Diagnose and Treat Borderline Personality Disorder

Borderline Personality Disorder (BPD) interferes with someone's ability to regulate emotion. Because of this emotional instability, the individual experiences extreme and sudden mood swings, impulsive behavior, poor self-image, and intense interpersonal relationships. People with BPD have sudden outbursts of anger that are unpredictable and can sometimes lead to self-injury. They are extremely sensitive to rejection and have a fear of being abandoned or left alone. If you are concerned that you, a loved one, or someone you know may have this disorder, then keep reading to know what the criteria in order to be diagnosed with BPD is.

Steps

  1. Determine if the individual has five or more of the following symptoms of Borderline Personality Disorder:
    • frantic efforts to avoid real or imagined abandonment
    • pattern of unstable and intense interpersonal relationships
    • identity disturbance: markedly and persistently unstable self-image
    • impulsiveness in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating, cutting)
    • recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
    • affective instability due to a marked reactivity of mood (extreme changes in mood typically lasting a few hours and only rarely more than a few days)
    • chronic feelings of emptiness
    • inappropriate, intense anger or difficulty controlling anger
    • transient, stress-related paranoid ideation or severe dissociative symptoms (This means feeling "out of it," or not being able to remember what you said or did. This mostly happens in times of severe stress.) [1]
  2. Know that, if five or more symptoms have been determined, there is treatment.There is hope. Although BPD is difficult to treat, long-term treatment can result in significant improvement and can immensely improve the quality of your life.
  3. See one or more of these people. Professional counseling can be provided by a:
    • Psychiatrist.
    • Psychologist.
    • Licensed mental health counselor who has special training in treating borderline personality disorder.
    • Social worker who has special training in treating borderline personality disorder.[2]
  4. Know the different types of counseling commonly used to treat the disorder.
    • COGNITIVE-BEHAVIORAL THERAPY (CBT), which focuses on changing certain thoughts and behavior patterns to control the symptoms of a condition.
    • DIALECTICAL BEHAVIOR THERAPY, which helps reduce destructive behaviors by teaching healthy ways to adapt to and cope with challenges and feelings of frustration or lack of power.
    • PSYCHODYNAMIC THERAPY, which focuses on uncovering or understanding your past to gain insight into your actions and current behavior. This technique assumes that problems with behavior are caused by internal conflicts that you are not consciously aware of.
    • FAMILY THERAPY, which can help educate your family about your condition and provide support to you and to those who care about you and are affected by your condition. For example, it is sometimes difficult for a parent with borderline personality disorder to be nurturing, even to his or her own child.
    • SUPPORT GROUPS, where you and people you care about are able to meet others who share similar challenges.[2]
  5. Consider medicine therapy along with professional counseling. It can be prescribed by your:
    • Psychiatrist (who can also diagnose mental health conditions).
    • Internist.
    • Family medicine physician.
    • General practitioner.
    • Physician assistant.
    • Nurse practitioner.[2]

Tips

  • Sensitivity to criticism or rejection.
  • Shifts in mood lasting only a few hours.
  • Great difficulty trusting people and themselves.
  • Many have a background of childhood physical, sexual, or emotional abuse or physical/emotional neglect.
  • Splitting: the self and others are viewed as "all good" or "all bad."
  • Alternating distancing and clinging behaviors ("I hate you, don't leave me").
  • Heavy need for affection and reassurance.
  • When a person leaves (even temporarily), they may have a problem recreating or remembering feelings of love that were present between themselves and the other.
  • Some people with Borderline Personality Disorder may have an unusually high degree of interpersonal sensitivity, insight, and empathy.
  • Their lives may be a chaotic landscape of job losses, interrupted educational pursuits, broken engagements, hospitalizations.
  • People with BPD are often bright, witty, funny, life of the party.
  • Some people with borderline personality have eating disorders.
  • Here are some extra diagnostic tips...

Warnings

  • The anger experienced by a person with BPD often becomes self directed. This anger can lead to self injury. They may turn their rage inward, internalizing the feeling and acting on it against their own bodies. Or, they may show anti-social behaviors like fighting and reckless driving when their anger escalates into rage.
  • There are a few important reasons why you should seek professional help as soon as possible, if you believe that you or a loved one may have Borderline Personality Disorder. Don't just "wait to see"! By then it may be too late.
  • Co-occuring disorders are common with BPD (i.e. depression, bipolar, anxiety, PTSD, eating disorders and substance abuse).
  • Don't put it off; get help!
  • It's characteristic of people with BPD to act impulsively. The impulse to anger can rarely escalate to violent behavior.
  • Ultimately, some borderline patients will internalize their rage to such an extent that they may attempt suicide.
  • Intense emotions, impulsivity and instability of interpersonal relationships may be lifelong struggles. However, most gain greater strength and stability during their 30s and 40s and after 10 years about 50% no longer fully met the criteria for BPD.
  • Completed suicides occur in 8%-10% in people with BPD.

Related Articles

Sources and Citations

  1. ↑ http://www.behavenet.com/capsules/disorders/borderlinepd.htm
  2. ↑ 2.0 2.1 2.2 http://www.cigna.com/healthinfo/ty6802.html
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