The Surface Of Borderline Personality Disorder
Borderline Personality Disorder (BPD) is still a relatively newly accepted disorder and still not entirely accepted diagnosis in the psychology community. It was first introduced by Adolph Stern and further developed from there. BPD is often characterized as overlapping with other psychiatric disorders. There are is a combination of tools utilized in order to treat BPD. BPD is a complex personality disorder that is often misdiagnosed and even used as a blanket diagnosis in the psychiatric community to simply give a diagnosis to a patient.
BPD was first developed in 1983 by Adolph Stern to describe a group of patients but was not yet a diagnosis. It was then considered a mild form of schizophrenia or bordering on schizophrenia. The reasoning behind not properly categorizing BPD as a disorder was because it was usually, as often as 85%, cooccurring with another disorder. It wasn’t until 1980 that BPD was included in DSM II, the Diagnostic Statistic Manual used for the diagnosis of mental disorders. Now in the DSM V there is 9 criteria for BPD, 5 of which must be met to be diagnosed.
1.Frantic efforts to avoid real or imagined abandonment. 2.Unstable and intense personal relationships involving idealization and devaluation. 3.Unstable self-image. 4.Impulsive and self-destructive behavior with respect to at least two of the following: spending, sex, drugs and alcohol, binge eating. 5.Suicidal behavior and threats; self-mutilation. 6.Emotional overreaction causing unstable moods; for example, intense irritability or anxiety lasting hours to days. 7.Feelings of emptiness. 8.Inappropriate intense anger or difficulty controlling anger. 9.Under stress, paranoid thoughts or severe dissociative symptoms (feelings of unreality or split consciousness).
As previously mentioned there is often an accompanying disorder along with BPD. Among the most common are Post Traumatic Stress Disorder, most usually from childhood trauma, Depressive Disorder, and Narcissistic Personality Disorder. Further down the line is Bipolar Disorder and psychosis. In the simplest terms Borderline Personality Disorder is pseudo-neurotic Schizophrenia. It is caused by both nature and nurture. A patient could have lived an entirely normal life but due to a chemical imbalance develop BPD and vice versatile, however most often such is not the case. BPD is a diagnosis that gets tossed around for patients that don’t fit within the guidelines for another diagnosis and are often regarded as a hassle, however for therapists that take the diagnosis seriously it is a different story.
When asked about BPD, Dr. Robert Renkin says “BPD patients are among the most challenging to treat, they require the most time, which is why I only see one BPD patient at a time.” Upon further inquiry he explained that often BPD patients require a lot of attention and up to decades of treatment, usually improvement isn’t seen up until around two or more years of therapy, along with medication. There’s also a high risk for suicide. Including a thousand times the suicide of the general population. Due to the low serotonin levels, studies have proven, inT BPD patients, which is only further aggravated by other disorders or traumas, there is poor impulse control. The process for treating a BPD patient begins with a treatment plan which includes therapy, medications, and sometimes a holistic approach as well.
Therapy begins with creating realistic goals and integrating Systems Training for Emotional Predictability and Problem-Solving (STEPPS) and Dialectic Behavioral Thinking (DBT) therapy. According to Straus and Kreisman, “DBT blends a matter-of-fact and at times outrageous attitude, parasuicidal, and other dysfunctional behaviors with therapist warmth, flexibility, responsiveness, and strategic self discipline.” DBT and STEPPS are two of the best tools for the BPD patients coping toolbox when dealing with suicidal or other self injurious behavior. As for medications there are at least methodically prescribed types of drugs; anti-depressants, mood stabilizers, and anti-psychotics. These usually include medications such as; Effexor, Amitriptyline, Lithium, Lamotrigine, Risperidone, etc. Other treatments include assimilating exercise, such as yoga, and naturally derived serotonin boosters, which is one of the main causes for mood instability and poor impulse control in BPD patients. Long term studies show BPD patients “out-grow” in a sense some of the behaviors in their control over time usually in middle age time frame, however the most persistent symptom is suicidal ideations.
Because the emergencies that can arise due to BPD vary on different spectrums, from addiction to suicide, there is a website dedicated to hotlines for people suffering with BPD. https://www.bpdworld.org/helplines/usa-helplines.html
BPD World. (n.d.). USA Helplines. Retrieved May 18, 2018, from https://www.bpdworld.org/helplines/usa-helplines.html
Harvard Health Publishing. (2006, June). Borderline personality disorder: Origins and symptoms - Harvard Health. Retrieved May 18, 2018, from https://www.health.harvard.edu/newsletter_article/Borderline_personality_disorder_Origins_and_symptoms
Kreisman, J. J., & Straus, H. (2006). Sometimes I act crazy: Living with borderline personality disorder. Hoboken, NJ: John Wiley & Sons.
Olabi, B., & Hall, J. (2010, March). Borderline personality disorder: Current drug treatments and future prospects. Retrieved May 18, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513859/#!po=22.0000
OPI Team. (2017, July 24). The History of BPD - Optimum Performance Institute. Retrieved May 18, 2018, from https://www.optimumperformanceinstitute.com/bpd-treatment/the-history-of-bpd/
Renkin, R. (2018, May 18) Personal Interview
Taylor-Davis, E. (2016, February 25). Exercise isn't a cure-all for mental health problems. For me, it quickly led to self-destruction. Retrieved May 18, 2018, from https://www.independent.co.uk/voices/exercise-isnt-a-cure-all-for-mental-health-problems-for-me-it-led-to-self-destruction-a6895106.html