Types of BPD: How Different Experts Categorize Borderline Personality Disorder

Borderline personality disorder (BPD) is a mental health condition that can impact the quality of your relationships, sense of self, and ability to regulate emotions. BPD can show up in many ways. There are nine main symptoms people typically experience: 

1. Fear of abandonment, which often leads to frantic efforts to avoid real or even perceived abandonment 

2. A pattern of intense relationships that often alternate between extremes — for example, putting someone on a pedestal one day and then completely devaluing them the next

3. Unstable self-image or sense of self 

4. Impulsivity that can often lead to risky behaviors

5. Self-harming behavior and/or a pattern of suicide attempts 

6. Intense mood swings

7. Chronic feelings of emptiness 

8. Intense anger or problems controlling anger 

9. Feelings of dissociation, or feeling disconnected from yourself and your body 

People need to experience at least five out of the nine symptoms listed above to meet the criteria for a BPD diagnosis. In addition, they need to have been experiencing these symptoms for a long time to be considered as having BPD. This means not everyone with BPD struggles with exactly the same symptoms, and that BPD can look different from person to person.

Risk factors for BPD include both genetic and environmental factors, including growing up in an invalidating or unstable environment. One study found that people with BPD are 13 times more likely than the general population to have experienced childhood trauma. About 1% of people in the U.S. live with BPD.

Types of BPD

Experts agree there are different types of BPD. In fact, based on the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, there are 256 symptom combinations that can lead to a diagnosis. But there is no agreement on how many official types of BPD exist. 

While some experts say there are three types of BPD, others use a four-type or even a five-type model. We break down three popular models and explore why understanding the different types of BPD matters. 

Smits’ 3 types of BPD

Researcher Maaike Smits and her colleagues identified three types of BPD. They were able to identify three distinct types of BPD using the SCID-II, an assessment used to diagnose personality disorders. They also looked at factors including: 

• Symptom severity

• Quality of life

• Trauma history

• Interpersonal challenges

Other researchers who concluded there are three types of BPD include Kenneth Critchfield and Mark Lenzenweger. While each researcher has a slightly different name and criteria for each type of BPD, here is how Smits and her colleagues broke it down. 

1. Core BPD

People who have “core BPD,” the most common type, mainly live with symptoms of BPD. Unlike with the other two types, they don’t show symptoms associated with other personality disorders. 

Considered to represent a more typical person with BPD, this group reported the highest: 

• Symptom severity

• Relational problems

• Disorganized attachment style

• Unstable identity 

2. Extravert/externalizing BPD

People with this type of BPD may exhibit traits associated with other personality disorders, including: 

• Histrionic

• Narcissistic

• Antisocial 

This means that, while BPD is their main diagnosis, they may: 

• Exhibit a “dominant, self-centered style”

• Have trouble adjusting to social norms

• Be more avoidant in relationships compared to the other types

3. Schizotypal/paranoid BPD

The smallest group, those with this type of BPD are categorized by having BPD symptoms in addition to schizotypal and paranoid features. People with “schizotypal” features may:

• Socially isolate themselves

• Lack a desire to feel close to people

• Mistrust others

• Have high levels of attachment anxiety

Millon’s 4 types of BPD

Personality disorder expert Theodore Millon described four types of BPD in his 1999 book “Personality Disorders in Modern Life.” 

Keep in mind that his work uses outdated language and has not been replicated in more recent studies. But his four types of BPD are widely cited and can help you understand the different ways BPD can manifest. 

Here are Millon’s four types of BPD. 

1. Discouraged BPD

For people with this type of BPD, their core concern is feeling helpless and dependent on others. This can look like: 

• Feeling completely reliant on one or two people to meet all your needs

• Reacting strongly if these relationships feel threatened 

• Appearing “clingy”

• Struggling to find an identity outside of these relationships

2. Impulsive BPD

For people with this type of BPD, their core concern is engaging in impulsive or even dangerous behavior as a way to regulate big emotions. They may: 

• Feel like they need lots of attention from others

• Get bored easily

• Be prone to acting on a whim 

Examples of impulsive behavior someone with this type of BPD may engage in include: 

• Substance misuse

• Risky sexual activity

• Disordered eating

• Impulsive self-harm

• Compulsive shopping 

• Gambling

• Reckless driving

• Sudden relationship breakups

3. Petulant BPD

The main characteristic of this type of BPD is negativity and low mood. People with this type of BPD may often find themselves:

• Feeling irritable, pessimistic, and even resentful of others 

• Having a difficult time feeling satisfied in their relationships 

• Feeling constantly disappointed 

Keep in mind, this label for BPD is outdated and considered condescending by current standards. 

