Self-Assessment Questionnaire for Borderline Personality Disorder (BPD) Symptoms
Please answer the following questions honestly to assess your current mental health status.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Have your closest relationships often been full of arguments, breakups, or emotional ups and downs?
Yes
No
Have you ever hurt yourself on purpose - like cutting, burning or hitting yourself??
Yes
No
Have you had at least two kinds of impulsive behaviors - like binge eating, overspending, heavy drinking, risky sex, or angry outbursts?
Yes
No
Do you often feel very angry, or act angry or sarcastic towards others, even when it doesn't seem necessary?
Yes
No
Have you experienced intense and frequent mood swings - like feeling fine one moment and very upset or irritable the next?
Yes
No
Have you often found it hard to trust other people - even when they haven't done anything wrong?
Yes
No
Do you sometimes feel like you or your surroundings aren't real - like you're detached or watching life from the outside?
Yes
No
Do you often feel empty inside - like there's a hole or something missing?
Yes
No
Do you often feel unsure of who you are - like your sense of self changes depending on who you're with or what you're doing?
Yes
No
Have you made strong or desperate efforts to avoid being left by someone - like calling or texting constantly, begging, or clinging to them physically?
Yes
No
Thank you for completing this self-assessment. Your mental health matters.
If you answered "Yes" to 5 or more questions, especially if some of them cause distress or affect relationships, consider speaking with our mental health professionals.
Contact Us
If you would like to get in touch with us for further assistance or questions, please contact our Happy Place HQ office. Email: happyplacehq@proton.me || Phone: 909-798-1841
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