Borderline Personality
Disorder
Borderline Personality Disorder (BPD) is characterized by
impulsivity and by instability in mood, self-image, and personal
relationships. It is fairly common and
is diagnosed more often in females than males.
What are symptoms of BPD?
Individuals with BPD have several of the following symptoms:
t Marked mood swings with periods of intense depression,
irritability and/or anxiety lasting a few hours to a few days.
t Inappropriate, intense, or uncontrolled
anger.
t Impulsiveness in spending, sex, substance
use, shoplifting, reckless driving, or binge eating.
t Recurring suicidal threats or
self-injurious behavior.
t Unstable, intense personal relationships with extreme black
and white
views of people and experiences, sometimes alternating between
"all good" idealization and "all bad" devaluation.
t Marked persistent uncertainty about
self-image, long term goals, friendships, values.
t Chronic boredom
or feelings of emptiness.
t Frantic efforts to avoid abandonment,
either real or imagined.
What causes BPD?
The causes of BPD are unclear, although psychological and
biological factors may be involved.
Originally thought to "border on" schizophrenia, BPD now appears to be more related to serious depressive illness. In some cases, neurological or attention
deficit disorders play a role. Biological problems may cause mood
instability and lack of impulse control, which in turn may contribute to
troubled relationships. Difficulties in
psychological development during childhood, perhaps associated with neglect,
abuse, or
inconsistent parenting, may create identity and personality
problems. More research is needed to
clarify the psychological and/or biological factors.
How is BPD treated?
A combination of psychotherapy and medication appears to
provide the best results for treatment of BPD.
Medications can be useful in reducing anxiety, depression, and
disruptive impulses. Relief of such
symptoms may help the individual deal with harmful patterns of thinking and
interacting that disrupt daily activities.
However, medications do not correct ingrained character
difficulties. Long-term outpatient
psychotherapy and group therapy (if the individual is carefully matched to the
group) can be helpful. Short-term hospitalization
may be necessary during times of extreme stress, impulsive behavior, or
substance abuse.
While some individuals respond dramatically, more often
treatment is difficult and long term.
Symptoms of the disorder are not easily changed and often interfere with
therapy. Periods of improvement may
alternate with periods of worsening.
Fortunately, over time most individuals achieve a significant reduction
in symptoms and improved functioning.
Can other disorders be present at the same time?
Yes. Determining
whether other psychiatric disorders may be involved is critical. BPD may be accompanied by serious depressive
illness (including bipolar disorder), eating disorders, and alcohol or drug
abuse. About 50% of people with BPD
experience episodes of serious depression.
At these times, the "usual" depression becomes more intense
and steady, and sleep and appetite
disturbances may occur or worsen. These symptoms, and the other disorders
mentioned above, may require specific treatment. A neurological evaluation may be necessary
for some individuals.
What medications are prescribed for BPD?
Antidepressants, anticonvulsants, and short-term use of neuroleptics are common for BPD. Decisions about medication use should be made
cooperatively between the individual and the therapist. Issues to be considered include the person's
willingness to take the medication as prescribed and the possible benefits,
risks, and side effects of the medication, particularly the risk of overdose.
ALLIANCE FOR THE MENTALLY ILL
NAMI OF GREATER CHICAGO
1536 West Chicago Avenue
Chicago, Illinois
60622
312-563-0445
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