Borderline personality disorder - Wikipedia, the free encyclopedia

http://en.wikipedia.org/wiki/Borderline_personality_disorder

Borderline personality disorder
From Wikipedia, the free encyclopedia

Borderline personality disorder (BPD) is a personality disorder described as a prolonged disturbance of personality function in a person (generally over the age of eighteen years, although it is also found in adolescents), characterized by depth and variability of moods.[n 1] The disorder typically involves unusual levels of instability in mood; blackand-white thinking, or splitting; the disorder often manifests itself in idealization and devaluation episodes, as well as chaotic and unstable interpersonal relationships, self-image, identity, and behavior; as well as a disturbance in the individual's sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation.[1] Splitting in BPD includes a switch between idealizing and demonizing others. This, combined with mood disturbances, can undermine relationships with family, friends, and co-workers. BPD disturbances also may include self-harm.[2] Without treatment, symptoms may worsen, leading (in extreme cases) to suicide attempts.[n 2]

Borderline personality disorder
Classification and external resources ICD-10 F60.3 (http://apps.who.int /classifications/icd10/browse /2010/en#/F60.3) 301.83 (http://www.icd9data.com /getICD9Code.ashx?icd9=301.83)

ICD-9

MedlinePlus 000935 (http://www.nlm.nih.gov /medlineplus/ency/article /000935.htm) eMedicine article/913575 (http://emedicine.medscape.com /article/913575-overview) MeSH D001883 (http://www.nlm.nih.gov /cgi/mesh /2011/MB_cgi?field=uid& term=D001883)

There is an ongoing debate among clinicians and patients worldwide about terminology and the use of the word borderline,[3] and some have suggested that this disorder should be renamed.[4] The ICD-10 manual has an alternative definition and terminology to this disorder, called Emotionally unstable personality disorder. There is related concern that the diagnosis of BPD stigmatizes people and supports pejorative and discriminatory practices.[5]

Contents
1 Signs and symptoms 2 Diagnosis 2.1 Diagnostic and Statistical Manual 2.2 International Classification of Disease 2.3 Chinese Society of Psychiatry 2.4 Millon's subtypes 2.5 Family members 2.6 Adolescence 2.7 Differential diagnosis

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Borderline personality disorder - Wikipedia, the free encyclopedia

http://en.wikipedia.org/wiki/Borderline_personality_disorder

3 Causes 3.1 Childhood abuse 3.2 Other developmental factors 3.3 Genetics 3.4 Research on mediating and moderating factors 4 Management 4.1 Psychotherapy 4.2 Medications 4.3 Services 5 Prognosis 6 Epidemiology 7 History 8 Society and culture 8.1 Film and television 8.2 Literature 8.3 Awareness 8.4 Notable people 9 Controversies 9.1 Gender 9.2 Stigma 9.3 Terminology 10 Notes 11 References 12 Further reading 13 External links

