Borderline Personality Disorder: Causes, Symptoms and Treatments
Borderline Personality Disorder can be a traumatic experience not only for the patient but also for his relatives and loved ones. A person suffering from Borderline Disorder considers each and every of his actions as perfect and appropriate. However, these actions can cause havoc in his life without him even understanding what is really happening.
He seems that all of his behaviors and feelings are justified. But such behaviors and feelings actually create a lot of problems for him in the long run.
Borderline personality disorder is one of the most prevalent personality disorders in the world. According to an estimate, 1-4% of total world population has borderline personality disorder. Similarly, women are more prone to the disorder as compared to men. As a matter of fact, out of 100 patients of borderline personality disorder, 75 are women.
Symptoms actually start to appear during late childhood or early adolescence. Furthermore, any kind of personality disorder including borderline disorder can range from mild to severe. The good news is that most of the patients fully recover after the diagnosis and effective treatment.
WHAT IS BORDERLINE PERSONALITY DISORDER?
In the days gone by, experts believed that the person suffering from borderline personality disorder is literally at the border between two mental conditions.
Neurosis: A mental condition in which a person can differentiate between the reality and imagination despite being mentally distressed.
Psychosis: A condition in which a mentally distressed person cannot differentiate between the reality and imagination. Such a person may also experience delusions such as strong belief in something that cannot really happen or is totally implausible.
However, this is the most inaccurate description of the disorder according to modern medical science. The borderline disorder is a disorder of interpersonal functions (how one interacts with others and his environment) and mood. A patient of borderline disorder behaves impulsively, reacts extremely or inappropriately to certain situations and usually has unstable relationships in addition to showing many other symptoms.
Suffering from the disorder happens to be a painful circle marked with reckless behaviors, emotional volatility and the tendency of getting irritated by pretty small things. It is pertinent to note that many people struggling with borderline disorder will attempt suicide or at least try to self-harm. In fact, almost 80% of patients do attempt suicide out of which 10% eventually succeed in killing themselves.
In simple terms, borderline personality disorder is a type of emotional disorder which makes it difficult for you to think and feel properly about yourself and others.
COMMON MYTHS ASSOCIATED WITH BORDERLINE PERSONALITY DISORDER
Before we talk about the causes and treatments of the disorder, it is imperative to debunk some of the most common myths associated with it.
People Do it for Attention
This is a common myth about borderline personality disorder especially when the patients show suicidal behaviors. You need to keep in mind that patients often try to communicate their feelings through self-injury even if they are not trying to commit suicide. Therefore, you need to consider their behavior as legitimate and valid. Most often, they don’t do it for attention.
It is a Variation of Bipolar Disorder
It is not a variation of bipolar disorder but a completely different disorder altogether. They are two distinct illnesses despite the fact they have similar symptoms and treatments.
It is Untreatable
Borderline personality disorder is treatable. In fact, most patients fully recover and return to normal life after timely diagnosis and effective treatment.
Only Women Suffer from BPD
It is a fact that women are more commonly diagnosed with BPD but men do suffer from the disorder as well.
Only Bad People Suffer from BPD
This is one of the most common and popular myths about the borderline personality disorder. In fact, they are not bat but are simply patients of a disorder that totally ruins their life and makes it difficult for them to recognize what is right and what is wrong. As discussed above, they return to normal life after necessary treatment.
All Patients are Victims of Child Abuse
Child abuse can lead to the development of BPD in adolescence. However, it is totally wrong to say that all victims of BPD experience child abuse early in their life. There are many causes of BPD and child abuse is only one of them.
SYMPTOMS OF BORDERLINE PERSONALITY DISORDER
A patient of borderline personality disorder can display a myriad of symptoms.
In fact, the disorder can manifest in many different ways. According to mental health professionals, all the symptoms of the disorder generally fall into nine major categories which are explained as under.
Impulsive and Destructive Behaviors
Patients of BPD have the tendency to behave impulsively. You may engage in many different types of self-destructive and harmful activities especially if you are upset or angry. Some of the activities you can indulge in include shop lifting, reckless driving, unprotected or dangerous sex, binge eating, and spending money mindlessly and drug overdose etc. These risky behaviors may seem totally appropriate at the moment but will actually create a lot of problems for you and those you love.
If you have borderline personality disorder, you can exhibit many dangerous symptoms as well. You can attempt suicide or try to harm yourself at any time. Similarly, you keep thinking about suicide and even make suicidal threats and gestures, keeping people around you on their toes. On the other hand, you can do many other things such as burning and cutting to self-harm yourself when you are not actually thinking about committing suicide.
Fear of Abandonment
People suffering from this particular personality disorder often fear that their loved ones will abandon them. You become horribly terrified even when someone goes out for a weekend or returns home late from work. Such innocuous things are enough to fill you heart with intense fear. You may try desperately to keep those you love close to you at any cost. You may even resort to begging, tracking their movements, jealousy, fighting or even forcefully preventing them from leaving the house. Unfortunately, you actually drive others away instead of bringing them closer by displaying such behaviors.
