Borderline Personality Disorder example essay topic

"Borderline Personality Disorder is a severe, chronic, disabling, and potentially lethal psychiatric condition" (BPD Research Foundation). A person with a Borderline Personality Disorder (BPD) is characterized by having a repetitive pattern of mood instability and poor self-image. The Diagnostic and Statistical Manual (DSM-IV) 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: 1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.2. 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).

Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior 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 (BPD Central, Markovitz, Skodol). BPD is characterized by mood instability and poor self-image. Relationships with others are intense and stormy, very unstable and are difficult in maintaining intimate, close connections. The Borderline person has difficulty with trusting others and may manipulate at the same time. There is emotional instability that can lead to depression.

BPD's tend to take their anger out on themselves causing themselves a great deal of pain. The depression which accompanies this disorder can cause much suffering and can lead to serious suicide attempts. Even in less severe instances, there is often trouble with relationships, friendships and work performance. They are extremely quick to anger when they do not get their way (Corelli). BPD is a common disorder ranging from 10 - 14% of the general population says Corelli, while BPD Central and Skodol say 2% of the general population have BPD. BPD in women is two to three times more likely than that in a male.

This may be related to genetic or hormonal influences. An association between this disorder and severe cases of premenstrual tension has been suggested. Women commonly suffer from depression more often than men (BPD Central, Corelli). The increased frequency of borderline disorders among women may also be a consequence of the greater incidence of incestuous experiences during their childhood.

This is believed to occur ten times more often in women than in men, with estimates running to up to one-fourth of all women. "This chronic or periodic victimization and sometimes brutalization can later result in impaired relationships and mistrust of men and excessive preoccupation with sexuality, sexual promiscuity, inhibitions, deep-seated depression and a seriously damaged self-image", says Corelli. Pheil believes "there must be Biological and Neurological predisposition for those to develop BPD". Some therapists feel the onset of Borderline Personality Disorder is at puberty, some feel that it is earlier.

Most will not diagnose a person with BPD until adulthood claiming the angst of puberty can mimic some forms of BPD. While some are diagnosing the BPD in puberty now others use the Oppositional Defiance Disorder and Conduct Disorder diagnosis until adulthood (Masterson). Some people with BPD are so incapacitated by their illness that they are unable to work. They may spend a great deal of time in the hospital because of self-mutilation, severe eating disorders, substance abuse, or suicide attempts. BPD makes it very hard for them to form relationships, so they may have a weak support system (BPD Central). Most borderline behavior is about one thing: trying to cope with internal anguish.

However, people with BPD may do this in different ways. In our experience, the behavior of people with BPD tends to fall into two general categories: "acting out" and "acting in". These are not official, empirically researched categories. Rather, they are a convenient, real-world way of looking at differences. Acting-out behaviors are attempts to alleviate pain by dumping it onto someone else-for example, by raging, blaming, criticizing, making accusations, becoming physically violent, and engaging in verbal abuse. Acting-out behaviors cause direct anguish for friends, family members, and partners.

For example, one borderline woman, Kiesha, became very angry when she felt that her husband was ignoring her at an office Christmas party. So she went up to him, threw her drink in his face, and stalked out. Acting-in behaviors mostly hurt the person with BPD, although non-BPs are also affected. Someone with BPD who mostly acts in may feel extremely guilty over imagined transgressions. They may mutilate themselves, try to hold in their anger, and blame themselves for problems that are not their fault. Suicide is also a possibility.

Some BPs seem to mainly act in. Some mainly act out. And some both act in and act out. Take Kiesha, for example; after she embarrassed her husband at the Christmas party, she felt very guilty. She walked home from the party, a distance of several miles. When she arrived home, she grabbed several ornaments from the tree and crushed them with her hands, causing a great deal of bleeding.

(BPD Central) Recovering from Borderline Personality Disorder is a hard task to complete and has a poor probable outcome (Ballas, BPD Central, Koenigsberg et al, Markovitz, Masterson, Skodol). For the borderline it may involve facing horrible childhood abuse or deep-rooted feelings of shame. People with a Borderline Personality feel trapped. The only way through it is to want it very badly.

You cannot make someone want this, any more than someone can make you want to change yourself. It has to come from within. About 9% of Borderline patients kill themselves. This is why it is imperative to get treatment. More than six million people in the United States of America have Borderline Personality Disorder, and these people greatly affect the lives of at least thirty million others. Borderline (BPD Central).

Dr. Moskowitz says that treatment is still evolving in both the psychotherapeutic and physical realm. Dialectical Behavior Therapy and EMDR are both products of the last decade and are still progressing. In the last five years, the EMDR community has turned considerable attention toward a concept known as Resource Installation, which helps provide patients skills for managing self-destructive impulses that can interfere with trauma work before the latter begins. Dr. Corelli believes psychotherapy is one of the best treatments.

Psychotherapy allows the patient to talk about their present and past experiences with an "empathetic, accepting and non-judgemental therapist" by their side. The therapy needs to be constant, and structured with the patient encourages to talk about their feelings rather than to disregard them as they normally would. The cause of BPD is hard for experts to agree on says Pheil. Pheil believes that medication is the first way to treat the disorder, followed by Cognitive Behavior Therapy (CBT). Phillip W. Long, M.D. noted: "During brief reactive psychoses, low doses of antipsychotic drugs may be useful, but they are usually not essential adjuncts to the treatment regimen, since such episodes are most often self-limiting and of short duration. It is, however, clear that low doses of high potency narcoleptics (e. g., haloperidol) may be helpful for disorganized thinking and some psychotic symptoms.

Depression in some cases is amenable to neuroleptics. Neuroleptics are particularly recommended for the psychotic symptoms mentioned above, and for patients who show anger, which must be controlled. Dosages should generally be low and the medication should never be given without adequate psychosocial intervention". The very characteristics of the disorder, such as unstable relationships and intense anger, interfere with establishing the therapeutic relationship that is necessary to any treatment, whether psychotherapy or medication. Further, mental health professionals often are reluctant to treat these individuals because they exhibit two characteristics likely to lead to clinician "burnout": the BPD person's hostility towards the clinical professional and their persistent suicidal thoughts and feelings. Despite the devastating nature of this disorder, it hasn't received the scientific and clinical attention that other health and psychiatric problems of equal, or even lesser, level of disability have received (Skodol).

In conclusion, Borderline Personality Disorder is a common disorder that most people do not know about. Borderline Personality Disorder is a serious disorder that affects real people and the people in their lives. Treatment is absolutely necessary in order for a Borderline person to stop hurting themselves and others around them. If properly diagnosed treatment could save a Borderline persons life.

Bibliography

Ballas, Christos. Yahoo! Health Encyclopedia: Borderline Personality Disorder. 28 March 2003.
BPD Central. 28 March 2003.
Corelli, Richard. Borderline Personality Disorders. 28 March 2003.
Kien, B., Swales, M. "An Overview of Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder". Mental Help Net (1995): 15 pp.
28 Mar. 2003 Koenigsberg, Harold.
et al. Borderline Patients: Extending the Limits of Treat ability. Basic Books, 2000.
Markovitz. Borderline Personality Disorder Sanctuary. 1 April 2003.
Masterson, James., Treatment of the Borderline Adolescent: A Developmental Approach. John Wiley & Sons, Inc., 1972.
Pheil, Tim., "The Cause of Borderline Personality Disorder". (1996-2003): 3 pp.
28 March 2003 Skodol, Andrew E.
Borderline Personality Disorder Research Foundation. 20 March 2003.