Borderline Personality Disorder

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Borderline Personality Disorder is the name of a Personality Disorder that is characterised by unstable relationships with others, unstable emotions, dangerous behaviour, self-harm and an intense fear of abandonment. The disorder is part of the ‘Dramatic, Emotional and Erratic’ cluster of personality disorders. People with Borderline Personality Disorder also often suffer from substance abuse or Depression, and there are some worrying suicide statistics when it comes to this disorder. This is the most well-known personality disorder. This article provides a general look at this disorder.

 

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Personality disorders can make life incredibly difficult to cope with

 

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A person with Borderline Personality Disorder will typically suffer from:

  • Emotional Instability – Characterised by rapidly changing emotions such as rage, shame, terror and loneliness. Mood swings are common. Sometimes, an individual will feel suicidal.
  • Disturbed Thoughts – Characterised by upsetting thoughts such as having a low self-esteem, feeling you don’t exist and confusion. Sometimes, there are elements of Psychosis, such as hallucinations or distressing beliefs.
  • Impulsive Behaviour – Many people with this disorder self-harm. This is normally conducted by cutting an arm with a razor blade. Self-harming can be impulsive. Moreover, people who suffer from this disorder also engage in reckless or risky activities – such as drug abuse, spending sprees or having unprotected sex with strangers.
  • Intense but unstable Relationships – People with Borderline personality disorder struggle to maintain friendships and relationships. They have an intense fear of abandonment, and often repeatedly text a loved one, or call friends and family during the middle of the night. Sometimes, the fear of abandonment can lead to the individual physically trying to stay near someone else. People with the disorder can also struggle to interpret others’ feelings – leading them to lash out verbally. Anger is a common mood when relationships struggle. Relationships are typically unstable, which often leads to break-ups.

 

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There is no set cause of Borderline Personality Disorder, though it appears several factors contribute to its onset. Genetics appear to play a big part, with some genes appearing to make an individual more vulnerable to developing the disorder. Levels of some brain chemicals also appear to differ from someone with this disorder and a non-sufferer. Some chemicals like serotonin appear to be diminished, which can cause the mood swings seen in the disorder. Moreover, brain scans have revealed that people with the disorder often have had brain development issues, which leads to a lack of emotion regulation and self-control. Brain development issues can be caused by some childhood events. This includes trauma, distress, neglect, physical or sexual abuse, and growing up being exposed to an individual who had a serious mental health condition or addiction. These brain abnormalities appear to be key. Unfortunately, a difficult childhood raises the risk of developing this disorder tremendously. Any of these factors listed can contribute to the disorder developing, or many together can.

 

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If you suspect you have a personality disorder, it is generally advisable to see your GP. It is likely that they will refer you to a specialist. This specialist will perform a diagnosis – which will involve asking you several questions about your condition and the impact it has had on your life. Generally, the clinician will use guidelines from the American Psychiatric Association to confirm a diagnosis. There has been some controversy over its suitability for making a diagnosis. The guidelines state a diagnosis can be made if five of the following factors are present.

 

  1. The individual has an intense fear of being left alone – causing them to act in extreme ways e.g. constantly contacting someone
  2. Has a long-term pattern of unstable relationships with other people – sometimes thinking they are in love, before suddenly hating them.
  3. Struggles to make sense of their own self, while being unclear regarding their self-image.
  4. Engages in impulsive activities such as unsafe sex, drug abuse or a spending spree.
  5. Has made repeated suicide threats or attempts, or engaged in self-harming.
  6. Suffers from severe mood swings – e.g. switching from a depressive phase to a feeling of mania.
  7. Had long-term feelings of emptiness and loneliness.
  8. Has sudden and intense feelings of anger, making it sometimes difficult to contain this anger.
  9. Suffers from feelings of paranoia or being disconnected from the world when in stressful situations.

 

Source: American Psychiatric Association 2013, pp. 663–8

 

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Individuals diagnosed with Borderline Personality Disorder are normally treated with Psychotherapy. The therapy will be used with the intention of providing day-to-day support and treatment. Owing to its seriousness, patients with this disorder will commonly create a care plan with a trained clinician, before a keyworker if appointed to assist when required. A form of psychotherapy can enable a change in attitude and behaviour, as well as allowing an individual to gain more control over their thoughts and feelings. With the right clinician-patient trust, and a concerted effort from both parties, an improvement can take place. Borderline personality disorder is difficult to overcome, but it is possible. Patients who suffer from Anxiety or Depression as a result of the disorder can be given medication – normally an antidepressant, though occasionally a mood stabiliser.

 

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Other Personality Disorders:

 

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