Over six million Americans suffer from Borderline Personality Disorder, approximately 2% of the general population in the United States. BPD is seen in about 10% of the outpatient mental health population and in about 20% of all psychiatric patients.

DSM-IV (Diagnostic Statistical Manual) defines BPD as a pervasive pattern of instability of interpersonal relationships, self-image, and effects, and marked impulsivity beginning by early childhood and present in a variety of contexts, as indicated by at least five (or more) of the following:

1. Frantic need to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. (Everything is defined as either good or bad with no shades of gray in between).
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (i.e., binge spending, sex or promiscuity, substance abuse, reckless driving, binge eating, and shoplifting).
5. Recurrent suicidal ideations, gestures, or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (i.e., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger, or difficulty controlling anger (i.e., frequent displays of temper, and recurrent physical fights).
9. Stress-related paranoid ideation or severe dissociative symptoms.

A diagnosis of BPD does not require all nine identifying traits to be present at the same time. If five of the nine identifying traits are present, then the proper diagnosis can be made utilizing the DSM-IV criteria for BPD.