Many people associate self-harm with borderline personality disorder — and rightly so, as self-harm is a symptom of borderline personality disorder — but can you self-harm and not have borderline personality disorder? Or, more specifically, can you self-harm and still be correctly diagnosed with bipolar disorder (or something else) and not borderline personality disorder? Self-harming and not having borderline personality disorder is actually quite common (Self-Inujry, Self-Harm Statistics and Facts).
A History of Self-Harm But Not Borderline Personality Disorder
I have a history of self-harm but I do not have borderline personality disorder. This seems to trouble some people. In fact, online, people like to yell at me that I can’t have bipolar disorder because I have a history of self-harm. I don’t know why people find this something to yell about, but I assure you, just because you self-harm doesn’t mean you have borderline personality disorder. In fact, it doesn’t necessarily even mean you have a mental illness.
Borderline Personality Disorder and Self-Harm
Let’s review what borderline personality disorder is.
According to the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) borderline personality disorder is diagnosed on the basis of (1) a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and (2) marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by at least five of the following:
- Frantic efforts to avoid real or imagined abandonment; this does not include suicidal or self-mutilating behavior covered below
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
- Markedly and persistently unstable self-image or sense of self
- Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating); this does not include suicidal or self-mutilating behavior covered below
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, or recurrent physical fights)
- Transient, stress-related paranoid ideation or severe dissociative symptoms
Borderline personality disorder, like all mental illnesses, is a very specific cluster of symptoms. And, as you can see, self-harming is only one of these symptoms and it’s not even required for a diagnosis of borderline personality disorder.
Now I’m not going to go over my whole history, but suffice it to say, I don’t even meet main criterion one or two let alone enough of the others.
Bipolar disorder is very different than borderline personality disorder. It’s primarily a mood disorder (Mood Disorder Questionaire) and just because you self-injure, that doesn’t mean that you can’t have it.
Borderline Personality Disorder Does Not Equal Self-Injury
Self-injury is but one behavior and one behavior never indicates a specific disorder. Any mental illness is diagnosed with a cluster of symptoms – never just one. So if you self-harm, you may have borderline personality disorder or you may not, but self-harm alone does not mean you have borderline personality disorder.
(Please note where self-harm is concerned, it’s important to realize that self-harm is quite common and doing it does not mean you have a mental illness. You might, but then again, you might just be using an unhealthy coping technique. Either way, though, self-harm should always be taken seriously and be treated by a professional.)