BORDERLINE PERSONALITY DISORDER BRENDA ORTIZ PERIOD 1 APRIL 14, 2012

WHAT IS BPD? BPD is a personality disorder. It is a pervasive patter of instability most evident in relationships, mood, and sense of identity. It primarily affects women, especially those who have felt abuse or abandonment at some point in their lives.

ASSOCIATED FEATURES: A person suffering from BPD usually has unstable interpersonal relationships along with severe depression and negative emotions. They will often have feelings of emptiness. Many times, a BPD sufferer will be deeply affected by things that another person would simply shrug off.

ASSOCIATED FEATURES (CONT.): Splitting: Believing that something or someone is either completely good or completely bad. Intense rage or distress at random times. Identity confusion. Will often engage in reckless behaviors, such as unprotected sex, spending, substance abuse, binge eating, or violence in order to stimulate themselves. Severe mood swings; seeming normal at first, then shifting from depressed to incredibly hostile and violent.

ASSOCIATED FEATURES (CONT.): Feeling hopeless or helpless constantly. Not being able to feel pleasure without guilt. Having problems with their sexuality and gender expression (constantly questioning it). Having a hard time understanding what others are feeling, which may lead to believing the other person does not like them or is constantly judging them. Difficulty with self-care. Losing touch with reality (hearing voices, feeling intense feelings of paranoia).

DSM-IV-TR CRITERIA 1.Frantic efforts to avoid real or imagined abandonment. 2.A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. 3.Identity disturbance: markedly and persistently unstable self-image or sense of self. 4.Impulsivity in at least two areas that are potentially self-Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. 5.Affective instability due to a marked reactivity of Chronic feelings of emptiness. 6.Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights). 7.Transient, stress-related paranoid ideation or severe dissociative symptoms.

ETIOLOGY Biological: A “gender-specific” reaction to endorphins. Environmental: Chaotic parental relationships that interfered with emotional and interpersonal development Physical, emotional, or sexual abuse Criminal behavior Complex reactions to trauma

PREVALENCE BPD is more common among women than with men. A lot of the symptoms of BPD are self- harming and stereotypically “feminine,” which leads some scientists to believe that the diagnosis and research may be biased. It is estimated that 1-4% of people suffer from BPD.

TREATMENT When extreme, hospitalizations may be required, especially if the patient is harming themselves or has attempted or is planning to attempt suicide.  Some symptoms can be managed and kept under control by taking medication:  Types of medications include antidepressants, antipsychotics, and mild tranquilizers.  Some medications used are Prozac, Lithium, or Thallium.

TREATMENT (CONT.) For BPD patients, therapy is another option. Dialectal Behavior Therapy, or DBT therapy, is often said to be effective. When in DBT, the patient is taught to set goals for themselves, as well as being made to acknowledge the fact that they’re unhealthy and that they must learn how to manage and deal with their emotions and stress. However, therapy proves to be incredibly difficult with BPD patients, as they might become dependent on their therapist or severely enraged when they don’t live up to their own expectations.

PROGNOSIS While symptoms for Borderline Personality Disorder cannot be completely cured, they can be managed. Some BPD patients spend the rest of their lives in therapy. BPD is very difficult to treat, so it may take a long time for the patient to accept their illness and make progress. However, in some adults, early signs of BPD usually abate after some time.

REFERENCES Lilienfield, S. (2012, January/February). The truth about borderline personalities. Scientific American Mind, volume 22. Retrieved from EBSCOhost. Borderline Personality Disorder. (2011).CRS – Adult Health Advisor. Retrieved April 19 th, 2012, from EBSCOhost.