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Understanding Borderline

Do you or someone you know exhibit Borderline Personality Disorder-like symptoms? Gain a comprehensive understanding of what BPD is and how to get treatment.

Borderline Personality Disorder

    Borderline Personality Disorder is a psychological condition in which the inflicted person suffers from pervasive patterns of instability in interpersonal relationships, self-image, and emotions (Grohol). Because of this constant fluctuation of thoughts, people with Borderline usually also exhibit erratic or impulsive behavior. The onset of this disorder usually occurs in early adulthood or late adolescence. However, in nearly all cases, those with BPD have had difficulty interacting with others since early childhood. Borderline Personality Disorder is very difficult to treat and typically involves a combination of long-term psychotherapy and medication.
    Perhaps the most marked symptom of Borderline Personality Disorder is the inability for people to control or regulate their thoughts, feelings, and behaviors. People with Borderline Personality Disorder will exhibit some, if not all, of the following symptoms. The most prevalent of erratic behaviors is the desperate effort to avoid or delay abandonment, whether it is real or imagined. The idea of abandonment, separation, or rejection is unbearable for the BPD patient. They may display excessive sadness or anger for something as simple as someone showing up late for a dinner date. This coincides with short, yet very intense episodes of anxiety or depression. Another common symptom of Borderline is episodes of risky or suicidal behavior. This can manifest in many ways, such as gambling sprees, dangerous drug use, self-mutilation, or suicide attempts (Staff). People with Borderline also have very extreme thinking, seeing things in black and white. They believe that others are either all good or all bad, instead of having qualities of both. They often utilize extreme vocabulary such as “never” or “always.”
    Borderline Personality Disorder is more common than most people realize. In the United States, 5.9% of adults (or 14 million American adults) have it. That makes Borderline more common than schizophrenia and bipolar disorders. The risks of BPD are very clear; it has one of the highest suicide rates of any psychological ailment, with over 10% of all patients committing suicide. In all cases of American youth suicides, 33% showed symptoms of BPD. 55-85% of BPD cases have mutilated themselves. It is estimated that 1 in 5 prisoners in the United States have Borderline (NEA.BPD).
    The causes of Borderline Personality Disorder are unclear. It is best understood from a biopsychosocial model. It is believed that biological factors, ways of thinking, and social stressors can all contribute to the onset of Borderline. Biologically, patients with BPD have abnormalities in the size and functioning of the amygdala, hippocampus, and frontal lobes. Interestingly enough, these are the areas of the brain that regulate emotions and thinking. Borderline is not believed to be genetically inherited. Psychosocial factors are being actively researched and are still not completely understood. However, one thing is clear: Most people with BPD have been sexually or physically abused in childhood or have had neglectful parents. It seems that these stressors complicated the patient’s ability to develope appropriate social skills and the ability to control emotional fluctuations (Dreyden-Edwards).
    Like most personality disorders, treatment of Borderline Personality Disorder is extremely difficult. 85% of those with BPD have other comorbid disorders (NEA.BPD). However, in recent years, treatments for Borderline patients have greatly improved. 4 out of 10 patients are expected to be clinically recovered 10 to 20 years after admission to treatment. Therapy seems to be at partially helpful for most people with BPD. The psychodynamic approach known as Transference-Focused Psychotherapy seems to have the best results to date. TFP is based on firstly discovering the underlying issues that caused the disorder and then working to build new ways of thinking and behavior. Medications have also been proven to be helpful, for those who can afford it (BPD RC). 38% of BPD patients are on three or more medications (NEA.BPD). Antidepressants such as SSRI’s are often utilized as mood stabilizers and treatment for general depressive disorder or dysthymia, which are often comorbid with Borderline. Neuroleptics, which are primarily used for schizophrenia patients can help with the intense episodes of anxiety and depression. Small doses of Lithium may also be helpful to reduce the dosage of mood stabilizers. Tranquilizers and sedatives are occasionally used with caution since they are dangerously addictive.

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