Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. It is a disorder of emotion dysregulation and is among the most misunderstood mental diseases.

Why should I be aware of this?

Borderline Personality Disorder often disrupts family and work, long-term planning, and the individual’s sense of self-identity. While less well known than schizophrenia or bipolar disorder (manic-depressive illness), BPD is as common, affecting between .07 to 2% of the general population.

All about Borderline Personality Disorder

Effects of this disorder include intense emotions, self-destructive acts, and stormy interpersonal relationships. Borderline Personality Disorder was officially recognized in 1980 and was thought to occur on the border between psychotic and neurotic behavior.

It is often difficult to treat patients because of the complexity of the symptoms. However there has been considerable progress in the last 25 years in the understanding of and specialized treatment for BPD. It is, in fact, a diagnosis that has a lot of hope for recovery.

Causes

Borderlines are born with an innate biological tendency to react more intensely to lower levels of stress than others and to take longer to recover. They peak "higher" emotionally on less provocation and take longer coming down.

In addition, they were raised in environments in which their beliefs about themselves and their environment were continually devalued and invalidated. These factors combine to create adults who are uncertain of the truth of their own feelings and who are confronted by three basic dialectics they have failed to master:

• vulnerability vs invalidation
• active passivity (tendency to be passive when confronted with a problem and actively seek a rescuer) vs apparent competence (appearing to be capable when in reality internally things are falling apart)
• unremitting crises vs inhibited grief.

Symptoms

• Feeling of abandonment, real or imagined and efforts to avoid the same.
• A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
• Unstable self-image or sense of self.
• Impulsivity in at least two areas including spending, sex, substance abuse, reckless driving, binge eating – areas which are potentially self-damaging
• Recurrent suicidal behavior, gestures, or threats, or attempts at self harm.
• Mood swings causing instability (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
• Chronic empty feelings
• Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

Treatment

BPD has a good prognosis when treated properly. Such treatment usually consists of medications, psychotherapy and educational and support groups. Medications have been shown to be very helpful in reducing the severity of symptoms and enabling effective psychotherapy.

There are a growing number of psychotherapeutic approaches specifically developed for people with BPD. Some of these have been in use, tested in research trials, and appear to be very effective. Tthe newer ones are very promising.

CopperBytes

• BPD rarely stands alone. There is high co-occurrence with other disorders.
• BPD affects between .07 to 2% of the population. The highest estimation, 2%, approximates the number of persons diagnosed with schizophrenia and bipolar disorder.
• Estimates are 10% of outpatients and 20% of inpatients who present for treatment have BPD.
• 75% are women. This number may, in part, reflect that women more often seek treatment, that anger is seen as more acceptable in men, and that men with similar symptoms often enter the penal system receiving a diagnosis of antisocial personality disorder.
• 75% of patients self-injure.
• Approximately 10% of individuals with BPD complete suicide attempts.

References:

• What is Borderline Personality Disorder