Borderline Personality Disorder (BPD)

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Wednesday, 22 November 2006

Borderline Personality Disorder (BPD) is a disorder in which a person may experience a pattern of unstable personal relationships, a poor self-image, and low impulse control in areas such as spending, sexual conduct, driving, eating, and substance abuse.

Additionally, the person suffering from BPD may experience feelings of chronic emptiness and fear of abandonment and feel driven to go to great lengths to prevent this abandonment and fill the emotional void.

Symptoms

The clinical presentation of Borderline Personality Disorder varies widely and can be very vague and difficult to diagnose. This is definitely a condition that needs expert assessment and it is extremely important to see a healthcare professional with experience in BPD to obtain an accurate diagnosis.

Symptoms may include:

a pattern of undermining oneself just as a goal is about to be achieved
psychotic-like features, especially in times of stress
a history of suicide attempts or self-harm
history of substance misuse

Causes

The cause of Borderline Personality Disorder is not known for certain although there are some suspected contributors to developing this condition.

Psychosocial studies reveal a high prevalence of childhood trauma (eg. physical and sexual abuse), early separation or loss, and abnormal parenting in patients with Borderline Personality Disorder.

Biological investigations suggest impairment of neuropsychological function and dysfunctions of specific neurotransmitters and electrophysiological mechanisms.

Treatments

The aims of treatment are to:

provide stability and support to prevent or reduce self-destructive behaviours
enhance functioning (in the short term)
improve the consistency of functioning and stress tolerance (in the long term)

A therapy called dialectic behaviour therapy has been developed specifically for treating Borderline Personality Disorder. Psycho-educational therapy which is designed to improve the patient's understanding of specific symptoms and to help the patient to develop less impulsive and emotionally over-reactive responses is also commonly used.

Other forms of therapy which have been found to be useful are:

Psychodynamic therapy (including transference-focused psychotherapy)
Cognitive Behavioural Therapy
Group therapy, which may be effective in a few patients.
Medications would rarely be prescribed for the treatment of Borderline Personality Disorder (although they may be prescribed for related conditions such as depression which is often present in people with BPD) as there is virtually no evidence (other than clinical anecdotes) to suggest their helpfulness

References:

National Institute of Mental Health (US). http://www.nimh.nih.gov/publicat/NIMHbpd.pdf

Mental Illness Fellowship of Australia Inc. http://www.schizophrenia.org.au/pdfs/U%20Borderline%20Personality%20Disorder.pdf

Last Updated ( Tuesday, 14 August 2007 )

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