Signs and symptoms
Borderline personality disorder is a diagnosis about which many articles and books have been written, yet about which little is known based on empirical research.[6] Studies suggest that individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone or perceived failure.[n 3] Individuals with BPD may show lability (changeability) between anger and anxiety or between depression and anxiety[7] and temperamental sensitivity to emotive stimuli.[8] The negative emotional states specific to BPD may be grouped into four categories: destructive or self-destructive feelings; extreme feelings in general; feelings of fragmentation or lack of identity; and feelings of victimization.[9] Individuals with BPD can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative, generally after a disappointment or perceived threat of losing someone. Self-image can also change rapidly from extremely positive to extremely negative. Impulsive behaviors are common, including alcohol or drug abuse, unsafe sex, gambling and recklessness in general.[10]
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abuse and unwanted pregnancy. powerlessness and defensive reactions. can be hyper-alert[6] to signs of rejection or not being valued and tend toward insecure. the free encyclopedia http://en.[11] Evidence suggests that individuals with BPD. must be present for this diagnosis. a counter-intuitive result.Borderline personality disorder .or novelty-seeking. Today BPD is used more generally to describe individuals who display emotional dysregulation and instability.[18] Stressful life events related to sexual abuse have been found to be a particular trigger for suicide attempts by adolescents with a BPD diagnosis.[24] Ongoing family interactions and associated vulnerabilities can lead to self-destructive behavior.[17] Parents of individuals with BPD have been reported to show co-existing extremes of over-involvement and under-involvement.[1] Borderline personality disorder was once classified as a subset of schizophrenia (describing patients with borderline schizophrenic tendencies). "preoccupied".org/wiki/Borderline_personality_disorder Attachment studies have revealed a strong association between BPD and insecure attachment style.[18] BPD has been linked to increased levels of chronic stress and conflict in romantic relationships.[20] The suicide rate is approximately 8 to 10 percent. these links may be general to personality disorder and subsyndromal problems. with paranoid ideation or delusions being only one criterion (criterion #9) of a total of 9 criteria.[19] Suicidal or self-harming behavior is one of the core diagnostic criteria in DSM IV-TR. and less commonly by high-lethality attempts that are attributed to impulsiveness or comorbid clinical depression. The assessment incorporates the patient's self-reported experiences as well as the clinician's observations. the most characteristic types being "unresolved". 3 of 24 1/14/2012 6:12 PM . and "fearful". The resulting profile may be supported or corroborated by long-term patterns of behavior as reported by family members.wikipedia.[21] Self-injury attempts are highly common among patients and may or may not be carried out with suicidal intent. but analysis and findings generally trace behaviors to inner pain and turmoil.[12] They tend to view the world as generally dangerous and malevolent.[25] Diagnosis Diagnosis is based on a clinical assessment by a qualified mental health professional.[14][15][n 4] There has been limited research on family members' understanding of borderline personality disorder and the extent of burden or negative emotion experienced or expressed by family members. or more. or limited coping and communication skills. including by some mental health professionals (and in the DSM-IV). while being high in intimacy. For BPD such effect may be neutral or positive as opposed to negative. of which 5.[22][23] BPD is often characterized by multiple low-lethality suicide attempts triggered by seemingly minor incidents. and management of and recovery from this can be complex and challenging. friends or co-workers.[6] Individuals with BPD are often described.[13] as deliberately manipulative or difficult. decreased satisfaction of romantic partners. avoidant or ambivalent. The list of criteria that must be met for diagnosis is outlined in the DSM-IV-TR. or fearfully preoccupied patterns in relationships.Wikipedia.[16] However the effect of expressed emotion by family members may actually be opposite (paradoxical) from the anticipated effect on individuals with such illnesses as depressive disorders and schizophrenia. with interpersonal stressors appearing to be particularly common triggers.

2. promiscuous sex. intense episodic dysphoria. 3. DSM IV-TR. 4. International Classification of Disease The World Health Organization's ICD-10 defines a conceptually similar disorder to borderline personality disorder called (F60.. delusions or severe dissociative symptoms It is a requirement of DSM-IV that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.3) ) Emotionally unstable personality disorder.3 (http://apps. 9.Borderline personality disorder . 3. reckless driving). liability to outbursts of anger or violence. Transient. Affective instability due to a marked reactivity of mood (e. 4. Note: Do not include suicidal or self-injuring behavior covered in Criterion 5 5. eating disorders.g. Identity disturbance: markedly and persistently unstable self-image or sense of self. interfering with the healing of scars (excoriation) or picking at oneself. as well as marked impulsivity.wikipedia. the free encyclopedia http://en. recurrent physical fights).. 6.Wikipedia. one of which must be (2): 1. Chronic feelings of emptiness 8. with inability to control the resulting behavioural explosions. substance abuse. It has two subtypes described below. unstable and capricious mood. especially when impulsive acts are thwarted or criticized.g. binge eating. Note: Do not include suicidal or self-injuring behavior covered in Criterion 5 2. defines borderline personality disorder (in Axis II Cluster B) as:[1][13] A pervasive pattern of instability of interpersonal relationships.[26] F60.org/wiki/Borderline_personality_disorder Diagnostic and Statistical Manual The Diagnostic and Statistical Manual of Mental Disorders fourth edition. Frantic efforts to avoid real or imagined abandonment.who. threats or self-injuring behavior such as cutting. a widely used manual for diagnosing mental disorders. gestures. Recurrent suicidal behavior. self-image and affects.int/classifications/icd10/browse/2010/en# /F60. marked tendency to quarrelsome behaviour and to conflicts with others. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. stress-related paranoid ideation.. irritability or anxiety usually lasting a few hours and only rarely more than a few days). frequent displays of temper. as indicated by five (or more) of the following: 1. 4 of 24 1/14/2012 6:12 PM . constant anger. Inappropriate anger or difficulty controlling anger (e. marked tendency to act unexpectedly and without consideration of the consequences. Impulsivity in at least two areas that are potentially self-damaging (e. beginning by early adulthood and present in a variety of contexts. 7. difficulty in maintaining any course of action that offers no immediate reward. 5.30 Impulsive type At least three of the following must be present.g.

