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Borderline Personality Disorder: Description, Diagnostics, and Management
Introduction
Borderline Personality Disorder (BPD) is a mental health condition that impacts emotional control leading to intense anxiety, impulsiveness, mood swings, and personal isolation. BPD is a chronic condition common in both the general population and clinical settings. Intensive fear or distress during childhood and past emotional, physical, and sexual abuse are the risk factors for BPD. People with BPD have twisted ideation of themselves and others, resulting in unstable relationships with friends, loved ones, and family. People with BPD live low quality of life characterized by difficulty maintaining employment and relationships. BPD is a chronic mental illness that challenges emotional and behavioral regulations, influencing poor relationships and dangerous behaviors.
Main body
The criteria for BPD diagnosis involve identifying unusual patterns of anger and interpersonal relationships displayed by the patients. The review of self-image and perception by the individuals is also used to diagnose BPD. Emotional instability is the main symptom of BPD in various contexts, including impulsivity, irritability, overthinking, intense episodes of sadness, and anxiety (Lazarus et al., 2018). An inverted perception of oneself and others is also a critical BPD symptom that leads to self-damaging behaviors. BPD patients create imagined abandonment that could result in explosive anger. The symptoms criteria through detailed interviews with the patient, psychological assessment through questionnaires, and clinical history help the clinician rule out symptoms of BPD.
The interviews, psychological assessments, and questionnaires evaluate symptoms of intense and unstable emotions and relationships. They evaluate how the individual sense of self and their clarity of self-image. People with BPD are unclear about their self-image and have a disturbed sense of self (Lazarus et al., 2018). BPD is also associated with patterns of unstable relationships with other people marked by recurrent fights and quarrels due to impulsivity. The poor relationship with others is due to behaviors of explosive anger and emotional swings. Self-harming behaviors such as substance abuse, suicide attempts, and reckless decision-making are common in patients with BPD. The symptoms of BPD should be identified and screened at a young age.
The effective emotional instability caused by BPD is subjective to identity disturbance and interpersonal challenges. The patients suffer the chronic feeling of emptiness with a profound lack of emotional depth or sense of experience. Individuals typically feel disconnected from themselves more frequently due to the recurrent feeling of emptiness; patients experience intervals of sadness, mood swings, and anxiety. BPD causes impulsive behavior that could influence potentially self-damaging behaviors such as substance abuse and reckless spending. BPD displays severe and heterogeneous symptoms during diagnosis that require equally complex care and intervention strategies.
The medication for BPD includes antidepressants, antipsychotics, and mood stabilizers. According to Bozzatello et al. (2020), various medications are prescribed after diagnosis to alleviate emotional symptoms. BPD depends on a combination of drugs to manage the multiple symptoms associated with the condition. Antidepressants manage emotional hyperactivity, stress, and anxiety and foster emotional stability. The most commonly used antidepressants are Fluvoxamine, Zoloft, and Lexapro (Bozzatello et al., 2020). Depression medication has side effects, including allergic reactions and intense bleeding. There is consistent research-based evidence that antidepressants are significantly effective in limiting critical BPD symptoms.
Antipsychotics boost antidepressants to suppress impulsive behaviors. They are effective in improving aggression, anxiety, psychotic symptoms, and anger (Bozzatello et al., 2020). Some of the antipsychotics used in BPD management include Abilify, Zyprexa, Fan apt, Capylyta, and Risperdal. Mood stabilizers or anticonvulsants stabilize mood swings that cause unusual behaviors. The most common prescription for BPD includes topiramate, valproate, and Lamictal. The side effects of anticonvulsants include blurred vision, abnormal behavior, and allergic reaction. The appropriate dosage for each medication is determined by the health care professional depending on the individual symptoms and nature of BPD.
Psychotherapy is administered to BPD patients besides the medication. The psychotherapy target is enhancing relationships, emotional control, and altering the disastrous behaviors in BPD management. Cognitive Behavioral Therapy (CBT), Mentalization-based therapy (MBT), and Dialectical Behavior Therapy (DBT) are the psychotherapeutic approaches used to remedy the emotional and interpersonal challenges posited by BPD (Bozzatello et al., 2020). Psychotherapy aims to enable individuals to understand and improve their emotions, perceptions, and behavioral symptoms. The counselor helps people identify what triggers them and how to manage those situations. Psychotherapy in the management of BPD focus on the strengths and ability to function to rectify behaviors and emotional response. The therapist adopts the most suitable psychotherapy to address the patients individual needs.
