What Is Borderline Personality Disorder?

One of the more difficult mental illnesses to manage, borderline personality disorder, or BPD, is one of the four Cluster B types of personality disorders. With BPD, a person has issues regulating and controlling their emotions.

Generally, manifesting during early adulthood, BPD is marked by periods of intense emotion, many moods, problems with self-image, and extreme behavioral outbursts – followed by an inability to return to a baseline mood for a few hours to several days. Some people who have BPD share the trait of narcissism, in certain aspects, with those who have narcissistic personality disorder.

Those with BPD can suffer from extreme views of how they see themselves and their place in the world, often projecting their own issues onto those around them. Relationships suffer tremendously from outbursts, which vary from idealization and extreme love to devaluation and utter contempt – and can happen in just a few short moments.

Symptoms of BPD

The behaviors exhibited by a person with BPD are based on a markedly disturbed perception of self and others in their world. They can exhibit near-frantic responses to often-imagined feelings of abandonment, which can result in extreme reactions including self-harm (cutting, for example), making suicidal threats, or attempts at suicide.

People with the condition are plagued by prolonged periods of intense depression, boredom, irritability, and the inability to find a source of happiness. Their need for emotional “supply” from others often determines their behaviors in relationships. Family members, friends, and partners of people with BPD can suffer the effects of being in relationship with them, due to a high level of controlling, manipulative, and sometimes abusive behavior.

People with this condition often have a negative viewpoint under the surface even if they seem positive. This includes an unhealthy self-image that affects their moods, cares, goals, values, and relationships, which they often self-sabotage out of fear. Sources of stress often result in dissociative feelings and paranoid delusions that result in psychotic episodes or psychological breakdowns.

Causes of Borderline Personality Disorder

Researchers and scientists don’t agree on the cause of the condition but agree on several potential risk factors for BPD to manifest, such as genetics, environment, and brain function. If a person has an immediate family member with BPD, they are about five times as likely to also develop the condition.

Traumatic life events like sexual or physical abuse during childhood, or instances of neglect by a parent, increase risk factors of developing BPD. The emotional regulation system of the brain consists of three interactive portions: the threat system that detects and responds to threats, the drive system that motivates a person to identify and seek resources, and the soothing system that helps balance the other two systems and regulates feelings of satisfaction and well-being. If one or more systems are not functioning properly, because of trauma or abuse for example, it can cause the development of BPD in a person.

Treatments for BPD

The cornerstone treatment for BPD is psychotherapy, which attempts to address emotional dysregulation by teaching appropriate coping skills, acceptance, and increased insight. The three main types of treatment that are successful in treating BPD are dialectical behavioral therapy or DBT, cognitive behavioral therapy or CBT, and mentalization-based therapy or MBT.

DBT centers on teaching coping skills to combat the knee-jerk response of counterproductive urges, regulate emotional responses, and help improve personal relationships with others. It utilizes techniques like meditation, regulated breathing, and self-soothing imagery. DBT has been effective in reducing psychiatric hospitalizations, helping interpersonal relationships, decreasing suicidal thoughts, and managing anger.

CBT addresses a person’s thoughts, beliefs, and behaviors by identifying and focusing on problems the person may imagine exist. CBT is thought to reduce anxiety and mood symptoms along with self-harming behaviors and suicidal thoughts and feelings. It focuses on reducing the absolute negatives that a person with BPD suffers and replaces them with proper strategies to manage and reduce anger.

MBT centers around a patient’s difficulties in visualizing or being able to create a mental image of their emotions, feelings, or beliefs about themselves or others. A long-term study on this therapy, when coupled with medication, showed a reduction of the need for anti-psychotic medication and the number of suicidal threats or attempts, and an increase in the chance for recovery within the five years following completion of therapy.

Psychotherapy Services in Southbury, Connecticut

For people who have a family member with BPD, there is hope and treatments are available that have proven successful. Living with someone who exhibits these traits can be extremely troubling, and their behaviors are often so extreme that the entire family suffers the effects. Help for family members is often just as important as it is for the person with BPD.

Dr. Mark Stracks at Psy-Visions provides diagnostic evaluations for a variety of psychiatric conditions or disorders, including behavioral and addiction. The initial evaluation is typically completed in one session.

Contact us at (203) 405-1745 or request a consultation online, and learn how life can be improved and better-managed.

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