BPD
www.TheCitizensWhoCare.org
Borderline
Personality Disorder
What
are Personality Disorders?
Borderline
Peersonality Disorder (BPD)
Borderline Personality Disorder (BPD) is a serious mental
illness marked by unstable moods, behavior, and
relationships. In 1980, BPD was listed in the Diagnostic and
Statistical Manual for Mental Disorders, Third Edition
(DSM-III) as a diagnosable illness for the first time. Most
psychiatrists and other mental health professionals use the
DSM to diagnose mental illnesses.
Because some people with severe BPD
have brief psychotic episodes, experts originally thought of
this illness as atypical, or borderline, versions of other
mental disorders. While mental health experts now generally
agree that the name “Borderline Personality
Disorder” is misleading, a more accurate term does not
exist yet.
People with BPD tend to
experience:
- Problems with regulating emotions
and thoughts;
- Impulsive and reckless
behavior;
- Unstable relationships with other
people.
People with this disorder also have
high rates of co-occurring disorders, such as depression,
anxiety disorders, substance abuse, and eating disorders,
along with self-harm, suicidal behaviors, and completed
suicides.
According to data from a subsample of
participants in a national survey on mental disorders, about
1.6 percent of adults in the United States have BPD in a
given year.
BPD is often viewed as difficult to
treat. However, recent research shows that BPD can be
treated effectively, and that many people with this illness
improve over time.
According to the DSM, Fourth Edition,
Text Revision (DSM-IV-TR), to be diagnosed with borderline
personality disorder, a person must show an enduring pattern
of behavior that includes at least five of the following
symptoms:
- Extreme reactions — including
panic, depression, rage, or frantic actions — to
abandonment, whether real or perceived;
- A pattern of intense and stormy
relationships with family, friends, and loved ones, often
veering from extreme closeness and love (idealization) to
extreme dislike or anger (devaluation);
- Distorted and unstable self-image
or sense of self, which can result in sudden changes in
feelings, opinions, values, or plans and goals for the
future (such as school or career choices);
- Impulsive and often dangerous
behaviors, such as spending sprees, unsafe sex, substance
abuse, reckless driving, and binge eating;
- Recurring suicidal behaviors or
threats or self-harming behavior, such as
cutting;
- Intense and highly changeable
moods, with each episode lasting from a few hours to a
few days;
- Chronic feelings of emptiness and
/ or boredom;
- Inappropriate, intense anger or
problems controlling anger;
- Having stress-related paranoid
thoughts or severe dissociative symptoms, such as feeling
cut off from oneself, observing oneself from outside the
body, or losing touch with reality.
- Seemingly mundane events may
trigger symptoms. For example, people with BPD may feel
angry and distressed over minor separations—such as
vacations, business trips, or sudden changes of
plans—from people to whom they feel close. Studies
show that people with this disorder may see anger in an
emotionally neutral face and have a stronger reaction to
words with negative meanings than people who do not have
the disorder.
What are
Personality Disorders?
Personality is the way of thinking, feeling and behaving
that makes a person different from other people. An
individual’s personality is influenced by experiences,
environment (surroundings, life situations) and inherited
characteristics. A personality disorder is a way of
thinking, feeling and behaving that deviates from the
expectations of the culture, causes distress or problems
functioning, and lasts over time.
There are 10 specific types of
personality disorders (such as borderline personality
disorder). Common to all personality disorders is a
long-term pattern of behavior and inner experience that
differs significantly from what is expected. The pattern of
experience and behavior begins by late adolescence or early
adulthood, and causes distress or problems in functioning.
Without treatment, the behavior and experience is inflexible
and usually long-lasting. The pattern is seen in at least
two of these areas:
- Way of thinking about oneself and
others
- Way of responding
emotionally
- Way of relating to other
people
- Way of controlling one’s
behavior
The 10 specific personality disorders
are grouped into three categories called
“clusters”.
Cluster A
Paranoid personality disorder:
a pattern of distrust and suspiciousness where others’
motives are seen as mean or spiteful. People with paranoid
personality disorder often assume people will harm or
deceive them and are reluctant to confide in others or
become close to them.
Schizoid personality disorder:
a pattern of detachment from social relationships and a
limited range of emotional expression. A person with
schizoid personality disorder typically does not seek close
relationships, chooses solitary activities and appears
indifferent to praise or criticism from others.
