Borderline Personality Disorder - Research Paper Example

Borderline personality disorder May 7, Overview According to Millon (1996), borderline personality disorder is a “prolonged disturbance of personality function in a person, characterized by depth and variability of moods.” Borderline personality disorder is a psychological mood disorder that renders patients as being unable to control their emotions, often feeling disrupted and troubled by the constant changing of emotions that they can experience throughout each day. Borderline personality disorder centers more around negative, harmful emotions, mingled scarcely with happiness and bursts of energy. When a person has borderline personality, they are unable to control the emotions that they want to feel, frequently displaying emotions that are inappropriate for any given situation. Symptoms Borderline personality alters the way in which a person views themselves, their surroundings, and their relationships with others. One of the first signs that someone may be suffering from borderline personality disorder is that they begin to look down on themselves, regarding themselves as evil or worthless, or feeling as though they do not exist at all. The person becomes insecure and loses their sense of self-worth. This often leads to problems within the work area, family, or intimate relationships. One moment the person may completely adore someone, and then the next moment they may want absolutely nothing to do with them (Kreisman & Straus, 1991); these feelings can also describe how a person feels about themselves. Someone being effected by borderline personality disorder cannot decide how they really feel about someone, and even if their explanations of their feelings to themselves make sense, their emotions often say something entirely different. To make matters worse, their emotions change from day to day, so they can never pinpoint their honest feelings. Other symptoms of borderline personality disorder include risky behavior, such as unsafe sex, gambling, drug and alcohol use and abuse, and reckless driving, as well as a difficulty in controlling the impulses to engage in the aforementioned activities. Intense emotions that come and go often, uncalled for anger and negativity, and harsh but random spikes of depression or anxiety, and suicidal thoughts and attempts are also symptoms that have been linked to borderline personality disorder. One of the more common symptoms is a fear of being alone, as a person with borderline personality realizes that they are pushing people away without that being their intentions, yet they are not sure how to make their emotions display otherwise. Diagnosis As there are a variety of personality disorders with many similar symptoms, a person suspected to have borderline personality disorder must undergo an intense psychological evaluation, as well as the patient’s self-reported experiences and the observations of friends, family, and the attending doctor. Furthermore, the patient’s symptoms and experiences must exist in accordance to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders specific to borderline personality disorder and the basic criteria of personality disorders. The criteria for borderline personality disorder is as follows: desperate attempts to avoid being alone, thus depleting the chances of being abandoned; unstable relationships; a decrease in one’s self-image or representation of self; at least two impulsive, potentially self-damaging behaviors, such as drug usage or unsafe sex; repeated mentioning or attempts at suicide; constantly feeling numb or empty; inappropriate outbursts of anger and an inability to control said anger; and stress-induced paranoia or delusions (American Psychiatric Association, 2000). In regard to the basic criteria surrounding personality disorders in general, a patient must experience or display the following: the behavior that an individual displays is different from the accepted norm, and this behavior must be dysfunctional over a range of personal and social situations; the individual is distressed or there is an impact on the social environment (Dowson & Grounds, 2006); the behavioral or emotional problems must be constant and having had its onset from childhood or adolescence; and the individual does not meet the criteria of an adult mental disorder. Once a person goes through the required tests and observations, which are done to rule out other possible disorders, the proper treatment is able to be sought. However, if a child appears to have the symptoms of borderline personality disorder, including many of those that are outlined in the Diagnostic and Statistical Manual of Mental Disorders, further observations and tests are done, since children are too young to meet the age requirement of someone with borderline personality. Treatments Once a person has been diagnosed with borderline personality disorder, the first treatment step is to prescribe them medication that will help get their mood swings under control, as well as decreasing the commonality of depression and anxiety. Once their mood swings have subsided enough, the next treatment step is to initiate psychotherapy and basic therapy. While medication is often the first step of treating borderline personality disorder, psychotherapy is the core of the treatment process. The purpose of psychotherapy is to help the patient learn to regulate their emotions while improving one’s self-image and relationships and overcoming the distress that comes with having the disorder (Horwitz et al., 1996). Another method of psychotherapy common to borderline personality disorder treatment is transference-focused psychotherapy, which helps the patient understand the difficulties that may be taking place in their relationships or that could possibly arise. The knowledge and techniques that they learn in their therapy sessions can be adapted to their personal relationships. Unfortunately, according to