What is borderline personality disorder?
Borderline Personality Disorder is one of ten personality
disorders recognised by the DSM IV.
A personality disorder is a type of mental illness. For a mental
illness to be classed as a personality disorder it must fit a
certain criteria. With personality disorders, the symptoms have
usually been present for a long time. These symptoms have an overall
negative affect on the sufferer’s life.
One of the core signs and symptoms in BPD is the proneness to
impulsive behaviour. This impulsiveness can manifest itself in
negative ways. For example, self-harm is common among individuals
with BPD and in many instances, this is an impulsive act. Sufferers
of BPD can also be prone to angry outbursts and possibly criminal
offences (mainly in male sufferers) as a result of impulsive urges.
Another common feature of BPD is affective lability. This means
that sufferers have trouble stabilising moods and as a result, mood
changes can become erratic.
Other characteristics of this condition include reality
distortion, tendency to see things in ‘black and white’ terms,
excessive behaviour such as gambling or sexual promiscuity, and
proneness to depression
(To learn more about symptoms and diagnostic criteria please go
to the section on diagnostic criteria)
These traits can sometimes make it very difficult for a person to
maintain a relationship with someone with BPD as their behaviour and
actions can be difficult to tolerate and hard to understand. It is
important for persons close to a BPD sufferer to educate him or
herself on the condition so they can empathise with what the
sufferer is going through and how they are feeling.
BPD is not usually diagnosed before adolescence. It has been
suggested that BPD symptoms can sometimes improve as time goes on or
even disappear all together. This is not always the case however as
BPD can continue to affect sufferers well into later life.
Traits from other mental illnesses and psychological conditions
from the DSM IV can often co-exist in BPD patients. These are
usually anxiety disorders, eating disorders, obsessive-compulsive
disorder (OCD) and bipolar disorder (also known as manic
depression).
Is borderline personality disorder a mental illness?
Yes! A mental illness is an illness that affects a person’s
behaviour primarily rather than their physical well-being. BPD is
considered by medical practitioners to be a severe psychiatric
disorder. It is recognised as such by the DSM IV.
Mental illness is often not taken as seriously as physiological
illness even though it is very common and can be very debilitating.
It is often viewed as moodiness, craziness or a weakness when it is
in fact a genuine illness that can be caused by physiological
factors. People have as much control over developing a mental
illness as they do over catching a cold. Like physical illness,
mental illness needs treatment and is not something that someone can
just will to go away.
Why the name borderline?
The name borderline was coined by Adolph Stern in 1938. This name
was used to describe patients who were on a ‘borderline’ between
neurosis and psychosis. However, the symptoms of BPD are not so
simplistic as to be defined in terms of neurotic and psychotic. The
diagnosis of BPD is based upon signs of emotional instability,
feelings of depression and emptiness, identity and behavioural
issues rather than signs of neurosis and psychosis. However, the
name Borderline has remained even though the definition has changed.
Throughout Europe, the same disorder has been given the more
appropriate and less misleading title of ‘Emotionally Unstable
Personality Disorder.’
The Facts on BPD
• Three quarters of people with BPD are female and usually within
childbearing age.
• 70 to 80 % of patients meeting the diagnostic criteria for BPD
self mutilate or self harm
• One in ten BPD sufferers successfully completes a suicide
attempt.
• BPD patients are recognised as responding poorly to treatment.
• BPD patients are generally thought to have a long term, poor
quality of life.
• BPD has been associated with other conditions such as
schizophrenia, several types of psychosis, other affective disorders
and epilepsy.
• Very little research has been conducted to investigate BPD in
men
• BPD sufferers are reported to be very frequent users of mental
health resources.
• Men with BPD compared with men suffering from other personality
disorders have shown more evidence of dissociation, image
distortion, frequency of childhood sexual abuse experiences, longer
experiences of physical abuse and experiences of loss at an early
age.
• Research suggests that male BPD patients are more regularly
diagnosed with substance abuse problems than female BPD patients
are.
• Only two personality disorders are associated with self-harm
behaviour. One is BPD and the other is antisocial behaviour
disorder.
• People who have BPD are more likely to self-harm for two
reasons: a) as a response to impulsive urges and b) as part of a
suicidal gesture.
• Research suggests that people with BPD frequently suffer from
identity and interpersonal issues.
• At least 50% of BPD sufferers also suffer form major depressive
disorder, dysthymia, or even both.
• It is very difficult to say weather a person with BPD's
condition will change over time. Research has suggested that some
people’s symptoms improve, some get worse and some remain unchanged.
• 11% of diagnosed BPD patients are treated in outpatient clinics
• 20% of BPD patients spend time in psychiatric hospital
• Between 40% and 70% of BPD patients report having been sexually
abused, often by a non-care giver.
• Clinicians are often wrongly educated or under educated about
BPD and BPD treatments.
• Approximately 2% of the population are affected by BPD.
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