This is the last in a series on the major mental illnesses, also called brain disorders. As a parent who once knew nothing about these things before my daughter, now twenty-nine, was diagnosed, I began to gather information to help both myself and others who are on a similar difficult journey.
May is Mental Health Awareness Month, therefore, my blogs have focused on these issues. I’ve addressed Bipolar Disorder, Major Depression, Panic Disorder, Obsessive-Compulsive Disorder and Schizophrenia. You can access these posts here.
Today’s topic is Borderline Personality Disorder. I hope you find it helpful. I’m not an expert, so I turn to the best in the field, the National Alliance on Mental Illness, nami.org. On their website you will find many additional articles on each of these disorders and much more.
The following information was written by Ken Duckworth, M.D.
Borderline Personality Disorder (BPD) is characterized by impulsivity and instability in mood, self-image, and personal relationships. It’s fairly common and is diagnosed more often in females than in males.
Individuals with BPD experience several of the following symptoms:
Marked mood swings with periods of intense depression, irritability, and/or anxiety lasting a few hours to a few days.
Anger that is intense, uncontrolled and/or not understood.
Impulsiveness in spending, sex, substance abuse, shoplifting, reckless driving, or binge eating.
Recurring suicidal threats or self-injurious behavior.
Unstable, intense personal relationships with intense, categorical views of people and experiences, sometimes alternating between “all good” idealization and “all bad” devaluation.
Marked, persistent uncertainty about self-image, long-term goals, friendships, and values.
Chronic boredom or feelings of emptiness.
Frantic efforts to avoid abandonment, either real or imagined.
The causes of BPD are unclear, although psychological and biological factors may be involved. Originally thought to “border on” schizophrenia, BPD also appears to be related to major depressive illness. In some cases, neurological disorders play a role. Biological factors may cause mood instability and lack of impulse control, which in turn may contribute to troubled relationships. Difficulties in psychological development during childhood, perhaps associated with neglect, abuse, or inconsistent parenting, may create identity and personality problems. More research is needed to clarify the psychological and/or biological factors causing BPD. The field is also actively looking at genetic vulnerabilities.
A combination of psychotherapy and medication appears to provide the best results for treatment. Medications can be useful in reducing anxiety, depression, and disruptive impulses. Relief of such symptoms may help the individual deal with harmful patterns of thinking and interacting that disrupt daily activities.
Long-term outpatient psychotherapy and group therapy (if the individual is carefully matched to the group) can be helpful. Short-term hospitalization may be necessary during times of extreme stress, impulsive behavior, or substance abuse. More structured cognitive interventions like dialectical behavioral therapy (DBT) are now widely used.
BPD may be accompanied by serious depressive illness (including bipolar disorder), eating disorders, and alcohol or drug abuse. It’s critical to determine this prior to treatment. About 50 percent of people living with BPD experience episodes of serious depression. At these times, the “usual” depression becomes more intense and steady, and sleep and appetite disturbances may occur or worsen. These symptoms, and the other illnesses mentioned above, may require specific treatment. A neurological evaluation may be necessary for some individuals.
Antidepressants, anticonvulsants, and the new atypical antipsychotics are commonly part of the treatment for BPD. Decisions about medication should be made cooperatively between the individual and their health care provider. Issues to be considered include the person’s willingness to take the medication as prescribed, and the possible benefits, risks, and side effects, particularly the risk of overdose. (This is where Dr. Duckworth’s article ends.)
Most people living with BPD who are engaged in a personalized treatment plan that includes effective medication and other treatment supports find that their symptoms are reduced enough to help them achieve fulfilled recovery.
BPD is a disorder of emotional dysregulation which can be difficult to diagnose. It affects between 1% and 2% of the general population and impacts the individual’s family and work. It rarely stands alone, with high frequency of co-occurring disorders.
Several organizations offer education programs and/or support to families challenged with mental health issues. The National Alliance on Mental Illness (NAMI), The National Education Alliance for Borderline Personality Disorder (NEA-BPD), The Depression and Bipolar Support Association (dbsalliance.org) and the Mental Health Association(MHA) for your city/county offer programs across the nation.
Family training and support programs such as NAMI’s Family to Family and NEA- BPD’s Family Connections (www.neabpd.org) are in great demand. Through these resources a lot of support is available that didn’t exist a ten years ago.
This can all sound pretty frightening, but we need to keep our eyes on God. Ultimately, He’s our source of help and hope, courage and strength, endurance and stamina. With Him we will be okay.
If your loved one is resistant to taking their medication or cooperating with treatment, a great book you need to read is I Am Not Sick, I Don’t Need Help by Dr. Xavier Amador. His website offers videos of people using his highly effective LEAP method. leapinstitute.com
Be encouraged by these Scriptures:
May your unfailing love be with us, Lord, even as we put our hope in you (Psalm 33:22, NIV).
Our help is in the name of the Lord, the Maker of heaven and earth (Psalm 124:8, NIV)