I love surfing the net, it’s my kryptonite next to reading. People say it’s a bad thing; “Nancy, you’re addicted to your phone, drop it”, “Nancy, your Phone is your only friend, stop making yourself a loner”. But people don’t know that my love for knowledge lead to my love for reading, watching documentaries and surfing the net.
It was a normal day I was reading a novel online and came across a disorder people live with but might not know. You might have written off a person as too bipolar for your taste not knowing that he or she is dying inside not knowing how to reach out, borderline personality disorder is the cause. But let’s understand what BPD is first.
Borderline personality disorder (BPD) is a serious mental illness that centers on the inability to manage emotions effectively. The disorder occurs in the context of relationships: sometimes all relationships are affected, sometimes only one. It usually begins during adolescence or early adulthood.
While some persons with BPD are high functioning in certain settings, their private lives may be in turmoil. Most people who have BPD suffer from problems regulating their emotions and thoughts, impulsive and sometimes reckless behavior, and unstable relationships
Other disorders, such as depression, anxiety disorders, eating disorders, substance abuse and other personality disorders can often exist along with BPD
The diagnosis of BPD is frequently missed and a misdiagnosis of BPD has been shown to delay and/or prevent recovery. Bipolar disorder is one example of a misdiagnosis as it also includes mood instability. There are important differences between these conditions but both involve unstable moods. For the person with bipolar disorder, the mood changes exist for weeks or even months. The mood changes in BPD are much shorter and can even occur within the day.
Officially recognized in 1980 by the psychiatric community, BPD is more than two decades behind in research, treatment options, and family psycho-education compared to other major psychiatric disorders. BPD has historically met with widespread misunderstanding and blatant stigma. However, evidenced-based treatments have emerged over the past two decades bringing hope to those diagnosed with the disorder and their loved ones.
Incidence
* BPD affects 5.9% of adults (about 14 million Americans) at some time in their life
* BPD affects 50% more people than Alzheimer’s disease and nearly as many as schizophrenia and bipolar combined (2.25%).
* BPD affects 20% of patients admitted to psychiatric hospitals
* BPD affects 10% of people in outpatient mental health treatment
Causes Of Borderline Personality Disorder
Research on the causes and risk factors for BPD is still in its early stages. However, scientists generally agree that genetic and environmental influences are likely to be involved. Certain events during childhood may also play a role in the development of the disorder, such as those involving emotional, physical and sexual abuse. Loss, neglect and bullying may also contribute. The current theory is that some people are more likely to develop BPD due to their biology or genetics and harmful childhood experiences can further increase the risk.
What Does “Borderline Personality Disorder” Mean?
Historically, the term “borderline” has been the subject of much debate. BPD used to be considered on the “borderline” between psychosis and neurosis. The name stuck, even though it doesn’t describe the condition very well and, in fact, may be more harmful than helpful. The term “borderline” also has a history of misuse and prejudice—BPD is a clinical diagnosis, not a judgment.
Current ideas about the condition focus on ongoing patterns of difficulty with self-regulation (the ability to soothe oneself in times of stress) and trouble with emotions, thinking, behaviors, relationships and self-image. Some people refer to BPD as “Emotion Disregulation”
Borderline personality disorder is a mental illness marked by an ongoing pattern of varying moods, self-image, and behavior. These symptoms often result in impulsive actions and problems in relationships. People with borderline personality disorder may experience intense episodes of anger, depression, and anxiety that can last from a few hours to days.
Symptoms of Borderline Personality Disorder
Borderline personality disorder symptoms vary from person to person and women are more likely to have this disorder than men. Common symptoms of the disorder include the following:
Having an unstable or dysfunctional self-image or a distorted sense of self (how one feels about one’s self)
Feelings of isolation, boredom and emptiness
Difficulty feeling empathy for others
A history of unstable relationships that can change drastically from intense love and idealization to intense hate
A persistent fear of abandonment and rejection, including extreme emotional reactions to real and even perceived abandonment
Intense, highly changeable moods that can last for several days or for just a few hours
Strong feelings of anxiety, worry and depression
Impulsive, risky, self-destructive and dangerous behaviors, including reckless driving, drug or alcohol abuse and having unsafe sex
Hostility
Unstable career plans, goals and aspirations
Many people experience one or more of the above symptoms regularly, but a person with borderline personality disorder will experience many of the symptoms listed above consistently throughout adulthood.
