Borderline Personality Disorder

Borderline Personality Disorder

Borderline Personality Disorder

Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a Cluster B Personality Disorder characterized by poorly regulated responses in five main areas: emotions, behaviors, interpersonal relationships, sense of self, and cognition. BPD is perhaps the most heavily stigmatized mental health condition both in the media and the psychiatric field.

Prevalence

Up to 6% of the population is reported to be affected with BPD in a given year. The male to female ratio of people diagnosed with BPD is 1:3, and it appears to become less common among older people.

The behaviors that characterize BPD typically begin by early adulthood, occur across a variety of situations, and may be triggered by events considered normal to others. BPD commonly coexists with other conditions such as substance abuse, major depressive disorder, and eating disorders.

Symptoms of Borderline Personality Disorder:

The symptoms of BPD include:

  • Marked sensitivity to minor rejection or criticism
  • Frantic efforts to avoid real or imagined abandonment
  • Chronic feelings of emptiness
  • Impulsivity, lack of self-control, and reckless behaviors
  • A pattern of intense and unstable relationships with loved ones such as family, friends, and romantic partners
  • Splitting – switching from extreme love and treating certain people as perfect to extreme loathing and character assassination of them
  • Confusion or uncertainty about one’s social role, function, or personal goals
  • Distorted self-image or sense of self
  • Affective instability and intense emotional expression
  • Dissociation – out-of-body experiences or detachment from reality
  • Perceptual disturbances – auditory or visual hallucinations

People with BPD often report the triad of:

  • 1. Feeling betrayed
  • 2. Feeling out of control
  • 3. “Feeling like hurting myself”

Diagnosing Borderline Personality Disorder:

Self-harming or suicidal behavior is one of the core diagnostic criteria for BPD. Self-harm occurs in up to 80% of people with BPD, and the most frequent method is cutting.

Nearly three quarters of people with BPD who self-harm do so without attempting to end their lives. Reasons for self-harm include expressing emotion (particularly anger), self-punishment, and distracting oneself from emotional pain.

Causes of Borderline Personality Disorder:

The causes of BPD remain unclear, but genetic, biological, environmental, psychological, and social factors have all been implicated.

The findings of neuroimaging studies (MRIs and CAT scans) in people who have BPD have revealed brain abnormalities such as reductions in regions of the brain involved in the regulation of stress responses and emotion. Adverse life events such as sexual abuse and having a family history of BPD are factors that increase a person’s risk of developing BPD.

Risk factors for Borderline Personality Disorder:

The lifetime risk of suicide among people with BPD is between 3% and 10%. Men with BPD are approximately twice as likely to die by suicide compared to women with the same condition. 

Treatment for Borderline Personality Disorder:

Talking therapy is the first-line treatment for BPD.

Dialectical behavioral therapy (DBT) is a type of long-term talking therapy that utilizes the concept of mindfulness, or being aware of and attentive to the current situation and moods. DBT also teaches skills to control intense emotions, tolerate distress, reduce self-destructive behaviors, and improve relationships. DBT recognizes the natural tension between the need for acceptance and the need for change.

Up to half of people with BPD improve over a ten-year period.

Symptoms of Borderline Personality Disorder:

The symptoms of BPD include:

  • Marked sensitivity to minor rejection or criticism
  • Frantic efforts to avoid real or imagined abandonment
  • Chronic feelings of emptiness
  • Impulsivity, lack of self-control, and reckless behaviors
  • A pattern of intense and unstable relationships with loved ones such as family, friends, and romantic partners
  • Splitting – switching from extreme love and treating certain people as perfect to extreme loathing and character assassination of them
  • Confusion or uncertainty about one’s social role, function, or personal goals
  • Distorted self-image or sense of self
  • Affective instability and intense emotional expression
  • Dissociation – out-of-body experiences or detachment from reality
  • Perceptual disturbances – auditory or visual hallucinations

People with BPD often report the triad of:

  • 1. Feeling betrayed
  • 2. Feeling out of control
  • 3. “Feeling like hurting myself”

Diagnosing Borderline Personality Disorder:

Self-harming or suicidal behavior is one of the core diagnostic criteria for BPD. Self-harm occurs in up to 80% of people with BPD, and the most frequent method is cutting.

Nearly three quarters of people with BPD who self-harm do so without attempting to end their lives. Reasons for self-harm include expressing emotion (particularly anger), self-punishment, and distracting oneself from emotional pain.

Causes of Borderline Personality Disorder:

The causes of BPD remain unclear, but genetic, biological, environmental, psychological, and social factors have all been implicated.

The findings of neuroimaging studies (MRIs and CAT scans) in people who have BPD have revealed brain abnormalities such as reductions in regions of the brain involved in the regulation of stress responses and emotion. Adverse life events such as sexual abuse and having a family history of BPD are factors that increase a person’s risk of developing BPD.

Risk factors for Borderline Personality Disorder:

The lifetime risk of suicide among people with BPD is between 3% and 10%. Men with BPD are approximately twice as likely to die by suicide compared to women with the same condition. 

Treatment for Borderline Personality Disorder:

Talking therapy is the first-line treatment for BPD.

Dialectical behavioral therapy (DBT) is a type of long-term talking therapy that utilizes the concept of mindfulness, or being aware of and attentive to the current situation and moods. DBT also teaches skills to control intense emotions, tolerate distress, reduce self-destructive behaviors, and improve relationships. DBT recognizes the natural tension between the need for acceptance and the need for change.

Up to half of people with BPD improve over a ten-year period.

Sources NIMH | WIKIPEDIA – Self Harm | WIKIPEDIA – Cutting