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In this post, we discuss the symptoms of borderline personality disorder. In order to provide more context beyond the stiff language of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), we take as an example a well-known cartoon character who displays these symptoms, Bill from King of the Hill.

We all know Bill (full name: William Fontaine de la Tour Dauterive), the perpetually unloved but loveable oaf from King of the Hill. As Hank’s neighbor and close friend, we see Bill in most episodes and get to know him intimately as the sad, pathetic, and simple-minded army barber that longs for affection and fills his inner void with mountains of snacks. Although living in a cartoon, 2-dimensional world, Bill is built up to be quite the complex person, albeit predictable at times.

But did you realize that Bill actually checks most, if not all boxes for Borderline Personality Disorder (BPD, for short)?

The diagnostic criteria outlined in DSM-5 define BPD as “a pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five or more of the following:

1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge-eating).
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.”

Don’t see it yet? That’s okay. Let’s take it step by step.

Frantic efforts to avoid real or imagined abandonment

Bill shows us over and over how lonely he is. You might have even felt bad for him, seeing how lonely and sad he becomes. But have you noticed how clingy Bill becomes when fearing he will lose whoever he has attached himself emotionally to? This can be observed in multiple episodes, where Bill gets a little too bent on belonging, and often overstays his welcome.

In the episode titled “Happy Hank’s Giving”, all the characters apart from Bill have plans outside of Arlen for Thanksgiving, leaving Bill alone on this holiday. Bill invents and excuse to drive Hank and his family to the airport and ends up hanging around the area and following them around, because he felt abandoned.

In “Bill’s House”, Bill does a great job taking care of the Hill family when they get sick, but upon getting their strength back, Bill becomes disheartened and tries to poison their soup, which he was preparing, in a frantic effort to keep them sick longer so he can care for and be around them.

In the episode “Leanne’s Saga”, Leanne Platter, Luanne’s mom, dates Bill and mistreats him as it is revealed she becomes more and more disgusted by him. As Leanne is physically and verbally abusing Bill in a drunken frenzy, Bill brushes this off and even maintains his plans of marrying her. All in all, we can definitely see that his frantic efforts to avoid any sort of abandonment have led Bill to suffocatingly attach himself to any person he has affection for.

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A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

When we think of Bill’s relationships, we can definitely see them being unstable and intense. These are the characters we know have been somehow romantically involved with Bill so far: his ex-wife Lenore, Leanne Platter, Laoma Souphanousinphone, Reverend Stroup, Charlene, former Texas Governor Ann Richards, and a few nameless odd characters such as Bill’s deceased cousin’s widows, a woman who was released from prison and shortly lived with Bill, and a police officer (although we are unclear on that). All of Bill’s relationships had been stormy and short-lived, and ended up with either the women leaving Bill after denigrating him (e.g. Lenore who cheated on Bill and belittled him during their time together), or Bill losing interest in them when the relationship became more serious (e.g. Reverend Karen Stroup, who even gave up her holy post to be with Bill). Needless to say, Bill’s relationships all start out with him idealizing his partners to the point of losing himself, and most end up with him devaluating the women, for various reasons.

Identity disturbance: markedly and persistently unstable self-image or sense of self

It might be the people-pleasing aspect, but Bill’s no Hank Hill when it comes to his sense of self. We’ve seen Bill on highs and lows, both physically and mentally. His personality appears fixed, but actually is quite fluid, depending on the influence. Take for instance the episode titled “Bill, Bulk and the Body Buddies”. Bill, fearful of the upcoming army physical, builds a gym with the help of the other main characters and starts working out, slowly making progress, until he meets a body builder who volunteers to help him get in shape. Bill then becomes fixated on his body builder buddies to the point where he neglects his friends in favor of getting shredded with his new friends, building an entirely new persona.

In another episode, “Dia-BILL-ic Shock”, Bill is made aware he is at risk of diabetes after a sugar spike which puts him in the hospital and is recommended by a doctor that he get a wheelchair to prepare for losing his legs (the doctor was practicing tough love, trying to scare Bill into improving his physical health). After this, Bill “gives up” and uses his wheelchair prematurely, however, meets a buff guy in a cooler wheelchair whom he immediately idolizes, once again neglecting his friends in favor of the new guy and his companions. Bill once again constructs a different persona for this and embraces his new personality, until he drunkenly gets out of his wheelchair and walks to the bathroom, immediately shocking and alienating his new wheelchair buddies. He tries to prove to them he is ill by showing his blood sugar is high, however due to recent fitness, was normal. To refer now to our first point on the BPD list, Bill tries to eat a bag of sugar to get his blood sugar up so he can get back to his sick self and in the company of his new friends.

