Borderline Personality Disorder


Borderline Personality Disorder

Overview:

Borderline Personality Disorder is a mental illness that leads to many negative outcomes in a person’s life. It is characterized by chronic and intense feelings of abandonment, anger, and depression. They experience dysphoria, which is when they feel extremely uncomfortable in their body and their environment. Borderline individuals usually have unstable relationships because they can’t maintain any commitment for more than a few days or weeks at a time. They generally have trouble with their self-esteem and view themselves negatively.

One of the most common issues that arise from this disorder is suicidal behavior. 80% of individuals with BPD have attempted suicide at some point in their lives (Linehan). Why would someone who feels so horrible about themselves try to kill themself? Individuals with borderline frequently engage in thought patterns called “all or nothing thinking” which can lead to thoughts of suicide when they make a mistake (Linehan). They might say to themselves: “if I do not succeed in this task, then what is the use of trying again;” or ” if this person does not want me, then there must be something wrong with me.” These negative thought processes result in suicidal thoughts because the individual thinks there is no hope for improvement.

BPD also has many negative physical effects on the brain. Brain scans of BPD patients have found that their brains look different than non-BPD brains (Mann, 2003). Inside the brain, three main structures regulate arousal and emotions: The amygdala, hippocampus, and prefrontal cortex. The amygdalae are involved in fear responses, emotional memory, and anxiety disorders. People with borderline personality disorder have an overactive amygdala which leads to extreme emotional reactions even when they are not warranted (Wisconsin Medical Society). This heightened sense of anxiety can cause them to see most situations as threatening which results in heightened levels of stress. the hippocampus also plays a role in their anxiety because the hippocampus helps them regulate their emotions. The prefrontal cortex is the last area of the brain which regulates arousal and emotion. The prefrontal lobe helps people predict outcomes in a situation and plan for future events. This is important in BPD because people with borderline personality disorder have a hard time planning things out in advance and thinking through their actions. A borderline personality disorder is a very serious mental illness that affects many areas of a person’s life, both mentally and physically.

Borderline Personality Disorder Facts:

A person sitting on a bed

About 1.6% of the general population has BPD (NIMH).

The average age of diagnosis is 30 years old (NIMH).

Men are less likely to be diagnosed with borderline personality disorder than women (Kessler). Boys who act out aggressively may receive an incorrect diagnosis of conduct disorder, while girls tend to be given diagnoses of attention deficit hyperactivity disorder or depression more often (University of Southern California).

Almost 75 percent of people diagnosed with borderline personality disorder were sexually abused as children, and about 60 percent experienced physical abuse (NAMI).

People who suffer from borderline personality disorder usually do not seek help because they feel like their symptoms are a part of their character, and they do not want to be seen as “crazy” (NAMI). This illness is often misdiagnosed because it can be very similar to bipolar disorder or depression.

Schizophrenia vs. Borderline Personality Disorder:

There are many similarities between schizophrenia and borderline personality disorder. Both conditions involve manic-depressive episodes, hallucinations, obsessive thoughts, drastic changes in moods, and erratic behavior. However, there are two main differences between these two mental illnesses. The first difference is that schizophrenia can be treated with medicine whereas borderline personality disorder cannot be medicated into remission (Wisconsin Medical Society). This is because the cause of schizophrenia is still not fully understood but it is believed to be due to abnormal brain chemistry which can be regulated with medication (Wisconsin Medical Society). Borderline personality disorder on the other hand is believed to be caused by an array of environmental factors. There are also many differences in how these two conditions interfere with a person’s daily life. People who suffer from schizophrenia have trouble with cognition, while people suffering from borderline personality disorder experience extreme distress. When compared to schizophrenia, borderline personality disorder leads to more intense emotions and impulsive behavior which make it harder for them to control their actions.

Other Disorders that may co-occur With BPD:

Many people diagnosed with BPD also struggle with mood disorders such as major depression or clinical depression. They may also have anxiety disorders such as obsessive-compulsive disorder, panic attacks, social phobia, or an eating disorder. People with borderline personality disorder often abuse alcohol or other drugs to cope with their overwhelming emotions and stress (NIMH).

