Borderline Personality Disorder

This article is about Dialectical Behavior Therapy (DBT) and its evidence based treatment for Borderline Personality Disorder (Chapman, PhD & Fraser, 2006). The article also discusses how DBT can be used to help parasuicidal women with borderline personality disorder (BPD) as well as those with Substance Use Disorders (SUDs), binge-eating disorders and depression in older folks (Chapman, PhD & Fraser, 2006). DBT includes aspects of cognitive-behavioral therapy, and cognitive restructuring. The five functions of treatment with DBT are also discussed; enhancing capabilities, generalizing capabilities, improving motivation and reducing dysfunctional behaviors, enhancing and maintaining therapist capabilities and motivation and structuring the environment.

Individuals affected by borderline personality disorder are able to have normal and productive lives, by finding the correct support and treatment. Psychological therapies are the most effective form of treatment for individuals impacted by borderline personality disorder. Psychological therapies assist individuals in managing and understanding their behaviours, feelings and responses. Other forms of treatment can include counselling and therapy. Medicines such as antidepressants, mood stabilisers, and antipsychotics are also types of treatments. In combination with therapy and counselling, they might be helpful in treating symptoms of borderline personality disorder. Healthy habits such as getting enough sleep, eating healthy foods,

Borderline Personality Disorder (BPD) can be described in simple terms as a condition in which sufferers experience long periods of emotional instability and troubled feelings about themselves and other people. These troubled feelings allow individuals to take impulsive measures and have trouble in their relationships (Bouchard, Sabourin, Lussier & Villeneuve, 2009). BPD basically comprises of unusual intensities of instability in mood and irrational thinking also referred to as splitting. Splitting in BPD involves a switch between negative perception of others and idealization (Sperry, 2003). This usually occurs along with irregular mood swings and can negatively impact on the existing relationships such as family,

Borderline personality disorder is defined in its most simplest sense as being a mental health disorder that generates significant emotional instability. [1] In sufferers it generates a wide range of symptoms typically characterised into three groups; Problems regulating emotions and thoughts; impulsive behaviour without thinking of the consequences of actions; and lastly unstable relationships. Evaluating the most effective treatment(s) for BPD remains a target for mental health services as the disorder is associated with self harm and suicide attempts, with suicide attempts recorded in 69-80% of patients. [2]

The main feature of borderline personality disorder is the pervasive pattern of unstable relationships, self-image, and impulsiveness. Borderline personality disorder begins by early adulthood and is present in a variety of situations. A person with borderline personality disorder will make major efforts to avoid any situation of abandonment. There are many symptoms that go along with having borderline personality disorder. Some examples would include: intense fears of abandonment, intense anger and irritability, impulsive and risky behavior, and wide mood swings. Self-harm, suicidal behavior and substance intoxication are very common in people with borderline personality disorder. A person with BPD experiences emotions in different ways than

Those with DBT have been found to have greater reductions in drug use, suicidal and self harming behavior. This could suggest that DBT allows for greater emotional health and sobriety for those diagnosed with borderline personality disorder.

Predisposing factors: Borderline personality disorder is a disorder that is characterized by a persons impulsive and/ reckless behavior, poor self-image, self-injury, emotional fluctuations, unstable relationships. There are links that suggest it could be caused by genetic and environmental factors, but it is still being studied. A person that is part of a community or culture with unstable upbringing can increase the risk for this disorder (National Institute of Mental Health, 2014). A childhood with physical and sexual abuse was often linked to people with BPD. It was more-so found to be linked with any neglect as a child (Am J Psychiatry, 1997 ). 6 to 10 million people are affected by borderline personality disorder. 75-90% of people with BPD are women (Borderline Personality Resource Center, 2012).

Psychologists perform many studies related to Borderline Personality Disorder. One study in adults proves that 2-8% of adults suffer from BPD. In the same study, psychologist discovered that in fact the disorder is far more common in women than in men. After obtaining research in children and teens we see the frequency of BPD in 9-19 years of age is about 11%. This study or theory also proves that BPD occurs more often in girls than in boys. Borderline Personality Disorder can be triggered or caused in many different ways. Some people suffer from BPD due to a disturbing childhood experience. Studies show this disorder could even be genetic. There are numerous reasons why a child, teen, adult can develop traits and eventually suffer from BPD. Many patients tell or report abuse or neglect during childhood or some pivotal time in their life. The most common abuse reported tends to be sexual abuse as a child. Forty to seventy percent of patients with Borderline Personality Disorder, who suffered abuse as a child, claim the abuse was sexual in nature. Other important causes revolve around family neglect, foster care, or trauma. BPD patients have an increased fear of losing a primary attachment figure. With higher awareness of BPD, we now know this disorder’s high personal, social, and economic toll make it a national public health

Although patients with Borderline Personality Disorder are considered difficult to treat, treatment approaches include psychotherapy, transference-focused psychotherapy, and mentalization-based therapy.

