What is borderline personality disorder? How do you deal with a partner that might have it?

Question

MY BOYFRIEND HAS THIS , I THINK. HOW WILL I KNOW?

Answer 1

http://www.nami.org/
National alliance on Mental Illness
Talk to your doctor and search on the internet to find out more information. There are support groups for all kinds of mental illness for the person and their families.

Borderline Personality Disorder
Borderline Personality Disorder (BPD) is characterized by impulsivity and instability in mood, self-image, and personal relationships. It is fairly common and is diagnosed more often in females than males.

What are the symptoms of BPD?

Individuals with BPD have several of the following symptoms:

marked mood swings with periods of intense depression, irritability, and/or anxiety lasting a few hours to a few days;
inappropriate, intense, or uncontrolled anger;
impulsiveness in spending, sex, substance use, shoplifting, reckless driving, or binge eating;
recurring suicidal threats or self-injurious behavior;
unstable, intense personal relationships with extreme, black and white views of people and experiences, sometimes alternating between "all good" idealization and "all bad" devaluation;
marked, persistent uncertainty about self-image, long term goals, friendships, and values;
chronic boredom or feelings of emptiness; and
frantic efforts to avoid abandonment, either real or imagined.
What causes BPD?

The causes of BPD are unclear, although psychological and biological factors may be involved. Originally thought to "border on" schizophrenia, BPD also appears to be related to serious depressive illness. In some cases, neurological disorders play a role. Biological problems may cause mood instability and lack of impulse control, which in turn may contribute to troubled relationships. Difficulties in psychological development during childhood, perhaps associated with neglect, abuse, or inconsistent parenting, may create identity and personality problems. More research is needed to clarify the psychological and/or biological factors causing BPD. The field is also actively looking at genetic vulnerabilities.

How is BPD treated?

A combination of psychotherapy and medication appears to provide the best results for treatment of BPD. Medications can be useful in reducing anxiety, depression, and disruptive impulses. Relief of such symptoms may help the individual deal with harmful patterns of thinking and interacting that disrupt daily activities.

Long-term outpatient psychotherapy and group therapy (if the individual is carefully matched to the group) can be helpful. Short-term hospitalization may be necessary during times of extreme stress, impulsive behavior, or substance abuse. More structured cognitive interventions like dialectical behavioral therapy (DBT) are now widely used.

Can other disorders co-occur with BPD?

Yes. Determining whether other psychiatric disorders may be involved is critical. BPD may be accompanied by serious depressive illness (including bipolar disorder), eating disorders, and alcohol or drug abuse. About 50 percent of people with BPD experience episodes of serious depression. At these times, the "usual" depression becomes more intense and steady, and sleep and appetite disturbances may occur or worsen. These symptoms, and the other disorders mentioned above, may require specific treatment. A neurological evaluation may be necessary for some individuals.

What medications are prescribed for BPD?

Antidepressants, anticonvulsants, and the new atypical antipsychotics are common for BPD. Decisions about medication use should be made cooperatively between the individual and the therapist or psychiatrist. Issues to be considered include the person's willingness to take the medication as prescribed, and the possible benefits, risks, and side effects of the medication, particularly the risk of overdose.

http://www.borderline-personality.big.com/?s=a&c=Borderline-Personality&k=borderline+disorder&h=borderline+disorder+borderline+disorder+borderline+disorder
http://www.palace.net/~llama/psych/bpd.html
http://www.nimh.nih.gov/publicat/bpd.cfm

HOPE THIS HELPS

Answer 2

BPD, no offense guys but you are making it to wordy. You can't diagnosis him that is correct. Only a qualified doctor can, and even they can be wrong, that is what is tricky about this personality disorder. He has to fit into a certain criteria from the DMV IV: Basically, the person has to have 6 of these to "qualify" for this disorder.

1. Frantic efforts to avoid real or imagined abandonment

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

3. Identity disturbance: markedly and persistently unstable self-image or sense of self

4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)

5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour

6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

7. Chronic feelings of emptiness

8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

9. Transient, stress-related paranoid ideation or severe dissociative symptoms

It is hard to have a BPD loved one though. Take it from me. I am a BPD myself, I've been diagnosed for about a year now, my mother is borderline. I'm in therapy and it helps and there is a lot out there that can help. Take a deep breath, relax and read up on it, there is a lot out the on the web and also in book stores. Here are some websites that can help you out that are not just supportive for him, but for you too, when times get tough.

