Mental Health Personality Disorders - Essay Example

Mental Heath Abstract The study that was conducted was aimed to be able to present a view on personality disorders. It can be considered as a general view but the main focus of the study that was undertaken is to specifically discuss current therapies that can be considered applicable in terms of focusing on the impact of the Borderline Personality Disorder. Introduction The borderline personality disorder, BPD, is one of the mental health conditions that are given attention in terms of the health of the public. Attention is vital on the basis that 10 to 13% of the population can be considered to possess personality disorders but a larger part can be included if the outpatient estimate is given which is 20 to 30% (Morana and Camara, 2006, p.539). Due to the aim to target the needs of the patients of the said mental ailment, there are different treatments that are given. Through the research that had been undertaken in relation of the said field, attention had been given to be able to decrease the cases of BPD. Although the disease can be considered of importance, a limited number of treatments can be classified that can be considered as main stream. Being more psychological in effects, the interventions are needed to be given a more intensive research and study prior to being considered as a treatment procedure. The focus of the research conducted revolves around the importance of the knowledge regarding the BPD, ultimately targeting the treatment process. Also, a view of the accumulated concepts regarding the mental condition is another vital issue to consider. Borderline Personality Disorder Defined Borderline personality disorder (BPD) is one of the disorders that affect the mental health of the patient. It can be considered as one of the serious mental illness due to the fact that it can harm the patient and the people around. The danger can be perceived from the fact that the patient cannot control the emotional changes. The behavior can greatly affect the relationship with other people. The main indications of BPD can be related to the insecurity in moods, relationships with other people and the self impression which are considered as the main reasons for the actions that are undertaken by the patients. Attention is required to be able to cure the condition due to the fact that the indications can be similar to other mental disorders such as schizophrenia and bipolar disorder which is also referred to as the manic-depressive illness. The only difference is the drastic changes in the behavior from being at peace and normal to being insecure and possessive. During the said periods, the patients are considered of most danger and at the same time are harmful. This can be attributed to the notion that people with BPD can harm either the people around or themselves. BPD related crimes and even deaths can be considered as one of the major concerns related to the disease (National Institute of Mental Health, 2001, p. 1). Considering the diagnosis of the patient and the analysis of the condition, it is important to be able to determine the proper ailment. This can be attributed to the similarity in symptoms. To be able to undertake an efficient treatment procedure for the patients in depth knowledge is required related to the disease, which can be considered lacking or below what is helpful in advancing the decrease in the cases of BPD. The harm that the disease can cause to the society is also another important issue that is needed to be given concentration to improve the status of the patient. Treating the BPD Patients The studies that are related to BPD can only be considered as a preliminary phase towards the resolution of the BPD related issues. Due to the said role, the discovered treatments and cures that can be considered as answers to the condition are the ultimate targets of the research and development initiatives related to the issue. In terms of the treatment of BPD, there are different concepts that can be considered of importance. One is the fact that a more intensive study is required in relation to the issues of mental health which can be attributed since mental health can be considered detrimental since psychological behavior can be considered as physiological manifestations. In that case, a simultaneous study of both the effects of the treatments under study on the physical and the psychological aspect. In terms of the different forms of treatments, the level of severity of the condition of the patient can be one of the bases for the determination of treatments between medication or rehabilitation therapies. Prior to the determination of the treatments that can be applied the physical and the psychological condition of the patient are analyzed. In terms of the physical aspect, the neurobiology is examined for abnormality in structure. Also the psychological history is analyzed including the development of personality and behavior throughout childhood, adolescence and adulthood (Morana and Camara, 2006, p. 541). A. Preliminary Treatments Prior to the recommendation and application of psychosocial rehabilitation, other treatment can be considered such as medication. There are cases wherein depressions and primary signs of BPD can be cured by mood stabilizers and antidepressants. In cases of emotional distress, anticonvulsive drugs and serotonin selective reuptake inhibitors (SSRIs) are recommended for use. Minimal doses of antipsychotic agents can also be given (Morana and Camara, 2006, p. 540-541). B. BPD Therapies Cognitive Therapy In relation then, there are various forms of treatments both on the basis of the focus and the effects. The cognitive therapy, CT, is one of the most important interventions in BPD cases. This type of treatment is essential