A pervasive pattern
of instability of interpersonal relationships, self-image, and affects,
and marked impulsivity beginning by early adulthood and present in
a variety of contexts, as indicated by five (or more) of the following:
Frantic efforts to
avoid real or imagined abandonment.
Apattern of unstable
and intense interpersonal relationships characterized by alternating
between extremes of idealization and devaluation
markedly and persistently unstable self-image or sense of self
Impulsivity in at
least two areas that are potentially self-damaging (e.g., spending,
abuse, reckless driving, binge eating).
Recurrent suicidal behavior, gestures, or threats, or self-mutilating
due to a marked reactivity of mood (e.g., intense episodic dysphoria,
irritability, or anxiety usually lasting a few hours and only rarely
more than a few days).
anger or difficulty controlling anger (e.g., frequent displays of
temper, constant anger, recurrent physical fights).
paranoid ideation or severe dissociative symptoms.
Dramatic or Erratic or Antisocial
have similar or even the same symptom. The clinician, therefore, in
his diagnostic attempt has to differentiate against the following
disorders which he needs to rule out to establish a precise diagnosis.
Personality Change Due to a General Medical Condition
Symptoms that may develop in association with chronic substance
The roots of Borderline
Personality Disorder (BPD) have long been in question. There is no
across-the-board agreement in the mental health profession when it
comes to this question.
and Psychotherapy [ See
Therapy Section ]:
Like with all
personality disorders, psychotherapy is the treatment of choice in
helping people overcome this problem. While medications can usually
help some symptoms of the disorder, they cannot help the patient learn
new coping skills, emotion regulation, or any of the other important
changes in a person's life.
The most successful
and effective psychotherapeutic approach to date has been Marsha Linehan's
Dialectical Behavior Therapy. Research conducted on this treatment
have shown it to be more effective than most other psychotherapeutic
and medical approaches to helping a person to better cope with this
disorder. It seeks to teach the client how to learn to better take
control of their lives, their emotions, and themselves through self-knowledge,
emotion regulation, and cognitive restructuring. It is a comprehensive
approach that is most often conducted within a group setting. Because
the skill set learned is new and complex, it is not an appropriate
therapy for those who may have difficulty learning new concepts.
Like all personality
disorders, borderline personality disorder is intrinsically difficult
to treat. Personality disorders, by definition, are long-standing
ways of coping with the world, social and personal relationships,
handling stress and emotions, etc. that often do not work, especially
when a person is under increased stress or performance demands in
their lives. Treatment, therefore, is also likely to be somewhat lengthy
in duration, typically lasting at least a year for most.
Psychopharmacology Section ] :
and anti-anxiety agents may be appropriate during particular times
in the patient's treatment, as appropriate. For example, if a client
presents with severe suicidal ideation and intent, the clinician may
want to seriously consider the prescription of an appropriate antidepressant
medication to help combat the ideation. Medication of this type should
be avoided for long-term use, though, since most anxiety and depression
is directly related to short-term, situational factors that will quickly
come and go in the individual's life.
[ See Self-Hep Section
for the treatment of this disorder are often overlooked by the medical
profession because very few professionals are involved in them. Encouraging
the individual with borderline personality disorder to gain additional
social support, however, is an important aspect of treatment. Many
support groups exist within communities throughout the world which
are devoted to helping individuals with this disorder share their
commons experiences and feelings.
Patients can be
encouraged to try out new coping skills and emotion regulation with
people they meet within support groups. They can be an important part
of expanding the individual's skill set and develop new, healthier
Personality Disorder Links