Borderline personality disorder
BPD usually begins in early adulthood. This condition seems to be worse in adulthood, young and may gradually get better with age.
Borderline personality disorder is a mental health disorder that impacts the way of thinking and feeling about itself and others, causing problems functioning in everyday life. It includes a pattern of distorted self-image, unstable intense relationships, extreme emotions inappropriate anger, and impulsiveness.
Signs and symptoms:
- A pattern of unstable intense relationships, such as idealizing someone at one moment and then suddenly believing that the person doesn't care enough or is cruel
- An intense fear of abandonment, even going to imagined separation or rejection or extreme measures to avoid real
- Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours
- Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all
- Suicidal threats or self-injury, or behavior often in response to fear of separation or rejection
- Impulsive and risky behavior, such as reckless driving, gambling, unsafe sex, binge eating or drug abuse, spending sprees, or sabotaging success by suddenly quitting a good job or ending a positive relationship
- Wide mood swings lasting from a few hours to a few days, which can include intense irritability, happiness, shame or anxiety
- Inappropriate, intense anger, such as being sarcastic, frequently losing your temper, or bitter, or having physical fights
- Ongoing feelings of emptiness
Causes: Genetics, history of child abuse or neglect, Brain abnormalities such as emotion regulation, impulsivity and aggression.
Risk factors:
- Hereditary predisposition
- Stressful childhood
- Personality - impulsiveness and aggression
Complications:
- Self-injury, such as burning, or cutting and frequent hospitalizations
- Not completing an education/ Repeated job changes or losses
- Unplanned pregnancies, sexually transmitted infections, motor vehicle accidents and physical fights due to impulsive and risky behavior
- Depression/ Anxiety disorders/ Alcohol or other substance misuse
- Eating disorders
- Bipolar disorder
- Attention-deficit/hyperactivity disorder (ADHD)
- Conflict-filled relationships, marital stress or divorce
- Post-traumatic stress disorder (PTSD)
Diagnosis: A diagnosis of borderline personality disorder is usually made in adults, not in children’s or teenagers.
- Medical history and exam
- Detailed interview with mental health provider or doctor
- Psychological evaluation that may include completing questionnaires
- Review of signs and symptoms
Treatments:
Psychotherapy: It is also called talk therapy; it is a fundamental treatment approach for borderline personality disorder. The goals of psychotherapy are:
- Learn to manage emotions that feel uncomfortable
- Focus on you current ability to function
- Reduce your impulsiveness by helping you observe feelings rather than acting on them
- Learn about borderline personality disorder
- Work on improving relationships by being aware of your feelings and those of others
Types of psychotherapy:
- Dialectical behavior therapy (DBT): DBT can include group or individual therapy designed specifically to treat borderline personality disorder. DBT uses a skills-based approach to teach you how to tolerate distress, manage emotions, and improve relationships.
- Mentalization-based therapy (MBT): MBT is a type of talk therapy that helps to identify the own feelings and thoughts at any given moment and create an alternate perspective on the situation. MBT emphasizes thinking before reacting.
- Schema-focused therapy: Schema-focused therapy can be done individually or in a group. It can help you identify unmet needs that have led to negative life patterns, which at some time may have been helpful for survival, but as an adult are hurtful in many areas of your life. Therapy focuses on helping to get the needs met in a healthy manner to promote positive life patterns.
- Systems training for emotional predictability and problem-solving (STEPPS): STEPPS is a 20-week treatment which involves working in groups that incorporate with caregivers, family members, friends or significant others into treatment. STEPPS is used in addition to other types of psychotherapy.
- Transference-focused psychotherapy (TFP): It is also called as psychodynamic psychotherapy, TFP aims to help to understand the emotions and interpersonal difficulties through the developing relationship between you and your therapist.
- General psychiatric management: This treatment approach focuses on making sense of emotionally difficult moments or relies on case management and by considering the interpersonal context for feelings. It may integrate groups, medications, family education and individual therapy.
Medications: Although no drugs have been approved by the F&D specifically for the treatment of borderline personality disorder, certain medications may help with co-occurring problems such as depression, impulsiveness, aggression or anxiety or symptoms. Medications may include antipsychotics or mood-stabilizing drugs and antidepressants.
Hospitalization: Hospitalization may keep safe from self-injury or address suicidal thoughts or behaviors.
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