Volume 4 Issue 1 January, 2014
Personality Disorders are identified as being “pervasive, persistent, inflexible, maladaptive patterns of behavior that deviate from expected cultural norms”. Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed BPD as a diagnosable illness for the first time. Most people who have BPD suffer from: Problems with regulating emotions and thoughts, impulsive and reckless behavior and unstable relationships with other people. People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.
Who Is At Risk?
According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have BPD in a given year. BPD usually begins during adolescence or early adulthood.
Causes:
A substantial body of research points to several variables relevant to the etiology of BPD, notably childhood physical and sexual abuse, childhood family environment, and familial aggregation of both internalizing and externalizing disorders.
Diagnosis:
According to the DSM-IV-TR, to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms: “Intense and unstable personal relationships, Frantic efforts to avoid real or imagined abandonment, Identity disturbance or problems with sense of self, Impulsivity that is potentially self-damaging, Recurrent suicidal or parasuicidal behaviour, Affective instability, Chronic feelings of emptiness, Inappropriate intense or uncontrollable anger, and Transient stress-related paranoid ideation or severe dissociative symptoms”
Suicide and Self-harm:
As many as 80 percent of people with BPD have suicidal behaviors, and about 4 to 9 percent commit suicide. Self-harming behaviors linked with BPD include cutting, burning, hitting, head banging, hair pulling, and other harmful acts. People with BPD may self-harm to help regulate their emotions, to punish themselves, or to express their pain. They do not always see these behaviors as harmful.
Management:
BPD is often viewed as difficult to treat. However, recent research shows that BPD can be treated effectively, and that many people with this illness improve over time. Psychotherapy is usually the first choice for people with BPD. It is important that people in therapy get along with and trust their therapist. The very nature of BPD can make it difficult for people with this disorder to maintain this type of bond with their therapist. Types of psychotherapy used to treat BPD include the following: Cognitive behavioral therapy (CBT), Dialectical behavior therapy (DBT) and Schema-focused therapy. Therapy can be provided one-on-one between the therapist and the patient or in a group setting. While medications do not cure BPD, pharmacotherapy may be helpful in managing specific symptoms such as anxiety, depression, or aggression. Families of people with BPD may also benefit from therapy. The support of family and friends is of critical importance in the treatment of BPD as many people with this illness may isolate themselves from
these relationships in times of greatest need.
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