A summary of borderline personality disorder, or BPD. Includes most likely causes, affect of childhood on development, most common symptoms and how to help patients manage them, and treatment with medication and therapy
- BPD is a type of personality disorder also known as emotionally unstable personality disorder
(EUPD), characterized by patterns of emotional instability, impulsive behavior, distorted self-image,
and unstable relationships
- In the United States, BPD occurs in ~1.6% of adults
- Although the exact cause is still debated, there are multiple contributing factors:
o Genetics – BPD may have a genetic background, highlighted by twin studies
o Environmental factors – growing up in unstable, abusive, neglectful environments may
increase risk
o Serotonin abnormalities – abnormalities in serotonin production may be involved in the risk
of developing BPD
- Those at risk of BPD:
o Individuals who have family members with BPD
o Individuals who have felt emotionally unstable or vulnerable as children
o People in the household were impulsive
o Individuals who were emotionally abused as children
- Symptoms of BPD include:
o Frantically avoiding real or imaginary abandonment
o Patterns of unstable relationships, alternating between idealizing and devaluing others in a
relationship
o Unstable self-image or self-identity
o Acting impulsively in at least 2 areas of one’s life, in ways that can be self-damaging, e.g.,
impulsive spending, abusing substances
o History of suicidal or self-mutilating behaviour
o Frequent mood swings, usually lasting a few hours and sometimes lasting several days
o Severe and long tern feelings of emptiness
o Difficulty controlling one’s anger or getting angry without cause. Feeling angry all the time,
displaying anger frequently or getting in fights frequently
o Periods of stress related paranoia or experiencing severe dissociation, occurs when mind is
detached from emotions or body
Treatment
- Psychotherapy – this is the main treatment for BPD
o Cognitive behavioural therapy (CBT) – help to identify and change unhealthy beliefs,
behaviours, and inaccurate perceptions. Teaches healthy ways to react to stimuli.
o Dialectical behavioural therapy (DBT) – teaches patients how to recognize, be aware of, and
accept beliefs and behaviours. Also teaches healthy responses to behaviours.
o Schema-focused therapy – helps to view oneself and the world in a positive way
- Medication – medication does not cure BPD but can help to alleviate symptoms
o Antidepressants to cure depression
o Antipsychotics to treat aggressive symptoms
o Antianxiety medication to cure anxiety
- If symptoms are severe, e.g., displays of suicidal thoughts/ tendencies and thoughts of others,
temporary hospitalisation may be recommended
- Omega-3 fatty acids may also relieve symptoms of depression and aggression, however more
research is needed to confirm this
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