TIFS on Your Mental health: Experts say five of nine traits are inherent within those with serious personality issues

Borderline Personality Disorder is a psychiatric diagnosis built around nine traits that describe patterns of unstable emotions, relationships, and self‑image. Clinicians look for a combination of at least five traits before considering the diagnosis.

The list includes fear of abandonment, intense and shifting relationships, an unclear sense of identity, impulsive behavior, self‑harm or suicidal thoughts, rapid mood changes, chronic emptiness, difficulty controlling anger, and episodes of paranoia or dissociation during stress.

These traits matter most when they appear together and persist over time. A person who fears being left, struggles to maintain steady relationships, acts impulsively, swings quickly between emotional highs and lows, and feels empty much of the time is showing a pattern that strongly aligns with the disorder.

Although BPD can affect anyone, the way it appears in people with lower intellectual functioning can look different. The underlying condition does not change, but the person’s ability to communicate, regulate emotions, and solve problems can shape how the symptoms are expressed.

Emotional reactions may be more immediate because the person has fewer tools to manage distress. Impulsive behavior can stand out more clearly when planning and reasoning skills are limited. Communication challenges can also blur the picture. Someone who cannot easily describe feelings of emptiness or identity confusion may express distress through actions rather than words.

What appears to be anger may actually be fear or sadness that the person cannot explain.

Relationships often become unstable for reasons tied both to BPD and to cognitive limitations. A person may cling to caregivers, panic when separated, or shift quickly between affection and frustration. These behaviors reflect the classic BPD fear of abandonment but may be intensified by a reliance on others for daily support. Self‑harm, when it occurs, can be especially difficult to interpret. I

n people with lower IQ, self‑injury can stem from frustration, sensory issues, or communication barriers. When BPD is involved, it is often linked to emotional overwhelm. Distinguishing the cause requires careful evaluation. Stress‑related paranoia or dissociation may also appear differently. Instead of describing a sense of unreality, the person may seem confused, frightened, or suspicious without being able to explain why.

Diagnosing BPD in someone with lower cognitive functioning is complex because many behaviors overlap with developmental disabilities or trauma responses. Clinicians look for long‑term emotional patterns, consistent triggers, and behavior across different settings to determine whether the traits truly reflect BPD.

The goal is not to label the individual but to understand their needs so they can receive appropriate support. With predictable routines, supportive relationships, and skills‑based approaches that teach emotional regulation, people with BPD, regardless of cognitive ability, can move toward greater stability and healthier connections.