Borderline Personality Disorder is a severe mental disorder comprising of patterns of behavioral, moods, functioning and self-image instability. Though the feelings justified to the person affected, such experiences always result in unstable relationships and impulsive actions. An individual with BPD tend to experience strong episodes of depression, anger, and anxiety that last only for a few hours or even days. On the other hand, there are those people who have higher BPD co-occurring rate, which involves mental disorders like mood disorders, anxiety disorders and eating disorders (Holm & Severinsson, 2008). Also, are self-harm, suicidal thinking and suicide. Moreover, according to a 2007 survey funded by National Institute of Mental Health (NIMH), searchers reported that about 9% of adults in the United States have Borderline personality disorder. Unfortunately, most of these population were also found to be experiencing co-occurring severe mental disorders. Besides, BPD is difficult to treat. However, with intervention known as dialectical behavior therapy (DBT), BPD patients can get help. Patients are equipped with coping like mindfulness, mastering negative emotions and tolerating distress. Hence, this paper explores BPD, its diagnosis, symptoms and treatment.
Borderline Personality Disorder Statistics on Prevalence
The term borderline is in reference to the boundary between neurosis and psychosis. Recent research in the United States shows that about 1.6% of the countrys total population have Borderline Personality Disorder. The percentage translates to about four million people. Moreover, a 2007 study by National Institute of Mental Health (NIMH) reported that 9% of the American population with BPD are men. Hence, more than 75% of individuals diagnosed with BPD are always women. However, it is unclear to researchers why more women have BPD than men. A section of researchers thinks that women could be more prone to BPD while others think that it is because more women do pursue treatment than men. Hence, exposing themselves to BPD diagnosis than their male counterparts. Other reasons are that women are being subjected to gender bias during diagnosis. That is men with BPD are most likely to be misdiagnosed with a different condition such as serious depressive disorder or Post-traumatic stress disorder. Therefore, about four million of the U.S. population has Borderline Personality disorder. Moreover, more women are affected than men (Rizvi & Salters-Pedneault, 2013).
According to recent data by Abuse and Mental Health Services Administration (SAMHSA), an estimated 19 million Americans are likely to develop BPD in their lifetime. Such population will be directly acquired BPD or be diagnosed with the disorder as a result of their association or living together with individuals diagnosed with BPD.
Causes of BPD
The causes of BPD has remained unclear. Some researchers report that BPD could be as a result of chemical imbalance in the human brain compounded with other biological factors such as heredity. Childhood trauma like neglect and abuse, sustained environmental influence, family dynamics and interactions have also been identified as possible causes for BPD.
BPD As a Result of Family Dynamics
Studies show that among the traits that underlie BPD, some of them are highly heritable. Hence, having a family member who is suffering from the disorder is a risk factor for people around him or her to develop the illness. Besides, 40% to 70% of patients with BPD do report childhood sexual abuse. Although traumatic experience such as sexual abuse is a strong risk factor for perpetuating the later development of BPD, at least 10% of individuals with such history are diagnosed with the disorder. Therefore, childhood abuse cannot be considered as a determining factor for the disorder (Rizvi & Salters-Pedneault, 2013).
Genetic studies state that some parts of the brain functioning as emotion and impulse regulators are often different in both volume and level of activity in various individuals. However, it is not clear whether the brains anatomical differences causes either BPD or borderline symptoms. It is also not clear if external factors do cause changes in the brains of those with BPD over a given period. Besides, important brain variations exist between men and women. Hence, it can explain why more women develop BPD than men.
Leading researchers have concluded that BPD can develop from the interaction between environmental and genetic factors. Bradley states that whatever may begin as a biological vulnerability is likely to be traced back to some environmental events. Hence, it is such multiple contributing environmental factors that complicate both diagnosis and treatment of Borderline Personality Disorder. Besides, additional factors like trauma can contribute the development of various mental disorders other than BPD. Therefore, there is no accurate correlation between individual or environmental elements and the diagnosed BPD (Leichsenring, Leibing, Kruse, New & Leweke, 2011).
Though BPD is not well known to the public like other disorders, is still considered as more common on like schizophrenia. Also, even though the exact cause of BPD is not known, researchers believe that such mental disorder is as a result of a combination of factors like difficult childhood experiences, genetic factors and environmental factors (Trull, Jahng, Tomko, Wood & Sher, 2010).
Symptoms of Borderline Personality Disorder
Symptoms of Borderline Personality Disorder vary from one individual to another. The common symptoms of BPD are as follows:
Having distorted, unstable or dysfunctional sense of self.
