Borderline personality disorder (BPD) is a type of mental disorder that is categorized in the group of personality disorders. Of the types of these disorders, the BPD is the most common and also the most complicated and worrying problems encountered in psychiatry. In the United States, more than 6% will experience the BPD at some point of their lives. This disorder typically involves severe mood instability and splitting (black and white thinking). BPD patients normally show turbulent negative emotions, such as personal feelings and feelings towards others. BPD may result in loss of identity, impulsive actions, disrupted work life, chaotic relationships, and even self-inflicted harm. Till now, the causes of the borderline personality disorder are yet to be known and are under research. However, it is thought that factors such as genetic, social and family relationship factors contribute to the making of this disorder. Some common risk factors include growing up in a broken family, poor communication within family, childhood abandonment and sexual or physical abuse. BPD patients go through tough times because of the tormenting symptoms they have to experience. Common symptoms include depression, intense bouts of anger, as well as anxiety that may last a few hours to a day.
One common behaviour in BPD patients is a symptom called splitting, also known as ‘black and white thinking’. This symptom means that their attitude towards others will shift from idealization (love and admiration) to devaluation (intense resentment and displeasure). They may adore and be close to one of their loved ones , and suddenly turn against them or feel resentful especially if triggered by any events or minor conflicts. This symptom usually results in unstable social and family relationships.
BPD also causes high mental and emotional sensitivity. Thus, BPD patients react strongly with anger and anguish towards rejection, separations, sudden change in plans and minor conflicts. They fear abandonment and despise as well. They may also develop ‘clinging’, a condition when the patients cannot bear a certain individual being away from themselves. Increased self-awareness and identity crisis may also lead to fear of crowd or frantic efforts to avoid being alone. This sensitivity and phobia makes suicide threats and attempts common among BPD patients.
The serious complications of BPD should not be neglected. Among BPD patients, completed suicide happens with 8 – 10% of the individuals. It is also normal for BPD patients to display impulsive and abusive behaviour such as spending excessively, alcoholism, binge eating, self-mutilation, excessive sex drive as well as unsafe sex. This disorder also causes serious implications to a patient’s life, as it may lead to negative issues such as loss of jobs, interrupted education, unwanted pregnancies as well as broken marriages.
For the treatment of this personality disorder, psychological treatment is prioritised, which is similar to any other anxiety disorder. A common treatment method is group or individual psychotherapy. However, in recent years a new promising psychosocial treatment method known as the dialectical behaviour therapy (DBT) was developed specifically for the treatment of BPD. DBT is a combination of cognitive therapy with behavioural therapy with the blending of Western psychology with Eastern Zen practice. In DBT, the therapists show acceptance, recognition, warmth and appropriate response to the patients’ abusive behaviour.
Pharmacological treatments are also used to assist in the treatment of BPD. Medication can be prescribed to target specific symptoms of the patient. To soothe depression or labile mood, antidepressant drugs and mood stabilizers may be prescribed. When symptoms like mind distortions appear, anti-psychotic drugs may be also be given.
Patients with BPD often require extensive mental health care and treatment, contributing to 20% of psychiatric-related hospitalization. Only with strong support and professional help will the patients improve and regain normal and productive lives. However, the outlook depends on the gravity of the patient’s condition and his or her willingness to undergo treatment. The chances for a better recovery depend highly on the patient’s cooperation. Treatment may take a long time, thus patience and determination is also crucial.