Psychotherapy is best described as the patient talks to a therapist and explains the situation to get it of his/her chest. This is the most effective way to have a sense of belonging and true caring for the patient. Transference focused psychotherapy midpoints around the relationship between the victim and their therapist. The victim can then understand the sensations and complications that mature in the relationship. Those patients most often go on to use those skills when developing other relationships with new friends. Currently there are no medications to cure borderline personality disorder. There are medications that help conceal some of the moods though such as depression, and anxiety. Dialectical behavior therapy was precisely designed to treat people with borderline personality disorder. (If that doesn’t tell you how effective it is going to be, I don’t know what will.) This type of therapy can be done in a group setting, or one on one. It uses a certain skills-based approach to teach the patient how to diffuse their emotions, bear distress, and progress

“Personality disorders have been documented in approximately 9 percent of the general U.S. population” (Angstman, Rasmussen, 2011). Emotional dysregulation disorder or its common name borderline personality disorder is a very serious and chronic disorder. The Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) describes borderline personality disorder as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts” (Gardner, 2006). Within the last 20 years, psychologists and other mental health professionals have made tremendous strides in research on what exactly borderline personality disorder, some of its triggers and possible effective treatment options. Borderline personality disorder is defined as a disorder that generates severe emotional instability which can be a springboard that can lead to other stress induced mental and behavioral problems.

The 97% of patients associated with this disorder, with either attempted or completed suicide, makes psychosocial interventions mandatory for severe cases, even when concomitant pharmacotherapy is applied. DBT has been shown to be more effective and successful than most other resources by helping to teach the patient how to learn to: take control of their lives, emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring. Pharmacotherapy, or the use of medication, has also been administrated to help reduce depression, anxiety, and impulsive aggression that are present in patients with antidepressants or mood stabilizers. It gives the patients a chance to stop medication after they have learned to manage themselves. In a placebo-controlled trial, the drug called olanzapine was superior in the treatment of all four subcategories of borderline psychopathology. The efficacy of SSRIs on rapid mood shifts, anger, depression, and anxiety have been put through placebo based trials as well. There have been mixed studies of these drugs have reported mixed results for patients with a comorbid bipolar disorder and impulsive aggression of personality disorders. There was some difficulty for some of these studies because of the high dropout rate of patients that had a hard time staying on medication for a sustained period of

The findings that these authors were able to get could definitely suggest for continual studies in ways for borderline personality disorder to be coped with due to the emotional dysregulation it takes part in. In addition the behaviors of people could be more closely defined to be borderline and though people may have antisocial personalities, it does not mean they are equally unemotionally stable. These findings also imply that

There also is some debate in the field, some researchers suggest borderline personality disorder should be reclassified as a mood disorder rather than be categorized as a personality disorder (Pershall, 2011). There seems to be a lack of knowledge and understanding of how to cater to patients’ needs in recovering with their borderline personality disorder, some therapists are hesitant to treat patients with borderline personality disorder, patients diagnosed regarded as being resistant to treatment and emotionally demanding, which is a cause of frustration in therapists (Hebblethwaite et al.,

Though several personality disorders are highly complex and a challenge to treat, there are effective treatments available (“Treating Borderline” 1). The various treatments are broken down by method, the first of which being cognitive behavioral therapy, which attempts to alter the conscious thoughts and behavioral patterns of patients (Daniel); (“Treating Borderline” 2). Cognitive behavior therapy itself is broken down into two therapies, dialectical behavioral therapy and schema-focused therapy (“Treating Borderline” 2). Dialectical behavioral therapy, developed by Dr. Linehan, is centered on the basis that personality disorders are formed when hypersensitive patients are in situations which lack the emotional support they require, therefore leading to their “inability to regulate emotions” (“Treating Borderline” 2). Thus, the treatment serves to help the patient gain control over their emotion and behavior (“Treating Borderline” 2). The treatment itself consists of group and individual sessions and typically lasts approximately one year (“Treating Borderline” 2). During the group sessions, patients learn to become more aware of their behaviors and emotions through sessions pertaining to “problem solving, mindfulness meditation, and breath training“(“Treating Borderline” 2). In personal sessions, referred to as psychotherapy, the psychiatrist explains to the patient how the lessons from the group therapy sessions are applicable