Borderline Personality Disorders
Borderline personality disorder is a very distressing medical condition, both for the people who have it and for those around them. People who have borderline personality disorder (BPD), have difficulty controlling their emotions and are often in a state of upheaval — perhaps as a result of harmful childhood experiences or brain dysfunction. Borderline personality disorder affects how people feel about themselves, how they relate to others and how they behave. People with BPD often have an insecure sense of who they are. Their self-image or sense of self often rapidly changes. They may view themselves as evil or bad, and sometimes may feel as if they don’t exist at all. An unstable self-image often leads to frequent changes in jobs, friendships, goals, values and gender identity.
Their relationships are usually in turmoil. Their anger, impulsivity and frequent mood swings may push others away, even though they yearn for loving relationships. They often experience a love-hate relationship with others. They may idealize someone one moment and then abruptly and dramatically shift to fury and hate over perceived slights or even minor misunderstandings. This is because people with the disorder have difficulty accepting gray areas; things are either black or white. The disorder often presents quite differently from one person to another, thus making accurate diagnosis somewhat confusing to a clinician not skilled in the area. Some of those most prevalent symptoms include;
- frantic efforts to avoid real or imagined abandonment.
- a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
- identity disturbance: markedly and persistently unstable self-image or sense of self
- impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
- recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
- affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
- chronic feelings of emptiness
- inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
- transient, stress-related paranoid ideation or severe dissociative symptoms
Increasing awareness and research are helping improve the treatment and understanding of borderline personality disorder. Although a chronic disorder that is resistant to change, BPD has a good prognosis when treated properly. In many patients with BPD, medications have been shown to be very helpful in reducing the severity of symptoms and enabling effective psychotherapy to occur. Medications are also often essential in the proper treatment of co-occurring disorders. Emerging evidence indicates that people with borderline personality disorder often get better over time and that they can live happy lives.
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