Unstable or Unclear Self-Image
You normally have unclear or distorted self-image when you are suffering from borderline disorder. You even start looking yourself as evil or. You may even go to the extent of hating yourself. Sometimes, you do feel good about yourself but such occurrences are few and far between. You don’t have any idea of what your life goals are or who you are in the first place. As a result, you don’t normally hold to anything including your lovers, jobs, homes, friends, goals, values and even your religion and sexual identity for long.
People having BPD usually don’t have happy relations. Mostly, their relationships are short-lived and intense. Such people consider every new person they meet as their messiah and fall in love with him almost instantly, only to be disappointed later on. There are only two extremes of your relationships. They are either horrible or perfect without anything in between. Your rapid swings between hate and anger as well as idealization and devaluation can also land an emotional blow to members of your family, friends and everyone else you truly love.
Extreme Emotional Swings
Unstable emotions and frequent mood swings are an indispensible part of borderline personality disorder. You frequently move between the state of happiness and the state of despondence. You can go to an emotional tailspin due to little things other people simply do not pay any attention to. In BPD, mood swings are typically intense but pass relatively quickly as compared to that of bipolar disorder or depression. They normally last from few minutes to few hours.
Borderline personality disorder can also instill explosive anger in your personality. In fact, short temper and explosive anger are two of the biggest symptoms of the disorder. You may also find it really difficult to control or stop yourself when you are really angry. Subsequently, anger totally consumes you and you start yelling, throwing things and indulge in complete madness without any fear of the consequences.
Chronic Feelings of Emptiness
Patients of borderline personality disorder have a chronic feeling of emptiness. Some of them even claim that they have a deep void or hole somewhere inside them. In most extreme cases, you start considering yourself as “nobody.” You try to get rid of this uncomfortable feeling by resorting to sex, food and drugs. However, the feeling prevails and nothing seems to alleviate the intense pain.
You do not Recognize Realty
You can also struggle with paranoia if you have borderline personality disorder. You start getting suspicious about other people’s routine activities as well as their “hidden motives.” You may even fail to differentiate between imagination and reality when you are too stressed, the phenomenon commonly known as Dissociation. You also feel spaced out, foggy and you think that you are outside your body.
Many normal people also exhibit any or all of the above mentioned symptoms due to different reasons. However, a patient of borderline personality disorder experiences them regularly during his adulthood before seeking treatment.
CAUSES OF BORDERLINE PERSONALITY DISORDER
Most mental experts believe that there are more than one causes of borderline personality disorder. In fact, the disorder is the result of combination of different factors such as genetic factors, environmental factors, neurotransmitters and neurobiology. Following lines explain these factors one by one.
A normal adult has a certain level of neurotransmitter, a substance called serotonin, in his brain. On the other hand, there is reduced amount of serotonin in the brain of a BPD patient or he fails to respond to serotonin correctly. It has also been scientifically proved that inability to control self-destructive behaviors, aggression and depression are directly associated with the low levels of serotonin in the brain.
It is worth mentioning that low levels of other two important neurotransmitters, called noradrenaline and dopamine, can result in emotional instability and thus, also supposedly cause borderline personality disorder.
Mental experts have spent years and years on studying brains of people suffering from borderline personality disorder with the help of MRI scans. These scans produce extremely detailed images of body interior through radio waves and strong magnetic fields.
Some of the MRI scans revealed that unusual activity in three different parts of brain can lead to development of the disorder. Similarly, these same parts are smaller in size in people having BPD as compared to that of normal people. These parts are as under.
The Amygdala: The amygdala is responsible for regulating emotions including anxiety, aggression, fear and all other negative emotions.
The Hippocampus: The hippocampus is responsible for regulating self-control and related behaviors.
The orbitofrontal Cortex: The orbitofrontal cortex plays an important role in decision making and planning.
You are very likely to show the symptoms of borderline personality disorder if one or all of these parts of brain malfunction.
Your early upbringing has a lot to do with the proper or improper development of these parts of brain. They also regulate your mood which precisely explains why people having borderline disorder struggle to form long lasting relationships.
Genetic problems may also lead to the development of borderline personality disorder in individuals. Studies being done on twins present the strongest evidence that genetics can actually cause borderline disorder. One of the studies reveals that there are two in three chances that an identical twin will develop the disease if the other twin already has the disorder.
However, there has been no conclusive evidence that humans have a gene for disorder. People do inherit certain personality traits such as the tendency to be emotionally unstable or aggressive from their parents.
However, it does not mean that they are going to develop borderline personality disorder as well. Similarly, identical twins share many environmental factors because they grow up in the same family environment and household. That is why they display similar character traits and behaviors.
People suffering from borderline personality disorder share a lot of environmental factors such as:
- They can be victims of sexual, emotional or physical abuse.
- They experienced distress or chronic fear when they were children.
- One or both parents neglected them when they needed them the most.
- They grow up with another member of the family with serious mental condition such as severe drug abuse, depression or bipolar disorder.
Different people see the world and interact with other people differently depending upon the nature of their relationship with their parents and rest of the family. You can develop variety of distorted thinking patterns in adulthood due to chronic distress, anger and unresolved fear from your childhood.
