Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a mental illness wherein the person often experiences a repetitive pattern of disorganization and instability in self-image, mood, behavior and close personal relationships.^[1] The unstable emotions cause the affected person to take impulsive actions which leads to chaotic relationships.^[2]

Epidemiology

BPD is relatively common afflicting about 10-14% of the general population. Females are affected two to three times than males.^[1]

Causes

Specific cause is unknown. BPD is thought to be the result of a combination of biological vulnerabilities, ways of thinking, and social stressors. Theories suggest that genetics has no role in BPD although it can somewhat run in families. ^[3] Hormonal influences are postulated as well in the etiology of BPD so that association between this disorder and severe cases of premenstrual tension has been suggested.^[1]

Risk Factors

               Persons at increased risk of developing BPD are the following^[3][4]:

·         individuals abandoned during childhood or adolescence

·         persons with disrupted families

·         sexually abused

·         adolescents with alcohol-use disorder

·         children with learning and temperament problems

Signs and Symptoms

Individuals with BPD are usually uncertain about their identity thus their interests and values may change rapidly. They also see things in extremes (either all good or all bad). Shifting feelings lead to unstable relationships. They also may feel emptiness or boredom and fear of being abandoned. They frequently display inappropriate anger. They may have repeated acts of self-injury like wrist cutting and often engage in impulsive activities like binge eating, promiscuity, substance abuse and money spending. ^[4]

Diagnosis

BPD is diagnosed based on a psychological evaluation and the history and severity of the symptoms. ^[2]

Treatment

The central treatment for BPD is psychotherapy with the gold standard treatment DBT or Dialectical Behavioral Therapy.^[5] Medications like antidepressants, lithium carbonate, or antipsychotic drugs may be used. During acutely stressful or destructive episodes like suicides, patients need to be briefly hospitalized.^[1]

Prognosis

Outlook depends on the severity of symptoms and the willingness of the patient to acknowledge the disorder and accept help. With long-term talk therapy, the individual will often gradually improve. ^[4]

References:

1. http://www.stanford.edu/~corelli/borderline.html
2. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001931/
3. http://www.medicinenet.com/borderline_personality_disorder/page2.htm#causes
4. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001931/
5. http://psychcentral.com/lib/2010/living-with-borderline-personality-disorder/all/1/