Borderline personality disorder is characterized by a pervasive pattern of instability of interpersonal relationships, self-image and affects along with marked impulsivity. Borderline personality disorder is the most common personality disorder and occurs in about 2% of the population.
It usually presents itself by early adulthood and is present in a variety of settings (e.g., not just at work or home). Symptoms usually flare up when a psychological stressor occurs, such as the threat of a break-up in a close relationship. Typically, when the stress subsides the symptoms subside as well.
Borderline personality disorder often overlaps with dysthymia (milder, longer lasting form of depression) and psychotic disorders. Nearly 3/4 of those suffering from the disorder attempt suicide or display self-mutilating behaviors like cutting themselves with razors or burning themselves. Only about 10% of suicide attempts are successful.
Symptoms of borderline personality disorder and risks of suicide are greatest during young adulthood and seem to diminish later in life. Most people with borderline personality disorder, especially those who receive therapy, achieve some stability in their life as they age.
Symptoms
The major symptoms or characteristics of borderline personality disorder are:
Unstable Personal Relationships
People with borderline personality disorder fear abandonment and make desperate attempts to maintain relationships. However, their perception of relationships is so unstable that a friend can become an enemy over an ordinary disagreement.
Unstable Self-Image
This disorder is characterized by marked uncertainty in major life issues, such as life goals, sexual orientation, values, career choices, or types of friends.
Unstable Emotions
Their emotional state can fluctuate dramatically from euphoria to intense anxiety to rage in a matter of hours or days. Typically, these emotional fluctuations are reactions to social interactions.
Lack of Impulse Control
Reckless impulsivity may cause people with this disorder to act in self-destructive ways such as driving dangerously or bingeing on food, alcohol, or sex.
Causes
Borderline personality disorder has as many causes as there are people who suffer from it. The disorder may be caused by a combination of a person’s parental upbringing, their personality and social development, as well as genetic and biological factors.
While the exact cause is not yet known, it is understood that the disorder most often manifests during increased times of stress and interpersonal difficulties in the person’s life. There is a common misconception that people with this disorder are weak or should be able to “snap out of it.”
It’s important to understand that those who suffer from borderline personality disorder are not consciously holding themselves back from correcting their behavior.
Treatment
Individual psychotherapy is the most effective treatment for this personality disorder. Treatment most often focuses on increasing the person’s coping mechanisms and their interpersonal skills. The more severe the disorder, the longer the duration of therapy.
Brief therapy can include a supportive, problem-solving approach, cognitive techniques to challenge distorted thinking, and interpersonal therapy to teach the person how to develop meaningful relationships. Brief therapy usually lasts four to twelve weeks.
Medication may be used to treat other accompanying disorders or specific symptoms the person may have, such as depression, psychotic symptoms, or anxious symptoms.
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