Psychology and Psychiatry

Borderline personality disorder

Borderline personality disorder refers to the emotionally unstable state, which is characterized by impulsivity, low self-control, emotionality, a strong level of desocialization, an unstable connection with reality and high anxiety. Frontier personality disorder, being a mental illness, is marked by a sharp drop in mood, impulsive behavior and serious problems with self-esteem and relationships. Individuals with this disease often also have other health problems: eating disorders, depression, alcohol and drug abuse. The first signs of the disease appear in young years. Border pathology according to the available statistics is observed in 3% of the adult population, of which 75% are women. Self-harming or suicidal behavior is an essential symptom of the disease, completed suicides reach about 8-10%.

Causes of borderline personality disorder

Of the 100 people, two have borderline personality disorder, and experts still doubt the reasons for this condition. It can be caused by an imbalance of chemicals in the brain called neurotransmitters that help in regulating mood. The mood is also influenced by the environment and genetics.

Borderline personality disorder is five times more common in those people whose relatives suffered from this disease. This condition is often found in families where there are other diseases associated with mental illness. These are problems associated with the abuse of alcohol and drugs, antisocial personality disorder, depressive states. Often patients survived the strongest trauma in childhood. This may be physical, sexual, emotional abuse; ignoring, sharing with the parent or his early loss. If such an injury is observed in combination with certain personality traits (anxiety, lack of resistance to stress), then the risk in the development of a borderline state increases significantly. Researchers recognize that individuals with borderline personality disorder have impaired functioning of parts of the brain, which still does not allow us to find out: these problems are the effects of the condition or its cause.

Borderline personality disorder symptoms

Patients with a borderline state of personality often have unstable relationships, problems with impulsivity, low self-esteem, which begin to manifest themselves from childhood.

The emergence of borderline personality disorder is due to the efforts of American psychologists from 1968 to 1980, which allowed the inclusion of borderline personality type in the DSM-III, and then in ICD-10. But research and theoretical work carried out by psychologists were devoted to the substantiation and identification of an intermediate personality type between psychosis and neurosis.

The sign of disorder include low-risk suicidal attempts due to minor incidents and occasionally dangerous suicide attempts due to comorbid depression. Often provoke suicide attempts interpersonal situations.

Common to this disorder is the fear of being left alone or abandoned, even if it is an imaginary threat. This fear is capable of provoking a desperate attempt to hold on to those who are with such a person. Sometimes a person rejects others first, responding to the fear of being abandoned. Such odd behavior can provoke problematic relationships in any sphere of life.

Diagnosis of borderline personality disorder

This condition must be differentiated from schizophrenia, anxiety-phobic, schizotypical and affective states.

DSM-IV to the signs of borderline disorder classifies instability of interpersonal relations, pronounced impulsivity, emotional instability, disturbed internal preferences.

All these symptoms occur at a young age and make themselves felt in various situations. Diagnosis includes, in addition to the main, the presence of five or more of the following symptoms:

- making excessive efforts to avoid an imaginary or real fate to be abandoned;

- prerequisites to be drawn into tense, intense, unstable relationships, which are characterized by alternating extremes: depreciation and idealization;

- personality identity disorder: persistent, noticeable instability of the image, as well as feelings of I;

- impulsivity, which is manifested in the waste of money, violation of traffic rules; sexual behavior, overeating, substance abuse;

- suicidal relapsing behavior, threats and hints about suicide, acts of self-harm;

- mood variability - dysphoria; affective instability;

- Feeling constantly emptied;

- inadequacy in the manifestation of strong anger, as well as difficulties caused by the need to control the feeling of anger;

- pronounced dissociative symptoms or paranoid ideas.

Not every individual who has five or more of these symptoms will be diagnosed with borderline pathology. In order for the diagnosis to be established, the symptoms must be marked for a sufficiently long time period.

Borderline personality disorder is often confused with other conditions that have similar symptoms (antisocial or dramatic personality disorder).

Attempts to suicidal behavior are often noted among individuals with borderline pathology, with 10% of them committing suicide. Other conditions that arise along with borderline personality pathology also require treatment. These additional conditions can complicate treatment.

Conditions arising with borderline pathology include:

  • depression or dysthymia;
  • eating disorders;
  • alcohol and drug abuse problems;
  • bipolar disorder;
  • panic attacks;
  • attention deficit hyperactivity disorder.

In addition to this disease, other disorders may join. Some of these are:

  • dramatic personality disorder leading to emotional over-reactions;
  • anxiety personality disorder, including the avoidance of social contact;
  • antisocial personality disorder.

Treatment of borderline personality disorder

This state is included in DSM-IV and ICD-10. The classification of borderline pathology as an independent personality disease is controversial. Treatment is often very difficult and time consuming. This is because it is very difficult to deal with problems that are associated with behavior and emotions. However, treatment can give good results immediately after the start of therapy.

How to help yourself with borderline personality disorder? A significant place in the treatment is psychotherapy. Psychopharmacotherapy is used in the treatment of various combinations of pathology, such as depression.

How to live with a person who has borderline personality disorder? This question is often asked by relatives, because the patient always has increased susceptibility and is sensitive to all in the way of obstacles, they often experience a feeling inherent in a stress situation, and relatives do not know how to help them. Such individuals have difficulty controlling their thoughts and emotions, are very impulsive and irresponsible in their behavior, are unstable in relationships with other people.

In the implementation of psychotherapy, the most difficult task is to maintain and create a psychotherapeutic relationship. It can be very difficult for patients to maintain a certain framework of the psychotherapeutic union, since their leading symptom is their tendency to engage in intense, intense, unstable relationships, marked by alternating extremes. Sometimes psychotherapists themselves try to distance themselves from difficult patients, thereby protecting themselves from problems.