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Borderline Personality Disorder (BPD)



What is BPD?

BPD is among the Cluster B disorders, which are personality disorders characterized by dramatic and unpredictable patterns. BPD primarily affects relationships, including a strong fear of abandonment, although the erratic and volatile behaviour associated with this disorder may push people away.


Symptoms

The symptoms of BPD include:

• frantic efforts to avoid real or imagined abandonment

• a pattern of unstable relationships which alternate between strongly idealizing the other person and completely devaluing them

• disturbances in identity or sense of self

• impulsivity

• recurring suicidal behaviour, gestures, or threats, or self-mutilating behaviour

• emotional instability

• persistent feelings of emptiness

• inappropriate and intense anger or difficulty managing anger

• momentary, stress-related paranoid ideation or strong dissociative symptoms


Causes

Early childhood trauma is thought to play a role in the development of BPD. One study found that 76% of women with BPD reported having experienced childhood sexual abuse. Furthermore, the similarities in some of the symptoms between BPD and posttraumatic stress disorder (PTSD), such as challenges in mood regulation, impulse control, and interpersonal relationships, are believed to further underscore the link between abuse and DBT.


Prognosis

The symptoms of BPD gradually improve after age 30 if individuals survive. As many 6% of people with BPD commit suicide, making it among the deadliest mental illnesses, along with depression, anorexia nervosa, and bipolar disorder.


Treatment

Dialectical behaviour therapy (DBT) has been used to treat BPD. DBT focuses on acceptance as well as change, while teaching skills such as mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. While DBT was created to treat BPD, it can also help those struggling suicidal behaviour, self-harm, addiction, PTSD, depression and eating disorders.


Other treatment options include medications such as antidepressants, lithium, and atypical antipsychotics, with a major goal of these treatments being reducing the risk of suicide.

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