256 Shades of BPD

Understand the diversity of the disorder
Borderline Personality Disorder is frequently missed or mis-diagnosed in the quest for answers because it's generally difficult to pinpoint. The disorder is very chameleon-like and this section is provided to help illustrate the differences and nuances of every person dealing with BPD.

As you know, there are nine diagnostic criteria and, of those, only a minimum of five need be present for a diagnosis of BPD to be made however an individual may present with more than the five, up to and including all nine.

When we say that there are 256 types of BPD, we don't necessarily mean that there are 256 distinct presentations of BPD. The number - 256 - is based solely on a numerical combination algorithm rather than clinical research, observation or determination.

How did we arrive at the number? To help illustrate the combination algorithm we used, we'll simply rely on the counting numbers, one through nine.

If an individual needs to show a minimum of five of the nine diagnostic criteria to be diagnosed with BPD, they are not limited to which of the criteria need to be present. That means that a person who displays numbers 1-2-3-4-5 of the criteria is just as Borderline as a person who displays numbers 5-6-7-8-9 of the criteria or a person with the numbers 2-4-6-7-9 or the numbers 1-4-5-8-9, and so on.

Furthermore, the more criteria that are present, the more combinations are available.

Please keep in mind that the basic combination algorithm does not take into account the severity of the symptoms displayed. If a person displays self-mutilation in the form of cutting and burning (in accordance with the fifth diagnostic criteria) and another person's exhibition of the same criteria presents itself in the form of hitting him or herself in the leg, the degree of severity is obviously different.

Similarly, the fourth diagnostic criteria indicates a person needs to display impulsivity in at least two areas. Perhaps for one individual, that might be spending and reckless driving; perhaps for another person, it might include spending, reckless driving, substance abuse AND promiscuity. Again, a different level of severity.

Lastly, please keep in mind that BPD is generally found to be co-morbid with at least one other disorder and that co-morbid disorder may also present symptoms which add to or exacerbate the presentation of the Borderline symptoms.

To learn more about the complexity of Borderline Personality Disorder, pick up a copy of Putting The Pieces Together