often leading to emotional crisis. effective treatments. The construct has been described as a hybrid of the impulsive and borderline subtypes of the ICD-10's Emotionally Unstable Personality Disorder. recurrent threats or acts of self-harm. Chinese Society of Psychiatry The Chinese Society of Psychiatry's CCMD has a comparable diagnosis of Impulsive Personality Disorder (IPD). relief may be obtained through evidence that BPD is closely related to traumatic events during childhood and to post-traumatic stress disorder (PTSD).[28] Recovery can be faster with the help of family members and loved ones. about which much more is known. This is true especially because of evidence that this disorder originates in the families of those with it[18] and has a lot to do with psychosocial and environmental factors (Axis IV).[27] Millon's subtypes Theodore Millon. depressive or dependent features Impulsive borderline — including histrionic or antisocial features Petulant borderline — including negativistic (passive-aggressive) features Self-destructive borderline — including depressive or masochistic features Family members It is common for those with borderline personality disorder and their families to feel their problems compounded by a lack of clear diagnoses.Wikipedia.31 Borderline type At least three of the symptoms mentioned in F60. and accurate information. chronic feelings of emptiness. however those involved must be trained for their assistance to have an effective impact. with at least two of the following in addition: 1. 4.htm) 5 of 24 1/14/2012 6:12 PM .com/tools/articles5.[n 5][n 6] He suggests an individual diagnosed with BPD may exhibit none.wikipedia. has unofficially proposed four subtypes of borderline.30 Impulsive type must be present [see above]. aims. disturbances in and uncertainty about self-image. and internal preferences (including sexual).Borderline personality disorder . rather than belonging strictly in the personality disorders and mental retardation section (Axis II) of the DSM-IV construct. the free encyclopedia http://en. [1] (http://bpdfamily. a psychologist noted for popular works on personality disorders. 5. Conceptual. 2. The ICD-10 also describes some general criteria that define what is considered a personality disorder. 3." plus at least three out of eight other symptoms. A patient diagnosed as having IPD must display "affective outbursts" and "marked impulsive behavior. as well as therapeutic. one or more of the following: Discouraged borderline — including avoidant. liability to become involved in intense and unstable relationships.org/wiki/Borderline_personality_disorder F60. and also incorporates six of the nine DSM BPD criteria. excessive efforts to avoid abandonment.

minutes. or both.org/wiki/Borderline_personality_disorder Adolescence Onset of symptoms typically occurs during adolescence or young adulthood." In other words.Wikipedia.[37][38] while others maintain the categorical distinction between the disorders while noting they often co-occur. especially alcohol dependence or abuse which is often combined with the abuse of other drugs.[citation needed] The behavior is typically in response to external psychosocial and intrapsychic stressors. to a lesser extent.[31] Borderline personality disorder and mood disorders often appear concurrently. days. [39][40] Some findings suggest BPD lies on a bipolar spectrum. therapists are discouraged from diagnosing anyone before the age of 18. There is some evidence that BPD diagnosed in adolescence is predictive of the disorder continuing into adulthood. as well as a marked nonreactivity of mood." In borderline personality disorder. suddenly and dramatically and last for seconds. the features must have been present for at least 1 year. hours. whether due to impulsivity or as a coping mechanism.[32][33][34] Both diagnoses involve symptoms commonly known as "mood swings. weeks or months.[41][42] Other findings suggest that the DSM-IV BPD diagnosis mixes up two sets of unrelated items—an affective 6 of 24 1/14/2012 6:12 PM . the free encyclopedia http://en.[2] Some features of borderline personality disorder may overlap with those of mood disorders. somatoform or factitious disorders dissociative disorders Substance abuse is a common problem in BPD. whereas mood with respect to borderline personality and co-occurring dysthymia remains markedly reactive and sleep disturbance not acute. the former showed a higher rate of also meeting criteria for[30] anxiety disorders mood disorders (including clinical depression and bipolar disorder) eating disorders (including anorexia nervosa and bulimia) and. While borderline personality disorder can manifest itself in children and teenagers.[36] Some hold that BPD represents a subthreshold form of affective disorder. and may arise or subside. It is possible that the diagnosis.[1][29] Differential diagnosis Comorbid (co-occurring) conditions are common in BPD. complicating the differential diagnostic assessment. due to adolescence and a still-developing personality. would be helpful in creating a more effective treatment plan for the child or teen. When comparing individuals diagnosed with BPD to those diagnosed with other personality disorders. and 50 percent to 70 percent of psychiatric inpatients with BPD have been found to meet criteria for a substance use disorder. with a number of points of phenomenological and biological overlap between the affective lability criterion of borderline personality disorder and the extremely rapid cycling bipolar disorders. but a more conservative approach should be taken. the term refers to the marked lability and reactivity of mood defined as emotional dysregulation.wikipedia. if applicable. The DSM-IV states: "To diagnose a personality disorder in an individual under 18 years. it is possible to diagnose the disorder in children and adolescents. There are some instances when BPD can be evident and diagnosed before the age of 18.Borderline personality disorder .[35] Bipolar depression is generally more pervasive with sleep and appetite disturbances.

