Introduction
Having an irritable friend, undergoing unstable relationship with fluctuating moods often makes one wonder if such a person is suffering from a personality disorder or not. Although, people might label others on the basis of some characteristics which they find deviant or awkward, diagnosing someone with a disorder requires a ground rule and a set of criteria. Personality disorders are diagnosed on Axis II of DSM IV TR which is a manual to diagnose mental disorders amongst individuals on the basis of standard criteria.
Symptoms and Diagnostic Criteria
Borderline personality disorder is a type of a personality disorder where a person is found to have inconsistent unstable relationships, emotional instability, impulsiveness, anger, and fluctuating self-image. This disorder is mainly found in females which usually begin during early adulthood. DSM IV TR (American Psychiatric Association, 2000) has proposed the following set of criteria to diagnose a person with borderline personality disorder:
- Individuals usually put in great effort to stay away from real as well imagined abandonment. In other words, these people are very sensitive to change and often fear being abandoned. As a result, they may retaliate and get angry. Even a rescheduling of an appointment would also infuriate them. This is due to their underlying belief of being bad because of which people abandon them.
- Intense unstable relationships are typical of such individuals where instability is often marked with extreme idealization at one hand and extreme devaluation on the other.
- They have a persistently prevalent unstable sense of self and self image.
- They experience impulsivity in at least two aspects which are quite self damaging. This might include impulsiveness in unsafe sex, binge eating, substance abuse and more.
- Individuals demonstrate a recurrent pattern of suicidal an self mutilating behavior
- Emotional instability
- They go through severe feelings of emptiness
- They show extreme uncontrollable anger
- When stressed, these individuals depict dissociative symptoms.
Prevalence
The prevalence of Borderline Personality Disorder has been researched to be about 2% of the total population where as it estimates to be between 30% and 60% among those individuals who are diagnosed with other personality disorders.
As mentioned early that females are usually seen to be diagnosed with Borderline Personality Disorder is during young adulthood, DSM IV TR suggests that severe instability is usually visible during early adulthood. In this regard, these individuals are at the greatest risk of committing a suicide where these tendencies subside with age. In addition, Borderline Personality Disorder is also said to be prevalent amongst individuals with a family history of Borderline Personality Disorder of other disorders such as Mood Disorders, Substance-Related Disorders and Anti-Social Personality Disorder (American Psychiatric Association, 2000).
Causes
Quite often, individuals suffer from different disorders and its etiology becomes a matter of concern. Despite several interventions and in-depth analysis, scholars at times fail to point out the exact cause of an illness or a disorder. In this case of Borderline Personality Disorder, researchers claim a number of factors which collectively cause this disorder. Some of these include genetics which is also coherently mentioned by DSM IV TR. The onset of this disorder is also attributed to neurotransmitters which serve the function of transmitting signals between the neurons/ brain cells. These transmitters are responsible for the mood fluctuation amongst human beings. For this reason, since Borderline Personality Disorder is all about emotional instability, anger and fear, neurotransmitters is said to contribute to the onset of the disorder. Apart from considering the functioning and structure of the brain to be responsible for causing Borderline Personality Disorder, studies have also highlighted a number of environmental variables. Traumatic experiences such as death in a family, sexual assault, rape or abuse might also result in Borderline Personality Disorder. Also, stressful childhood events where children are neglected or mistreated by the parents is also one of the reasons for the disorder. In addition, growing up in a family having individuals suffering from similar disorders may also increase the likelihood of developing Bipolar Personality Disorder.
Interpersonal Relationships
Individuals suffering from Borderline Personality Disorder (BPD) are quite controlling and demanding in their relationships. The beginning would be magical where the BPD sufferer would attract an individual with her shyness and caring nature. However, as time passes, she will begin to demonstrate emotional fluctuation which might be so abrupt that it would change with the blink of an eye. If one moment she is crying because of worldly ailment, the other moment she will cheer up and hug her lover followed by an abrupt transformation of a needy person. Once the BPD person has her lover in her control, she will show the side of her rage. This side is confusing and difficult to understand as it often unexpectedly comes without a reason. She will begin to hate, show resentment and shout at her lover without any particular reason. As a result, she will end up with a broken relationship that would further worsen her already bad condition (Stanley, 2009).
Treatment
While looking at the characteristic features of Borderline Personality Disorder, it is quite evident that the disorder is slightly difficult to treat. Although, as put forward by DSM IV TR, individuals between 30 and 40 years eventually achieve a stable condition, research stresses upon the problems attached to treating BPD (American Psychiatric Association, 2000). One of the foremost ways to treat BPD is through Psychotherapy via Cognitive Behavioral Therapy, Schema-focused therapy and Dialectical behavior therapy. All these forms of psychotherapy enable the patient to alter the way they perceive themselves and the environment by focusing on resolving specific issues they face while interacting with others. Psychotherapy helps alleviate the symptoms of mood and anxiety. Therapies can be individual conducted as well as in the form of groups. Moreover, the families of the patient can also benefit from it. Apart from therapies, BPD can also be treated using medicines. Although studies have not found a significant impact of medications on treating BPD, several patients receive therapies as well as medicines to treat their problem.
Conclusion
Thus, life is all about challenges and hardships. It is the courage; effort and the belief of the person which makes him fight and live up to these situations. Borderline Personality Disorder is a condition marked with emotional instability, fear, resentment, anger and impulsivity. All these conditions affect the individual himself, his behavior towards others and ruin his relationships thereby making various aspects of life quite difficult. For this reason, it is essential to look at the factors which might result in BPD. Although genetic and biological factors cannot easily be addressed, it is the role of the society especially parents to provide their children with a healthy environment so that they do not grow up to face such problems. If this behavior is adopted, BPD can eventually cease to exist.
REFERENCES
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: Author.
Bradley, R. (2005). The psychodynamics of borderline personality disorder: A view from developmental psychopathology. Development and Psychopathology, 17: 925-957.
Stanley, B. (2009). The interpersonal dimension of borderline personality disorder. AM J Psychiatry, 167: 24-39.
