Understanding Borderline Personality Disorder and Treatment Options
Borderline Personality Disorder is the most commonly recognized personality disorder and is characterized by instabilities in self-image, interpersonal relationships, and affects. There is also marked impulsivity present in a variety of settings beginning in early adulthood. There are nine total symptoms, and five need to be met in order to have a BPD diagnosis. Some of these include abandonment, self-harm, chronic feelings of emptiness, intense anger, and paranoid ideation or dissociative symptoms.
BPD is one of the most misunderstood diagnosis in mental health, and it affects over 14 million Americans. 5.9% of the adult population has BPD. Almost 75% of individuals with BPD make one or more suicide attempts, with up to 10% dying by suicide. The suicide rate in BPD exceeds that of the general population by 400 times. BPD is more common among women than men and is the third leading cause of death among women aged 15 – 24. This diagnosis is associated with serious stigma and negative baggage.
It is incredibly challenging to diagnose BPD because it contains a wide range of symptoms that overlap with other mental health disorders. In addition, it usually co-occurs with other conditions such as anxiety, eating disorders, or substance use disorders. This is also a reason why people with BPD are often on multiple medications, and there is currently no single medication known to treat BPD. May is Borderline Personality Disorder Awareness Month, created to raise awareness, reduce stigma, and encourage those affected to seek help.
There is no clear cause identified for BPD. However, several factors may contribute, such as genetics, neurobiological factors, and environmental factors. Individuals with a family member diagnosed with BPD are at an increased risk for BPD. Some structural and functional brain changes are associated with the disorder, although it is not clear if the changes are the cause or result of the disorder. In addition, individuals with BPD usually have a history of trauma, adverse childhood experiences, and exposure to violence and intense conflicts.
Treatment for BPD may involve a variety of factors, including psychotherapy, medication, and family and peer support, with hospitalization recommended in some cases. It is important to get treatment for any other co-occurring mental health disorders. Learning skills can help individuals cope with this disorder and better manage challenges. Some effective types of psychotherapy for BPD include Dialectical Behavior Therapy (DBT), Schema-Focused Therapy, Mentalization-Based Therapy (MBT), Systems Training for Emotional Predictability and Problem-Solving (STEPPS), and Transference-Focused Therapy (TFP).
DBT is a common approach to treating BPD. It involves group and individual sessions designed to specifically treat BPD. DBT is focused on mindfulness and paying attention to the present moment. It helps individuals become more aware of their present moods, emotions, and behaviors. These skills, which are at the core of DBT, help individuals observe without judging. In addition, DBT teaches interpersonal effectiveness, distress tolerance skills, and emotion regulation skills. This type of psychotherapy seeks to find a balance between accepting and changing behaviors and is a proactive, problem-solving approach.