Borderline Personality Disorder
Borderline personality disorder (BPD) is a chronic condition that may include mood instability, difficulty with interpersonal relationships, and high rates of self-injury and suicidal behavior. This instability often disrupts family and work life, long-term planning, and an individual's sense of identity. People with BPD, originally thought to be at the "border" of psychosis and neurosis, suffer from difficulties with emotion regulation. While less well known than schizophrenia or bipolar disorder, BPD affects 2% of adults. People with BPD exhibit high rates of self-injurious behavior, such as cutting and elevated rates of attempted and completed suicide. Impairment from BPD and suicide risk are greatest in the young-adult years and tend to decrease with age. BPD is more common in women than in men, with 75% of cases diagnosed among women.
What are the symptoms of BPD?
Borderline personality disorder affects how you feel about yourself, how you relate to others and how you behave. Signs and symptoms may include:
- An intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection.
- A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel.
- Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all.
- Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours.
- Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship.
- Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection
- Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety.
- Ongoing feelings of emptiness.
- Inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights.
When to see a doctor?
If you're aware that you have any of the signs or symptoms above, talk to your doctor or a mental health provider. If you have suicidal thoughts, fantasies or mental images about hurting yourself then get help right away.
Is there treatment for BPD?
The recommended treatment for BPD includes psychotherapy, medication, and group, peer, and family support. Group and individual psychotherapy have been shown to be effective forms of treatment for many patients. Psychotherapy is the first-line treatment for BPD, and several forms of therapy, such as dialectical behavioral therapy (DBT), mentalization-based therapy (MBT), cognitive behavioral therapy (CBT), and psychodynamic psychotherapy, have been studied and proven to be effective ways to alleviate symptoms.
Can medication help people with borderline personality?
Pharmacological treatments are often prescribed based on specific target symptoms shown by the individual patient. Antidepressant drugs and mood stabilizers may be helpful for depressed and or labile mood (exaggerated changes in mood). Antipsychotic drugs may also be used when there are distortions in thinking.
References
Borderline Personality Disorder | Psychology Today
Borderline personality disorder - Symptoms and causes - Mayo Clinic