2 2025
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Due date: August 2025
CHALLENGES IN DIAGNOSING BORDERLINE PERSONALITY DISORDER: CLINICAL
AND CULTURAL IMPLICATIONS IN SOUTH AFRICA
1. INTRODUCTION
Borderline Personality Disorder, or BPD, is a serious mental health condition that affects
how a person feels, thinks, and behaves. It often leads to unstable emotions, poor self-
image, and difficulties in building and keeping relationships. Diagnosing this disorder can be
hard because its symptoms look like other mental illnesses such as depression, anxiety, or
bipolar disorder. People with BPD often feel intense emotions, fear being left alone, and may
act in risky or self-harming ways.
This essay will first explain the criteria used to diagnose personality disorders, especially
BPD, according to the DSM-5. It will then look at the main signs of BPD and how it affects
people’s daily lives. The next part will focus on the problems that mental health professionals
face when trying to diagnose this disorder. For example, the symptoms can be different in
every person, and many people with BPD also have other mental health issues, making
diagnosis more confusing.
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CHALLENGES IN DIAGNOSING BORDERLINE PERSONALITY DISORDER:
CLINICAL AND CULTURAL IMPLICATIONS IN SOUTH AFRICA
1. INTRODUCTION
Borderline Personality Disorder, or BPD, is a serious mental health condition that
affects how a person feels, thinks, and behaves. It often leads to unstable emotions,
poor self-image, and difficulties in building and keeping relationships. Diagnosing this
disorder can be hard because its symptoms look like other mental illnesses such as
depression, anxiety, or bipolar disorder. People with BPD often feel intense
emotions, fear being left alone, and may act in risky or self-harming ways.
This essay will first explain the criteria used to diagnose personality disorders,
especially BPD, according to the DSM-5. It will then look at the main signs of BPD
and how it affects people’s daily lives. The next part will focus on the problems that
mental health professionals face when trying to diagnose this disorder. For example,
the symptoms can be different in every person, and many people with BPD also
have other mental health issues, making diagnosis more confusing.
Finally, this essay will explore how these challenges play out in the South African
context. In South Africa, there are extra difficulties like lack of mental health services,
cultural misunderstandings, and stigma. These factors make it even harder to
diagnose and treat BPD properly in the country (Burke et al., 2019).
2. DSM-5 DIAGNOSTIC CRITERIA AND HALLMARK FEATURES OF
PERSONALITY DISORDER AND BORDERLINE PERSONALITY DISORDER
Personality disorders are mental health conditions that affect the way a person
thinks, feels, and behaves across different situations and over time. According to the
DSM-5, a personality disorder is diagnosed when these traits become rigid and lead
to distress or problems in social, work, or other important areas of life. These
patterns must start in adolescence or early adulthood and be long-lasting. People
with personality disorders often have trouble understanding or connecting with others
and may not realise that their behaviour is problematic (Burke et al., 2019).