts of violent and threatening behavior are common, especially when criticized by others.

At least three of the following characteristics or behaviors must be present for Emotionally Unstable Personality Disorder to be impulsive.

• clear tendency to act unexpectedly and without regard for the consequences
• marked tendency to quarrels and conflicts with others. Occurs especially when impulsive actions are restrained or reprimanded.
• Tendency to outbursts of anger or violence with inability to control this explosive behavior
• Difficulty maintaining actions that are not immediately rewarded
• volatile and unpredictable moods

Some hallmarks of emotional instability are present, and self-image, goals, and preferences (including sexual ones) are often unclear and disturbed. There is usually a chronic feeling of inner emptiness. The propensity for intense but volatile relationships can lead to repeated emotional crises. Concomitantly, there may be: excessive efforts not to be abandoned, suicide, threats and/or self-harm. Scratching, burning or scalding of skin areas can also occur without clear triggers.

At least three of the criteria listed under F60.30 must be present and in addition at least two of the following characteristics and behaviors in order to assign the emotionally unstable personality disorder to the borderline type:

• Disorders and insecurity regarding self-image, goals, and inner preferences (including sexual)
• Tendency to engage in intense but unstable relationships, often resulting in emotional crises
• Excessive efforts not to be abandoned
• persistent feeling of inner emptiness
• self harm
• Suicide, threats and endangerment