Those who have BPD suffer from recurrent, uncontrollable and difficult changes in mood. They experience significant difficulty making and sustaining relationships with other people, and often find it difficult to control their own impulsive behaviour – doing things without first considering the consequences. Those with BPD often have a history of impulsive self-harm behaviour such as physical self-harm, suicide attempts and unsafe sexual activity.

In order to obtain an official diagnosis of BPD, five of the following symptoms must be present:
1.  Emotional instability – impulsive emotional change in response to everyday events (intense sadness, anxiety, or irritability etc.)
2.  Intense and inappropriate anger which is difficult to control and arises unexpectedly for others (e.g., frequent and noticeable displays of temper and/or physical violence towards other people).
3.  Chronic feelings of worthlessness and emptiness.
4.  Unstable and intense relationships (often fluctuating rapidly from idealisation and praise to devaluation and criticism).
5.  Engaging in frantic and agitated behaviour in order to prevent real or imagined abandonment by others.
6.  Engaging in impulsive and potentially damaging behaviour such as;
o Unsafe sexual behaviour
o Excessive spending
o Drug and alcohol abuse
o Binge eating
o Reckless driving
7.  Recurrent suicidal behaviour such as making threats or actual attempts, or engaging in self-harm (e.g., cutting).
8.  An unstable sense of self and feeling unsure of “who you are”.
9.  Stress related paranoia that someone is trying to harm you; or significant dissociative symptoms such as feeling disconnected from your body and mind.

As is the case with all personality disorders, the exact cause of BPD is unclear. It is most likely a combination of psychological, social and biological factors.

Childhood traumatic events are associated with the development of BPD and many people with this particular personality disorder have experienced parental neglect or physical, sexual or emotional abuse at a young age.

Of all the problems associated with BPD, the most severe is suicide. Research shows that as many as 75% of people who have BPD will attempt suicide at some point in their lives. Aside from suicide, the following mental health conditions or behavioural problems are common amongst those with BPD:

o Substance abuse
o Generalised anxiety disorder
o Bipolar disorder
o Depression
o Eating disorders, such as anorexia or bulimia
o Another personality disorder, such as antisocial personality disorder

Research has shown that men with BPD are more likely to develop drug and alcohol problems than their female counterparts. However, women with BPD are more likely to develop an eating disorder than men.

Psychiatric medication is not recommended for those with ongoing symptoms of BPD as there is currently no medication known to be effective when treating this personality disorder. However, medication can be helpful when treating the other mental health problems that commonly occur for those with BPD.

Treatment for BPD usually involves talking therapy. The National Institute for Health and Care Excellence (NICE) suggests the following types of talking treatments:

o Dialectical Behaviour Therapy (DBT) – individual and group therapy that is used to help the individual learn ways to cope with difficult emotions.

o Mentalisation-Based Therapy (MBT) – helps the individual to recognise and understand their own mental states, and the mental states of others. This then encourages them to examine and explore their own thoughts about themselves and others.

o Cognitive Behavioural Therapy (CBT) – aims to help the individual understand how their thoughts and beliefs affect their behaviour and the way they feel.

o Cognitive Analytic Therapy (CAT) – combines the practical methods of CBT with a focus on the relationship between the individual and their therapist. This can help the individual to explore how they relate to other people, and consider any patterns they may have developed.

o Other talking therapies – schema-focused cognitive therapy, psychodynamic therapy, interpersonal therapy or arts therapies.

When treating BPD, therapeutic communities can also be utilised. These are specially designed programmes where the individual works with a group of other people who are experiencing mental health problems and they each support one another with their recovery. In some instances, these groups may live together or they may just meet up regularly.

See nhs.uk

Please feel free to get in touch with us if you have any questions about the psychological therapies we offer at our facilities that could be able to help with borderline personality disorder.