Good luck!

Answer 3

Has he been diagnosed with this disorder? If so, find a book on the Borderline Personality, then decide whether you want to deal with it.

Answer 4

You need to direct him to a physician who can better diagnose his condition. There are many facets to personality disorders and they can be treated with bi-polar or anti-depressant therapy along with pscyhiatric counseling. I'd recommend his Primary care Physician first and maybe he or she will refer him to a Psychiatrist. Hope this helps. Take care...

Answer 5

You are not a doctor. If you care abot him encourage him to get help. Dont be dragged down by his actions to you

Answer 6

BPD is a bullsh it diagnosis.

Love Jack

Answer 7

Borderline personality disorder (BPD) is defined within psychiatry and related fields as a disorder characterized primarily by emotional dysregulation, extreme "black and white" thinking (believing that something is one of only two possible things, and ignoring any possible "in-betweens"), and turbulent relationships.

The name originated with the idea that individuals exhibiting this type of behavior were on the "borderline" between neurosis and psychosis. This idea has since fallen out of favor, but the name remains in use, as noted in the Diagnostic and Statistical Manual of Mental Disorders; the ICD-10 has an equivalent called emotionally unstable personality disorder, borderline type. There is currently some discussion by the American Psychiatric Association about changing their name for the disorder to emotional dysregulatory disorder, or emotional dysregulation disorder in the next version of the DSM.

Psychiatrists and some other mental health professionals describe borderline personality disorder as a serious mental illness characterized by pervasive instability in mood, interpersonal relationships, self-image, identity, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self. The majority of those diagnosed with this disorder appear to have been individuals abused or traumatized during childhood.

Origin of the term
Originally thought to be at the "borderline" between psychosis and neurosis, people with BPD are now said to suffer from what has come to be called emotional dysregulation. While less well-known than schizophrenia or bipolar disorder (manic-depression), BPD is more common, affecting two percent of adults, mostly young women. Studies have also shown a strong correlation between childhood abuse and development of BPD. There is a high rate of self-injury without suicidal intent, as well as a significant rate of suicide attempts and, in severe cases, successful suicides. The suicide rate is approximately 8-10%. Patients often need extensive mental health services, and they account for 20 percent of psychiatric hospitalizations. It is recognized that they often receive poor service, however, in part due to lack of sympathy with or understanding of self-harm, impulsivity or so-called 'non-compliance'. However, most individuals improve over time and are able to lead more stable and happy lives.

Controversy
Many people with the diagnosis of borderline personality disorder feel it is unhelpful and stigmatizing as well as simply inaccurate, and there are many proposals for the term to be changed or done away with.

Dyslimbia has been suggested by Dr. Leland Heller.

Emotional regulation disorder and emotional dysregulation disorder have been suggested by TARA, (Treatment and Research Advancement Association for Personality Disorders) as having "the most likely chance of being adopted by the American Psychiatric Association.". Emotional regulation disorder is the term favored by Dr. Marsha Linehan, pioneer of one of the most popular types of BPD therapy, but impulse disorder or interpersonal regulatory disorder would be equally valid alternatives, says Dr. John Gunderson of McLean Hospital, near Boston.

Australian psychiatrist Carolyn Quadrio has promoted the term post traumatic personality disorganisation (PTPD), arguing the term summarises the condition's status as both a form of chronic post traumatic stress disorder (PTSD) as well as personality disorder and highlights the fact that the condition is a common outcome of developmental or attachment trauma.

Additionally, Dr. Judith Herman has argued that BPD is strongly related to PTSD.

The most colorful suggestion so far is mercurial disorder, proposed by Harvard's Dr. Mary Zanarini.

DSM-IV-TR diagnostic criteria
The DSM-IV-TR, a widely-used reference book for diagnosing mental disorders, defines borderline personality disorder as a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

Frantic efforts to avoid real or imagined abandonment. (not including suicidal or self-mutilating behavior covered in Criterion 5)
A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Identity disturbance: markedly and persistently unstable self-image or sense of self.
Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating; [not including suicidal or self-mutilating behavior covered in Criterion ).
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Transient, stress-related paranoid ideation or severe dissociative symptoms.

