A 26 year-old female has a long history of sexual promiscuity and substance abuse. She frequently expresses anger when she feels abandoned. She also has difficulty in controlling her anger at times. Her past relationships have been intense and short-lived. She has attempted suicide twice in the past 18 months. This patient exhibits which of the following disorders?

• A. Bipolar
• B. Avoidant personality
• C. Borderline personality
• D. Dissociative

Answer: (C)

Unstable relationships, fear of abandonment, significant impulsivity, and recurrent self-harm are hallmark features of borderline personality disorder. This patient’s pattern fits: a long history of impulsive behaviors (substance use and promiscuity), intense and rapidly changing relationships, clear anger outbursts when she feels abandoned, and past suicide attempts. These elements point to a pervasive, enduring pattern of instability in self-image, affect, and interpersonal functioning.

In contrast, bipolar disorder would require discrete mood episodes of mania or depression with clear cycles over time, not a consistent pattern of fear of abandonment and relationship turbulence. Avoidant personality features involve social inhibition and hypersensitivity to rejection without the pervasive impulsivity and self-destructive behaviors seen here. Dissociative disorders focus on memory gaps or identity disruption rather than the pattern of unstable relationships and impulsivity described.