Borderline personality disorder’s main feature is instability’s pervasive pattern in self - image, interpersonal relationships and emotions. Individuals with BPD often demonstrate behaviors of self-injurious character (suicide attempts, cutting and risky behaviors of sexual character), usually they are very impulsive. In most this disease occurs by early adulthood. Persisting for years not stable pattern of interaction with other people is usually connected with early social interactions and the person’s self-image. Such people feel sensitivity to circumstances in the environment. Impending rejection or separation’s perception may result in complete changes in behavior, self-image, cognition and affect. Even when in plans exist not avoidable changes (fury or panic when a close or important person must refuse an appointment or is late not for a long time), they experience inappropriate anger and intense abandonment fears. These fears of abandonment relate to a necessity to have other individuals with them and to an intolerance of being alone. The individual’s emotions and relationships may sometimes look like being shallow or be seen by others. Deviating from the person’s culture norm, borderline personality disorder is relatively common - with this condition live about one in twenty five people. Across a broad range of social and personal situations the enduring pattern is pervasive and inflexible. Typically it leads to impairment in different functioning areas such as work and social area or to significant distress. Having a long duration, its beginning may be traced back to adolescence or early adulthood. (Steve Bressert, 2014)
Exhibiting impulsive behaviors, an individual having borderline personality disorder has next symptoms:
Uncontrollable, intense or inappropriate anger.
Lasting a few hours to a few days with periods of intense anxiety, irritability and depressed mood, marked mood swings
Impulsive behaviors that lead to psychological distress and bad outcomes, such as shoplifting, substance use, sexual encounters or excessive spending.
Emptiness feeling or chronic boredom.
Devaluation and unstable personal relationships.
Permanent uncertainty about values and friendships, long-term goals and self-image.(Ken Duckworth et al. 2012)
Personality disorders are frequently diagnosed in adulthood, because they describe enduring and long-standing behavior patterns. Due to the fact that a teen or child is under constant maturation, changes of personality and development, he is diagnosed in adolescence or childhood, but the diagnosis in this period must embrace the features, which are shown up during at least 12 months. This disease is more prevalent in women than men, affecting about 5.9 % of the total masses of people. The intensity of the BPD decreases with age, thus when the person is 45 or 50, he has lack of most extreme symptoms. (Pamela S. Hyde, 2010)
Individuals with BPD can demand from lovers or potential caregivers to spend a lot of time together, idealize them at the initial or second meeting and early in a relationship talk about their most intimate details. However, such people are able not only to idealize other individuals but also to devalue them, having a sense that another individual does not give enough or does not care enough. Only if these people expect that other individual on demand helps them to meet their needs, they may nurture and empathize with other individuals. People with borderline personality disorder in their view of others are prone to dramatic and sudden shifts, they see other as cruelly punitive or beneficent supports. There are also dramatic and sudden shifts in imaging self that is reflected by changing of vocational aspirations, values and goals. Sudden changes may be in plans and opinions about types and values of friends, sexual identity or about career; such people can even change a needy supplicant’s role to past mistreatment’s righteous avenger role. At times they can feel non-existence at all, although people with borderline personality disorder often image themselves based on evil or being bad. Individuals may feel such experiences only when they feel no support, nurturing or meaningful relationship. In school situations or unstructured work these people can show bad performance. (John Grohol, 2015)
Psychiatrist or psychologist, who is considered as a mental health professional, has an ability to diagnose borderline personality disorder, which is included in a range of personality disorders. This type of psychological diagnosis is not made by general practitioners and family physicians, because they are not well-equipped or trained. In order to diagnose this disease, mental health professionals use no genetic or blood tests and no laboratory. Most of the individuals, who have borderline personality disorder, do not want to be treated. Until the disease begins to otherwise affect a life of person or significantly interfere, they have no desire to seek out treatment. Such situation frequently occurs when for dealing with stress a person has stretched too thin coping resources. A mental health professional compares patient’s life history and his symptoms with symptoms listed above for diagnosis of borderline personality disorder. After that a determination is made whether patient’s symptoms are meeting necessary for this disease diagnosis criteria. (R. Skip Johnson, 2014)