Some of these behaviors include behaving as a child even in the adulthood, expecting others to bully you or act as a parent to you and idealizing others etc.
TREATMENTS OF BORDERLINE PERSONALITY DISORDER
There are different types of treatments for borderline personality disorder depending upon how serious your condition is. Following lines explains some of the most popular treatments for BPD.
Care Program Approach (CPA)
You will become a part of treatment method commonly known as Care Program Approach if the symptoms are moderate to severe. The CPA ensures that you do get the right treatment for your condition. There are actually four stages of CPA which are as under.
- Experts will assess you condition and social needs.
- The second stage is to create a care plan incorporating your social needs and the treatments for your condition.
- Thirdly, you will be assigned a care coordinator. He is usually a nurse or social worker. It is actually he who introduces you to other members of the community.
- Finally, experts regularly review your progress and make necessary changes to your care plan if required.
Different types of psychological therapies also help in treatment of borderline personality disorder. You need to keep in mind that all types of psychotherapies take some time (normally 12-18 months) to improve your condition and help you better understand who you are and how to see the world and behave with people.
Your psychotherapist will listen to all of your problems and issues and subsequently, suggest ways to improve your attitude and behavior. In some cases, he will advise practical solutions to your problems as well.
The main aim of psychotherapy is to help patients regain control of their thinking, feelings and thoughts. Keep in mind that you should get such treatment only from a trained professional such as psychotherapist, psychiatrist or other mental health professionals with years of experience.
Depending upon your condition, your doctor can recommend any of the following types of psychotherapies.
- Cognitive Behavioral Therapy (CBT). This type of therapy helps you get rid of negative perceptions you might have about yourself as well as all types of negative thoughts and emotions, unhealthy beliefs and self-destructive behaviors. You learn healthy ways to respond to the feelings of suicide, anxiety, insecurity and aggression.
- Dialectical Behavioral Therapy (DBT). Dialectal behavioral therapy has especially been designed to treat only borderline personality disorder. DBT treats the disorder by doing two things. Firstly, it instills a belief in you that all your emotions are real and valid, a process commonly known as Validation. Secondly, experts teach you the ways about how to be open to opinions and ideas that contradict yours, the process called as Dialectics. The therapists will normally try to bring positive change to your personality and behavior by trying both of these methods.
- Mentalization Based Therapy (MBT). Mentalization based therapy is another type of psychotherapy to treat borderline personality disorder. The concept behind the therapy is very simple that is people having BPD cannot “mentalize” properly due to their reduced mental capacity. The therapist will encourage you to examine your own beliefs and thoughts. Subsequently, you will assess whether they are based on realty and are really useful or not.
Another aspect of MBT is to recognize other people’s thought, beliefs, wishes, emotions and needs as well. You also need to remember that you may not correctly interpret their mental states. Finally, you must recognize how your actions can impact other people’s lives. If you manage to do all this properly, you will eventually get rid of borderline personality disorder forever.
You need to remember that medication does not fully cure borderline personality disorder. Medicines only alleviate the pain and relieve symptoms for a short period of time. In fact, you need to take medicines for co-occurring problems such as anxiety and depression.
Your therapist may decide if you need medication in addition to psychotherapy after assessing your condition. For example, they may prescribe any or all of the following medicines.
- antipsychotics to treat aggressive symptoms
- antidepressants to treat depression
- antianxiety medications to treat anxiety
Your therapist can also recommend you to enter a hospital for treatment if your condition is severe and shows no signs of improvement. You can also go to hospital for suicidal thoughts and behaviors as well as after attempts to commit suicide or harm yourself or others.
IMPLICATIONS OF BORDERLINE PERSONALITY DISORDER
Borderline personality disorder can affect your life in many different ways. There are many implications of the disease which can transform your life into a nightmare.
Apart from showing standard symptoms of the disease, you can also develop related disorders such as depression, anxiety, eating disorders, bipolar disorder, post-traumatic stress disorder and substance abuse etc. In addition, borderline disorder also considerably increases the risk of the following.
- Not completing your education
- Multiple legal issues such as serving jail time
- Sexually transmitted infections
- Problems at office or work
- Relationship problems
- Unplanned pregnancies
- Be a part of abusive relationship where you become either an abused or abuser
- Increased chances of self-injury and suicide
- Getting into accidents of different types
- Getting into physical fights.
- Indulging in violent crimes or becoming a victim of one
Suffering from borderline personality disorder is a horrible experience. It not only makes life difficult for the patient but for his family and friends as well. Therefore, you and your family need to seek help as soon as you are diagnosed with BPD. Prolonged undetected illness can cause multiple problems for you including attempts to self-harm and suicide.
You also need to involve your family once your diagnosis is confirmed because your condition directly affects their lives. By telling them what you are going through, you will actually make your treatment more effective because they will be in better position to identify behaviors that indicate you are in a crisis and desperately need help.
No matter whatever you do, just keep in mind that BPD is fully treatable. You only have to find the right psychotherapist and take all his advises. Only then you will be able to return to normal and happy life.
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