since there are limited types of cure that can be considered as wide used in terms of treating the disease. The main target of the said treatment is the improvement and prevention of the patients self inflicted acts and manifestation such as self injury or even suicide. Improvement of the conditions of the patients that had undertaken cognitive treatment had been achieved by patients that were involved in the study had been identified through the reduction of depression and other stressful manifestations that can be related to BPD (Brown, Newman, Charlesworth, Crits-Christoph, and Beck, 2004, p. 268-9). Upon the analysis of the actions undertaken by the specialists through the CT, it can be perceived that to be able to fight BPD cognition is the weapon developed. Cognitive aspect targets the intellectual capabilities of the patient. This can be undertaken by arming the patients with awareness of the disease which can help then determine of they are acting out some of the indications. The patients themselves can be responsible for the actions that are undertaken (Brown, Newman, Charlesworth, Crits-Christoph, and Beck, 2004, p. 261-2). The behavioral therapy on the other hand focuses on the management of the behavior of the patient by being conscious of the actions that are undertaken. This can be acquired through the development and orientation to be able to reach the stage when the patient can recognize the effects of the actions he/she undertakes (Morana and Camara, 2006, p.541). Psychosocial Treatments The psychosocial form of treatments can be considered as another essential area of the BPD treatment. The said form can be classified on the application of different forms such as transference-focused psychotherapy (TFP), dialectical behavior therapy (DBT) and supportive psychotherapy (Clarkin, Levy, Lenzenweger and Kenberg, 2004). The said procedures can be described independently on the basis of the application of different principles in the treatment. Application of any particular treatment process can be determined on the basis of the case of the patients and the feasibility of application to the patient. The transference-focused psychotherapy (TFP) deals with relationships between the patient and the caregivers and the incorporation of psychoanalytic principles. The main method applied is the testing of generated principles in relation to BPD by testing through the attachment of the patient to the caregivers. Through the planned course of action the improvement from temperament to emotional control of stimulated distress can be undertaken. It was discovered that negative stimuli such as trials, maltreatment, etc. do not necessarily equate to BPD but can be considered as the most important risk factor. The treatment then through the application of TFP can be described as an understanding of the negative causes of behavior disturbance such as hostility and aggression and then development and improvement of self-regulation and consciousness of action. This will enable achievement of control that can be considered as lacking in BPD patients. Aside from the disruption of the self-destructive tendencies of the patients, the identification of the elements that can trigger significant effects to the patients are determined, generated and minimized (Clarkin, Levy, Lenzenweger and Kenberg, 2004, p. 52). C. Management of Severe Cases of Personality Disorders The main basis for consideration of severe cases of personality disorders is the harm that the patient can do, specifically to himself/herself such as injuries and even suicide. In cases wherein the patients showed signs of such physical harm, severity is considered to prevent morbidity issues (Tyrer and Mulder, 2006, p. 401-2). Due to the serious status of the personality disorders at this stage, medication for immediate action can be considered as the most important treatment. This can be attributed to the fact that cognitive and behavioral therapies cannot be effective in the event of serious psychosis. Upon improvement of the condition though, a combination of the treatments can be recommended (Morana and Camara, 2006, p. 539-41). Requirements for Application of the Treatment Interventions Aside from the study of the treatments that can resolve the increasing cases of BPD, the application and execution of such treatments are also vital in the process of treatment. The success of the treatment then greatly depends on the psychiatric nursing which incorporates the application of the corresponding treatments to the patients. The relationship then must be able to generate trust for both sides, the patients and the nurse, and also care from the medical professional. For the said interaction between the patient and the care giver, there are different guidelines that can be considered as vital. One is education of the nursing personnel that incorporates a mastery of the disease that is under study. Knowledge and awareness regarding the condition should be on the expert level to be able to resolve encountered problems at different phases of the treatment process (Bland and Rossen, 2005; Woods and Richards, 2003, p. 508-511). Another focus on the required capability of the nurses and the medical personnel that are considered the first hand interaction of the patients are in terms of the emotional support that they also require (Bland and Rossen, 2005). This can be attributed to the fact that the process of treating a mental patient can be considered to be classified in a stressful environment especially if the patients are violent in nature. Due to the fact that the nurses are also human beings, they can be susceptible to emotional instabilities also. In terms of the duty, the support of the administration is important to the practitioners to be able to exhibit what