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Borderline Personality Disorder

Borderline personality disorder is considered to be a serious and complex mental illness in terms of its symptoms and ability to diagnose.

Also referred to as BPD, the complexities of this illness can result in negative stigma and discrimination due to many people's misinterpretations of the symptoms.

Between 2% and 5% of Australians are affected by BPD at some stage in their lives with symptoms of the disorder normally first appearing in the patients mid-to-late teens, or in early adulthood, with women three times more likely to be diagnosed with BPD than men.

Mental health experts now agree that the label 'borderline personality disorder' is misleading, however a more accurate term to describe this disorder does not exist yet. Many people living with borderline personality describe themselves as 'emotionally sensitive' or 'emotionally dysregulated'.

What Is Borderline Personality Disorder?

Borderline personality disorder is a serious mental illness that centers on the persons inability to manage their emotions effectively, occuring in the context of relationships. Sometimes all relationships are affected, and sometimes only one.

Those living with borderline personality frequently experience intense emotions which can leave them feeling quite distressed and result in difficulty in relating to other people, and self-harming behaviour. They also experience feelings of impulsivity and dysregulation on a regular basis.

It is considered to be a personality disorder as it influences how a person can perceive, relate to, and think about their environment and themselves.

What Are The Symptoms?

Borderline personality can manifest in many different ways, where some may experience a certain range of symptoms regularly, where another group may not experience those symptoms as often. Those living with borderline personality frequently experience intense, unstable emotions and moods which can pass quickly, unlike the emotional swings experienced with bipolar disorder.

People with borderline personality can also feel a constant difficulty in being able to relate to other people, and the world around them, which can result in distress and isolation from others.

Symptoms may include one or more of the following;

Feelings of Insecurity

People with borderline personality can have difficulties coping with fear of abandonment and loss resulting in continually seeking reassurance, regardless of how big or small the perceived 'problem'. It is also common to express inappropriate anger towards others who they consider responsible for how they feel, with a low sense of self and self-esteem.

Impulsive Behaviour

The impulsiveness in those living with borderline personality is a general response to feeling emotionally overwhelmed, and at times can prompt self harming behavour including drug and alcohol abuse, cutting, burning, and binge eating. Self-harm can leave the patient with feelings of short-term relief from their emotional distress, but it can have a long-term impact on the person, at times resulting in attempts at suicide.

Conflicting Emotions

It is common for people living with borderline personality to frequently question or change their emotions and attitudes towards others and aspects of their life including their career, living situation, sexual orientation, goals, and hobbies.

What Are The Causes?

The causes of borderline personality are not yet fully understood, however are likely to be a combination of biological and life factors. Research shows people living with borderline personality have been more susceptible to experiences of abuse, trauma and/or neglect throughout their childhood, and can contribute to the development of the disorder.

Treating Borderline Personality Disorder

The diagnosis for borderline personality disorder is made by a psychiatrist, with ongoing treatment managed by a psychiatrist and/or clinical psychologist. The most effective treatment involves a combination of psychological therapy and support with the aid of medication to help manage some symptoms such as depression, anxiety and mood swings.

With the right treatment and support, people with borderline personality can lead a full, productive and happy life.

Psychological Treatments

Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT) is regarded as extremely beneficial in the treatment of borderline personality disorder by decreasing the depressive symptoms and reducing hospital admissions.

Cognitive behaviour therapy is one of the most common-known form of psychotherapy, focusing on helping people learn how their thoughts can change their feelings and behaviour.

Dialectical behaviour therapy is a specific form of cognitive behaviour therapy, building upon those existing foundations. It places emphasis on the psycho-social aspects of treatment in how a person interacts with people in different set environments and relationships.

Interpersonal psychotherapy (IPT) is another form of psychological therapy, teaching the person new and effective ways to relate to significant people in their lives.

Psychological therapies are undertaken face-to-face with a trained professional, and there are also many growing online resources providing online course modules via the internet.

Medical Treatments

Medications for borderline personality disorder are generally administered through a psychiatrist on a case-by-case basis as each person is different. Medication does not fix or cure borderline personality, however it is very helpful in the management of some symptoms such as depression, anxiety and mood swings.

The prescription of medication should be made in consultation with your psychiatrist and psychologist.

How To Manage Borderline Personality

  • Stick to your treatment plan; visit your psychiatrist and psychologist on a regular basis to ensure you are on track with your treatment
  • Learn how to relax; meditate daily in the morning and/or evening to assist with mood elevation, mindfulness and muscle relaxation
  • Talk to your close family and friends about your current diagnosis and how they can support you; your psychologist can help you in addressing this
  • Learn to be self aware; the way you think will have an affect on the way you feel. Self-awareness through mindfulness and meditation may help prevent symptoms from escalating by being able to recognise an emotion and knowing how to address it before it has the potential to escalate into a episode
  • Develop and maintain a healthy lifestyle; regular exercise such as a simple 30 minute brisk walk or yoga routine each day along with a diet containing good nutrients can aid in managing symptoms whilst providing distractions from negative thoughts
  • Keep a routine; good sleeping habits, a nutritious diet along with healthy stress management and taking your medications as prescribed can reduce symptoms including mood changes, impulsiveness and irritability
  • Join a support group; there are various BPD support groups online where people can share their experiences and struggles
  • Create healthy habits; alcohol, drugs, and stimulant abuse is known to exacerbate the symptoms and can cause major disruptions to your emotional wellbeing and overall treatment.

How To Get Help

Borderline personality disorder is best diagnosed and treated by a psychiatrist and psychologist, which can be sought by asking your General Practitioner (GP) for a referral.

Your psychiatrist will develop a treatment plan to help manage your symptoms. Psychological treatment in the form of dialectical behaviour therapy is highly recommended for the long-term management of borderline personality disorder, and can be arranged through your psychologist.

Your Mental Health Treatment Plan will also be arranged in order to receive a Medicare rebate for any necessary treatment with your new psychologist.

Definitions & References

Psychologists are trained and qualified mental health professionals who provide psychological therapies such as Dialectical Behaviour Therapy (DBT) at both an emotional and psychological level. Sessions can be conducted with either an individual or a group, and can provide various methods on how to manage existing symptoms.

Psychiatrists are doctors who are also extensively trained in mental health in order to make both medical and psychiatric diagnoses. Psychiatrists will generally administer medication deemed suitable to treat a patients condition, in a private practice and/or psychiatric hospitals

Counsellors are trained to give guidance on personal problems. Common personal problems include difficulties with relationships and life circumstances, grief, anxiety and depression.

Data References:
Australian Bureau of Statistics (2007/2008).
National Survey of Mental Health and Wellbeing: Summary of Results, 2007 (4326.0 & 1301.0).
Canberra: Australian Bureau of Statistics.