The causes of borderline personality disorder are not known by researchers, though there are a lot of theories concerning this disease’s possible causes. A causation’s biopsychosocial model is subscribed by most professionals, that is psychological factors (shaped by the environment, temperament and personality of the patient), social factors ( condition, in which an individual interacts with his friends and family in his early development), genetic and biological factors ( to the children this illness can be passed down from parents, if even one of them has this disorder ) may be considered as the borderline personality disorder’s causes. All this means that no one factor can be a cause for occurrence of this disease - all 3 factors are likely intertwined and complex. The connection of other mental disorders with borderline personality disorder is established very well. Individuals with this disorder are at increased risk for substance abuse, anxiety disorders, eating disorders and depressive disorders. In order to get a proper diagnosis most of the people wait for years, because this disease is frequently misdiagnosed. (John G. Gunderson, 2011)
Dealing with an individual with BPD doctors and therapists must be like a rock. For contrasting the client’s lability of thinking and emotion the psychologist should suggest his stability. By working with such individuals a lot of professionals are turned-off, as from the clinician they receive mostly negative feelings. These happen because of the patient’s possibility of self - mutiliating behavior, his constant suicidal behaviors, thoughts and gestures, and constant demands on a clinician. For this disorder nearly always the doctors use psychotherapy; for stabilizing mood swings they also give medications to their patients. In helping people to overcome borderline personality disorder, the treatment of choice is regarded psychotherapy. Contracting with the patient to be sure that he does not commit suicide is an initially important aspect of this therapy. Suicidality should be monitored and carefully assessed in the course of treatment; hospitalization and medication had to be seriously considered, if the client has suicidal feelings. To date “Dialectical Behavior Therapy” of Marsha Linehan has been an effective and the most successful psycho-therapeutic approach. This therapy seeks to teach the patients how through cognitive restructuring, emotion regulation and self-knowledge to take control of themselves, their emotions and their lives. Frequently conducting within a group setting this approach is comprehensive. Other psychological treatments focus on conflict resolution and social learning theory, but they are less effective. Focusing on solutions, often the core problem of the clients suffering from borderline personality disorder is neglected - due to faulty cognitions they have difficulty in expression of appropriate emotions. The therapists should by psychotherapy not restructure the personality of the patient but help him to function independently. (Joel Paris, 2005)
Low doses of antipsychotic drugs can be given to the patient during brief reactive psychoses, but for treatment of borderline personality disorder these medications are not essential adjuncts. For some psychotic symptoms and disorganized thinking may help the high potency neuroleptics in low doses. If the client shows anger, which is difficult to control, doctors particularly recommend neuroleptics. Without adequate psychosocial intervention therapists never give medication, generally they provide only low dosages. During particular times anti-anxiety and antidepressant agents in the patient’s treatment can be appropriate, for instance, when the patient has severe suicidal intent and ideation. These medications should not be used for long-term treatment, as depression and anxiety are connected with situational and short-term factors. Besides the medications, one of the most effective treatments is self-help method, an important aspect of which is gaining additional social support. Throughout the world there are a lot of support groups, which are organized within communities and which help people to share their feeling and common experiences. (Mike Batcheler et al. 2003)
The borderline personality disorder (BPD) is not studied for a long time, the researchers started to take attention at it only recently despite its enormous public health costs and its prevalence in clinical settings. Even today the exact cause of this disorder is unknown, some people think that it is exclusively environmental disorder, others-genetic. This disorder has a good prognosis, although it is a resistant-to-change disorder. Many other things will be revealed, if researchers continue their studies of this disorder.
References
John G. Gunderson. (2011). An Introduction to borderline personality disorder: diagnosis, origins, course, and treatment. McLean’s Borderline Center Publishing, 6-9.
Steve Bressert. (2014). Borderline personality disorder symptoms. Psych Central. Retrieved from: http://psychcentral.com/disorders/borderline-personality-disorder-symptoms/
Ken Duckworth&Jacob L. Freedman. (2012). Borderline personality disorder. The National Alliance on Mental Illness, 1.
Pamela S. Hyde. (2010). Report to Congress on borderline personality disorder. The Substance Abuse and Mental Health Services Administration (SAMHSA), 13-18.
John Grohol. (2015). Characteristics of borderline personality disorder. Psych Central. Retrieved from http://psychcentral.com/lib/characteristics-of-borderline-personality- disorder/
Joel Paris. (2005). Recent advances in the treatment of borderline personality disorder. Can J Psychiatry Publishing, 435- 438.
Mike Batcheler&Auckland DHB Balance Team. (2003). Treatment approaches for borderline personality disorder. DHB Balance Publishing, 7-10.
R. Skip Johnson. (2014). What are the symptoms of borderline personality disorder? National Institute of Mental Health, 7-12.
