Borderline personality disorder

Answer 1

Definition

Borderline personality disorder is a condition in which a person makes impulsive actions, and has an unstable mood and chaotic relationships.

Alternative Names

Personality disorder - borderline

Causes, incidence, and risk factors

Personality disorders are long-term (chronic) patterns of behavior that negatively affect relationships and work. The cause of borderline personality disorder (BPD) is unknown. People with BPD are impulsive in areas that have a potential for self-harm, such as drug use, drinking, and other risk-taking behaviors.

Risk factors for BPD include:

• Abandonment in childhood or adolescence
• Disrupted family life
• Poor communication in the family
• Sexual abuse

This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.

Symptoms

Relationships with others are intense and unstable. They swing wildly from love to hate and back again. People with BPD will frantically try to avoid real or imagined abandonment.

BPD patients may also be uncertain about their identity or self-image. They tend to see things in terms of extremes, either all good or all bad. They also typically view themselves as victims of circumstance and take little responsibility for themselves or their problems.

Other symptoms include:

• Feelings of emptiness and boredom
• Frequent displays of inappropriate anger
• Impulsiveness with money, substance abuse, sexual relationships, binge eating, or shoplifting
• Intolerance of being alone
• Recurrent acts of crisis such as wrist cutting, overdosing, or self-injury (such as cutting)

Signs and tests

Personality disorders are diagnosed based on psychological evaluation and the history and severity of the symptoms.

Treatment

Group therapy can help change self-destructive behaviors. Having peers reinforce appropriate behaviors may be more successful than one-on-one counseling, because people with this condition often have difficulty with authority figures, which can prevent them from learning.

Medications can help level mood swings and treat depression or other disorders that may occur with this condition.

Expectations (prognosis)

Borderline personality disorder has a poor outlook because people often do not comply with treatment.

Complications

• Drug abuse
• Suicideattempts
• Eating disorders
• Depression

Calling your health care provider

Call your health care provider if you or your child is has symptoms of borderline personality disorder.

References

Moore DP, Jefferson JW. Borderline personality disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 138.

Montandon M, Feldman MD. Borderline personality disorder. In: Ferri FF, ed. Ferri's Clinical Advisor 2008: Instant Diagnosis and Treatment. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008.

Answer 2

Borderline personality disorder is a mental health condition characterized by difficulties in regulating emotions and behavior, unstable relationships, and a distorted self-image. Individuals with this disorder often experience intense mood swings, impulsivity, and feelings of emptiness. Treatment typically involves a combination of psychotherapy, medication, and support from mental health professionals.

Answer 3

Definition

Borderline personality disorder is a condition in which people have long-term patterns of unstable or turbulent emotions, such as feelings about themselves and others.

These inner experiences often cause them to take impulsive actions and have chaotic relationships.

Alternative Names

Personality disorder - borderline

Causes, incidence, and risk factors

The causes of borderline personality disorder (BPD) are unknown. Genetic, family, and social factors are thought to play roles.

Risk factors for BPD include:

• Abandonment in childhood or adolescence
• Disrupted family life
• Poor communication in the family
• Sexual abuse

This personality disorder tends to occur more often in women and among hospitalized psychiatric patients.

Symptoms

People with BPD are often uncertain about their identity. As a result, their interests and values may change rapidly.

People with BPD also tend to see things in terms of extremes, such as either all good or all bad. Their views of other people may change quickly. A person who is looked up to one day may be looked down on the next day. These suddenly shifting feelings often lead to intense and unstable relationships.

Other symptoms of BPD include:

• Fear of being abandoned
• Feelings of emptiness and boredom
• Frequent displays of inappropriate anger
• Impulsiveness with money, substance abuse, sexual relationships, binge eating, or shoplifting
• Intolerance of being alone
• Repeated crises and acts of self-injury, such as wrist cutting or overdosing

Signs and tests

Like other personality disorders, BPD is diagnosed based on a psychological evaluation and the history and severity of the symptoms.

Treatment

Many types of individual talk therapy, such as dialectical behavioral therapy (DBT), can successfully treat BPD. In addition, group therapy can help change self-destructive behaviors.

In some cases, medications can help level mood swings and treat depression or other disorders that may occur with this condition.

Expectations (prognosis)

The outlook depends on how severe the condition is and whether the person is willing to accept help. With long-term talk therapy, the person will often gradually improve.

Complications

• Depression
• Drug abuse
• Problems with work, family, and social relationships
• Suicideattempts and actual suicide

Calling your health care provider

Call your health care provider if you or your child has symptoms of borderline personality disorder. It is especially important to seek help right away if you or your child is having thoughts of suicide.

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 39.

Reviewed By

Review Date: 11/15/2010

Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.