Feelings of boredom, isolation and emptiness
Not feeling attached to other people
A trail of unstable relationships that changes drastically from an intense feeling of love, idolization then to extreme hate.
Extreme emotional reactions to both real and perceived abandonment (Holm & Severinsson, 2008).
Unstable moods that last for a few hours or several days
Strong feelings of depression, anxiety and worry
Impulsive, self-destructive and risky behaviors such as reckless driving, having unsafe sex, drug and alcohol abuse.
Unstable goals, career plans and aspirations.
It should be noted that many people do experience one or more of these symptoms occasionally. However, an individual suffering from borderline personality disorder tends to experience many of these symptoms consistently throughout adulthood. Ironically, those suffering from BPD do crave for closeness. However, due to their intense and repulsive emotional response, they tend to alienate others into their lives thus causing a long-term feeling of isolation. Besides, ordinary events may also trigger symptoms (Holm & Severinsson, 2008). For instance, people with BPD can feel angry and even distressed over minor separations like business trips, vacations or sudden change of plans involving those they are close to. Studies also indicate that people with this kind of mental disorder can also have a stronger reaction to words that have negative meaning than those who do not have BPD (Skodol, Clark, Bender, Krueger, Morey, Verheul & Oldham, 2011).
BPD Suicidality Statistics
The literature of on BPD and suicidality indicate that approximately 70% of individuals with BPD are likely to make at least a single suicide attempt in their lives. In additions, eight to ten percent of people with borderline personality disorder will likely complete the suicide. Hence, suicide is a prominent element of BPD disorder.
Tests and Diagnosis
BPD is diagnosed by a licensed mental health professional like a psychologist, psychiatrist or clinical worker based on the interview and inclusive medical examinations. The mental health professional may ask about BPD symptoms, personal and family medical history involving mental illness. The information obtained will assist the mental health professional in making an informed decision regarding the best treatment. It is because in most cases, co-occurring mental illness has symptoms that overlap with that of BPD. Hence, making it hard to distinguish BPD from the other mental disorders. For instance, a patient may mention a feeling of depression without bringing to the attention of the mental health professional about other symptoms. Unfortunately, BPD is often misdiagnosed or underdiagnosed (Paris, 2013).
Moreover, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) found out that comorbidities and symptoms vary by gender. Johnson found out that women patients are likely to have cormobid PTSD while male patients likely have drug abuse disorders. The NESARC results also indicated that female patients have greater mood, panic and depressive disorders. Comorbid anxiety was also higher in female patients as compared to male patients (Trull, Jahng, Tomko, Wood & Sher, 2010).
Though research regarding the effective treatment of BP D is ongoing, the following are the available treatments:
Psychotherapy is the main treatment given to BPD patients. It can be provided directly to a patient by a therapist or in a group setting. Group session therapy teaches BPD patients how to interact and express themselves in the presence of others. The psychotherapy helps the patients to identify and change behaviors or beliefs that underlie inaccurate perceptions about themselves and people around them. It also helps the patients to be mindful thus able to control intense emotions and tolerate stress. Moreover, it helps in correcting dysfunctional self-image caused by childhood experiences. Finally, the therapy also educated family members on how to interact consistently with loved ones who have BPD.
Medications are not the primary treatment of BPD. Occasionally, medication may be recommended to treat depression, mood swings and other disorder that may be caused by BPD. However, treatment with medication requires a decision made from just one medical professional. It is because of the high suicide risk of BPD patients who may abuse lethal drugs for suicide purposes (Skodol, Clark, Bender, Krueger, Morey, Verheul & Oldham, 2011).
Those BPD patients with severe symptoms require intensive inpatient and outpatient care. Though hardly does one with BPD disorder get well without any treatment administered to him or her, it is imperative that such patients seek medical attention.
In conclusion, Borderline Personality Disorder is caused by a combination of environmental, genetically and individual factors. Statistically, about four million adults in the United States have BPD. Besides, 18 million people are most likely to experience BPD in their lifetime. Also, more women are affected than men, though; there is no exact reason from researchers. Moreover, suicide is prominent in BPD cases. Common symptoms of BPD are hostility, isolation and suicidal attempts. Diagnosis for BPD must be done by a licensed mental health professional. Besides, psychotherapy is the most effective treatment for BPD disorder. Finally, because BPD patients are prone to committing or attempting suicide, medication should be given cautiously.
Holm, A. L. & Severinsson, E. (2008). The emotional pain and distress of borderline personality disorder: A review of the literature. International Journal of Mental Health Nursing, 17, 27-35.
Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74-84.
Trull, T. J., Jahng, S., Tomko, R. L., Wood, P. K., & Sher, K. J. (2010). Revi...
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