Schizotypal personality
disorder: a pattern of acute discomfort in close
relationships, distortions in thinking or perception, and
eccentric behavior. A person with schizotypal personality
disorder may have odd beliefs or magical thinking, odd or
peculiar behavior or speech, or may incorrectly attribute
meanings to events.
Cluster B: dramatic, emotional or
erratic behavior
- Antisocial personality
disorder: a pattern of disregarding or violating the
rights of others. A person with antisocial personality
disorder may not conform to social norms, may repeatedly
lie or deceive others, or may act
impulsively.
- Borderline personality
disorder: a pattern of instability in personal
relationships, emotional response, self-image and
impulsivity. A person with borderline personality
disorder may go to great lengths to avoid abandonment
(real or perceived), have recurrent suicidal behavior,
display inappropriate intense anger or have chronic
feelings of emptiness.
- Histrionic personality
disorder: a pattern of excessive emotion and
attention seeking. A person with histrionic personality
disorder may be uncomfortable when he/she is not the
center of attention, consistently use physical appearance
to draw attention or show rapidly shifting or exaggerated
emotions.
- Narcissistic personality
disorder: a pattern of need for admiration and lack
of empathy for others. A person with narcissistic
personality disorder may have a grandiose sense of
self-importance, a sense of entitlement, take advantage
of others or lack empathy.
Cluster C: anxious or fearful
behavior
- Avoidant personality disorder:
a pattern of social inhibition, feelings of
inadequacy and extreme sensitivity to criticism. A person
with avoidant personality disorder may be unwilling to
get involved with people unless he/she is certain of
being liked, be preoccupied with being criticized or
rejected, or may view himself/herself as being inferior
or socially inept.
- Dependent personality disorder:
a pattern of needing to be taken care of and
submissive and clingy behavior. A person with dependent
personality disorder may have difficulty making daily
decisions without reassurance from others or may feel
uncomfortable or helpless when alone because of fear of
inability to take care of himself or herself.
- Obsessive-compulsive
personality disorder: a pattern of preoccupation with
orderliness, perfectionism and control. A person with
obsessive-compulsive personality disorder may be
preoccupied with details or schedules, may work
excessively to the exclusion of leisure or friendships,
or may be inflexible in morality and values. (This is NOT
the same as obsessive compulsive disorder.)
Diagnosis of a personality disorder
requires a mental health professional looking at long-term
patterns of functioning and symptoms. For a person under 18
years old to be diagnosed, the symptoms must have been
present for at least a year. Some people with personality
disorders may not recognize a problem. Also, people often
have more than one personality disorder. An estimated 9% of
U.S. adults have at least one personality
disorder.
In a related condition, people can
experience a personality change due to another medical
condition.
Treatment
Certain types of psychotherapy are
effective for treating personality disorders. During
psychotherapy, an individual can gain insight and knowledge
about the disorder and what is contributing to symptoms, and
can talk about thoughts, feelings and behaviors.
Psychotherapy can help a person understand the effects of
their behavior on others and learn to manage or cope with
symptoms and to reduce behaviors causing problems with
functioning and relationships. The type of treatment will
depend on the specific personality disorder, how severe it
is, and the individual’s circumstances.
- Commonly used types of
psychotherapy include:
- Psychoanalytic/psychodynamic
therapy
- Dialectical behavior
therapy
- Cognitive behavioral
therapy
- Group therapy
- Psychoeducation (teaching the
individual and family members about the illness,
treatment and ways of coping)
There are no medications specifically
to treat personality disorders. However, medication, such as
antidepressants, anti-anxiety medication or mood stabilizing
medication, may be helpful in treating some symptoms. More
severe or long lasting symptoms may require a team approach
involving a primary care doctor, a psychiatrist, a
psychologist, social worker and family members.
In addition to actively participating
in a treatment plan, some self-care and coping strategies
can be helpful for people with personality
disorders.
- Learn about the condition.
Knowledge and understanding can help empower and
motivate.
- Get active. Physical activity and
exercise can help manage many symptoms, such as
depression, stress and anxiety.
- Avoid drugs and alcohol. Alcohol
and illegal drugs can worsen symptoms or interact with
medications.
- Get routine medical care.
Don’t neglect checkups or regular care from your
family doctor.
- Join a support group of others
with personality disorders.
- Write in a journal to express your
emotions.
