Borderline Personality Disorder & Other Personality Disorders
What is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a condition characterized by difficulties regulating emotion. This means that people who experience BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event.
This difficulty can lead to impulsivity, poor self-image, stormy relationships and intense emotional responses to stressors. Struggling with self-regulation can also result in dangerous behaviors such as self-harm (e.g. cutting).
It’s estimated that 1.4% of the adult U.S. population experiences BPD. Nearly 75% of people diagnosed with BPD are women. Recent research suggests that men may be equally affected by BPD, but are commonly misdiagnosed with PTSD or depression.
People with BPD experience wide mood swings and can feel a great sense of instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms may include:
- Frantic efforts to avoid real or imagined abandonment by friends and family.
- Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as "splitting."
- Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships.
- Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, substance abuse or reckless driving.
- Self-harming behavior including suicidal threats or attempts.
- Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
- Chronic feelings of boredom or emptiness.
- Inappropriate, intense or uncontrollable anger—often followed by shame and guilt.
- Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.
The causes of BPD are not fully understood, but scientists agree that it is the result of a combination of factors, including:
- Genetics. While no specific gene or gene profile has been shown to directly cause BPD, research suggests that people who have a close family member with BPD may be at a higher risk of developing the disorder.
- Environmental factors. People who experience traumatic life events—such as physical or sexual abuse during childhood or neglect and separation from parents—are at increased risk of developing BPD.
- Brain function. The emotional regulation system may be different in people with BPD, suggesting that there is a neurological basis for some of the symptoms. Specifically, the portions of the brain that control emotions and decision-making/judgment may not communicate optimally with one another.
There is no definitive medical test to diagnose BPD, and a diagnosis is not based on one specific sign or symptom. BPD is best diagnosed by a mental health professional following a comprehensive clinical interview that may include talking with previous clinicians, reviewing previous medical evaluations and, when appropriate, interviews with friends and family.
An effective Texas Care treatment plan will include your preferences while also addressing any other co-existing conditions you may have. Examples of treatment options include psychotherapy; medications; and group, peer and family support. The overarching goal of treatment is for a person with BPD to increasingly self-direct their own treatment plan as they learn what works and what doesn’t.
- Psychotherapy—such as dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT) and psychodynamic psychotherapy—is the first line of choice for BPD. Learning ways to cope with emotional dysregulation in a therapeutic setting is often the key to long-term improvement for those experiencing BPD.
- Medications may be instrumental to a treatment plan, but there is no one medication specifically made to treat the core symptoms of BPD. Rather, several medications can be used off-label to treat various symptoms. For example, mood stabilizers and antidepressants help with mood swings and dysphoria. And for some, low-dose antipsychotic medication may help control symptoms such as disorganized thinking.
- Short-term hospitalization may be necessary during times of extreme stress, and/or impulsive or suicidal behavior to ensure safety.
What Is a Personality Disorder?
What is a personality disorder and how would you know if you or someone you loved suffered from the condition? The term, personality disorder, actually refers to an entire group of mental illnesses that involve unhealthy and inflexible long-term patterns of thoughts and behaviors. The DSM-V personality disorders section (APA, 2013) lists 10 specific types in which we can get into later.
An individual’s personality is what defines how they perceive the world around them. It is a set of characteristics and features that cause them to think, feel, and act in a particular way.Genetic make-up, biological, and environmental factors all help to shape an individual’s personality.
When an individual has a personality disorder, it becomes harder for them to respond to the changes and demands of life and to form and maintain relationships with others.
The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual fifth edition (DSM-5) lists a number of personality disorders as diagnosable conditions for which people can seek treatment.
The DSM-5 groups personality disorders into three broad clusters that it refers to as A, B, and C.
Cluster A personality disorders
These disorders involve behavior that seems unusual and eccentric to others, according to Mental Health America (MHA).
- paranoid personality disorder
- schizoid personality disorder
- schizotypal personality disorder
Cluster B personality disorders
These disorders feature behavior that is emotional, dramatic, or erratic.
- antisocial personality disorder
- borderline personality disorder
- histrionic personality disorder
- narcissistic personality disorder
Cluster C personality disorders
Anxiety and fear underlie the behaviors that occur with Cluster C disorders.
Examples of these include:
- avoidant personality disorder
- dependent personality disorder
- obsessive-compulsive personality disorders
To receive a diagnosis of a personality disorder, an individual must meet certain criteria.
MHA describe a personality disorder as “A deeply ingrained, inflexible pattern of relating, perceiving, and thinking serious enough to cause distress or impaired functioning.”
These disorders probably result from a combination of genetic and environmental factors.
If you or someone you love are struggling with Borderline Personality Disorder (BPD)or any other mental health issue, LET US HELP. Give us a call at 1-888-98-TODAY. Feel free to fill out the new contact form listed under the Contact Us tab at the top of the Texas Care website for more information on how we can better serve you. It’s quick and confidential.