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| Borderline Personality Disorde |
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Borderline Personality Disorder
Definition
Borderline personality disorder is often a devastating mental condition, both
for the people who have it and for those around them.
Perhaps shaped by harmful childhood experiences or brain dysfunctions,
people diagnosed with borderline personality disorder live in a world of inner
and outer turmoil. They have difficulty regulating their emotions and are often
in a state of upheaval. They have distorted images of themselves, often
feeling worthless and fundamentally bad or damaged.
And while they yearn for loving relationships, people with borderline
personality disorder typically find that their anger, impulsivity, stormy
attachments and frequent mood swings push others away.
Over the last 10 years, increasing awareness and research are helping
improve the treatment and understanding of borderline personality disorder.
At the same time, it remains a controversial condition, particularly since so
many more women than men are diagnosed with it, raising questions about
gender bias. Although definitive data are lacking, it's estimated that 1 percent
to 2 percent of American adults have borderline personality disorder (BPD). It
occurs in about one in every 33 women, compared with one in every 100 men,
and is usually diagnosed in early adulthood.
Contrary to lingering perceptions, emerging evidence indicates that people
with BPD often get better over time and that they can live happy, peaceful
lives.
Signs and symptoms
Borderline personality disorder affects how people feel about themselves, how
they relate to others and how they behave.
People with BPD often have an unstable sense of who they are. That is, their
self-image or sense of self often rapidly changes. They typically view
themselves as evil or bad, and sometimes they may feel as if they don't exist
at all. This unstable self-image can lead to frequent changes in jobs,
friendships, goals, values and gender identity.
Relationships are usually in turmoil. People with BPD often experience a
love-hate relationship with others. They may idealize someone one moment
and then abruptly and dramatically shift to fury and hate over perceived
slights or even misunderstandings. This is because people with the disorder
have difficulty accepting gray areas - things are either black or white. For
instance, in the eyes of a person with BPD, someone is either good or evil.
And that same person may be good one day and evil the next.
In addition, people with BPD often engage in impulsive and risky behavior.
This behavior often winds up hurting them, whether emotionally, financially or
physically. For instance, they may drive recklessly, engage in unsafe sex, take
illicit drugs or go on spending or gambling sprees. People with BPD also often
engage in suicidal behavior or deliberately injure themselves for emotional
relief.
Other signs and symptoms of borderline personality disorder may include:
Strong emotions that wax and wane frequently
Intense but short episodes of anxiety or depression
Inappropriate anger, sometimes escalating into physical confrontations
Difficulty controlling emotions or impulses
Fear of being alone
Causes
As with other mental disorders, the causes of borderline personality disorder
are complex. The name arose because of theories in the 1940s and 1950s
that the disorder was on the border between neurosis and psychosis. But that
view doesn't reflect current thinking. In fact, some advocacy groups have
pressed for changing the name, such as calling it emotional regulation
disorder.
Meanwhile, the cause of BPD remains under investigation, and there's no
known way to prevent it. Possible causes include:
Genetics. Some studies of twins and families suggest that personality
disorders may be inherited.
Environmental factors. Many people with borderline personality disorder have
a history of childhood abuse, neglect and separation from caregivers or loved
ones.
Brain abnormalities. Some research shows changes in certain areas of the
brain involved in emotion regulation, impulsivity and aggression. In addition,
certain brain chemicals that help regulate mood, such as serotonin, may not
function properly.
Most likely, a combination of these issues results in borderline personality
disorder.
Risk factors
Personality forms during childhood. It's shaped by both inherited tendencies
and environmental factors, or your experiences during childhood. Some
factors related to personality development can increase the risk of developing
borderline personality disorder. These include:
Hereditary predisposition. You may be at a higher risk if a close family member
- a mother, father or sibling - has the disorder.
Childhood abuse. Many people with the disorder report being sexually or
physically abused during childhood.
Neglect. Some people with the disorder describe severe deprivation, neglect
and abandonment during childhood.
When to seek medical advice
People with borderline personality disorder often feel misunderstood, alone,
empty and hopeless. They're typically full of self-hate and self-disgust. They
may be fully aware that their behavior is destructive and be distressed about
it. Impulsivity may cause problems with gambling, driving or even the law. You
may find that many areas of your life are affected, including relationships,
work or school.
If you notice these things about yourself, talk to your doctor or a mental health
provider. The right treatment can help you feel better about yourself and help
you live a more stable, rewarding life.
If you notice these things in a family member or friend, talk to them about
seeing a doctor or mental health provider. But keep in mind that you can't
force someone to seek help. If the relationship has you unduly distressed, you
may find it helpful to see a therapist yourself.
Screening and diagnosis
Personality disorders are diagnosed based on signs and symptoms and a
thorough psychological evaluation. To be diagnosed with borderline
personality disorder, someone must meet criteria spelled out in the Diagnostic
and Statistical Manual of Mental Disorders (DSM). This manual is published by
the American Psychiatric Association and is used by mental health
professionals to diagnose mental conditions and by insurance companies to
reimburse for treatment.
The DSM criteria note that people with BPD have a pattern of unstable
relationships, self-image and mood, as well as impulsive behavior. These
typically begin in early adulthood.
For BPD to be diagnosed, at least five of the following signs and symptoms
must be present:
Intense fears of abandonment
A pattern of unstable relationships
Unstable self-image
Impulsive and self-destructive behaviors
Suicidal behavior or self-injury
Wide mood swings
Chronic feelings of emptiness
Inappropriate anger
Periods of paranoia and loss of contact with reality
A diagnosis of BPD is usually made in adults, not children or adolescents.
That's because what appear to be signs and symptoms of BPD may go away
with maturity.
Definition
Borderline personality disorder is often a devastating mental condition, both
for the people who have it and for those around them.
