Borderline Personality Disorder
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What is borderline personality disorder?
Borderline personality disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. People with BPD suffer from a disorder of emotion regulation. BPD is affecting 2 percent of adults, mostly young women. There is a high rate of self-injury without suicide intent, as well as a significant rate of suicide attempts and completed suicide in severe cases.
What are the symptoms?
Everyone has problems with emotions or behaviors sometimes. But if you have borderline personality disorder, the problems are severe, repeat over a long time, and disrupt your life. The most common symptoms include:
- Intense emotions and mood swings.
- Impulsive behaviors that are self-damaging, such as substance abuse, binge eating, and reckless driving.
- Relationship problems.
- Low self-worth.
- A frantic fear of being left alone (abandoned).
- Aggressive behavior.
Other symptoms may include:
- Feeling empty inside.
- Problems with anger, such as violent temper tantrums.
- Hurting yourself, such as cutting or burning yourself.
- Suicide attempts and suicidal thoughts.
- Feeling suspicious of others for no reason (feeling paranoid) or losing a sense of reality.
What causes borderline personality disorder?
The cause of BPD is unknown, both environmental and genetic factors are thought to play a role in predisposing patients to BPD symptoms and traits. Studies show that many, but not all individuals with BPD report a history of abuse, neglect, or separation as young children. Forty to 71 percent of BPD patients report having been sexually abused, usually by a non-caregiver. Researchers believe that BPD results from a combination of individual vulnerability to environmental stress, neglect or abuse as young children, and a series of events that trigger the onset of the disorder as young adults. Adults with BPD are also considerably more likely to be the victim of violence, including rape and other crimes. This may result from both harmful environments as well as impulsivity and poor judgment in choosing partners and lifestyles. Often people who get it faced some kind of childhood trauma such as abuse, neglect, or the death of a parent.
How is Borderline Personality Disorder diagnosed?
Personality disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with borderline personality disorder, someone must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV).
How is it treated?
The symptoms of borderline personality disorder can be treated, but there is no known cure.
Psychotherapy is the cornerstone of most treatments for Borderline Personality Disorder. Although development of a secure attachment to the therapist is generally essential for the psychotherapy to have useful effects, this does not occur easily with the BPD diagnosed individual, given the intense needs and fears about relationships. The standard recommendation for individual psychotherapy involves one to two visits a week with an experienced clinician. The symptoms of the disorder can be as difficult for professionals to experience as those experienced by family members. Within the past 15 years, a new psychosocial treatment termed dialectical behavior therapy (DBT) was developed specifically to treat BPD, and this technique has shown to be effective.
Pharmacological treatments are often prescribed based on specific target symptoms shown by the individual patient. Antidepressant drugs and mood stabilizers may be helpful for depressed and, or, labile mood. Antipsychotic drugs may also be used when there are distortions in thinking.
Is there self-help for Borderline Personality Disorder?
Living with borderline personality disorder can be difficult. You may fully realize that your behaviors and thoughts are self-destructive or damaging yet feel unable to control them. Treatment can help you learn skills to manage and cope with your condition.
Other things you can do to help manage your condition and feel better about yourself include:
- Sticking to your treatment plan
- Attending therapy sessions as scheduled
- Practicing healthy ways to ease painful emotions, rather than inflicting self-injury
- Not blaming yourself for having the disorder but recognizing your responsibility to get it treated
- Learning what things may trigger angry outbursts or impulsive behavior
- Not being embarrassed by having this condition
- Getting treatment for related problems, such as substance abuse
- Educating yourself about the disorder so you understand its causes and treatments better
- Reaching out to others with the disorder to share insights and experiences