Demystifying BPD Assessment: A Look Inside the Process

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Borderline Personality Disorder (BPD) is a mental health condition that affects an individual’s thoughts, feelings, and relationships.

When a patient starts the journey towards receiving an official diagnosis of Borderline Personality Disorder, they will find that there are many elements in the assessment process.

Due to long waiting lists, getting a diagnostic assessment for BPD in the NHS can be a long, drawn-out, and extensive process. However, a private Clinical Psychologist can also offer a diagnostic assessment for BPD in Birmingham.

The assessment usually takes place over one or two sessions. It is crucial, to be honest with the specialist administering the evaluation. Being nervous is normal, but this should not stop a person from being direct and open.

What Assessment Guidelines Do Doctors Follow?

When assessing BPD in a patient, a doctor will follow two sets of psychiatric guidelines; the International Classification of Diseases (ICD-11) produced by the World Health Organisation (WHO) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) produced by the American Psychiatric Association.

Psychiatric professionals use such guidelines to help guide them through the assessment and diagnosis of Borderline Personality Disorder. These guidelines give medical professionals all they need to know to check for BPD in a patient.

When receiving a diagnosis of Borderline Personality Disorder, there are several tools and criteria a Clinical Psychologist may use to identify BPD accurately. Each professional may use slightly different or varying approaches, but it is normal for the assessment to include the following:

  • Questionnaires
  • One-to-One Interviews
  • Psychological Tests
  • Medical evaluations

What Questions will be Asked?

A Clinical Psychologist will typically ask many questions during an assessment to determine the presence of specific thought and behavioural patterns. Some questions aim to identify the best treatment pathway and support available for that person.

During an assessment, a doctor will listen to a patient’s responses to questions to learn more about them and broader life interactions with others, following guidelines set out by the National Institute for Care and Excellence. This independent government body sets out the best practice clinical guidelines.

These questions could include but are not limited to the following:

  • Do you have a fear of being alone? Does this fear cause you to act out of the ordinary or in an extreme manner so you’re not alone?
  • Do you have feelings of emptiness or loneliness that are long-lasting?
  • Have there been unstable or intense relationships where you move between loving and hating a person?
  • How is your image of self? Is it clear or uncertain?
  • Have you self-harmed in the past or attempted suicide?
  • Are you prone to partaking in reckless or impulsive activities?
  • In stressful situations, do you feel paranoid?
  • Do you often feel disconnected from the world or yourself?
  • Do you experience long-lasting mood swings that last more than a few hours

At times the patient may feel that similar questions are asked in different ways multiple times, which may be the case. This is not to catch you out but to identify specific details that differentiate BPD from other mental health conditions.

Those undergoing assessment are encouraged to remain open and answer all questions asked to give the Clinical Psychologist a complete and accurate picture of their mental health.

When to Consider BPD Assessment?

Borderline Personality Disorder (BPD) is a condition that affects the thoughts and feelings of a person and the relationships around them. Those with this mental health issue may often experience intense periods of loneliness or emptiness or have patterns of intense, unstable, or irregular relationships with love/hate coming into play strongly.

If someone recognises multiple signs and symptoms of BPD in themselves or their loved ones, they could benefit by talking to a mental health professional or their GP to determine if a diagnostic assessment would be beneficial.

What are the Signs and Symptoms of Borderline Personality Disorder (BPD)?

When using guidelines to assess BPD, a Clinical Psychologist will look at whether a person experience many of the following signs and symptoms:

  • Extreme reactions to feelings of abandonment
  • Feelings of abandonment or emptiness that are long-lasting
  • Confused feelings of self-identity or self-image
  • Impulsive behaviours with potentially damaging consequences, i.e., spending, substance abuse, binge-eating, excessive sex, and excess binge-eating.
  • Extreme emotional relationships that can be unstable or intense
  • Regular episodes of self-harming or suicidal thoughts/tendencies
  • Feelings of paranoia when stressed
  • Episodes of dissociation or feelings of being separate from your body and the world around you
  • Intense moods which can swiftly switch
  • Difficulties regulating anger with intense episodes that are difficult to control and intense

How to Seek Assessment for Borderline Personality Disorder?

Those looking for a diagnostic assessment of BPD in Birmingham should start by consulting their GP or talking to a mental health professional like a Clinical Psychologist.

Those who wish to receive a BPD diagnostic assessment will typically be put on an NHS waiting list to see their local Community Mental Health Team (CMHT). However, private options are always available for those wanting faster turnaround times.

Will Assessment Highlight Treatment?

Treatment is unlikely to be talked about during the assessment period. However, if the person with BPD is undergoing a crisis, a Clinical Psychologist may offer support to help them stabilise their mental health before providing a diagnostic assessment.

When the assessment starts, the mental health specialist will use the answers to questions and time with a patient to find an appropriate treatment pathway for them.

The Clinical Psychologist administering the BPD diagnostic assessment may or may not be able to provide a provisional diagnosis at the end of the session, or they may need time to consider all information.

Should I Involve My Family?

This is down to a patient’s preference, but involving people who know you well and have known you for some time is recommended. Friends and family may also be involved once a formal diagnosis has been determined to help them understand what the diagnosis means and how they can be of the best support. More can be found about this over on our BPD diagnosis page.