Borderline Personality Disorder: Symptoms, Cause & Treatment

Personality is a pattern of thinking, feeling, and perceiving things that are unique to an individual. In personality disorders,  a person’s personality seems to deviate from the standard normal and starts to cause hindrances in day-to-day life functioning and take a toll on their personal and social relationships. Such abnormal spans of behavior and thinking patterns are quite prominent and easy to spot for the people who know or stay with or around the person regularly and be able to observe them closely. There are 10 such types of personality disorders in the DSM (Diagnostic and Statistical  Manual of Mental health Disorders ) published by the American Psychiatric Association. Borderline Personality Disorder is one of these 10 different kinds of personality disorders.

So what is Borderline Personality Disorder? Y is it important to know about it? And When is one subjected to a diagnosis?

Borderline Personality Disorder is characterized by high instability in regulating or balancing one's emotions. This is often displayed in the form of insecure behavior and a failed pattern of relationships.

Borderline Personality Disorder Symptoms

The DSM V suggests, that if someone has a long-term prevalence of at least 5 of the 9 traits mentioned, one can be diagnosed as having a Borderline Personality Disorder. These traits are as follows:-

1. A pattern of unstable and intense interpersonal relationships is characterized by extremes between idealization and devaluation (called 'splitting').
2. Frantic efforts to avoid real or imagined abandonment. (Do not include suicidal or self-mutilating behavior.)
3. Identity disturbance with markedly or persistently unstable self-image or sense of self.

4. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights) followed by shame and guilt.
5. Recurrent suicidal behavior, gestures, threats, self-harming behavior, or self-mutilating behavior.
6. Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating; Do not include suicidal or self-mutilating behavior.)
7. Chronic feelings of emptiness

8. Transient, stress-related paranoid ideation or severe dissociative symptoms.
9. Periods of intense depressed mood, irritability, or anxiety last a few hours to a few days.

This diagnosis can be made by a licensed professional only.

The Dilemma of BPD Diagnosis

Despite the possibility of diagnosing BPD through trait identification, the accuracy of BPD diagnosis remains low, and most of the time, people are misdiagnosed with some other psychological disorders. This happens because the symptoms of BPD overlap with the symptoms of other common disorders. For instance, mood fluctuation is a prominent feature of bipolar disorder.

Thus, the clinicians must be very cautious and take all these factors into account during the diagnosis.

What Causes Borderline Personality Disorder?

So far, there has been no concrete answer to this question, but studies have given various possible causes for it.

• Most studies claim that the causes of BPD are a combination of genetic and environmental factors.
• Childhood trauma such as sexual abuse at an early age, neglect of caregiver or guardian, trauma due to parental separation, loss of a close caregiver, or exposure to conflicting families can be a possible cause of BPD.
• Serotonin ( mood-regulating hormone ) abnormalities may also contribute to making one vulnerable to developing BPD.

This raises another important question, Is there any treatment for BPD?

Fortunately, the answer is positive and hopeful. The personality disorder can be treated and managed successfully by therapy with a licensed professional.

Treatment For Borderline Personality Disorder

There can be different approaches in therapy that can be applied to BPD patients, such as follow:-

Psychotherapy

It is used to locate and remedy the root cause of the problem; it can be done individually or in group therapy, depending upon the case.

Dialectical Behaviour Therapy (DBT)

This therapeutic method was devised particularly for Borderline Personality Disorder patients and incorporated concepts like mindfulness, acceptance, and situational and emotional awareness. It can help control self-destructive behaviors and improve personal relationships and social interactions.

Cognitive Behavioural Therapy (CBT)

It focuses on modifying the ‘core beliefs ‘ of individuals to positively and constructively affect their behavior. Consequently, it works on reducing anxiousness, mood fluctuation, and depressive and suicidal symptoms in Borderline Personality Disorder.

Medications

Medications are rarely used in Borderline Personality Disorder due to unproven benefits but may be taken up by the psychiatrist to control and dilute symptoms like mood swings, anxiety, or depression.

However, a critical fact with BPD patients is their trust issue with the therapist in the long term. This happens due to their constant fear of abandonment. Therefore, the therapist must take forward the therapy very sensitively and empathetically to keep the person feeling cared for in therapy.

With the help of therapeutic interventions, many people with BPD have been able to successfully evolve themselves and their relationships to become stronger, more stable, and durable to live a happy and fulfilled life :)