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In borderline personality disorder, however, mood swings are often peripheral. They are secondary to more core features of the disorder, such as intense fears of abandonment, unstable self-image, and difficulty with emotional regulation. The rapid shifts are part of a wider pattern of instability in relationships, self-identity, and behavior.
Predictability and Mentalization Deficits
A significant challenge for families dealing with a loved one with BPD is the unpredictability of their behavior. Unlike bipolar disorder, where mood episodes tend to follow a somewhat predictable pattern, borderline persionality involves a profound deficit in "theory of mind" — the ability to understand and attribute mental states to oneself and others.