Perhaps shaped by harmful childhood experiences or brain dysfunctions,
people diagnosed with borderline personality disorder live in a world of inner
and outer turmoil. They have difficulty regulating their emotions and are often
in a state of upheaval. They have distorted images of themselves, often
feeling worthless and fundamentally bad or damaged.
And while they yearn for loving relationships, people with borderline
personality disorder typically find that their anger, impulsivity, stormy
attachments and frequent mood swings push others away.
Over the last 10 years, increasing awareness and research are helping
improve the treatment and understanding of borderline personality disorder.
At the same time, it remains a controversial condition, particularly since so
many more women than men are diagnosed with it, raising questions about
gender bias. Although definitive data are lacking, it's estimated that 1 percent
to 2 percent of American adults have borderline personality disorder (BPD). It
occurs in about one in every 33 women, compared with one in every 100 men,
and is usually diagnosed in early adulthood.
Contrary to lingering perceptions, emerging evidence indicates that people
with BPD often get better over time and that they can live happy, peaceful
lives.
Signs and symptoms
Borderline personality disorder affects how people feel about themselves, how
they relate to others and how they behave.
People with BPD often have an unstable sense of who they are. That is, their
self-image or sense of self often rapidly changes. They typically view
themselves as evil or bad, and sometimes they may feel as if they don't exist
at all. This unstable self-image can lead to frequent changes in jobs,
friendships, goals, values and gender identity.
Relationships are usually in turmoil. People with BPD often experience a
love-hate relationship with others. They may idealize someone one moment
and then abruptly and dramatically shift to fury and hate over perceived
slights or even misunderstandings. This is because people with the disorder
have difficulty accepting gray areas - things are either black or white. For
instance, in the eyes of a person with BPD, someone is either good or evil.
And that same person may be good one day and evil the next.
In addition, people with BPD often engage in impulsive and risky behavior.
This behavior often winds up hurting them, whether emotionally, financially or
physically. For instance, they may drive recklessly, engage in unsafe sex, take
illicit drugs or go on spending or gambling sprees. People with BPD also often
engage in suicidal behavior or deliberately injure themselves for emotional
relief.
Other signs and symptoms of borderline personality disorder may include:
Strong emotions that wax and wane frequently
Intense but short episodes of anxiety or depression
Inappropriate anger, sometimes escalating into physical confrontations
Difficulty controlling emotions or impulses
Fear of being alone
Causes
As with other mental disorders, the causes of borderline personality disorder
are complex. The name arose because of theories in the 1940s and 1950s
that the disorder was on the border between neurosis and psychosis. But that
view doesn't reflect current thinking. In fact, some advocacy groups have
pressed for changing the name, such as calling it emotional regulation
disorder.
Meanwhile, the cause of BPD remains under investigation, and there's no
known way to prevent it. Possible causes include:
Genetics. Some studies of twins and families suggest that personality
disorders may be inherited.
Environmental factors. Many people with borderline personality disorder have
a history of childhood abuse, neglect and separation from caregivers or loved
ones.
Brain abnormalities. Some research shows changes in certain areas of the
brain involved in emotion regulation, impulsivity and aggression. In addition,
certain brain chemicals that help regulate mood, such as serotonin, may not
function properly.
Most likely, a combination of these issues results in borderline personality
disorder.
Risk factors
Personality forms during childhood. It's shaped by both inherited tendencies
and environmental factors, or your experiences during childhood. Some
factors related to personality development can increase the risk of developing
borderline personality disorder. These include:
Hereditary predisposition. You may be at a higher risk if a close family member
- a mother, father or sibling - has the disorder.
Childhood abuse. Many people with the disorder report being sexually or
physically abused during childhood.
Neglect. Some people with the disorder describe severe deprivation, neglect
and abandonment during childhood.
When to seek medical advice
People with borderline personality disorder often feel misunderstood, alone,
empty and hopeless. They're typically full of self-hate and self-disgust. They
may be fully aware that their behavior is destructive and be distressed about
it. Impulsivity may cause problems with gambling, driving or even the law. You
may find that many areas of your life are affected, including relationships,
work or school.
If you notice these things about yourself, talk to your doctor or a mental health
provider. The right treatment can help you feel better about yourself and help
you live a more stable, rewarding life.
If you notice these things in a family member or friend, talk to them about
seeing a doctor or mental health provider. But keep in mind that you can't
force someone to seek help. If the relationship has you unduly distressed, you
may find it helpful to see a therapist yourself.
Screening and diagnosis
Personality disorders are diagnosed based on signs and symptoms and a
thorough psychological evaluation. To be diagnosed with borderline
personality disorder, someone must meet criteria spelled out in the Diagnostic
and Statistical Manual of Mental Disorders (DSM). This manual is published by
the American Psychiatric Association and is used by mental health
professionals to diagnose mental conditions and by insurance companies to
reimburse for treatment.
The DSM criteria note that people with BPD have a pattern of unstable
relationships, self-image and mood, as well as impulsive behavior. These
typically begin in early adulthood.
For BPD to be diagnosed, at least five of the following signs and symptoms
must be present:
Intense fears of abandonment
A pattern of unstable relationships
Unstable self-image
Impulsive and self-destructive behaviors
Suicidal behavior or self-injury
Wide mood swings
Chronic feelings of emptiness
Inappropriate anger
Periods of paranoia and loss of contact with reality
A diagnosis of BPD is usually made in adults, not children or adolescents.
That's because what appear to be signs and symptoms of BPD may go away
with maturity.
| THE MOST COMMON MENTAL AND EMOTIONAL DISORDERS |
| The information provided on these pages are intended as a educational public service. New studies often change our understanding of how to diagnose and treat these illnesses and direct contact with the appropriate, licensed mental health professional prior to treatment is always reccomended. |