Borderline Personality Disorder |
Overview
Borderline personality disorder (BPD) is a serious yet treatable mental illness that is characterized by severe mood swings and problems with interpersonal relationships self-image and behaviour. It can seriously disrupt family and work life long-term planning and the individual's sense of self-identity. There is a high rate of self-injury as well as attempted (or successful) suicide among those with BPD. While it is one of the lesser known mental illnesses BPD affects 2 per cent of adults mostly young women. Patients often need extensive mental health services. Yet with help many improve over time and are eventually able to lead productive lives. Symptoms
A person with BPD may experience any of the following: - intense short-lived bouts of anger depression and anxiety.
- impulsive aggression and self-injury.
- frequent changes in long-term goals career plans jobs friendships gender identity and values.
- distorted sense of self.
- feelings of being fundamentally bad or unworthy.
- feelings of being unfairly misunderstood or mistreated.
- feelings of emptiness. These feelings can worsen when people with BPD are isolated and lacking in social support.
- frantic efforts to avoid being alone. These can result in extreme measures such as threats or attempts at suicide or self mutilation.
- highly unstable patterns of social relationships. Intense but stormy attachments.
- attitude towards family friends and loved ones suddenly shifting from great admiration and love to intense anger and dislike.
- forming an immediate attachment and idealization of another person but when a slight separation or conflict occurs switching unexpectedly to the other extreme. This sometimes leads to angry accusations of the other person of not caring for them at all.
- increased sensitivity to rejection even with family members.
- reacting with anger and distress to mild separations such as a vacation a business trip or a sudden change in plans. These fears of abandonment seem to be related to difficulties feeling emotionally connected to important persons when they are physically absent leaving the individual with BPD feeling lost and perhaps worthless.
- suicide threats and attempts.
- impulsive behaviors such as excessive spending binge eating and risky sex.
- drug or alcohol abuse.
- other psychiatric problems particularly bipolar disorder depression anxiety disorders substance abuse and other personality disorders.
Cause
The exact cause of BPD is unknown. 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 considerably more likely to be the victim of violence including rape and other crimes. This may result from harmful environments as well as impassivity and poor judgment in choosing partners and lifestyles. Treatment
Within the past 15 years a new psychosocial treatment termed dialectical behavior therapy (DBT) was developed specifically to treat BPD. Treatment studies are showing positive results. This approach acknowledges that people with BPD possibly die to invalidating environments during upbringing and biological factors as yet unknown and react abnormally to emotional stimulation. Their level of arousal goes up much more quickly peaks at a higher level and takes more time to return to baseline. This explains why borderlines are known for crisis-strewn lives and extreme emotional lability (emotions that shift rapidly). IN DBT particular problematic behavior or event is explored in detail beginning with the chain of events leading up to it going through alternative solutions that might have been used and examining what kept the client from using more adaptive solutions to the problem. It is essentially about learning to be a better manager of day to day crises. Group and individual psychotherapy are at least partially effective for many patients. |
