Borderline personality disorder (BPD) is a mental disorder, which is characterized by impulsiveness, emotional instability, increased anxiety, episodes of anger, difficulties in building long-lasting relationships with other people, alternation of idealization and depreciation. Borderline personality disorder is a long-lasting illness, it occurs at an early age and may last throughout life. The particular psychological structure, violence, carefree childhood may trigger this disorder. The diagnosis is based on patient’s answers during interviews, medical history and the results of special questionnaires. In treatment, psychotherapy and medication are used.
Borderline personality disorder is one of personality disorders (the obsolete term is psychopathy). This mental illness is associated with certain features of character and behavior, problems with socialization and building of personal relationships. According to statistics, approximately 2% of the population suffers from this mental disorder. It may be accompanied by other mental disorders. People with BPD are more likely to develop alcoholism and drug addiction. Psychotic episodes may take place.
Borderline personality disorder makes people’s lives unbearable. Failures in private life, combined with the constant fear of loneliness, professional and social problems provoke depression, pushing people to abuse substance and commit suicides. Borderline personality disorder treatment is a difficult task, however, adequate therapy improves patients’ conditions. The treatment is carried out by psychologists, psychotherapists, and psychiatrists.
Borderline personality disorder causes
Borderline disorder is a disease that occurs because of a number of factors. Genetic predisposition plays a major role. Gender plays a role as well – women suffer from borderline personality disorder more often than men do. Character traits, low self-esteem, increased anxiety, the tendency to pessimistic forecasts and low resistance to stress may lead to borderline personality disorder. Many patients suffered from sexual, physical or emotional abuse in childhood.
The lack of parental care or emotional contact with important adults, prohibition to express feelings, contradictory or excessive demands on the child may trigger BPD. The American psychologist Marsha Linehan studied the problem of borderline personality disorder and developed the method of treatment for this disease, she suggests that the disease may be associated with “emotional disability” of loved people around the patient during childhood. In all cases, in response to the unfavorable conditions of life, maladaptive patterns of behavior are formed, which later affect relationships with others.
In borderline personality disorder, an increased activity of the limbic system is noticed, however, it is not yet found out whether this is a primary violation or secondary as a result of constant emotional deprivation and a high level of emotional discomfort. Endogenous (changes in the level of neurotransmitters) or exogenous (developed behavior patterns in childhood) factors cause difficulties in modulating emotions. Patients suffering from borderline personality disorder are not able to talk about their own emotional state in an adequate way. They respond quickly and impulsively, this often leads to conflicts and makes the situation worse.
Borderline personality disorder symptoms
The first signs of the disorder may be noticeable in early childhood. Children are emotionally unstable, restless, often show emotional reactions stronger than they should be. Impulsive behavior is common. Nevertheless, these symptoms are insufficient for diagnosis since living conditions and behavior while growing older may change. As a rule, it is possible to make an accurate diagnosis about 25 years old.
A peculiar identity disorder is revealed. The image of “Self” is unstable and may vary depending on the mood or external circumstances. Patients are constantly afraid of being abandoned (sometimes this fear corresponds to reality and sometimes not). In order to stabilize the image of “Self” and eliminate the fear, people with borderline personality disorder try to find “complement and reflection of themselves” in ideal relationships, which reproduce the parent-child bond.
Such a bond is not possible in relations between two adults. Episodes of idealization, arising from unrealistic expectations, are changed by episodes of depreciation, which is caused by disappointment. Relations for patients suffering from BPD become tense, unstable, they are based on unrealistic demands on the partner. The situation gets worse because of the patient’s impulsiveness and mood swings with severe anxiety or dysphoria. Impulsive behavior may include not only problems in the relationship but also overeating, unreasonable waste of money, casual sex, substance abuse. People with BPD may commit suicides.
A person with BPD constantly feels exhausted. He finds it difficult to control his own emotions while communicating with other people. Sudden quarrels, bouts of anger or constant anger, frequent fights, irritability and so on are not uncommon. In stressful situations, patients with borderline personality disorder have paranoid thoughts that, in contrast to paranoia, are unstable and short-lasting. There may be symptoms of dissociation. All symptoms mentioned above do not allow to build romantic relationships and maintain a normal life in society.
K.G. Jung singled out a group of maladaptive schemes arising in the early years and associated with the emotional rejection of the significant adult. Patients with BPD constantly experience the fear of loss or rejection, which is expressed in the belief: “I will not find a loved one and I will always be alone.” They tend to obey, considering that wishes of others are more important than their own. Patients do not believe in their abilities to solve problems and feel dependent on other people. They believe they do not have volitional qualities, can not control their own lives and manage their own behavior.
Patients with borderline personality disorder consider themselves bad people. They think that others will turn away from them if they know what they really are, and believe that they deserve punishment. Patients suffer from distrust and suspicion, they are afraid that they will be used. The belief “my feelings and desires are insignificant to others” is accompanied by the fear of showing emotions.
Borderline personality disorder can be unnoticeable for a long period of time. During bouts of the disease, people go to psychologists and psychotherapists but after improvement, they stop the treatment as the fear of facing their current feelings and negative experiences from the past becomes stronger than fear not to cope with their lives in a given period of time. As a result, patients with borderline personality disorder often have a complicated history of contact with specialists and they begin thinking that “Psychologists are useless, they can not help me.”
Borderline personality disorder is often combined with other mental disorders, including panic disorder, generalized anxiety disorder, depression, obsessive-compulsive disorder, manic-depressive psychosis, paranoid, dependent, narcissistic, avoidant and schizotypal personality disorders. A person may suffer from alcoholism and drug addiction. This mental disorder may lead to suicide attempts and self-harm.
Borderline personality disorder treatment
It is difficult to find out this mental disorder because of a huge number of symptoms and its combination with other mental disorders. Different tests, conversation with the patient, particular symptoms, medical exam help to make an accurate diagnosis.
The treatment of borderline personality disorder involves discussion and reinterpretation of existing problems, development of abilities to control emotions and behavior, improvement of social skills, the formation of the protective mechanisms that help to overcome anxiety and stress. The most effective method of treatment is a dialectical behavior therapy. The treatment plan considers peculiarities of character and personality and includes individual therapy and support group.
The doctor may prescribe different tranquilizers, antipsychotic meds, and antidepressants. The patient’s age, the level of social, professional and personal compensation, relationships within the family and willingness to treat are considered in the prognosis of BPD. If you seek professional help timely, treatment will be effective. In other cases, patients with borderline personality disorder often “wander” from one doctor to another without any improvement.
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