9 Things About Borderline Personality Disorder You Need to Know video
Borderline personality disorder is a mental disorder characterized by difficulty in regulating emotions. This difficulty causes marked changes in mood, impulsivity and instability, self-image problems, and unstable interpersonal relationships. There may be frantic attempts to avoid situations of real or imagined abandonment. The combined result of living with borderline disorder can manifest itself in destructive behavior, such as self-harm (cutting) or suicide attempts.
It is estimated that 1.6% of the adult population has BPD, but it can reach 5.9%. Almost 75% of people diagnosed with this disorder are women, but recent research suggests that the percentage of affected men may equal that of women. In the past, men with borderline personality disorder were often misdiagnosed with post-traumatic stress disorder or depression.
Symptoms of borderline personality disorder can include:
- Frantic efforts to avoid abandonment.
- Unstable interpersonal relationships that alternate between idealizing - "I'm so in love!" - and the devaluation - "I hate it." This is also known as a "split".
- Distorted and unstable self-image, affecting mood, values, opinions, goals, and relationships.
- Impulsive behaviors that can have dangerous results, such as overspending, unsafe sex, substance abuse, or reckless driving.
- Suicidal behavior and self-mutilation.
- Periods of intense depressed mood, irritability, or anxiety that last a few hours or a few days.
- Chronic feelings of boredom or emptiness.
- Inappropriate, intense, or uncontrollable anger, often followed by shame and guilt.
- Dissociative symptoms: disconnecting from thoughts or sense of identity, or having a feeling of being "out of body", and stress-related paranoid ideation. Severe cases of stress can also cause brief psychotic episodes.
Borderline personality disorder is ultimately characterized by the emotional turmoil it causes. They feel emotions intensely and for long periods of time, and it is more difficult for them to return to a stable base after an emotionally intense episode. Suicide threats and attempts are very common in these people. Acts of self-mutilation, such as cutting or burning, are also common.
The causes of borderline personality disorder are not fully understood, but scientists agree that it is the result of a combination of factors:
- The genetic. While no specific gene has been shown to directly cause this disorder, twin studies suggest that this disorder has strong inherited links. Borderline disorder is about five times more common among people who have a first-degree relative with the disorder.
- Environmental factors. People who experience traumatic events in their life, such as physical or sexual abuse during childhood or neglect and separation from parents, are at higher risk of developing the disorder.
- The function of the brain. The way the brain works is often different in people with borderline disorder, suggesting that there is a neurological basis for some of the symptoms. Specifically, the portions of the brain that control emotions and decision-making / judgment may not communicate well with each other.
There is no medical test to diagnose BPD, and a diagnosis is not based on a symptom. It must be diagnosed by a mental health professional after a thorough psychiatric interview, which may include speaking with previous professionals, medical evaluations, and, where appropriate, interviews with friends and family. To reach the diagnosis, at least 5 of the 9 symptoms indicated above must be met.
A typical and comprehensive treatment plan includes psychotherapy, medication, and family support.
Psychotherapy is the cornerstone for treatment. In addition to dialectical behavior therapy, which was created specifically for the treatment of borderline personality disorder, there are other types of psychotherapy that are effective.
- Dialectical Behavioral Therapy (DBT) focuses on teaching coping skills to combat destructive impulses, regulate emotions, and improve relationships while adding validation. Including individual and group work, BDT encourages the practice of mindfulness techniques. BDD has been shown to be effective in reducing suicidal behavior, psychiatric hospitalization, treatment abandonment, substance abuse, anger, and interpersonal difficulties.
- Cognitive behavioral therapy (CBT) helps change negative thinking and behavior associated with BPD. The goal of this therapy is to recognize negative thoughts and teach coping strategies.
- Mentalization-based therapy (MBT) is a therapeutic approach developed by Fonagy and Bateman. The ability to mentalize is the process by which we understand our own mind and that of others, based on mental states (intentions, feelings, thoughts, desires and beliefs) in order to give meaning and anticipate the actions of each one. Mentalization (or reflective function) involves the ability to contain, regulate, experience, and make sense of emotions and feelings. Mentalization-based therapy seeks to better understand one's own emotions and those of others. Through this greater connection between feelings and thoughts, a more appropriate behavior is achieved as well as more satisfactory relationships with others.
There is no specific medication for the treatment of symptoms such as emptiness, abandonment and identity alteration, but it can be useful for the treatment of other symptoms such as anger, depression and anxiety. This medication can include mood stabilizers, antipsychotics, antidepressants, and anxiolytics.
When psychotherapy and medication are not enough, hospitalization may be necessary. A hospital can provide a safe environment for a person with BPD who self-harms or has suicidal thoughts.
A person with borderline personality disorder may have additional disorders that must be treated together, such as:
- Anxiety disorders , such as post-traumatic stress disorder .
- Bipolar disorder .
- Depression .
- Eating disorders, especially bulimia nervosa .
- Other personality disorders .
- Substance abuse .
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