Mnemonic
A commonly used mnemonic to remember the features of the borderline personality disorder is PRAISE:

P - Paranoid ideas
R - Relationship instability
A - Angry outbursts, affective instability, abandonment fears
I - Impulsive behaviour, identity disturbance
S - Suicidal behaviour
E - Emptiness

Symptoms
While a patient with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of depression, anxiety, or anger that may last only minutes, hours, or at most a day.[10] These may be associated with episodes of self-injury (including cutting), impulsive aggression, and drug or alcohol abuse. Difficulties in cognition and sense of self can lead to frequent changes in long-term goals, career plans, jobs, gender identity, friendships, and values. Sometimes people with BPD view themselves as fundamentally bad or unworthy. They may feel unfairly misunderstood or mistreated, bored, empty, and have little idea who they are. Such symptoms are most acute when people with BPD feel isolated and lacking in social support, and may result in frantic efforts to avoid being alone. Ironically, it is the desperate clinging to other people that often serves as the very catalyst for conflict that drives others away.

People with BPD often have highly unstable patterns of social relationships. While they can develop intense but stormy attachments, their attitudes towards family, friends, and loved ones may suddenly shift from idealization (great admiration and love) to devaluation (intense anger and dislike). Thus, they may form an immediate attachment and trust for the other person, but when a separation or conflict occurs that others may see as slight, they can lose their sense of attachment and trust and may become withdrawn or angry. Even with family members, individuals with BPD can be highly sensitive to rejection, for example reacting with distress or anger to separations. These fears of abandonment may be related to difficulties feeling emotionally connected to important persons when they are physically absent, leaving the individual with BPD feeling lost and perhaps worthless. Suicide attempts or self-injury may occur along with anger at perceived abandonment and disappointments.

People with BPD exhibit other impulsive behaviors, such as excessive spending, binge eating and risky sex. BPD often occurs together with other psychiatric problems, particularly bipolar disorder, depression, attention deficit disorder, anxiety disorders, substance abuse, eating disorders and other personality disorders.

As a consequence of difficulties with emotional regulation and maintaining some social boundaries, people with BPD can sometimes make rapid and seemingly deep connections with others, marked by unrealistically high levels of mutual admiration. When very open and in need of reassurance and love, they can sometimes overwhelm others with praise, attention and intimacy. They can also feel overwhelmed by others or be taken advantage of. Due to the inherent instability of such relationships, and unresolved issues for the person with BPD, particularly in matters of trust and self-worth, they are prone to react strongly to apparent slights and reverse their over-positive view. This can be experienced by others as unexpected hostility or betrayal, and can also be confusing and painful for the person with BPD.

Suicide
Patients with borderline personality disorder are at very high risk of suicide, about 5-10% or about 500 to 1000 times more than the general population. This risk greatly escalates when other co-morbid factors are present. The disorder is often poorly understood by psychiatrists and some psychiatrists simply refuse to accept BPD patients due to their instability (missed appointments, difficulty dealing with them). If a patient with BPD has co-morbid factors of substance abuse (alcohol or other drugs), the risk factor reaches an astounding 58% dying from suicide within five years.

Family support
Risk factors can be reduced by proper diagnosis and supportive care most often with involvement of family members. BPD victims need a strong supportive and loving security net of family and caregivers to get through this. Something as simple as validating love for the BPD victim in spite of behaviours can have a huge impact in reducing risk factors. This is not as easy as it sounds, but it is crucial.

Family members who wish to help people with BPD are advised to get clear information on the disorder from mental health professionals as this disorder is not easy to understand with the behaviors of sufferers being sometimes very difficult to tolerate and understand. The question "Why are you doing this?" may remain unanswered or validated by distorted illogical thinking. There is a tendency for some doctors to prescribe tranquilizers such as the benzodiazepine group (includes diazepam [Valium] and lorazepam) for symptoms of anxiety or distress that BPD patients may have, but these drugs can increase impulsivity due to disinhibition and may add to the risk factor[citation needed]. Victims of this disorder may be very intelligent, loving people with strong personalities in terms of holding opinions and defending their ideas, but their self-image is damaged and they seek fulfilment, sometimes in invalidating environments.

Treatment
Treatments for BPD have improved in recent years. [11] People with BPD, who are often distressed by at least some of their symptoms, typically undertake a series of empirical trials of drugs to see whether anything helps them, and may end up taking no drugs at all.