Heavy alcohol usage over a long period itself can cause an encephalopathy which may cause limbic damage. the causes of BPD are complex and not fully understood.[50] Patients with BPD have been found to be significantly more likely to report having been verbally. a vulnerable temperament and stressful maturational events during adolescence or adulthood.org/wiki/Borderline_personality_disorder instability dimension related to Bipolar-II. but rather a reaction to the isolating circumstances caused by a medical condition and the possibly coincident struggles of the patient to control his or her mood given damage to the brain's limbic system.[citation needed] Causes As with other mental disorders. and to have treated the child inconsistently. They were also reported to have failed to provide needed protection. Parents (of both sexes) were typically reported to have withdrawn from the child emotionally.Borderline personality disorder . and various frontal lobe syndromes can also result in disinhibition and impulsive behavior resembling BPD. environmental factors. Additionally. and development of BPD. abuse or neglect. and an impulsivity dimension not related to BipolarII.[28] Evidence further suggests that BPD might result from a combination that can involve a traumatic childhood. The 7 of 24 1/14/2012 6:12 PM .[44][46][47][48][49] Many individuals with BPD report to have had a history of abuse and neglect as young children.[45] Childhood abuse Numerous studies have shown a strong correlation between child abuse.[4] One finding is a history of childhood trauma. and neglected their child's physical care. women with BPD who reported a previous history of neglect by a female caregiver and abuse by a male caregiver were consequently at significantly higher risk for being sexually abused by a noncaregiver (not a parent). and may be biologically distinct from the post-traumatic stress disorder that could be a precursor to it. This may include hormonal dysfunction over a long period. physically or sexually abused by caregivers of either gender. and brain dysfunction (e.[51] It has been suggested that children who experience chronic early maltreatment and attachment difficulties may go on to develop borderline personality disorder.[43] General medical conditions can cause behavioral dysfunction resulting in a clinical picture that may resemble to some degree BPD. especially child sexual abuse.[4] There is evidence that suggests that BPD and post-traumatic stress disorder (PTSD) are closely related.Wikipedia. the encephalopathy caused by lyme disease).[44] although researchers have suggested diverse possible causes. such as a genetic predisposition. They were also much more likely to report having caregivers (of both genders) deny the validity of their thoughts and feelings.g.[52] Other developmental factors Some findings suggest that BPD is not necessarily a trauma-spectrum disorder. it is not BPD that results.[citation needed] These conditions may isolate the patient socially and emotionally. However. There has also been a high incidence of incest and loss of caregivers in early childhood for people with borderline personality disorder. neurobiological factors. emotionally. or brain abnormalities.wikipedia. the free encyclopedia http://en. and/or cause limbic damage to the brain.