People who have borderline personality disorder usually cannot trust others and fear abandonment. They tend to form intense but unstable relationships that usually end abruptly if the person does not meet all of the individual’s needs. This can make it very hard for them to make friends or sustain a romantic relationship because they will always be expecting the worst from people around them (NIMH). It is also extremely difficult for someone who has BPD to maintain employment because they will either become too frustrated at work, quit without giving enough notice, or become angry and hostile towards coworkers. These individuals often leave a job before receiving negative feedback which makes them come across as a flight risk.

Although research is still being done on this mental illness, it has been found that the demographics of BPD differ significantly depending on age and ethnicity. For example, African-American females are more likely to be diagnosed with BPD than white females (Kessler). This statistic may be because people who are not white males often feel out of place in American society which can cause stress that then manifests into symptoms of BPD (University of Southern California).

Symptoms of Borderline Personality Disorder:

People who suffer from BPD often engage in suicidal behavior and self-harm. Self-harm is when someone purposely damages their body such as cutting or burning themselves. Suicidal behavior includes suicide attempts, thinking about suicide constantly, and wanting to die all of the time (NIMH). Individuals with BPD also have a hard time controlling their emotions. They may experience extreme highs and lows which lead to feeling overwhelming happiness and sadness at the same time (University of New Hampshire: Mood Disorders). If they feel abandoned, people with a borderline personality disorder will cling to the person who left them and refuse to let them go even if it hurts both parties involved. These individuals can be very manipulative to get what they want out of their relationships (NIMH). They also have unstable views of themselves and the world around them. People with a borderline personality disorder often struggle with self-image and may view other people in extremes such as “all good” or “all bad”. These individuals also feel like they don’t belong anywhere even if they are surrounded by friends or family. Some studies suggest that there is a genetic component to BPD. A study by scientists at the University of Southern California found that people with BPD are twice as likely to have a parent or sibling who also struggles with BPD (University of Southern California).

Causes of Borderline Personality Disorder:

There is still a lot of research being done on BPD because there are many different explanations for why these personality traits develop. Some studies suggest that people who suffer from BPD have certain areas in their brains that may be underdeveloped. As mentioned above, there also seems to be a genetic component involved with the condition (University of Southern California). Some theories suggest individuals with BPD experience trauma at an early age which causes them to develop this mental illness. This would explain why so many individuals with BPD often experience childhood sexual abuse and neglect (NIMH).

Treatment of Borderline Personality Disorder:

Treatment for borderline personality disorder usually begins with psychotherapy. Cognitive-behavioral therapy has shown to be successful in helping people learn how to control their emotions by “recognizing when are feeling intense emotions and teaching skills for controlling these reactions” (Wisconsin Medical Society). The social worker who conducts this type of therapy will encourage the person to replace their self-defeating thoughts with more positive thoughts. Dialectical behavior therapy is also helpful in teaching people how to control their emotions by learning how to tolerate them without acting impulsively or doing something that could be dangerous or harmful (Wisconsin Medical Society).

Medication is not used in the treatment of BPD because it only relieves symptoms and does not cure the underlying mental illness. However, medications may treat other disorders that often co-occur with BPD such as depression, anxiety disorders, bipolar disorder, or an eating disorder (Mayo Clinic Staff). Sometimes medication can help in reducing irritability and aggression that impairs daily function.

Conclusion:

Borderline Personality Disorder is a mental illness characterized by intense feelings of abandonment, impulsivity, and unstable emotions. It can be difficult to diagnose because the symptoms vary depending on the individual. Treatment usually includes psychotherapy or dialectical behavior therapy which helps individuals learn how to control their emotions without acting impulsively or doing something dangerous. There are many different theories about what causes BPD but research suggests there may be an underlying brain disorder that requires further study. For now, treatment focuses on teaching people with a borderline personality disorder.

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