The fear of being abandoned can be overpowering in people suffering from BPD. There can be short term paranoia and loss of sense of reality. A personal crisis may be responsible for this. However, this psychosis generally is temporary. There can be frantic avoidance of reality, and the sufferer may think himself/herself to be someone else. This ‘someone else’ can be of far better character than the actual person. He/she may think that nobody knows the actual him/her. Imaginary abandonment can also be found in persons affected by BPD. Although there is no actual abandonment, the sufferer can display fear of being left alone in the world. This fear compels the person to hang on to those around, leading to excessive dependence. 

There is a pattern of unstable and intense interpersonal relationships. This can be an indicator of BPD. Besides, there can be alternation between two extremes. BPD sufferers view things in terms of extremes, like all good or all bad. The sudden acceptance and rejection in relationships can hinder the sufferer from maintaining long term relations with people. Sometimes, the sufferer may erratically reject a relationship for the fear of getting rejected.

There is a chronic feeling of emptiness. A person with BPD expresses emptiness, even though there is no actual emptiness in the person’s life. The restless sighing and non-motivated self can dampen the spirit of such persons, who display low self esteem. Such people talk a lot about emptiness and insecurity. BPD sufferers can be very sensitive to the way they are treated. The world to them appears dangerous and mean. There is strong reaction to criticism or hurt. There is evidence which suggests that such persons can be highly alert and score high in intimacy seeking. 

Another significant symptom is the strong impulsive behavior which can cause self destruction. Binge eating, careless driving, excessive spending, indulging in sex with multiple partners, etc. are activities which the BPD patient finds tempting. Self harm can be a hallmark of such people. The various techniques (which are implemented for self harm) can be attempts to cope with unregulated emotions. The abandonment pain, which is another symptom of BPD, can also account for the impulsive behavior. Impulsiveness can hinder social relationships for which they crave strongly. Non-suicidal self injury (NSSI) is commonly exhibited by BPD sufferers. NSSI can be preceded by diverse negative feelings.

About 80 percent of BPD patients show suicidal behavior. However, relatively fewer (up to 9 percent) actually commit suicide. Killing oneself is one of the most tragic consequences of any mental illness. If BPD is accompanied by depression, the risk of suicide increases. One of the studies suggests that the fatality of suicide attempts is the result of the interaction between impulsiveness and violent aggressiveness. Sometimes, BPD may occur along with other mental health conditions, bringing complications to the treatment. Appropriate combination of treatments, like dialectical behavior therapy (DBT) and talk therapy, can reduce suicide attempts.

BPD is also outlined by another symptom: the frequent display of inappropriate anger. Minor separations (like holidays, sudden alteration in a plan, etc.) may trigger anger in BPD patients. Anger, apparently, is the default state for these people. They also display stronger reactions to negative remarks/words (compared to those who are not affected by BPD). Temperamental sensitivity is also a characteristic feature. Violence and abuse can also emerge out of anger. An important attribute of BPD is that the anger is internalized, and directed towards harming oneself than others. Male BPD sufferers can be more physical and go out of control. Anger in women BPD patients is observed to be hateful and emotional. Anger management is an issue for both sexes.

Identity problems is also one of the symptoms of BPD. There is instability in the self image of BPD patients. Their behavior can be fine on one occasion but perplexing on another. They may also view themselves as fundamentally worthless. Their idea of being ‘bad’ can be revealed through sudden mood swings, making them difficult to be handled by others. There is uncertainty in identity and unstable feelings, accounting for turmoil in their relationships.