Borderline Personality Disorder (BPD).
Created | Updated Apr 30, 2009
What is BPD?
BPD is a Personality Disorder in its own right and was originally given this name as it was considered to be on the 'border' of neurosis and psychosis. Borderline Personality Disorder was first introduced as a diagnosis in the DSM-III (Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition; Washington, D.C; American Psychiatric Association, 1980), but was developed from an article by Spitzer, Endicott and Gibbon in 1979. In common with the vast majority of other people with psychiatric diagnoses, are NOT a danger to others. Indeed, they are far more likely to be a danger to themselves. People diagnosed BPD are not being histrionic or 'manipulative'. The intensity of emotions that Borderlines feel are extreme enough to interfere with basic tasks in day-to-day life.
Diagnosis
A diagnosis of BPD is made when at least 5 of the following 9 criteria are present, however is important to take the severity and intensity of these symptoms in to account as well as their duration and their impact on day-to-day living. Any person can experiance some of the symptom, to some extent, some of the time.
Borderline Personality Disorder is currently defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM IV) as being:
'A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
· frantic attempts to avoid real or imagined abandonment.
· a pattern of unstable and intense interpersonal relationships characterised by alternation between extremes of idealisation/devaluation.
· identity disturbance: markedly and persistently unstable self-image or sense of self.
· impulsivity in at least two areas that are potentially self-damaging, eg sex, binge-eating, alcohol or drug abuse, chronic
over-spending, gambling, shoplifting etc... Note: Do not include suicidal or self-mutilating behaviour.
· recurrent suicidal behaviour, gestures or threats, or self-mutilating behaviour.
· affective instability due to marked reactivity of mood.(e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
· chronic feelings of emptiness
· inappropriate, intense anger or difficulty controlling anger.
· transient, stress-related paranoid ideation or severe dissociative symptoms.
Whilst many people may experience some of these traits from time to time, a person diagnosed BPD will experience these symptoms severely, intensely and over a number of years.
Treatment...
Borderline Personality Disorder is difficult to treat as it involves challenging ingrained beliefs and characteristics. Treatment for BPD usually takes the form of drug therapy include anti-depressants, anxiolytics (which may aid sleep and produce a calming effect) and anti-psychotics (which may improve impulse control and sleep). Drug therpay alone is unlikely to achieve good results for a patient and drug therapy is often combined with some sort of individual or group therapy, such as Dialectical Behaviour Therapy (DBT, which has been shown to be highly effective in helping sufferers of BPD), Cognitive Behaviour Therapy (CBT), or Cognitive Analytical Therapy (CAT) or psychodynamic therapy.
Statistics...
· Borderline Personality Disorder is the most commonly diagnosed Personality Disorder (it accounts for about half of the total
number of PD diagnoses).
· It is estimated that between 2-3% of the general population are affected (over a million people in the United Kingdom).
· 75% of people diagnosed with BPD are female.
· People diagnosed with BPD will often also have other psychiatric diagnoses.
· BPD is diagnosed in 11% of psychiatric outpatients and 19% of inpatients.
· Over 50% of people diagnosed are victims of physical and or sexual abuse.
· In the region of 8-10% of Borderlines will commit suicide.