The therapies for BPD differ and can either be administered in group or individual therapies. DBT is most prevalent in treating personality behaviors by imparting the necessary emotional control skills and fostering interpersonal relationships and depression tolerance. CBT is broad-spectrum psychotherapy with specialized techniques applied in BPD management, such as cognitive restructuring, to tackle the identity dilemma (ODwyer et al., 2020). Alternatively, the MBT is administered through discussions to connect the individuals with their thoughts and feelings. Additionally, some recommended natural and home remedies are enough rest and meditation. Different or a combination of therapeutic interventions can be applied depending on the personality traits exhibited.
BPD has tremendous effects on personal life, family members, and abilities to secure or maintain gainful employment. First, BPD patients suffer low self-esteem and loss of interpersonal relationships, impacting their personal lives. The inability to control emotions cause many episodes of trouble with other people and potentially with law enforcement. The consistent impulsive decisions by BPD patients negatively impact their social interactions and network. Since persons with BPD are highly sensitive to abandonment, the isolation by most people alleviates feelings of anger and self-harm. The symptoms of chronic emptiness, loneliness, anger, depression, and anxiety affect the quality of the personal life of the victims (Seigerman et al., 2020). Furthermore, people with BPD face unemployment and challenges securing and maintaining unemployment. Employers do not appreciate the pervasive unpredictability of interpersonal relationships and emotions marked by impulsivity. From the perspective of affected individuals, the fear of disclosure, anticipated stigmatization, and low self-confidence impede their employment.
Without treatment, the symptoms of BPD alleviate, causing toxic interpersonal relationships, severe psychological effects, and self-harm behaviors. Increased depression and anxiety would trigger the infection of other medical complications and substance use disorders hence comorbid personality psychopathology. There is no definitive cure for BPD but rather a medication and therapeutic intervention to reduce the impacts of the symptoms (Mota & Lourenco, 2020). There are fewer risks of poor interpersonal and emotional effects with effective interventions, hence improved quality of life for BPD patients. Additionally, people with BPD have reduced life expectancy. BPD is a chronic condition that can improve over time with effective medication and counseling interventions.
The family members of individuals diagnosed with BPD face financial, stigmatization, and social challenges. Family members are responsible for caring for BPD patients who may feel exhausted and mystified by the condition. Harmful symptoms of BPD, such as mood swings and anger outbursts, are terrifying to the immediate family living with the victim. Avoiding isolation by the patients is disruptive to the family members affecting their schedules (Seigerman et al., 2020). Such family members often experience isolation and stigmatization from the community. The chronic stress and conflict associated with BPD affect romantic relationships and can be a major source of marital conflicts. Moreover, the financial burden of different medications and therapies for managing BPD may be overwhelming to the family.
Conclusion
In Conclusion, BPD is a psychotic disorder with significant impacts on behavior and emotional stability. BPD diagnosis is conducted through interviews, questionnaires, and psychological assessments to identify the behavioral and emotional symptoms. The main symptoms of BBPD are associated with behavioral and emotional uncertainty characterized by episodes of anger, sadness, and anxiety. Behavior, psychological, and psychosocial instability are evident in patients with BPD. A multidisciplinary perspective is necessary for BPD management through medication and therapies. Antipsychotics, anticonvulsants, and antidepressants are the medications for BPD, whereas DBT, CBT, and MBT are the psychotherapy treatments for borderline. The prognosis of the borderline disorder indicates that BPD is a chronic illness whose symptoms can be suppressed through continued intervention care. BPD does not only impact the affected individuals but also their entire network of family. Individuals with BPD struggle with interpersonal relationships and securing and maintaining employment. The immediate and extended family members of the patients. Suffer isolation, stigmatization, and social and financial burden.
References
Bozzatello, P., Rocca, P., De Rosa, M. L., & Bellino, S. (2020). Current and emerging medications for borderline personality disorder: is pharmacotherapy alone enough?. Expert Opinion on Pharmacotherapy, 21(1), 47-61. Web.
Lazarus, S. A., Scott, L. N., Beeney, J. E., Wright, A. G., Stepp, S. D., & Pilkonis, P. A. (2018). Borderline personality disorder symptoms and affective responses to perceptions of rejection and acceptance from romantic versus nonromantic partners. Personality Disorders: Theory, Research, and Treatment, 9(3), 197. Web.
Mota, P., & Lourenço, S. (2020). Am I bipolar or what? Exploring the phenomenological, treatment, and prognosis overlap of borderline personality disorder and bipolar disorder. Mental Health Review-Journal. Web.
ODwyer, N., Rickwood, D., Buckmaster, D., & Watsford, C. (2020). Therapeutic interventions in Australian primary care, youth mental health settings for young people with a borderline personality disorder or borderline traits. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 1-10. Web.
Seigerman, M. R., Betts, J. K., Hulbert, C., McKechnie, B., Rayner, V. K., Jovev, M. & Chanen, A. M. (2020). A study comparing the experiences of family and friends of young people with borderline personality disorder features with family and friends of young people with other serious illnesses and general population adults. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 1-8. Web.
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