Binks et al. (2006), there are no claims that psychotherapy is successful and effective in patients with borderline personality disorder, though it is believed that they can benefit on some of the resulting measures. Basic therapy is used to help patients understand their disorders, as well as to find methods to help them comprehend and control their emotions; it also doubles as a support system. Basic therapy differs from psychotherapy in the sense that it covers borderline personality disorder as a whole, while psychotherapy touches on each of the individual points and symptoms that a patient has. Further medication is sought when needed, or increased as seen fit; again, like psychotherapy, medication helps individual symptoms, paying closer attention to depression, anxiety, and impulsivity. In many cases, therapy and psychotherapy is enough for a patient to begin to help themselves overcome their symptoms of borderline personality disorder. As there is no cure for the disorder, understanding the disorder itself and the symptoms that come with it can lead to the patient being able to control their emotional instability. In the worst case scenarios, such as those in which a person proves to be a danger to themselves or to others, hospitalization is often implemented in the treatment plan. Causes and risk factors While there are no definite causes of borderline personality disorder, connections have been made with those that have the disorder and those that display symptoms that might be related to borderline personality. It is widely believed that borderline personality disorder is genetic, as it seems common in families that already have a history of the disorder. Abnormalities in the brain, such as changes in the areas that deal with emotion regulation and aggression, are typical signs for most types of personality disorders; furthermore, brain chemicals that are designated to help regulate mood and emotion, such as serotonin, may not be functioning as they should be. The most common characteristic found among patients with borderline personality disorder is that many have experienced childhood abuse or neglect, or separation from a loved one (Mayo Clinic Staff, 2008). As part of the criteria for borderline personality disorder is experiencing something from childhood that manifests itself as someone gets older, it is assumed that abuse or neglect is the key cause of borderline personality disorder. As with the majority of personality and mood disorders, many are connected with tragedy when the patient was a child, and these events seem to manifest themselves in the form of an imbalance of emotion and personality. The risk factors involved in borderline personality disorder are similar to the causes outlined above. As personality forms during childhood, a child that has been abused, neglected, or otherwise mistreated stands a chance at developing borderline personality disorder. Any negative experience in a child’s life that has greatly effected them or altered their mental and emotional perceptions of life can cause personality or mood disorders, such as borderline personality, as they get older. Other risk factors include hereditary tendency, such as a mother or father who has a history of the disorder, and being female, as women seem to develop the disorder more than men. Complications As with any personality disorder, borderline personality disorder comes with many complications that can potentially effect someone’s daily life. Jobs, schooling, relationships and friendships, and self-image can be damaged because of the disorder; while these things are common, they are not true for every person that has borderline personality disorder. Part of the disorder involves having low self-esteem and being able to manage relationships because of constant mood swings and outbursts of anger, so these complications are simply expected. Many people with borderline personality disorder harm themselves physically or attempt suicide, due to both their negative view of themselves and the uncontrollable bouts of anger that they feel. Suicide rates for borderline personality disorder are ten to fifteen percent (Moskovitz, 2001). Other health promises can arise from borderline personality disorder, such as depression, substance abuse, anxiety and eating disorders. Furthermore, people with borderline personality are at risk for developing other personality or mood disorders, such as bipolar disorder or multiple personality disorder. Borderline personality disorder might be an onset for another disorder, as opposed to be the disorder itself. It is quite common for someone to be diagnosed with borderline personality disorder only to be diagnosed a year or so down the road with a more complicated personality or mood disorder. Due to the reckless and impulsive behaviors that a person with borderline personality disorder displays and engages themselves in, a patient puts themselves at risks for unplanned pregnancies, obtaining a sexually transmitted disease, becoming involved in car accidents, or becoming injured due to physical fighting. If abuse was the initial cause for someone developing borderline personality disorder, there is an increased chance for them to be in one again, either as the abuser or the abused; even if abuse was not the cause for the disorder, a patient’s anger outbursts can still cause abusive relationships for them in the future, again, with them as the abuser or the abused. The feelings of not caring for one’s self only increases these actions, as they are unconcerned by what happens to them. Living with borderline personality disorder Support from others As aforementioned, there are no cures for borderline personality disorder, and medications and therapy can take coping with the disorder only so far. The actual effects of borderline personality disorder aside, patients often face being ostracized by friends, family, and co-workers, as these people do not know how to react