they think is the appropriate treatment to the patient without being too concerned of being reprimanded. Understanding is necessarily given to the personnel due to the fact that prevention of pressure from the organization can help maximize their performance and focus on the patients’ treatment. In relation to the clinical supervision of nurses in treatment of BPD patients, maximization of the capabilities while giving guidance and support can be considered as the most effective method that can be undertaken in the administration of a treatment facility. Such resolution can be achieved by giving the medical personnel the freedom to study and apply the treatment procedures that are perceived to be the most appropriate for the patient, developing it and maintaining the relationship of trust with the patient (Bland and Rossen, 2005; Woods and Richards, 2003). Comparative Analysis of the Treatments The treatments for personality disorders can be considered limited, which can be considered due to the challenges being faced by the field in terms of the complexity of the issues and even the areas to which the treatment procedures can be studied and tested. There are different forms of treatments that had been discussed on the basis of application to BPD. But preliminary procedures are required beforehand, to be able to determine the method that can be used. Prior to the determination of the most effective treatment to personality is the question of proper diagnosis. Due to the fact that the analysis of the symptoms through different methods such as the DSM-IV is impossible to be undertaken, the determination of the ailment cannot be accurately done in the primary diagnosis. Different diagnosis of similar nature can then be considered as working diagnoses. But due to the complicated treatment process that requires extensive amount of time, the effectiveness of the treatments is often in question (Fountoulakis and Kaprinis, 2006, p. 92-93). The most important consideration through is the decrease in the cases wherein there is a cycle of diagnosis then treatment then reevaluation to consider another diagnosis due to the fact that the immediate treatment of the patient is vital. In the issue concerning the most effective treatment procedure, it can be perceived and presented that the efficacy of the treatment lies subjective on the case of the patient. What is effective to one may not be effective to another. But on the basis of the cases that had been studied, the psychotherapies, both cognitive and behavioral therapies are considered widely used. The DBT then can be considered as one of the most utilized procedure. This can be attributed to the basis that there significant percentage of patients that are cured through the method. It can be presented that DBT is important specifically to patients that are not confided and staying with their families although it can be applicable to different cases and scenarios. The main action of DBT can be attributed to the skill-training approach. Such method can be perceived as important specifically for the individual DBT cases. Such cases can be considered as optimum application of the technique (Scheel, 2000, p. 76-80). In terms of the improvement of DBT, there are different areas that can be considered to be in need of further research and development. One is the limitation in application on the basis of the time required. This can be attributed to the establised efficiency in long term cases (Sharma, Dunlop, Ninan and Bardley, 2007, p. 220-4). Although such queries exist, the high percentage of success of the method can be considered as the main basis for the popularity and utilization of DBT (Fassbinder, Rudolf, Bussiek, et al., 2007). Another important method to treat BPD is through the Transference Focused Psychotherapy (TFP). The main mechanism in the said method is the influence of the therapists to the patient. If the influence to do the normal behavior and state of being is achieved, TFP can be considered successful. The main actions include studying and clarifying, reaching out to the patient through confrontations of different aspects and the transference of influence through therapeutic interaction (Levy, Clarkin, Yeomans, et al., 2006). The effectiveness of the said treatments can be attributed to the process that is undertaken. While being a treatment in progress, therapies also incorporate developmental diagnosis, thus, incorporation of other treatments are also based on the progress of the patients. Specifically the use of dialectical behavior therapy can be considered as one of the most important treatments. But it is important to consider that different treatments can be applied and be effective to different people. In the case of the TFP, one of the main reasons that it is less famous than DBT is the requirement belief and faith of the patient, which can clearly affect the outlook of the public regarding the treatments. References Bland, A. R. and Rossen, E. K. (2005). Clinical supervision of nurses working with patients with borderline personality disorder. Issues in Mental Health Nursing, June 2005, 26(5), 507-517. Brown, G. K., Newman, C. F., Charlesworth, S. E., Crits-Christoph, and Beck, A. T. (2004). An open clinical trial of cognitive therapy for borderline personality disorder. Journal of Personality Disorders, June 2004, 18(3), 257-271. Centre for Mental Health (2003). Mental Health Act Guide Book. NSW Department of Health. Charland, L. C. (2006). Moral nature of the DSM-IV Cluster B personality disorders. Journal of Personality Disorders, 20(2), 116-125. Clarkin, J. 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Effectiveness of nursing interventions in people with personality disorders. Journal of Advanced Nursing, May 2003, 44(2), 154-172. Read More