The Financial Express

The spectrums of borderline personality disorder

| Updated: August 31, 2022 19:27:57

The spectrums of borderline personality disorder

“I feel empty and lonely, sometimes like I don't exist at all, and saying my name feels like a lie because I know there's nothing inside. I play roles and try to be who I'm 'supposed' to be. I want to feel something, anything other than nothing. I go from okay to suicidal in an instant and don't even know why.”

This is how a real BPD (borderline personality disorder) patient once described the situation. Many people worldwide suffer from this debilitating mental condition, which significantly hampers emotional control.

As a result, these patients exhibit impulsive behaviour, have a negative self-image, and often show self-destructive traits.

Marsha Linehan, Adjunct Professor of Psychiatry and Behavioral Sciences at the University of Washington in Seattle and BPD specialist, said that these patients are highly sensitive and may agonise over the slightest touch or movement.

BPD is a lifelong problem that usually starts to manifest during adolescence. The person's emotional, cognitive, and interpersonal functions are dysregulated. Experts are still not sure what the mechanism is, but they point to some risk factors.

A positive family history - having a parent or sibling with BPD always increases the risk for others.

Physical or substance abuse, hardship in the family, abandonment, a tumultuous relationship between patients, or any other traumatic life events can trigger it. Some researchers argued that structural and functional changes in certain brain areas are responsible, but this still needs to be conclusively proven.

How do BPD patients behave? They are prone to extreme mood swings and react with exaggerated emotions to even a small change in their environment. They tend to view things as simple, good, and bad, of which they are the judge. As a result, their actions are reckless and impulsive. BPD patients also struggle to form stable interpersonal relationships.

BPD is diagnosed clinically by a licensed mental health care provider, e.g., a psychologist or a psychiatrist. US Diagnostic Statistic Manual (DSM-5) listed nine specific criteria for BPD. If a person has at least 05 of these, s/he is diagnosed as a BPD case. 

It is imperative to receive treatment for BPD, as it severely impacts the quality of life. These patients suffer from coping problems in society and often turn to suicide. Statistically, BPD patients are among the highest risk categories for suicide, and around 10 per cent of them kill themselves. Another 75 per cent demonstrate self-harm in the form of cuts, burns, or other injuries. They may need forced hospitalisation for their good.

BPD can increase the possibility of other mood disorders, e.g., eating disorders, anxiety, depression, bipolar, etc. The person may indulge in disruptive behaviours, resulting in arrest and prosecution.

With the advances in medical science, however, there are many avenues to help BPD patients. It is highly possible to help them keep control of their emotions and guide them through life with minimal problems.

Psychotherapy is often the best approach, sometimes with or without medications. However, hospitalisation for a short period may be necessary if symptoms are severe.

Including family and caregivers of the patient in the treatment plan is crucial. For any management approach to be successful, they need to be aware of it and know their roles around the patients.

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