A Glimpse Into Borderline Personality Disorder

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Abstract

Borderline Personality Disorder (BPD) is a type a personality disorder that is described as not being able to regulate one’s emotions. There are many reasons that this disorder can be diagnosed and treated. Professionals will often use psychotherapy treatments know as Dialectical and Cognitive Behavioral Therapy (DBT & CBT) to help a patient with BPD refocus their mind and help center any negative thoughts or behaviors. Some patients may require additional help in conjunction with the psychotherapy, which is where the use of medications can come into effect.

Borderline Personality Disorder

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There are many types of personality disorders that are diagnosed today. One of the more common, but also hard to define, is Borderline Personality Disorder (BPD) (Researchers Propose a Way to Study the Underlying Causes of Borderline Personality Disorder, 2019). BPD has a vast amount of key aspects. People with BPD will often find it hard to regulate their emotions. It will be difficult for them to return to a stable state of being triggered by whatever it is that has caused their distress. The emotions that they feel are more intense than people with out this disorder. Their emotional reactions will also last longer than usual. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017). Though many researchers do not always know the cause of this disorder, they do know that BPD can be followed by other conditions such as anxiety, depression, or even PTSD. (Researchers Propose a Way to Study the Underlying Causes of Borderline Personality Disorder, 2019)

As with any health conditions, there can be multiple sources or causes as to why the individual suffers. With BPD there are three main areas in which psychologist suggest it stems from. When we are conceived, we are given half of each parent’s DNA. So, it wouldn’t be a surprise that we could get BPD from one of parents who might also have it. Though there is not one specific gene that researchers can contribute to the disorder, it has been found that in some cases people who have a close or immediate relative with BPD, may have a higher risk of developing it themselves. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017). There are many cases where people have been through something in their lifetime, that has caused some sort of trauma. These events can stem from any physical or sexual abuse, and neglect or abandonment. Which is why many people with BPD will often be triggered by fears being abandoned. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017). These are just some of the environmental factors that can cause BPD. Our brain is a major key to how and why we respond to situations we experience. There are parts of our brains that are there to do specific functions. The temporal lobe is a part of the brain that houses the limbic system. The part of the limbic system that deal specifically with emotions, is the amygdala. In people with BPD this part of the brain may not function as it should. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017)

With this neurological difference, people do not have to have the other genetic or environmental factors to be diagnosed with BPD.

According to some recent studies, 1.4% of the adult population has been diagnosed with BPD. Of that 1.4%, 75% are women. It was also discovered that men are just as equally affected by this disorder but are often misdiagnosed with PTSD or depression. It was determined that BPD is not associated with one specific race or sex. It was found to be more associated with people who are facing certain experiences such as a significant other being absent, no job, or just a response in the brain to the suffering of other disorders. (ten Have et al., 2016). As one could guess there are people out there who have been diagnosed with BPD but will refuse treatment. This is suggested to be 42.4% of the adult population. (“NIMH » Personality Disorders,” 2017). With BPD, it does not always have to be present in the adult stage of life. There are kids that can be diagnosed with BPD, but doctors are not always ok with diagnosing a child under the age of 18. If diagnosed to early it runs the risk of misdiagnosing, from what could be caused from other disorders. Another reason it can be hard to diagnose an adolescent, is because many of the criteria that is present in BPD patients, can be present in the natural “coming of age” process. Many teens will have stages that they suffer through that resembles BPD, but they will often grow out of it by adulthood. (Miller, 2018).

When someone is undergoing a diagnosis for BPD, the psychologist or psychiatrist will look for certain criteria or symptoms the person may be experiencing. Though not everyone will experience the same or even all the symptoms, this will not stop the doctor from diagnosing them with the disorder. Some of the most common symptoms of this disorder are impulsivity, poor self-image, emotionally challenged relationships emotionally intense responses to stressors, and even poor self-regulation, which can lead to self- harm or other life-threatening behaviors. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017).