- Try relaxation and stress
management techniques such as yoga and
meditation.
- Stay connected with family and
friends; avoid becoming isolated.
Source: Adapted from Mayo
Clinic, Personality Disorders
Family members can be important in an
individual’s recovery by working with the
individual’s health care provider on the most effective
ways to help and support. But having a family member with a
personality disorder can also be distressing and stressful.
Family members may benefit from talking with a mental health
provider who can provide help coping with
difficulties.
References
Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition (DSM-5). American
Psychiatric Association. (2013).
Lenzenweger MF, Lane MC, Loranger AW,
Kessler RC. 2007. DSM-IV personality disorders in the
National Comorbidity Survey Replication. Biological
Psychiatry, 62(6), 553-564.
Source: projectsemicolon.com/borderline-personality-disorder/
©2007-2023,
www.TheCitizensWhoCare.org/bpd.html
BPD
Borderline
Peersonality Disorder (BPD) Borderline Personality Disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, BPD was listed in the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses. Because some people with severe BPD have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name “Borderline Personality Disorder” is misleading, a more accurate term does not exist yet. People with BPD tend to experience:
People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides. According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have BPD in a given year. BPD is often viewed as difficult to treat. However, recent research shows that BPD can be treated effectively, and that many people with this illness improve over time. According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms:
What are
Personality Disorders? Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual’s personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time. There are 10 specific types of personality disorders (such as borderline personality disorder). Common to all personality disorders is a long-term pattern of behavior and inner experience that differs significantly from what is expected. The pattern of experience and behavior begins by late adolescence or early adulthood, and causes distress or problems in functioning. Without treatment, the behavior and experience is inflexible and usually long-lasting. The pattern is seen in at least two of these areas:
The 10 specific personality disorders are grouped into three categories called “clusters”. Cluster A Paranoid personality disorder: a pattern of distrust and suspiciousness where others’ motives are seen as mean or spiteful. People with paranoid personality disorder often assume people will harm or deceive them and are reluctant to confide in others or become close to them. Schizoid personality disorder: a pattern of detachment from social relationships and a limited range of emotional expression. A person with schizoid personality disorder typically does not seek close relationships, chooses solitary activities and appears indifferent to praise or criticism from others. Schizotypal personality disorder: a pattern of acute discomfort in close relationships, distortions in thinking or perception, and eccentric behavior. A person with schizotypal personality disorder may have odd beliefs or magical thinking, odd or peculiar behavior or speech, or may incorrectly attribute meanings to events. Cluster B: dramatic, emotional or erratic behavior
Cluster C: anxious or fearful behavior
Diagnosis of a personality disorder requires a mental health professional looking at long-term patterns of functioning and symptoms. For a person under 18 years old to be diagnosed, the symptoms must have been present for at least a year. Some people with personality disorders may not recognize a problem. Also, people often have more than one personality disorder. An estimated 9% of U.S. adults have at least one personality disorder. In a related condition, people can experience a personality change due to another medical condition. Treatment Certain types of psychotherapy are effective for treating personality disorders. During psychotherapy, an individual can gain insight and knowledge about the disorder and what is contributing to symptoms, and can talk about thoughts, feelings and behaviors. Psychotherapy can help a person understand the effects of their behavior on others and learn to manage or cope with symptoms and to reduce behaviors causing problems with functioning and relationships. The type of treatment will depend on the specific personality disorder, how severe it is, and the individual’s circumstances.
There are no medications specifically to treat personality disorders. However, medication, such as antidepressants, anti-anxiety medication or mood stabilizing medication, may be helpful in treating some symptoms. More severe or long lasting symptoms may require a team approach involving a primary care doctor, a psychiatrist, a psychologist, social worker and family members. In addition to actively participating in a treatment plan, some self-care and coping strategies can be helpful for people with personality disorders.
Source: Adapted from Mayo Clinic, Personality Disorders Family members can be important in an individual’s recovery by working with the individual’s health care provider on the most effective ways to help and support. But having a family member with a personality disorder can also be distressing and stressful. Family members may benefit from talking with a mental health provider who can provide help coping with difficulties. References Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). American Psychiatric Association. (2013). Lenzenweger MF, Lane MC, Loranger AW,
Kessler RC. 2007. DSM-IV personality disorders in the
National Comorbidity Survey Replication. Biological
Psychiatry, 62(6), 553-564. |