Borderline Personality Disorder (BPD) is a complex mental health condition that has the potential to significantly alter the lives of those it affects unless it’s diagnosed and treated. Unfortunately, many mental health issues often go undiagnosed and considering that 20% of the known psychiatric inpatient population has Borderline Personality Disorder (BPD), it is reasonable to suggest that there are millions of undiagnosed BPD cases. It is, therefore, vital to raise awareness of the disorder and provide guidance on receiving effective and potentially life-changing treatment options.
What is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a mental health disorder characterised by pervasive instability in mood, self-image and interpersonal relationships. It falls within the category of personality disorders.
The term “borderline personality disorder” originated from the initial notion that the disorder existed at the “borderline” between neurosis and psychosis. However, this terminology is now considered somewhat outdated, as our current understanding recognises BPD as a distinct and complex personality disorder that doesn’t neatly align with such categorical distinctions.
How can someone be diagnosed with Borderline Personality Disorder?
According to the DSM-5, an individual can be diagnosed with borderline personality disorder if they show a consistent problem with unstable relationships, self-image and impulsive behaviour that starts in early adulthood. These feelings will occur up in different situations, with at least five of the following symptoms:
- Frantic efforts to avoid real or imagined abandonment: Individuals with this trait may go to great lengths to prevent perceived abandonment, even if it’s not real. This can lead to clingy or desperate behaviours in relationships.
- Having unstable and intense relationships, where feelings toward others go from extreme admiration to strong dislike: People with this trait struggle with maintaining consistent and balanced relationships, often experiencing intense and rapidly changing emotions towards others.
- Struggling with a shaky and ever-changing sense of self: Individuals may find it challenging to establish and maintain a stable sense of identity, leading to uncertainty about who they are and what they want in life.
- Acting impulsively in ways that could harm themselves, like spending too much, engaging in risky behaviour or substance abuse: Impulsive actions, such as reckless spending, engaging in risky behaviours or substance abuse, are common among individuals with this trait, potentially leading to negative consequences.
- Repeatedly engaging in self-harming behaviours or making threats of suicide: People with this trait may resort to self-harm or threaten suicide as a way to cope with emotional pain or to seek attention and support from others.
- Experiencing frequent and intense mood swings that last for a few hours or occasionally a few days: Individuals may undergo rapid and intense shifts in mood, moving from extreme highs to lows in a short period, impacting their emotional stability.
- Chronic feelings of emptiness: A persistent and profound sense of emptiness characterises the emotional state of individuals with this trait, contributing to their overall dissatisfaction with life.
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights): Intense and uncontrolled anger, expressed inappropriately or violently, is a common feature, leading to difficulties in interpersonal relationships.
- Having brief periods of paranoia or severe disconnection from reality during times of stress: Episodes of paranoia or severe disconnection from reality may occur, particularly in times of stress, contributing to difficulties in maintaining stable mental health.
Disclaimer
The provided diagnostic criteria are intended for use by medical professionals and should not be utilised as a self-diagnostic tool. In addition to these criteria, more detailed considerations are necessary for a comprehensive diagnosis. The information above serves as a general overview of the diagnostic process.
What are the causes of Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a complex mental health condition, and its exact causes are not fully understood. It likely results from a combination of genetic, neurological and environmental factors. Here are some potential contributing factors:
Invalidating environments: Growing up in an invalidating or inconsistent environment, where emotions are not acknowledged or validated, can impact emotional development and could contribute to BPD.
Is Borderline Personality Disorder dangerous?
Borderline Personality Disorder (BPD) itself is not inherently dangerous, but individuals with this disorder may experience intense and unstable emotions, difficulties with relationships and impulsive behaviours. It’s important to note that people with BPD are not inherently harmful or violent, and many individuals with BPD lead fulfilling lives with appropriate treatment and support.
However, there are some challenges associated with BPD that can impact relationships and well-being. Individuals with BPD may struggle with regulating their emotions, have a fear of abandonment and engage in impulsive behaviours such as self-harm or substance abuse.
Borderline Personality Disorder and Addiction
Approximately 78% of adults diagnosed with Borderline Personality Disorder (BPD) experience the onset of a substance-related disorder or addiction at some point in their lives. Individuals with this dual diagnosis tend to exhibit higher levels of impulsivity and clinical instability compared to those with BPD alone.
Moreover, they demonstrate increased tendencies toward suicidal behaviour, are more likely to discontinue treatment and experience shorter periods of abstinence.
Based on this comorbidity, it could be stated that those suffering from both BPD and addiction may be at risk to themselves and, to some degree, others around them. Addressing the co-occurrence of borderline personality disorder and addiction necessitates a specialised therapeutic approach.