to the constant intense mood shifts of the patient, and the patient is unable to make heads nor tails about how they feel about the people in their life. It is because of this that one of the most important things a borderline personality patient can get is support from others (Mason, 2010); therefore, the people in the lives of these patients need to take it upon themselves to understand the disorder and to seek help in able to know how to handle the patient. If a patient worries too much about being alone, the last thing that should be is stuck with the feeling that they are alone. Family members and people involved in intimate relationships with a patient with borderline personality disorder need to seek help and education to help understand what their loved one is going through. Not only will they be able to help their loved one cope through their emotional problems, but they can know what to expect and know how to react in a constructive way. A borderline personality patient’s biggest fear is being alone, or feeling as though nobody else cares, so if family and friends support that person through their hardships, that person will be able to comprehend that they are anything but alone. Helping one’s self One of the biggest issues regarding a person with borderline personality disorder is that they understand that their behaviors and attitudes are destructive and negative, but they are unable to control how they feel. The first thing that a borderline personality patient must do is stick to their treatment plan of medication and therapy as they are called for. Doctors and therapists know what they are doing, so they are the best, most knowledgeable people to turn to when it comes to coping with borderline personality disorder. Other methods to help cope with borderline personality is to find and practice healthier, safer ways to deal with painful emotions, as opposed to self-harm, such as taking up a sport or an art medium, and to understand the things that could cause outbursts of anger and learning how to respond to them in positive ways (Freeman & Fusco, 2003). Understanding the disorder and where that patient stands within the disorder will help the patient to become aware of the causes and treatments of the disorder, thus being able to help themselves as they are able to. If there are other issues inherent to borderline personality disorder, such as substance abuse, the patient should take it upon themselves to see to it that these issues are addressed and tended to in the appropriate fashion. Patients, as well as their family and friends, can seek therapy, group or otherwise, as this can help them to be all on the same level of what is going on with the patient, what is being done, and what can further take place to help the patient cope positively with their disorder. There are support groups designed specifically for people that are close to others that have borderline personality disorder. Also by doing this, the patient will realize that their friends and family make up the most important support group that they could possibly have. Conclusion Borderline personality disorder is a mood disorder that causes the patient to be emotionally unbalanced, experiencing intense outbursts of anger and loathing towards themselves and others. Common symptoms of borderline personality disorder are negative changes in how a person views themselves, how they get along with others, and reckless, dangerous behavior. When a person suffers from borderline personality disorder, they do not feel that they are worthwhile and they act out upon this, often bringing others down with them. Typical treatments of borderline personality disorder include medication and psychotherapy, as well as hospitalization if the person displays harmful actions towards themselves and others. While there is no definite cause of borderline personality, childhood neglect and abuse are often linked in patients that suffer from the disorder. Some of the complications associated with borderline personality involve becoming part of an abusive relationship and developing another personality disorder, using borderline personality as an onset. For a person to overcome the harmful effects of their disorder, as there is no cure, they need to keep to their treatment plans and seek further help and support, specifically from their family, who should do the same in an attempt to understand the disorder themselves. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, Text revision (4th ed). Arlington, VA: American Psychiatric Publishing, Incorporated. Binks, C.A., Fenton, M., McCarthy, L., Lee, T., Adams, C.E. & Duggan, C. (2006). Psychological therapies for people with borderline personality disorder. The Cochrane Library. Retrieved from http://mrw.interscience.wiley.com/ cochrane/clsysrev/articles/CD005652/frame.html Dowson, J.H. & Grounds, A.T. (2006). Personality disorders: Recognition and clinical Management. Cambridge, UK: Cambridge University Press. Freeman, A. & Fusco, G.M. (2003). Borderline personality disorder: A patient’s guide to taking control. New York: Norton, W.W. & Company, Inc. Horwitz, L., Gabbard, G.O., Allen, J.G., Frieswyk, S.H. & Newsom, G.E. (1996). Borderline personality disorder: Tailoring the psychotherapy to the patient. Arlington, VA: American Psychiatric Publishing, Incorporated. Kreisman, J.J. & Straus, H. I hate you, don’t leave me: Understanding the borderline personality. New York: HarperCollins Publishers Mason, P. (2010). Stop walking on eggshells. Oakland, CA: New Harbinger Publications. Mayo Clinic Staff. (2008). Borderline personality disorder: Causes. Retrieved from http://www.mayoclinic.com/health/borderline-personality-disorder/ DS00442/DSECTION=causes Millon, T. (1996). Disorders of personality: DSM-IV-TM and beyond. New York: John Wiley and Sons. Moskovitz, R.A. (2001). Lost in the mirror: An inside look at borderline personality disorder. Houston: Taylor Trade Publishing. Read More