Bill also pretends he is a gay hairstylist in “My Hair Lady” when he works alongside Luanne, adopting this persona to try to fit in and get more clients. Most remarkable of all, however, was the time Bill had a nervous breakdown and becomes Lenore in “Pretty, Pretty Dresses”, until he confronts his abandonment issues and gets back to normal.

Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge-eating)

This needs no introduction, as we all know Bill binge-eats, especially when he is sad, which is… Well… All the time. In the episode “Dia-BILL-ic Shock”, Bill keeps eating unhealthy foods even when faced with diabetes. What’s more, we all know he drinks quite a bit. But have you noticed he can be very impulsive, especially when feeling intensely emotional? In “Tankin’ It to the Streets”, Bill steals a tank from the US Army base after getting drunk in the barber shop and feeling upset at the thought of the army misleading him and using him as a guinea pig which is why he was fat, bald, and had body hair.

Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

In “Pretty, Pretty Dresses”, Bill is low as Christmas marks the anniversary of Lennore leaving him, and as Peggy bans Bill from their house due to his new pet iguana (whom Bill has cleverly named “Lennore”), Bill falls into a deep depression and attempts suicide several times, leading to him being monitored 24/7 by his friends. In the same episode, Bill says “all I do is sleep. I guess I’m just getting in practice, huh? For the big, long sleep”. In “Après Hank, le Deluge”, as Arlen is taken over by heavy rain and a subsequent flood, Bill dresses himself up in his army uniform and plops himself on his bed, ready to die. Luckily, Hank finds him and carries him out of the house just in time.

Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

As we’ve discussed so far, Bill is quite sensitive and his mood very dependent on other people and external events. We have seen Bill be lethargic, angry, anxious and hopeless quite a few times throughout the show. Luckily, he always bounces back to his goofy self with the help of his friends.

Chronic feelings of emptiness

Yep. Which is also why Bill will binge-eat and drink, as well as suffocate the objects of his affection, in an effort to fill his inner void. Throughout King of the Hill, Bill complains about being alone and not seeing a point to things. He also said once “at least if you’re feeling full, you’re feeling something”, referring to himself overeating. He then told Bobby to not feel sorry for him, “[…] that frees up a lot of time, which I fill with sleeping. Just being awake is too depressing”.

Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Bill becomes frustrated sometimes, we’ve established that. In the episode titled “The Wedding of Bobby Hill”, Bill becomes annoyed because everyone “gets to be married” and he doesn’t, then starts yelling angrily at Bobby and Luanne and scares off Dale. Earlier in the same episode, Bill is visibly angry at Bobby for getting the job of taking care of Boomhauer’s home while he is gone. We hear Bill screaming at Hank as he is dressed as Lenore in “Pretty, Pretty Dresses”, too. In “The Trouble with Gribbles”, when Dale pretends to find Nancy ugly to win a lawsuit, Bill’s anger explodes as he says Nancy leaving is breaking his heart. He subsequently lashes out at Dale for alienating Nancy, throws his money at Dale, and drives him away, also throwing his wallet at the door.

Transient, stress-related paranoid ideation or severe dissociative symptoms

Now this is a tricky one. We have seen Bill be quite dissociated when he is intensely sad, for instance in “Pretty, Pretty Dresses” when he is frantically trying to end his life and mentioned at some point with a completely flat voice: “I don’t feel anything”. In another episode he even says: “I’m so depressed, I can’t even blink”. If that’s not transient dissociation, I don’t know what is.

BONUS:

We know now that childhood trauma, such as abuse from a loved one, can be a reliable predictor for developing BPD. Bill has a complicated relationship with his father, to say the least. Although we don’t get to see Bill’s dad on screen, there are some interesting instances in which Bill reminisces about him, and it’s always a bit weird.

Bill admits his dad spanked him from when he was 9 until he was 16, saying he “turned out okay”. Then gets sad, pauses, and blurts out “master” before the scene ends.

“My dad used to punish me by telling me I was a girl. He used to make me wear dresses. Pretty, pretty dresses.”

“I know I miss my dad. I can’t tell you how many nights he locked me in that rabbit hut. I deserved it, though. I just couldn’t listen.”

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