SSRI antidepressants
Since about 1989, Prozac and other selective serotonin reuptake inhibitor (SSRI) antidepressants have repeatedly been shown to improve the symptoms of BPD in some patients, which seems to be a separate effect to antidepressant as such, focussing more on affect regulation. This, however, is questioned by some psychiatrists who caution against use of SSRI and SNRI drugs due to risk and side-effects. Medication must be carefully monitored with BPD patients as the ultimate risk is suicide, and this can potentially be the direct result of prescription drug mismanagement.

The book Listening to Prozac describes some of these remarkable changes. In general, it takes a higher dose of an SSRI to treat BPD than depression. It also takes about three months for benefit to appear, compared to two weeks for depression. The previous antidepressants, the tricyclics, were often unhelpful; side-effects are generally difficult to tolerate and the drugs are often lethal in overdose. Increasing evidence implicates inadequate serotonergic neurotransmission as strongly related to impaired modulation of emotional and behavioral responses to everyday life, manifesting as "overreacting to everything". Even thinking is recruited by the intense (or underregulated) emotionality so that the world is perceived primitively in intense black-and-white terms.

Often, an SSRI or a SNRI drug is prescribed to a patient with BPD without proper supervision and involvement of family caregivers, or explanation or warning of side effects. The drugs often cause agitation and insomnia initially and for some people these problems may persist, which can pose problems in someone who may be suicidal when they begin therapy. Many people can experience withdrawal symptoms when stopping which can leadto the impression they are 'addicted ' to the medication.

The impulsivity, suicidality and possible lack of supports in borderline patients may render them much more vulnerable to self-harm than those without these vulnerablilies should these problems arise.

It may be difficult for the treating physician to make the distinction between side effects that are worsened by increase of dose and the symptoms that a patient is experiencing from the disorder. Increasing the dose to address the worsening symptoms can be dangerous if the symptoms are in fact a side effect of the drug.

Mood stablilizers
Other pharmacological treatments are often prescribed for certain other specific target symptoms shown by the individual patient, especially for people with more than one psychiatric diagnosis. Mood stabilizers (lithium or certain antiepileptic drugs) may be helpful for explosive anger, impulsivity, or if there is an admixture of bipolar disorder.

Neuroleptics
Neuroleptics or antipsychotic drugs may also be used when there are distortions in thinking (e.g., paranoia).[13] Overall, medication has not been as effective for people who have only BPD (without any other mental illnesses) as it has been in many other psychiatric disorders, leading many researchers to focus on non-chemical treatments, such as dialectical behavior therapy, for "pure" BPD patients.

Dialectical behavioral therapy
In 1991, a new psychosocial treatment termed dialectical behavioral therapy (DBT) was developed specifically to treat BPD, and this technique was the first to show any efficacy compared to a control group. Marsha Linehan, the developer of DBT, said in the early days that it took about a year to see substantial enduring improvement. Combining SSRIs and DBT (probably the standard treatment now) seems to give satisfying synergy and faster results.

Linehan's dialectical behavior therapy is based on negotiation between therapist and patient. The dialectic described in the treatment's name is of the therapists' acceptance and validation of patients as they are, combined with the insistence on the need for change. The idea is to give patients tools that they never acquired as children, typically to control and handle their emotions. Some patients, when asked after several years of treatment, why they have stopped inflicting self-injury, give answers to the effect of "I picture myself sitting with my psychotherapist, and we talk about why I want to injure myself."
Other psychotherapies
Cognitive and behaviorally oriented group and individual psychotherapy are effective for many patients. Traditional psychoanalysis is usually avoided, because it has been known to exacerbate BPD symptoms.

Another relatively recent and exciting development is a variation on Jeffrey Young's schema therapy, entitled mode therapy. Details can be obtained from his book.

Recent research findings
Although the causes of BPD are uncertain, both environmental and genetic factors are thought to play a role in predisposing patients to BPD symptoms and traits, possibly through the final common pathway of reduced central serotonergic neurotransmission. Studies show that many (but not all) individuals with BPD report a history of abuse, neglect, or separation as young children.[14] Between 40% and 71% of BPD patients report having been sexually abused, usually by a non-caregiver. Many others have an apparently hereditary form of the disease.

Researchers believe that BPD results from a combination of individual genetic vulnerability and environmental stress, neglect or abuse as young children, and maturational events that trigger the onset of the disorder during adolescence or adulthood.