The term “borderline” refers to that fact that people with this condition tend to “border” on being diagnosed with additional mental health conditions in their lifetime, including psychosis.
One of the ironies of this disorder is that people with BPD may crave closeness, but their intense and unstable emotional responses tend to alienate others, causing long-term feelings of isolation.
Borderline Personality Disorder and Suicidality
Around 80 percent of people with borderline personality disorder display suicidal behaviors, including suicide attempts, cutting themselves, burning themselves, and other self-destructive acts. It is estimated that between 4 and 9 percent of people with BPD will die by suicide.
Tests and Diagnosis
A licensed mental health professional—such as a psychiatrist, psychologist, or clinical social worker—experienced in diagnosing and treating mental disorders can diagnose borderline personality disorder by:
• Completing a thorough interview, including a discussion about symptoms
• Performing a careful and thorough medical exam, which can help rule out other possible causes of symptoms
• Asking about family medical histories, including any history of mental illness
Borderline personality disorder often occurs with other mental illnesses. Co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with the symptoms of borderline personality disorder. For example, a person with borderline personality disorder may be more likely to also experience symptoms of depression, bipolar disorder, anxiety disorders, substance use disorders, or eating disorders.
Medications
Because the benefits are unclear, medications are not typically used as the primary treatment for borderline personality disorder. However, in some cases, a psychiatrist may recommend medications to treat specific symptoms such as:
• mood swings
• depression
• other co-occurring mental disorders
Treatment with medications may require care from more than one medical professional.
Certain medications can cause different side effects in different people. Talk to your doctor about what to expect from a particular medication.
Help for Borderline Personality Disorder
Living with borderline personality disorder, or being in a relationship with someone who has BPD, can be stressful. It can be very difficult to acknowledge and accept the reality of BPD, but treatment may help.
If you are concerned that you, or that someone you care about, may have borderline personality disorder, contact a licensed mental health professional. Many supportive healthcare professionals are available to help you get started on the path to healing. Since BPD can be a complex condition, and treatment usually requires long-term talk therapy, it will be important to find a mental health professional who has expertise in treating this condition.
It is possible to learn how to manage feelings better and find ways to have healthier and more rewarding relationships. With the help of talk therapy, one can learn how to reduce impulsive and self-destructive behaviors and understand more about the condition. With a commitment to long-term treatment, positive and healthy change is within reach.
Psychotherapy
Psychotherapy is the first-line treatment for people with borderline personality disorder. A therapist can provide one-on-one treatment between the therapist and patient, or treatment in a group setting. Therapist-led group sessions may help teach people with borderline personality disorder how to interact with others and how to effectively express themselves.
It is important that people in therapy get along with, and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with the disorder to maintain a comfortable and trusting bond with their therapist.
Two examples of psychotherapies used to treat borderline personality disorder include:
• Dialectical Behavior Therapy (DBT): This type of therapy was developed for individuals with borderline personality disorder. DBT uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state. DBT also teaches skills that can help:
• Control intense emotions
• Reduce self-destructive behaviors
• Improve relationships
• Cognitive Behavioral Therapy (CBT): This type of therapy can help people with borderline personality disorder identify and change core beliefs and behaviors that underlie inaccurate perceptions of themselves and others, and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.
Prognosis
Research has shown that outcomes can be quite good for people with BPD, particularly if they are engaged in treatment. With specialized therapy, most people with borderline personality disorder find their symptoms are reduced and their lives are improved. Although not all the symptoms may ease, there is often a major decrease in problem behaviors and suffering. Under stress, some symptoms may come back. When this happens, people with BPD should return to therapy and other kinds of support.
Many individuals with BPD experience a decrease in their impulsive behavior in their 40’s.
