Research shows that most people develop borderline personality disorder (BPD) by a combination of genetic and environmental factors. The clients that I have treated with diagnoses of BPD usually come from an invalidating environments where their caregivers were emotionally abusive and/or neglected their child's needs and feelings. This can be a challenging thought to process because we naturally want connection and support from our family members but sometimes that is not the case. As a clinician, when I am working with an individual that are showing signs of BPD, I also try and uncover any type of trauma as well. Trauma can include, but not limited to, sexual abuse, physical abuse, emotional abuse, poverty, and any deeply distressing or disturbing experience that alters a person's mental state. BPD is a mental health condition that affects a person's emotional regualtion, which can lead to impulsivity, changes in self-esteem, and difficult relationships with other people.
BPD is usually diagnosed in the late teens or early adulthood and can be triggered by stressful events. BPD affects 1.4% of the U.S. population and 75% of people with BPD are women. Common symptoms of BPD include:
Intense mood changes
Feelings about people change rapidly
Unstable relationships
Black-and-white thinking
Suicidal thoughts or self-harm behaviors
Impulsivity (spending sprees, sex without a barrier method, substance use, reckless driving, binge eating)
Sleep disturbances; likely to have chronic nightmares
Recklessness
Psychosis
Avoiding abandonment
Chronic feelings of emptiness
Difficulty controlling anger
Dissociation (problems with memory, emotional numbing, or burring feelings)
To treat BPD, it is important to be honest about your symptoms with your clinician. Clinicians will examine your symptoms at a single point in time compared to over the history of a longer period to make important distinctions. It can sometimes be challenging to determine if an individual has BPD or bipolar disorder because symptoms can overlap. To distinguish between BPD and bipolar disorder, most people with BPD experience more intense relationships and more likely to engage in self-harm behaviors. In addition, people with BPD has a history of elevated mood, history of goal-directed activity, and chronic nightmares.
In research studies, there are no psychotropic medications known to effectively treat BPD; however, dialectical behavioral therapy (DBT) has shown to be the most effective. Employing DBT in treatment, patients have recovered from their symptoms and the remission rates are 85% over a year and 99% over two years. Another way to determine if you have BPD is having an MRI done. With MRI data, it has shown that individuals with BPD have structural differences in the brain with lower hippocampal volume. People with BPD also have smaller amygdalas. If you feel like you have symptoms of BPD, it is important that you seek treatment right away because your symptoms can become more severe over time. Remember, it's not about the label of a diagnosis but treating the symptoms.
Reference:
Elliott, M., & Ragsdale, J. M. (2022). Stress exposure and well-being: correlates of meeting criteria for bipolar disorder, borderline personality disorder, or both. Social Psychiatry & Psychiatric Epidemiology, 57(9), 1885–1896. https://doi.org/10.1007/s00127-021-02172-z
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