Borderline Personality Disorder

Borderline Personality Disorder is a mental condition that disrupts an individual's ability to interact with other people around her. Traits of illness include severely distorted self-image, erratic emotional control and low self-esteem. BPD is diagnosed in 2 percent of the adult population, though due to the pervasiveness of attempted suicide and other detrimental behavior, Borderline individuals account for over 20 percent of patients hospitalized for psychiatric reasons. BPD is more prominent in women than in men and is most often treated with psychotherapy.

Symptoms

• The defining symptoms of BPD are episodes of extreme anger, impulsivity, substance abuse or self-mutilation that last for only several hours. These violent mood onsets can include heightened sexual activity or promiscuity, starving or binge eating, a lack of self worth, and a feeling of being lost, bored or in a state of identity crisis. The result of such tumultuous emotional distress is significantly disrupted family relationships, difficulty keeping a job and inability to maintain a romantic partner. Ironically, the episodes of BPD patients are exacerbated by feelings of rejection, being ostracized or the feeling of being abandoned by loved ones.

History

• Early assumptions about the condition likened it to schizophrenia, and many believed it to be a precursor to schizophrenia or a lessened version of it. One of the first people to identify BPD was I. C. Rosse, an American psychiatrist who in 1890 referred to a mental state called borderline insanity in which the patient had violent episodes of anger, depression and angst in succession within one day. Throughout the first half of the 20th century, the term borderline was loosely used to describe similar symptoms as a reference to the patient being on the border between neurosis and psychosis. However, it wasn't until1980 that standard criteria were established and the disorder was officially named and included in the Diagnostic and Statistical Manual of Mental Disorders.

Cause

• The cause of BPD is not completely known. However, there is speculation among the psychological community that hormone levels, genetic history and sexual abuse may contribute to the development of the disorder. One piece of evidence to support these assumptions is the fact that female patients tend to experience Borderline episodes during the hormone-saturated premenstrual period of the month. Similarly, between 40 percent and 70 percent of Borderline patients were sexually attacked before age 13, generally by a non-immediate family member. It has been speculated that children who have a Borderline parent, particularly a Borderline mother, are more likely to develop the condition than individuals with no family history. However, psychologists are unsure whether this is due to an inherited genetic trait or the fact that Borderline parents have problems bonding appropriately with their children. When this happens, it puts them at risk of developing similar inferiority and worthlessness complexes as their parents.

Treatment

• The foundation of all treatment for BPD is psychotherapy. Patients benefit from one-on-one sessions with therapists as well as group therapy. Both therapy environments try to explore the motivating emotions behind the disruptive and destructive behavior BPD patients experience, as well as steps that can be taken to encourage impulse control. There is no medication that treats all aspects of BPD. However, some psychiatrists may prescribe medications that are targeted to specific symptoms, such as anti-depressants or anti-anxiety drugs. Some patients who exhibit self-harming behavior may go through therapy sessions in a live-in treatment facility where they can be monitored. With continuing treatment, BPD patients have the opportunity to overcome their disorder and lead normal lives.

Other Risks

• Borderline individuals are statistically at greater risk of being victims of domestic or sexual abuse as adults than non-BPD individuals. This is due to a combination of factors, including their impulses toward reckless behavior and dangerous promiscuity--along with their emotional needs for approval and fear of abandonment. Their uncontrolled behaviors also place them at greater risk for acquiring HIV/AIDS and other sexually transmitted illnesses.