Will Borderline Personality Disorder ever go away?
While BDP is a chronic condition, the severity and expression of symptoms can fluctuate over time. With appropriate treatment and support, individuals with BPD can experience significant improvement in their symptoms and overall functioning.
It’s important to note that BPD is typically managed rather than ‘cured’. Individuals with BPD may find that their symptoms become less intense and disruptive with time and treatment. Some people may even no longer meet the criteria for a BPD diagnosis. However, the course of BPD varies from person to person, and not everyone experiences the same level of improvement.
Continued support, self-awareness and ongoing therapeutic interventions are crucial in managing and coping with BPD. Individuals with BPD need to work closely with mental health professionals to develop coping strategies, improve interpersonal skills and address any co-occurring issues. While BPD may not completely ‘go away’, many individuals can lead fulfilling lives with effective management strategies and support.
Treatment for Borderline Personality Disorder
Treatment for Borderline Personality Disorder necessitates a comprehensive and multifaceted approach tailored to address the diverse symptoms and challenges individuals may face. At treatment centres, the primary focus in addressing BPD involves various therapeutic interventions. This includes;
Therapeutic approaches
- Cognitive Behavioural Therapy (CBT): CBT helps with identifying and altering negative thought patterns and behaviours. This approach contributes to reducing the impulsivity found a lot in people with BPD, as well as self-harm tendencies and challenges in interpersonal relationships.
- Dialectical Behaviour Therapy (DBT): Specifically designed for BPD, DBT integrates cognitive-behavioural techniques with mindfulness strategies. It equips individuals with skills to manage emotions, tolerate distress and enhance interpersonal relationships.
- Family Therapy: Involving the education of family members about the disorder, family therapy aims to cultivate a supportive home environment conducive to the individual’s well-being.
Medication for Borderline Personality Disorder
While there are no medications specifically approved for BPD, doctors may prescribe certain drugs to alleviate specific symptoms, such as:
- Antidepressants: Prescribed to manage symptoms of depression and mood swings.
- Mood stabilisers: Utilised to mitigate mood fluctuations and impulsivity.
- Antipsychotics: Occasionally employed in low doses to address disorganised thoughts or paranoia.
Ongoing Self-Care and Coping Strategies:
Individuals with Borderline Personality Disorder benefit significantly from developing and implementing ongoing self-care and coping strategies. These strategies complement therapeutic interventions and contribute to long-term stability. Key components include:
- Mindfulness Practices: Incorporating mindfulness techniques helps individuals stay present, manage intense emotions, and foster a greater awareness of thoughts and feelings.
- Emotion Regulation Skills: Learning and practising emotion regulation skills are vital for individuals with BPD. This includes identifying and expressing emotions healthily and managing impulsive reactions.
- Interpersonal Effectiveness Training: Enhancing interpersonal skills is crucial for building and maintaining healthy relationships. Training in effective communication, boundary-setting, and conflict resolution contributes to more stable connections.
- Healthy Lifestyle Choices: Adopting a balanced and healthy lifestyle can positively impact mental well-being. This includes regular exercise, sufficient sleep, and a nutritious diet, all contributing to overall emotional and physical health.
- Journaling and Self-Reflection: Keeping a journal allows individuals to track emotions, identify patterns, and reflect on experiences. This practice enhances self-awareness and aids in identifying triggers and effective coping mechanisms.
By incorporating these self-care and coping strategies into their daily lives, individuals with BPD can empower themselves to navigate challenges, maintain emotional equilibrium, and continue their journey towards personal growth and well-being. It’s essential to recognise that ongoing commitment to self-care is a valuable aspect of managing Borderline Personality Disorder.
What are the next steps?
Taking the courageous step to seek professional medical help for yourself or someone you care about who may be experiencing symptoms of Borderline Personality Disorder (BPD) is a powerful and transformative decision. It’s natural to feel apprehensive but remember that reaching out is a crucial first step toward healing.
While BPD may not completely vanish, with appropriate care, symptoms can be managed, and individuals can experience significant improvements in their overall functioning. Each person’s path is unique, and continued support, self-awareness, and therapeutic interventions remain crucial.
In today’s day and age, significant advancements have been made in the understanding and treatment of BPD. With the right therapeutic strategies, individuals with BPD can lead fulfilling lives, building strong relationships and pursuing meaningful goals. Don’t let fear or uncertainty hold you back; instead, let it be the driving force behind the positive changes that seeking help can bring.
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FAQ’s
That being said, individuals with BPD may exhibit a range of symptoms and their experiences and expressions of the disorder can differ.
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