Borderline Personality Disorder

What is borderline personality disorder? Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed BPD as a diagnosable illness for the first time. Because some people with severe BPD have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name "borderline personality disorder" is misleading, a more accurate term does not exist yet.

Signs and Symptoms A person must show at least five of the following symptoms to be diagnosed with personality borderline disorder. Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation) Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices) Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating Recurring suicidal behaviors or threats or self-harming behavior, such as cutting Intense and highly changeable moods, with each episode lasting from a few hours to a few days Chronic feelings of emptiness and/or boredom Inappropriate, intense anger or problems controlling anger Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.

Statistics Borderline personality disorder affects Six to ten million Americans – or, about the population of New York City, twice that of both schizophrenia and bipolar disorder 2% to 6% of the general population At least 10% of all mental health outpatients At least 20% of psychiatric inpatients 75-90% of those diagnosed with BPD are women. 10%, or one in ten, people with BPD commit suicide.

Treatment Types of psychotherapy used to treat BPD include the following: Cognitive behavioral therapy (CBT). CBT can help people with BPD identify and change core beliefs and/or 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. Dialectical behavior therapy (DBT). This type of therapy focuses on the concept of mindfulness, or being aware of and attentive to the current situation. DBT teaches skills to control intense emotions, reduces self- destructive behaviors, and improves relationships. This therapy differs from CBT in that it seeks a balance between changing and accepting beliefs and behaviors. Schema-focused therapy. This type of therapy combines elements of CBT with other forms of psychotherapy that focus on reframing schemas, or the ways people view themselves. This approach is based on the idea that BPD stems from a dysfunctional self-image—possibly brought on by negative childhood experiences—that affects how people react to their environment, interact with others, and cope with problems or stress.

Treatment Therapist-led group sessions may help teach people with BPD how to interact with others and how to express themselves effectively. Many people with BPD are treated with medications in addition to psychotherapy. While medications do not cure BPD, some medications may be helpful in managing specific symptoms. For some people, medications can help reduce symptoms such as anxiety, depression, or aggression.

What would a day in the life of a person with borderline personality disorder be like? “The medical professional just saw a young girl, with not a thing wrong in her life at present, overdosing, going to A&E then running away. Attention seeking. I can't blame them for assuming this because I understand that's what it looked like and once I could explain why I would do what I would, an Advanced Statement was put in place to prevent me ever being treated like 'just' an attention seeker.” “Borderline Personality Disorder (BPD) itself means that people living with it find it difficult to name their feelings and emotions but this is no excuse for others to just assume what they may be.” “Outwardly, I was bubbly, confident and relaxed, afraid of nothing and living every day to the full. In reality, there were some days where I couldn't even get out of bed.”

Interesting Facts Women with BPD are more likely to have co-occurring disorders such as major depression, anxiety disorders, or eating disorders. In men, BPD is more likely to co-occur with disorders such as substance abuse or antisocial personality disorder. Studies on twins with BPD suggest that the illness is strongly inherited. BPD is often misdiagnosed and many people find they wait years to get a proper diagnosis, which leads to a better care plan. BPD affects 20% of patients admitted to psychiatric hospitals. BPD affects 50% more people than Alzheimer’s disease and nearly as many as schizophrenia and bipolar combined (2.25%).

Co-Occurring Disorders The despair of Borderline Personality Disorder patients is usually associated with self-destructive and impulsive behaviors, and therefore BPD patients almost always have coexisting mental health problems. Major Depressive Disorder: Approximately 60% Dysthymia (chronic, mild to moderate depression): Approximately 70% Substance abuse: Approximately 35% Eating disorders (anorexia, bulimia, binge eating) : Approximately 25% Bipolar disorder: Approximately 15% Antisocial Personality Disorder: Approximately 25% Narcissistic Personality Disorder: Approximately 25% Self-Injury: Approximately 55%-85%

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