Re-reading your post, there are a lot of themes I relate to as someone diagnosed with BPD. Like thinking in the moment my therapist could be "evil" or "omniscient" (AKA idealization/devaluation). The self destructive behaviors (specifically alcoholism and binging and purging--although right now I have been alcohol-free over four months and am more in a restricting mode) I see in myself. Rage--check.

Do you think the optical things and paranoia tend to happen together? I also have been previously diagnosed with schizoaffective (may have been downgraded to bipolar? depends who you ask) but either way have full on hallucinations, but I try to distinguish these from "perceptual disturbances" where things just kinda look trippy like how you describe and that's more from stress and sometimes happens when I dissociate--feel out of body/out of the present.

Regardless of whether you have BPD or something else or maybe "nothing" (as in, nothing described as a neat collection of symptoms in the DSM or ICD but could benefit from treatment), DBT could definitely be of interest to you. You should definitely look into groups or see if there's a therapist that does it near you--whichever you prefer.

I personally typically do better with groups, but the DBT group my clinic ran was a fustercluck and I did not last too long. I did well with an individual therapist until she essentially ghosted me (I don't know where you live, but go somewhere where people are happy with their treatment, not places people are forced to go to when they leave state hospitals on conditional discharges with insurance through social security).

If you don't feel comfortable with a group or ready to trust a therapist yet, you can get a workbook for DBT instead (or in addition for that matter). If you're interested in the story behind the woman who developed DBT, you can read Building a Life Worth Living: A Memoir (Marsha M. Linehan). I haven't read it myself yet, but my last inpatient stay another patient was reading it and said it was good. My provider recommended it as well.

BPD is kind of a new diagnosis for me. I'm 28, been in treatment since 17. First diagnosis was psychotic disorder NOS, then psychotic depression, then bipolar (later changed to schizoaffective, schizophrenia, and back and forth depending on the provider). Then they added PTSD when I was 20-ish. Once I started opening up and the psychosis and mania/depression settled a bit the BPD really became obvious and that wasn't until early last year. Some things that pointed that out where even outside of the mania and depression were I was still very rageful and moody but more like a tornado instead of a hurricane (in terms of duration), my relationships were very unstable and I was incredibly fearful and insecure within them, my sense of self fluctuates like the temperature--constantly shifting goals, values, preferences, I can dissociate a lot (to a point of blacking out and losing time), at times I have an extreme problem with self harm or just self-sabotaging behaviors in general, chronic (generally passive) suicidal ideation... It all was there, but it wasn't screaming as loud as the not sleeping for five days straight and thinking demons were following me in all the black SUVs and running around barefoot in snow followed by the weeks of black depressions for (essentially) the ten years prior so it went missed and I really suffered because of it. I think I didn't want to treat the bipolar because I'd rather deal with the mania and depression than the BPD symptoms (including/esp. that chronic sense of emptiness) honestly.