What is borderline personality disorder?

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Borderline personality disorder (BPD) is a common mental health disorder that can be treated. It affects people's thoughts, emotions, and behaviours, making it difficult for them to cope in all areas of life.

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We all see the world through different eyes, but a person with BPD has an abnormally distorted view of themselves and the environment around them

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People with BPD feel intense, uncontrollable emotions, which can make them very distressed and angry. They have trouble with their relationships and find it hard to feel comfortable in themselves. They may be very impulsive and appear to lead chaotic lives, act impulsively or intentionally harm themselves as a way of coping

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Borderline personality disorder can be difficult for other people to understand. it can be distressing for the person with BPD and the people around them, and it is often misunderstood.

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It is the most common personality disorder in Australia, affecting about 1 to 4 in every 100 people at some time in their lives. It's more common in women, and usually, the symptoms appear in the teenage years or early adulthood.

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What are the symptoms of borderline personality disorder?

There are many different BPD symptoms or traits including:

• strong, overwhelming emotions and feelings

• fear of being alone and frantic attempts to avoid abandonment

• feeling empty inside

• Feeling neglected, alone, misunderstood, chronically empty, or bored

• low self-esteem

• intense mood swings including outbursts of anxiety, anger, and depression

• alternating between idealising and devaluing other people

• feelings of self-loathing and self-hate

• black-and-white thinking, or difficulty compromising 

• feeling cut off and out of touch with reality

• a pattern of tumultuous relationships with friends, family, and loved ones

• paranoid thoughts in response to stress

• unstable and distorted self-image or sense of self

• feeling cut off and out of touch with reality

• Impulsive and risk-taking behaviours, such as unsafe sex, illegal drug use, gambling, over eathing, reckless driving or overspending

• self-harm, such as cutting as a coping mechanism

• suicidal thoughts or suicide attempts

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What causes borderline personality disorder?

 

As with most mental health disorders, the causes of BPD are not completely understood.

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It is caused by a combination of genes and life experiences. Having another mental health condition, being very sensitive, or suffering abuse or neglect during childhood may make some people more likely to develop a borderline personality disorder. but not everyone with these factors will experience BPD and not everyone with these experiences will develop BPD

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In some people, a stressful event or relationship breakup may be associated with the development of BPD. Curing times of stress, many people with BPD experience post-traumatic stress symptoms such as flashbacks, nightmares, feelings of unreality, and panic attacks.

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Sometimes negative experiences from the past return as voices or punishing self-talk that feels real and are difficult to ignore.

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How is borderline personality disorder diagnosed?

 

There is no single BPD test, if you think you or someone you know has symptoms of BPD, the first step is to see your doctor.

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It may take weeks or months to get a diagnosis. A health professional needs to get to know you properly first.

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They will need to do a complete mental health assessment, with questions about the current symptoms, past history such as suicide attempts, medical history, relationships, and family background such as childhood trauma.

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To be diagnosed with BPD, you need to have at least 5 of the following:

• frantic efforts to abode real or imaginary abandonment

• persistently distorted self-image or sense of self

• consistently intense and unstable relationships with other people, alternating between idealising them and devaluing them

• at least 2 impulsive behaviours that are potentially self-damaging

• intense feelings lasting hours to days

• ongoing self-harming behaviour, suicidal behaviour, or threats

• long-term, chronic feelings of emptiness

• feeling disconnected from reality, or having paranoid thoughts

• difficulty controlling intense and inappropriate anger

Teenagers may start showing the symptoms of BPD, but to be diagnosed they need to have symptoms that are sever enough to persistently interfere with daily functioning for 1 year or longer. A teenager with BPD symptoms has much more severe and long-lasting symptoms than a typical moody teen.

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How is borderline personality disorder managed?

 

Once a diagnosis is made for BPD, a mental health professional manages ongoing treatment.

The most effective treatment combines support and psychological therapy. Medicine may help in some cases, but it is not the main treatment for BPD. while medicine may help relieve some of the symptoms, it does not improve BPD itself.

 

Psychological therapy

Psychological therapy is the main type of treatment for BPD. Examples of therapies that can help include:

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• Dialectical behaviour therapy (DBT) was developed specifically for treating BPD. DBT has an educational approach with a focus on mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Here at CMD Counselling Services, we run a comprehensive DBT program that is a combination of an individual therapy sessions and group programs.

• Psychodynamic therapies, such as mentalisation-based therapy and transference-focused psychotherapy.

• Other forms of therapy, teach new ways to interact with people, or ways to view yourself or the world, such as schema therapy.

Contact us today to find out more information on commencing therapy.

 

Medicine

Medicine is not recommended as the main treatment for BPD, though it can sometimes help control symptoms. Medical may be useful if the person with BPD also has other mental health disorders, such as bipolar disorder, and anxiety disorder or depression.

In severe cases, a person with BPD may need to go to the hospital. this is usually only recommended as a short-term measure for those who are at risk of harming themselves or others.

The first step in seeking help and treatment for BPD is to visit a doctor who can coordinate a team of mental health professionals. Family and friends of people with BPD may also find therapy useful in helping them cope with caring for their loved ones.

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Sources:

The Royal Australian and NZ College of Psychiatrists (Borderline personality Disorder), 

National Health and Medical Research Council (Clinical Practice Guideline for the Management of Borderline Personality Disorder), 

SANE Australia (Borderline personality disorder),

Contemporary Behavioral Health Care (Systematic review of the clinical effectiveness of schema therapy), 

PubMed.gov - Ioana A. Cristea, PhD; Claudio Gentili, MD, PhD; Carmen D. Cotet, PhD; Daniela Palomba, MD; Corrado Barbui, MD; Pim Cuijpers, PhD (Efficacy of Psychotherapies for Borderline Personality Disorder A Systematic Review and Meta-analysis), 

Mental Illness Fellowship of Australia (MIFA) (Understanding borderline personality disorder)