Borderline Personality Disorder
What is Borderline Personality Disorder?
Borderline Personality Disorder is a complex and often misunderstood mental health condition that affects how individuals think, feel, and interact with others. Those diagnosed with BPD may experience intense mood swings, unstable relationships, and difficulty regulating their emotions.
Diagnosing BPD can be challenging due to the overlapping symptoms with other mental health conditions. A comprehensive evaluation by a mental health professional, such as a psychiatrist or psychologist, is necessary for an accurate diagnosis. This may include a review of symptoms, medical history, and psychological assessments.
BPD is most commonly a co-morbid condition to a far more consistent core disorder. The majority of those who have BPD also have other disorders such as depressive, schizophrenic, impulsive, dissociative, and identity disorders.
Symptoms of BPD
Intense Emotions: People with BPD often experience intense emotions that can fluctuate rapidly. These emotions may include feelings of emptiness, anger, anxiety, or depression.
Unstable Relationships: Individuals with BPD may struggle to maintain stable relationships due to fear of abandonment, idealization, and devaluation of others, and difficulty trusting others.
Impulsive Behavior: Impulsive behaviors such as substance abuse, reckless driving, binge eating, or self-harm are common among individuals with BPD.
Distorted Self-Image: People with BPD may have a distorted sense of self, leading to feelings of emptiness, identity confusion, and a lack of clear goals or direction in life.
Paranoid Thoughts: Some individuals with BPD may experience paranoid thoughts or dissociative symptoms during times of stress.
What causes this disorder?
The exact cause of BPD is not fully understood, but it is believed to be a combination of genetic, environmental, and neurological factors. Some potential causes and risk factors include:
Genetics: Individuals with a family history of BPD or other mood disorders may be at a higher risk of developing the condition themselves.
Trauma: Childhood trauma, such as abuse, neglect, or unstable family environments, has been linked to the development of BPD in some individuals.
Brain Chemistry: Imbalances in neurotransmitters, such as serotonin and dopamine, may contribute to the emotional dysregulation seen in BPD.
Environmental Factors: Stressful life events, such as loss or abandonment, can trigger or exacerbate symptoms of BPD in susceptible individuals.
Prevalence
The most recent research shows that BPD has a prevalence rate of 1.6% worldwide. Women tend to be diagnosed with BPD at higher rates than men. 75% of those diagnosed with BPD are women, however, this is currently contested as being due to medical bias in the diagnosing of mental illness in women as well as sampling bias in the most widely referenced studies.
According to the DSM-5, a person is five times more likely to be diagnosed with BPD if a direct family member (Parent or sibling by blood relation) has been diagnosed with BPD.
There is currently some data showing BPD is a common misdiagnosis for depressive, schizophrenic, impulsive, dissociative, and identity disorders due to many overlapping symptoms, but experts warn that more research needs to be done.
Treatment
Treatment for BPD often involves a combination of psychotherapy, medication, and support from loved ones. Some common treatment approaches include:
Dialectical Behaviour Therapy (DBT): DBT is a cognitive-behavioral therapy that focuses on teaching individuals with BPD skills to manage their emotions, improve interpersonal relationships, and reduce impulsive behaviors.
Mentalization-based therapy (MBT): MBT is a talk therapy that helps people identify and understand what others might be thinking and feeling.
Transference-focused therapy (TFP): TFP is designed to help patients understand their emotions and interpersonal problems through the relationship between the patient and therapist. Patients then apply the insights they learn to other situations.
Medication: While there are no specific medications approved for treating BPD, certain medications such as antidepressants, mood stabilizers, or antipsychotics may be prescribed to help manage symptoms such as depression, anxiety, or impulsivity.
Supportive Therapy: Individual or group therapy can provide a supportive environment for individuals with BPD to explore their emotions, develop coping strategies, and improve communication skills.
Art Therapy: Art Therapy has often been a supplemental treatment for people with personality disorders, including those with borderline personality disorder. Arts therapies include art therapy, dance movement therapy, drama therapy, and music therapy, which use arts media as their primary mode of communication.
Self-Care: Engaging in self-care activities such as exercise, mindfulness, and maintaining a healthy lifestyle can also be beneficial in managing symptoms of BPD.
One phenomenon that has been found in patients with BPD that is not shared with many other mental disorders is many people’s symptoms lessen as they age, many reporting little to no symptoms by age 50.
History
The term “borderline personality” was coined in 1938 by Adolph Stern to describe patients who fit into neither psychotic nor psychoneurotic group categories.
The concept of “borderline personality organization” was introduced by Otto Kernberg in 1975. Kernberg used this term to describe a consistent pattern of functioning and behavior characterized by instability and reflecting disturbed psychological self-organization.
The introduction of borderline personality disorder into DSM-III happened in 1980 but was not an approach taken by ICD-10. The concept of borderline personality disorder was first accepted in the US and had no wide currency in the UK before the mid-1980s.
Personal experience with Borderline Personality Disorder
Coming Soon.
Sources:
National Collaborating Centre for Mental Health (UK). Borderline Personality Disorder: Treatment and Management. Leicester (UK): British Psychological Society (UK); 2009. (NICE Clinical Guidelines, No. 78.) 2, BORDERLINE PERSONALITY DISORDER. https://www.ncbi.nlm.nih.gov/books/NBK55415/
National Institute of Mental Health. “Borderline Personality Disorder.” https://www.nimh.nih.gov/health/topics/borderline-personality-disorder
Skodol AE, Bender DS. Why are women diagnosed borderline more than men? Psychiatr Q. 2003 Winter;74(4):349-60. doi: 10.1023/a:1026087410516. PMID: 14686459. https://pubmed.ncbi.nlm.nih.gov/14686459/
National Institute of Mental Health. (n.d.). Borderline Personality Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing