People with borderline personality disorder suffer from extreme mood swings, fits of unprovoked anger, impulsiveness, fear of abandonment and a distorted self image, all of which cause turmoil in their lives and their relationships.
Personality disorders are mental illnesses characterized by patterns of thoughts, feelings and behaviors that frequently result in problematic relationships and situations. People with borderline personality disorder (BPD) have trouble regulating their emotions and behavior. Their lives are characterized by unstable moods and impulsive and reckless actions, which disrupt their interpersonal and work relationships and family lives. People with BPD seem to go from one crisis to another. To be diagnosed with BPD, a person must exhibit at least five of the following nine symptoms:
Unstable emotions: They experience intense bouts of emotion, swinging rapidly from feeling to feeling (anger, joy, anxiety…) in response to perceived stress.
Unstable self image: Their perception of themselves – their likes, dislikes, goals, worthiness, strengths and weaknesses, etc. changes often and rapidly.
Unstable relationships: Their feeling towards others can also change quickly and radically, swinging from idealizing someone to loathing them.
Impulsivity: They often act rashly and make hasty decisions. They may engage in reckless and self-damaging behaviors around spending, sex, substance use, eating, driving, etc.
Fear of abandonment: The threat of abandonment can be real or perceived, and gives rise to desperate attempts to avoid it.
Feelings of emptiness: They chronically feel "empty".
Issues with anger: Including frequent anger, unprovoked anger, intense anger and inability to manage anger.
Paranoia: Episodes of stress-related paranoia or disassociation ("spacing out", memory lapses).
Suicidal ideation: Repeated thoughts of, threats of and attempts to commit suicide.
BPD occurs equally in males and females, and is estimated to effect about 6% of the population. Like most mental disorders, its cause is not totally understood, but it's believed to arise from a complex interaction of biological and environmental factors. People with BPD tend to have experienced abuse, neglect or separation as children. BPD often occurs along with other psychiatric disorders like bipolar disorder, anxiety and depression, and is often associated with substance abuse in men and with eating disorders in women.
BPD is treated with a combination of therapy and psychiatric medications. A psychosocial treatment called dialectical behavior therapy (DBT) has been developed specifically to treat BPD. DBT addresses four main problem areas: self image, uncontrolled emotions, impulsive behavior and trouble relating to others. Antidepressant drugs and mood stabilizers such as topiramate (generic Topamax) and divalproex (generic Depakote) are often prescribed to address depressed and shifting moods. Antipsychotic drugs such as quetiapine (generic Seroquel) are used when needed to combat distorted thinking. Like most personality disorders, the symptoms of BPD decrease with age, and many sufferers are better able to maintain some stability in their lives by the time they are in their 40's and 50's.
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