According to the DSM-5 there are many symptoms anyone with BPD can experience. Individuals with this disorder will go through drastic efforts to avoid or run from real or imagined abandonments. They experience “splitting” which is often described as an unstable person relationship. An example would be you saying you love someone but also hate them (idealization vs devaluation) Their distorted and poor self-image can affect their mood, values, opinions, goals and relationships. Patients can suffer from intense periods of depressed moods, irritability or anxiety, lasting anywhere from a few hours to a few days. They can suffer from chronic feelings of boredom and emptiness. Patients will have dissociative feelings where they will disconnect from their feelings and sense of identity. This is described as “out of body” type feelings and even stress related paranoid thoughts. Sever cases can lead to brief psychotic episodes. (American Psychiatric Association, 2013). As doctors are evaluating and treating these patients, they must keep in mind that not everyone will demonstrate the same symptoms. Although the symptoms that they do display can have a major role in how their treatment plans are carried out.

Treatment can be very simple or very lengthy for some patients depending on what their triggers are and how they respond to their triggers. There is not sure way of medically testing for BPD, nor is it diagnosed because of one specific sign or symptom. Therefore, it is usually diagnosed by a mental health professional such as a psychiatrist or a psychologist. According to the National Alliance of Mental Illness, mental health professionals will use several forms or=f treatments. Some often used in conjunction with each other. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017). For people that are in treatment, the main purpose of them being there is to help them find a way to make and control their own treatment plans. They need to be able to learn to regulate their emotions on their own all over again. Some doctors will use what is known as psychotherapy. This includes different forms of different forms of behavioral therapy such as Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Mentalization based Therapy (MBT). Each of these are used to help patients be able to recognize, differentiate, separate, and control their own emotional thoughts and feelings from the environment around them. Making it easier for them to approach society and even their own triggers. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017). In some cases, a specialist will use medication. Since there is no medication that can be used to target the mental illness itself, they will prescribe medication that helps maintain the patient’s symptoms, aiding in lessening their effects of BPD. In some of the more severe cases and patient will be hospitalized due some impulse behaviors or some type if self-harm they may have tried to carry out. (“Borderline personality disorder | NAMI: National Alliance on Mental Illness,” 2017).

From my own knowledge and experience with BPD, I know that there are many things in this world that will affect us. Some more than others but it will still affect us. When you have BPD, it often will not let you experience situations as you should and can be a very powerful force against you, when you are physically trying to feel those feelings. After being diagnosed and currently going through treatment, I know first hand how BPD can distort your thoughts and feelings in ways you just have no control over at that moment.

References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Ed). Washington Dc: American Psychiatric Association.
  2. Borderline personality disorder | NAMI: National Alliance on Mental Illness. (2017). Retrieved from Nami.org website: https://www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder
  3. Miller, C. (2018, January 8). What Is Borderline Personality Disorder? Retrieved November 24, 2019, from Child Mind Institute website: https://childmind.org/article/borderline-personality-disorder/
  4. NIMH » Personality Disorders. (2017, November). Retrieved from Nih.gov website: https://www.nimh.nih.gov/health/statistics/personality-disorders.shtml
  5. Researchers Propose a Way to Study the Underlying Causes of Borderline Personality Disorder. (2019, September 5). Researchers Propose a Way to Study the Underlying Causes of Borderline Personality Disorder. Retrieved November 24, 2019, from Brain & Behavior Research Foundation website: https://www.bbrfoundation.org/content/researchers-propose-way-study-underlying-causes-borderline-personality-disorder
  6. ten Have, M., Verheul, R., Kaasenbrood, A., van Dorsselaer, S., Tuithof, M., Kleinjan, M., & de Graaf, R. (2016). Prevalence rates of borderline personality disorder symptoms: a study based on the Netherlands Mental Health Survey and Incidence Study-2. BMC Psychiatry, 16(1). https://doi.org/10.1186/s12888-016-0939-x
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