Adults with BPD are also considerably more likely to be the victim of violence, including rape and other crimes. This may be the result of vulnerabilities resulting from BPD (e.g., willingness to tolerate unsafe environments to avoid abandonment, tendency to form intense relationships) as well as impulsivity and poor judgment in choosing partners and lifestyles. Anger, impulsivity, and poor judgment may also explain why people with BPD are more likely than average to be arrested for and convicted of crimes ranging from petty theft to murder.

Neuroscience research examines brain mechanisms possibly underlying the impulsivity, mood instability, aggression, anger, and negative emotion seen in BPD. Studies suggest that people predisposed to impulsive aggression have impaired regulation of the neural circuits that modulate emotion. The amygdala, a small almond-shaped structure deep inside the brain, is an important component of the circuit that regulates negative emotion. In response to signals from other brain centers indicating a perceived threat, it marshals fear and arousal. This might be more pronounced under the influence of stress and/or drugs like alcohol. Areas in the front of the brain (pre-frontal area) act to damp the activity of this circuit. Recent brain imaging studies show that individual differences in the ability to activate regions of the prefrontal cerebral cortex thought to be involved in inhibitory activity predict the ability to suppress negative emotion.

Serotonin, norepinephrine and acetylcholine are among the chemical messengers in these circuits that play a role in the regulation of emotions, including sadness, anger, anxiety and irritability. Drugs that enhance brain serotonin function sometimes improve emotional symptoms in BPD. Likewise, mood-stabilizing drugs that are known to enhance the activity of GABA, the brain's major inhibitory neurotransmitter, may help people who experience BPD-like mood swings.

Future progress
Studies that translate basic findings about the neural basis of temperament, mood regulation and cognition into clinically relevant insights which bear on BPD represent a growing area of research. Research is also underway to test the efficacy of combining medications with behavioral treatments like DBT, and gauging the effect of childhood abuse and other stress. Data from the first prospective, longitudinal study of BPD, which began in the early 1990s, is expected to reveal how treatment affects the course of the illness. It will also hopefully pinpoint specific environmental factors and personality traits that predict a more favorable outcome.

The NonBP, or counter-borderline
NonBP is a non-clinical term originally coined by Kreger & Mason in the book Stop Walking on Eggshells (ISBN 1-57224-108-X) in the mid-1990's. It has since come into widespread and popular usage. The term describes individuals who are in a consistent, and sometimes significant, relationship with a person exhibiting a Borderline character, aspects of complex post traumatic stress disorder (C-PTSD), or a formally diagnosed borderline personality disorder. These people can be friends, spouses, lovers, offspring, co-workers, and extended family members, among others.

While "NonBP" is a colloquial expression, and not a clinically defined condition or syndrome, the idea parallels that of the "roles" that people often take on in alcoholic families, or abusive relationships. It is also consistent with the idea of "roles" described in co-dependent relationships, such as "enabler", "counter-dependent", and/or "agent". Part of the value of this type of informal terminology is that it helps describe the manner in which others potentially behave when in relationship to a person whose social skills are inadequate, in what ever way that presents itself.

When talking about the Borderline relationship, the "Non-reactive NonBP" is considered to be a person who interacts with the Borderline character, while not being drawn into, or engaging, the chaos of the disorder. The "Reactive NonBP", however, both interacts with the Borderline character, and engages the Borderline behavior. This often throws the person off-center, and promotes a kind of parallel emotional dysregulation within them. The "Reactive" relationship style breaks down into two distinct sub-styles; transpersonal, or the "trans-Borderline", and counterpersonal, or the "counter-Borderline".

The "trans-Borderline" is an individual who engages the Borderline character, and is drawn only to the chaos of the disorder itself. Rather than being directly affected, s/he is more apt to stay focused on "cleaning up" after the Borderline personality. This is something akin to the "caretaker/enabler" role found in alcoholic relationships. In both cases, this person is characteristically co-dependent, or set up to be co-dependent in that relationship. S/he acts as enabler, or agent, or both.

The "counter-Borderline", on the other hand, not only reacts to and integrates the Borderline style, but reflects it, as well. This individual is the most negatively affected by his/her relationship to the Borderline personality. Very often, this person will begin to behave in a manner very similar to a person with a Borderline personality. This type of relationship is very treacherous and, when talking about chaotic relationships with Borderline personalities, this is the sort of situation to which most people are referring. This type of relationship often leaves the NonBP questioning his/her own sanity, and the "emotional hangover" of such a relationship can take a considerable amount of time from which to recover.