Borderline personality disorder is one of ten personality disorders; the condition is mainly diagnosed in adults and not usually in teenagers or young children.
Challenges with borderline personality disorder diagnosis
Like most personality disorders, accurate diagnosis can sometimes be challenging, especially in children and young adults.
Inherently, what appears to be the symptoms of borderline personality disorder may disappear as teenagers, and young adults mature and grow.
How does borderline personality disorder get diagnosed?
There are various criteria associated with borderline personality disorder (BPD).
A BPD diagnosis usually entails:
- A thorough medical history review and examination
- A comprehensive psychological evaluation that may involve participating in questionnaires
- A complete interview and discussion with a mental health professional or your doctor
- A detailed discussion about your symptoms and any other health issues that might be related to your condition
Medication
According to the research literature, there isn’t currently a specific medication approved by the FDA to treat borderline personality disorder.
However, some medications have proven effective for those with BPD symptoms.
Conjunctive therapy
Medication for BPD often gets used as a conjunctive treatment along with psychotherapy (or other treatments) rather than just treating a person with medication alone.
Research shows that people with borderline personality disorder often get prescribed medications that treat depression and anxiety.
However, such medication may also help alleviate BPD symptoms.
Co-occurring disorders
People with BPD often have other mental health conditions known as co-occurring disorders.
Thus medications may also get prescribed to treat the conditions that often coexist with BPD, such as substance misuse or major depressive disorder.
What are the telltale signs of borderline personality disorder?
There are various symptoms of borderline personality disorder. BPD is a mental health disorder that affects how you think (and feel) about yourself and others.
Borderline personality disorder may cause various complications such as:
- Problems related to your self-image
- Difficulty regulating your behaviour and emotions
- A pattern of unstable or inconsistent relationships
- Problems with daily functioning
Thoughts and feelings
If you think you have borderline personality disorder, you may frequently experience an intense fear of instability or abandonment; you might also be afraid or anxious about being alone.
One of the challenges of BPD is the counter-intuitive manner in which the condition can affect people’s thoughts and behaviour.
Fear of abandonment
For example, despite having an intense fear of abandonment, people with BPD often demonstrate inappropriate anger, frequent mood swings and impulsiveness, which can lead others to distance themselves.
The symptoms of BPD may result in a person acting out of alignment with their wants and needs. For instance, people with BPD may push others away despite wanting intimacy and fulfilling relationships.
Symptoms of borderline personality disorder
Individuals with BPD may experience many symptoms, which often depend on the person and the presence of other physical or mental health conditions.
Symptoms of BPD include:
- Rapid changes in self-image and self-identity, such behaviours include seeing yourself as a terrible person or as if you are non-existent; your goals and values may also shift.
- Risky or impulsive behaviour such as substance use, gambling, dangerous driving, unsafe sex, binge eating, or self-sabotage such as ending significant relationships or quitting your job
- Chronic feelings of emptiness
- Intense fear of abandonment and going to great lengths to avoid actual or imagined rejection or separation
- Significant mood swings that may last anything up to a few hours or a few days; during this time, you may feel intense sorrow, happiness, shame, anxiety or irritability
- Suicidal thoughts or behaviour or self-harm, which may occur in response to rejection or separation
- Pervasive patterns of unstable relationships, you may idealize a person one minute and then shortly afterwards, believe they are cruel or uncaring.
- Frequent and inappropriate angry outbursts which may involve physical fights, or bitterness and sarcasm
Speaking to a doctor or mental health professional
If you think you have any of the above symptoms, you must speak to your doctor or mental health professional, who can advise you on what to do next.
Risk factors
Various risk factors may put a person at higher risk of developing borderline personality disorder, such as:
- Brain changes or abnormalities – Studies show that changes in specific areas of the brain that affect aggression, impulsivity and emotion regulation might be responsible for a person developing BPD.
- Genetics – Some research suggests that a family history of personality disorders or other mental health conditions may put a person at risk of BPD. Family and twin studies indicate that BPD could be an inherited condition.
- Trauma – A history of emotional trauma such as physical, mental or sexual abuse may also put someone at a higher risk of developing borderline personality disorder
Treatment for BPD
Psychotherapy is one of the most effective treatments for BPD.
Essentially, psychotherapy is a talk therapy that allows people to explore and understand what might be causing them to think, feel and behave the way they do.
Treatment objectives
You may find that your therapist adapts your treatment according to your needs and goals.
Psychotherapy allows people to:
- Manage uncomfortable emotions
- Alleviate impulsive behaviours by helping them to observe and process their feelings rather than act on them
- Improve their relationships through self-awareness and awareness of others
- Concentrate on their current ability to function
- Understand and educate themselves about borderline personality disorder and other co-occurring conditions
Other evidence-based psychotherapy treatments
Additional psychotherapy treatments are also helpful for borderline personality disorder.
Types of psychotherapy
Types of psychotherapy include:
- Schema-focused therapy – focuses on individuals getting their needs met in healthy and constructive ways to promote positive life patterns. Schema-focused treatment helps people to identify unmet needs that might have led to destructive habits that may have once served a person but no longer have the same positive effect.
- Dialectical behaviour therapy (DBT) – Dialectical behaviour therapy or DBT adopts a skills-based approach that teaches people to tolerate distress, manage emotions and improve their relationships. DBT involves individual and group therapy and is used to treat BPD specifically.
- Transference-focused psychotherapy (TFP) – TFP allows people to understand and work through their difficulties within the relationship dynamic between patient and therapist. Transference-focused therapy is also called psychodynamic psychotherapy.
- Mentalization-based therapy (MBT) – is a type of talk therapy that allows people to identify and regulate their thoughts, feelings and emotions in the present moment, allowing them to consider an alternative view on the situation or event. The approach of MBT is to encourage people to ”think before they act.”
Outlook
Some people with BPD may require hospitalization, particularly when the symptoms of BPD are severe.
Having to stay in hospital can be a daunting and unsettling prospect for many; however, it may allow you to get the treatment you need and help you stay safe from self-harm or help you address suicidal thoughts or behaviours.
Learning to manage emotions
Like many mental health disorders, you will likely experience periods when your symptoms feel better or worse.
Fortunately, studies show that many people with BPD improve considerably over time, especially as they age.
Learning how to manage your thoughts, feelings and behaviours can take time; however, with proper treatment, many people experience a good prognosis for the future.
It is possible to manage self-destructive thoughts and behaviours, particularly with treatment and support from friends and family members.
Help and support are always available – if you need someone to talk to, our friendly team at Centres for Health and Healing is always there to offer a listening ear.
Contact us today to find out how we can help you on your journey to recovery.
