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How to Get Diagnosed
With BPD in the US

A borderline personality disorder (BPD) diagnosis comes from a licensed mental health professional after an in-depth conversation about your symptoms and history. The usual first step is your primary care provider, who can refer you. Most health insurance covers the evaluation, and there are low-cost options if you’re uninsured.
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Who can diagnose BPD

A licensed mental health professional, such as a psychiatrist, psychologist or clinical social worker, can diagnose BPD. If you’re not sure where to start, talk to your primary care provider. They can check for physical causes and refer you to a specialist.

BPD is usually diagnosed in late adolescence or early adulthood. Occasionally someone under 18 is diagnosed, if symptoms are severe and have lasted at least a year.

What happens in an evaluation

There is no blood test or brain scan for BPD. The evaluation is a conversation, and it may take more than one appointment. The professional will usually:

  1. Ask about your symptoms: what you’ve noticed, how long it has lasted and how it affects work, home and relationships. They will compare this with the 9 criteria for BPD.
  2. Ask about your history: your personal and family history, including any mental health conditions in the family.
  3. Rule out other explanations: several conditions share signs with BPD, such as bipolar disorder, depression and PTSD. A medical exam can rule out physical causes.
  4. Possibly use structured questionnaires or interviews, and, with your permission, review past records or talk with people close to you.
  5. Talk through next steps, including treatment options if BPD is diagnosed.

Cost and insurance

What you pay depends on your insurance and the provider, so ask the office for an estimate before you book.

  • Marketplace (ACA) plans must cover mental health services as an essential health benefit, including psychotherapy and counseling. They can’t refuse coverage or charge more because of a mental health condition.
  • Mental health parity: limits on mental health care, such as copays or visit caps, generally can’t be stricter than limits on medical care.
  • Medicaid also covers mental health services, though what’s included varies by state.
  • Check before you book: ask your insurer whether the provider is in network and whether you need a referral or prior authorization.
  • Positioning

Low-cost options

If you’re uninsured or the cost is a barrier, these routes can help:

Community health centers

Federally funded centers adjust fees to your income and family size, serve everyone even if they can't pay, and treat mental health. Find one with the HRSA health center finder.

SAMHSA's treatment locator

Search FindTreatment.gov for mental health services near you, including sliding-scale options.

University training clinics

Many universities with psychology programs run clinics where supervised trainees see clients at lower fees.

Community mental health centers

Community mental health centers run by your county or state.

How to start the conversation

You don’t need to say “I think I have BPD.” Describe what’s happening. For example:

“For a long time I’ve had intense emotions that change within hours, I’m very afraid of people leaving, and my relationships keep swinging between close and broken. It’s affecting my work and my life. Can we talk about what might be going on, or can you refer me to someone?”

You can also bring notes. Our free BPD traits checklist gives you a summary of the past
three months to take with you. It is not a diagnosis.

Before your appointment

Write down:

  • What has been happening, when it started and how often it happens
  • How it affects work, home, relationships and sleep
  • Any medicines and substances you use
  • Any past diagnoses or treatment
  • Mental health conditions in your family
  • The questions you want to ask

Useful questions to ask a provider:

  • How do you assess BPD, and how do you rule out other explanations?
  • If it is BPD, what treatment do you recommend, and do you offer dialectical behavior therapy (DBT)?
  • What are the fees, what does insurance cover, and how long is the wait?

NIMH’s tips for talking with a health care provider can also help you prepare.
If you’re struggling right now, don’t wait for an appointment: call or text 988, or see crisis support.

  • Questions

Frequently asked questions

How do I confirm if I have BPD?
Only a licensed mental health professional can confirm BPD. Start by talking to a primary care provider, who can refer you to a psychologist, psychiatrist or clinical social worker for an evaluation.
The professional talks with you in depth about your symptoms, how long they’ve lasted, your relationships and your personal and family history. They may use structured interviews or questionnaires, and a medical exam can rule out other causes. There’s no blood test or brain scan for BPD.
Free online screeners can help you reflect, but they aren’t a diagnosis. For a formal evaluation, lower-cost options include community health centers, university training clinics and sliding-scale therapists. Medicaid and most insurance plans cover mental health assessments.
A primary care provider is a good place to start. They can rule out physical causes and refer you to a mental health professional, who usually makes the diagnosis.

Sources

National Institute of Mental Health: Borderline Personality Disorder (revised 2025)
National Institute of Mental Health: Tips for talking with your health care provider
National Education Alliance for BPD: BPD fact sheet
HealthCare.gov: Mental health and substance abuse coverage
HRSA: What is a health center?
SAMHSA: FindTreatment.gov