Borderline personality disorder (B.P.D.) is a condition that is most commonly diagnosed by the presence of several symptoms related to an individual’s impulsive behaviours, relationship patterns and self-perception. Symptoms of impulsiveness related to B.P.D. might include behaviours that potentially are self-harming. A person with this disorder will usually have a personal history of unstable relationships. He/she might experience a shifting self-image that is easily influenced by external events. The symptoms of B.P.D. affect every aspect of the individual’s life, including work/school functioning and interpersonal relationships.
One of the most common symptoms of B.P.D. is a pattern of rocky interpersonal relationships. An individual with this disorder might experience a rapidly changing view of significant others. Lacking the ability to view others in shades of gray, the individual initially might believe a new acquaintance to be perfect but, later see the same person as unworthy. Fear of being alone can lead the individual to cling inappropriately to others. Conversely, he/she might adopt a rejecting attitude in an attempt to pre-empt possible abandonment.
Impulsive and potentially self-injurious behaviour is another of the most common symptoms of B.P.D. A person with this disorder might frequently engage in risky behaviours that could lead to physical harm or other serious consequences, such as reckless driving, going on gambling sprees or having unprotected sex. Impulsiveness also might manifest as a tendency to express anger inappropriately, which could negatively affect social interactions or even lead to physical fights.
Another common symptom of B.P.D. is frequent change in the individual’s sense of personal identity. The person might over-identify with significant others because of an inability to define his/her own values, goals and preferences. Instability of self-concept can lead to numerous disruptions in work/life and personal relationships. Low self-esteem might also occur in relation to the individual’s undefined sense of self. Typically, the symptoms of B.P.D. become apparent by early adulthood. A diagnosis of B.P.D. requires the ongoing presence of at least five symptoms that have a severe impact on daily functioning.
- Make frantic efforts to avoid real/imagined abandonment.
- Have a pattern of difficult relationships caused by alternating between extremes of intense admiration and hatred of others.
- Have an unstable self-image or be unsure of his/her own identity.
- Act impulsively in ways that are self-damaging, such as extravagant spending, frequent and unprotected sex with many partners, substance abuse/binge-eating, or reckless driving.
- Have recurring suicidal thoughts, make repeated suicide attempts, or cause self-injury through mutilation, such as cutting/burning.
- Have frequent emotional overreactions or intense mood-swings, including feeling depressed/irritable, or anxious. These mood swings usually only last a few hours and in rare cases a day/two.
- Have long-term feelings of emptiness.
- Have inappropriate, fierce anger/problems controlling anger.
- The person may often display temper tantrums or get into physical fights.
B.P.D. sometimes might be confused with other types of personality disorders, such as histrionic (overdramatic in reaction/behaviour) personality-disorder or antisocial personality=disorder.
In addition, B.P.D. frequently occurs along with other mental health problems, including mood-disorder, eating disorders, bipolar=disorder and substance abuse.
Like with all personality disorders, psychotherapy is the treatment of choice in helping people overcome this problem. While medications can usually help some symptoms of the disorder, they cannot help the client/patient learn new coping skills/emotion regulation, or any of the other important changes in a person’s life. Furthermore suicidal ideation is also monitored to ensure the safety of the client/patient.
© 2012 – 2016, Content: Dr Vasilios Silivistris – Artwork: Ian Francis. All rights reserved.