4. Self-destructive BPD 

For people with this type of BPD, their core concern is turning their big emotions against themselves. This can look like: 

• Engaging in self-harm

• Experiencing suicidality

• Struggling with negative thoughts and harsh inner criticism

Oldham’s 5 types of BPD

Personality disorder expert John M. Oldham, MD, proposed that there are five types of BPD. He developed each subtype using theories about the causes of BPD and how they can impact treatment. 

Someone can experience symptoms from more than one subtype. But Oldham’s subtypes are determined by which symptoms impact you the most. 

Here are the five types of BPD, according to Oldham. 

1. Impulsive BPD

For people with this type of BPD, trouble controlling impulsive behavior is the symptom that impacts them the most. These impulsive behaviors commonly occur as a response to emotional stress. 

2. Affective BPD

For people with affective BPD, emotional dysregulation greatly impacts their mood, causing extreme and sudden mood swings. In general, people with BPD experience higher highs, lower lows, and have a harder time returning to their emotional baseline. 

For people with affective BPD, difficulty regulating their emotions may be the biggest way BPD impacts their lives.

3. Aggressive BPD

People with this type of BPD may take their emotional dysregulation out on others in ways that appear aggressive or with higher intensity than the situation seems to warrant. Those who fit in this category might especially be quick to pick fights with others or become irritable and defensive.

It’s important to note that although people with BPD may struggle with anger, they are not more likely to become violent than the general population.

4. Dependent BPD

For people with the dependent type of BPD, the fear that a loved one could abandon them is constant. This fear impacts how they interact with others. This could look like: 

• Fearing being alone 

• Appearing “clingy,” such as texting a lot or wanting to hang out all the time

• Being overly agreeable to avoid making others upset 

• Having trouble setting boundaries 

• Ending a relationship early to avoid the risk of being abandoned 

5. Empty BPD

People with empty BPD primarily struggle with unstable self-image and feelings of emptiness. They may often feel like they don’t know who they are and frequently experience dissociation.

Do treatment methods vary depending on the type of BPD?

As with all mental health diagnoses, there is no “one size fits all'' treatment approach for BPD. Understanding which type of BPD you have could influence treatment options. 

For example, in Smits’ three-type model, she points out that most evidence-based BPD treatments were developed for people who have core BPD. Those who have BPD traits that overlap other personality disorders may benefit from different treatment considerations. 

In looking at Oldham’s five-type model, researchers found that those who live with affective, impulsive, and aggressive types of BPD may benefit from medication at the beginning of treatment. This can help them reach a place of stability as they start therapy. For people with dependent or empty BPD, different types of psychotherapy may be the first line of action.

Regardless of the type, recommended therapies for people with BPD include: 

• Dialectical behavior therapy (DBT)

• Schema-focused therapy 

• Mentalization-based therapy 

• Transference-focused psychotherapy 

Resources and support for borderline personality disorder

If you or your loved one live with BPD, there are resources that can help. Check out the following organizations that provide information and support for people with BPD, as well as resources that can help you find treatment: 

• National Education Alliance for Borderline Personality Disorder

• Borderline Personality Disorder Resource Center

• Emotions Matter

• DBT-Linehan Board of Certification

• FindTreatment.gov

• Psychology Today 

Why trust our experts?

Written by:

Sarah Schuster

Sarah Schuster is a master of social work (MSW) student at California State University, Los Angeles. She earned her journalism degree at Syracuse University and spent 6 years helping people tell their health and disability stories at The Mighty.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

India B. Gomez, PhD

India B. Gomez, PhD, is a licensed clinical psychologist with a certificate in Latin American Family Therapy. She completed her doctoral education at the California School of Professional Psychology/Alliant International University.

Our editorial standards

Meet our experts