Borderline Personality Disorder
Borderline Personality Disorder
Description, Causes and Risk Factors:
Borderline personality disorder is a most misunderstood, serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. It is a disorder of emotion dysregulation. This instability often disrupts family and work, long-term planning, and the individual's sense of self-identity. While less well known than schizophrenia or bipolar disorder (manic-depressive illness), BPD is as common, affecting between 0.07 to 2% of the general population.
No one knows exactly what causes Borderline Personality Disorder, but the familiar nature-nurture combination of genetic and environmental misfortune is the likely culprit. Linehan has found that some borderline individuals come from homes where they were abused, some from stifling families in which children were told to go to their room if they had to cry, and some from normal families that buckled under the stress of an economic or healthcare crisis and failed to provide kids with adequate validation and emotional coaching. "The child does not learn how to understand, label, regulate or tolerate emotional responses, and instead learns to oscillate between emotional inhibition and extreme emotional lability," Linehan and her colleagues write in a paper to be published in a leading journal, Psychological Bulletin.
Biologically, individuals with BPD are more likely to have abnormalities in the size of the hippocampus, in the size and functioning of the amygdala, and in the functioning of the frontal lobes, which are the areas of the brain that are understood to regulate emotions and integrate thoughts with emotions. Although some research asserts that people with Borderline Personality Disorder seem to have areas of the brain that are more and less active compared to individuals who do not have the disorder, other research contradicts that. Therefore, specific patterns of brain functioning, as they are currently studied and understood, seem unreliable predictors of BPD.
It is a common disorder with estimates running as high as 10-14% of the general population. The frequency in women is two to three times greater than men.
While men with BPD are more likely to also have a substance-use disorder. BPD is more likely to be associated with eating disorders symptoms in women. In adolescents, Borderline Personality Disorder tends to co-occur with more anxious and odd personality disorders like schizotypal and passive aggressive personality disorder, respectively. Adults who have antisocial personality disorder, formerly also called sociopaths, may be more likely to also have BPD. Interestingly, even people who have some symptoms (traits) of BPD but do not meet full diagnostic criteria for the disorder can experience both traits of BPD and narcissistic personality disorder.
Although there has been some controversy as to whether or not Borderline Personality Disorder is truly its own disorder or a variation of bipolar disorder, research supports the theory that BPD, like virtually every medical or other mental-health disorder can appear (present) in nearly as many unique and complex ways as there are people who have it. In other words, some individuals with BPD will have that disorder alone, while others will have it in combination with bipolar or another mental disorder. Still others will appear to have BPD but really qualify for the diagnosis of bipolar disorder and vice versa.
Everyone has problems with emotions or behaviors sometimes. But if you have BPD, the problems are severe, repeat over a long time, and disrupt your life. The most common symptoms include:
Harmful, impulsive behaviors. These may include things like substance abuse, binge eating, out-of-control spending, risky sexual behavior, and reckless driving.
Relationship problems. You may see others as either "good" or "bad" and may shift from one view to the other suddenly, for minor reasons. This can make relationships very difficult.
A frantic fear of being left alone (abandoned). This fear may lead to frantic attempts to hold on to those around you. Or it may cause you to reject others before they can reject you.
Intense emotions and mood swings.
Other symptoms may include:
Problems with anger, such as violent temper tantrums.
Hurting yourself, such as cutting or burning yourself.
Suicide attempts and suicidal thoughts.
Times when you feel paranoid or lose a sense of reality (psychosis).
Feeling empty inside.
There is no specific definitive test, like a blood test, that can accurately assess that a person has BPD. People who are concerned that they may suffer from BPD might explore the possibility by taking a self-test, either an online or printable test. To determine the presence of this disorder, practitioners conduct a mental-health interview that looks for the presence of the symptoms, also called diagnostic criteria, previously described. As with any mental-health assessment, the practitioner will usually work toward ruling out other mental disorders, including mood problems like depression, anxiety disorders including anxiety attacks or generalized anxiety, types of other personality disorders like narcissistic personality disorder, dependent personality disorder or histrionic personality disorder, substance-abuse problems as well as problems being in touch with reality, like schizophrenia or delusional disorder. The professional will also likely try to ensure that the individual is not suffering from a medical problem that may cause emotional symptoms. The mental-health practitioner will therefore often inquire about when the person has most recently had a physical examination, comprehensive blood testing, and any other tests that a medical professional deems necessary to ensure that the individual is not suffering from a medical condition instead of or in addition to emotional symptoms. Due to the use of a mental-health interview in making the diagnosis and the fact that this disorder can be quite resistant to treatment, it is of great importance that the practitioner knows to conduct a thorough assessment. This is to assure that the person is not incorrectly assessed as having Borderline Personality Disorder when he or she does not.
Borderline personality disorder can be hard to treat. It is common for symptoms to return. And many people with the disorder have troubled relationships with their counselors and doctors. But you can take steps to help control the disorder. Long-term treatment can reduce symptoms and harmful behaviors and help you better manage your emotions. Treatment may include:
Pharmacological Options May Include: The use of psychiatric treatment medications, like antidepressants (for example, fluoxetine [Prozac], sertraline [Zoloft], citalopram [Celexa], escitalopram [Lexapro], venlafaxine [Effexor], duloxetine [Cymbalta], or trazodone [Desyrel]), mood stabilizers (for example, divalproex sodium [Depakote], carbamazepine [Tegretol], or lamotrigine [Lamictal]), or antipsychotics (for example, olanzapine [Zyprexa], risperidone [Risperdal], aripiprazole [Abilify], paliperidone [Invega] or asenapine [Saphris]) may be useful in addressing some of the symptoms of Borderline Personality Disorder but do not manage the illness in its entirety. On the positive side, some women who suffer from both BPD and bipolar disorder may experience a decrease in how irritable and angry they feel, as well as a decrease in how often and severely they become aggressive when treated with a mood stabilizer like Depakote. On the other hand, the use of medications in the treatment of symptoms in individuals with BPD may sometimes cause more harm than good. For example, while people with Borderline Personality Disorder may experience suicidal behaviors no more often than other individuals with a severe mental illness, they often receive more medications and therefore suffer from more side effects. Also, given how frequently many sufferers of BPD experience suicidal feelings, great care is taken to avoid the medications that can be dangerous in overdose.
Counseling and therapy: It is important to find a counselor you can build a stable relationship with. This can be hard, because your condition may cause you to see your counselor as caring one minute and cruel the next, especially when he or she asks you to try to change a behavior. Try to find a counselor who has special training in treating this disorder.
Healthy Habits: such as getting enough sleep, eating healthy foods, getting regular exercise, and avoiding alcohol and drugs. These habits can help reduce stress and anxiety.
NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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