[57] Other research has examined whether the negative affectivity associated with BPD—that is. people who are highly apt to feel rejected.[53] Otto Kernberg formulated a theory of borderline personality based on a premise of failure to develop in childhood. The results of this study found that thought suppression mediated the relationship between negative affectivity and BPD symptoms. Boldero and Bell examined another facet of BPD. contempt. Other factors including family environment also contribute to the development of the disorder. in other words. Self-complexity. sibling and other family studies indicate a partially heritable basis for impulsive aggression. or being aware of one's own mental patterns. Thus. but studies of serotonin-related genes to date have suggested only modest contributions to behavior. Research has found that both physical and sexual abuse appear to be factors in developing BPD symptoms.[54] Genetics An overview of the existing literature suggested that traits related to BPD are influenced by genes. Among those high in self-complexity. the tendency to often feel anger.. which is instability of the sense of self. found that rejection sensitivity and executive control are predictors of BPD symptoms. are more likely to develop BPD. did not appear to predict later development of BPD. but they may also be related to more persistent aspects of interpersonal and family environments in childhood.[53] Research on mediating and moderating factors Research suggests that. the relationship of negative affectivity to BPD symptoms is mediated by thought suppression.Wikipedia. BPD may develop as a result of a number of different factors. the relationship between AI 8 of 24 1/14/2012 6:12 PM . Ayduk. namely a child's ability to tolerate delayed gratification at age 4. or consciously trying not to think certain thoughts. Kernberg argued that failure to achieve the developmental task of psychic clarification of self and other can result in an increased risk to develop varieties of psychosis. guilt. et al. rather than having a single cause. Their findings indicated that Self-Discrepancy--the sense of failing to match one's own ideals—was strongly correlated to BPD. the other also met criteria in 35 percent of cases. nervousness. Another factor the authors studied.org/wiki/Borderline_personality_disorder personality symptom clusters seem to be related to specific abuses.wikipedia.[57] found that both child sexual abuse (CSA) and childhood physical abuse both directly influence the development of BPD symptoms directly and are mediated by family environment.[56] Twin. the free encyclopedia http://en.[55] A major twin study found that if one identical twin met criteria for BPD.[58] While negative affectivity significantly predicted BPD symptoms. and other negative feelings—can be helped by the technique of thought suppression.Borderline personality disorder . People that have BPD influenced by genes usually have a close relative with the disorder. and/or who have poor control of their emotions and behavior. Writing in the psychoanalytic tradition. while failure to overcome splitting results in an increased risk to develop a borderline personality. this relationship was greatly reduced when thought suppression was introduced into the model.[57] Bradley et al.[59] Parker. was not.

valproate semisodium may ameliorate depression and interpersonal problems.[63] Psychotherapy Four comprehensive psychosocial interventions for BPD – two psychodynamic treatments (mentalization-based. Of the mood stabilizers studied. and it may reduce anger. Among the antidepressants.[60] Management Main article: Management of borderline personality disorder Psychotherapy forms the foundation of treatment for borderline personality disorder with medications playing a lesser role. if any. rather than upon the diagnosis of BPD with co-morbid conditions determining medications use.org/wiki/Borderline_personality_disorder self-discrepancy magnitudes and BPD features was lower than among those with less self-complexity. olanzapine may decrease affective instability. especially physical self-harm. psychotic paranoid symptoms. fluvoxamine and phenelzine sulfate showed no effect. and ziprasidone treatment demonstrated no significant therapeutic affect.Wikipedia. impulsivity. depression. and transference-focused) and two cognitive-behavioral treatments (dialectical behavioral. and the effect of 9 of 24 1/14/2012 6:12 PM . topiramate may ameliorate interpersonal problems.[66] Medications A 2010 review by the Cochrane collaboration found that the total severity of BPD is not significantly affected by any drug.[67] Of the typical antipsychotics studied in relation to BPD. impulsivity. the free encyclopedia http://en. psychotic paranoid symptoms. identity disturbance and abandonment. anger and general psychiatric pathology. Omega-3 fatty acid may ameliorate suicidality and improve depression. so the evidence is not strong. lamotrigine may reduce impulsivity and anger.wikipedia.Borderline personality disorder . and anxiety. amitriptyline may reduce depression." However. but mianserin. anger. No drugs show promise for "the core BPD symptoms of chronic feelings of emptiness. haloperidol may reduce anger. and schema-focused) – were the subject of a 2009 review that found that each therapy reduced the severity of the disorder or some elements of it. fluoxetine. Actual-ought self-discrepancy relationship with BPD features was not significantly moderated by self-complexity. anxiety. Among the atypical antipsychotics. anger.[65] A special problem of psychotherapy with borderline patients is intense projection. and general psychiatric pathology. The review warned that most trials have not been replicated. anxiety.[62] Hospitalization has not been found to improve outcomes or prevent suicide over community care in those with BPD.[61] Treatments should be based on individual case presentation. and flupenthixol may reduce the likelihood of suicidal behavior.[64] A 2010 review found that the highest quality evidence from clinical trials of psychotherapeutic interventions supports dialectical behavior therapy and mentalization-based therapy. It requires the psychotherapist to be flexible in considering negative attributions by the patient rather than quickly interpreting the projection. but carbamazepine treatment demonstrated no significant effect. but placebo had a greater ameliorative impact on suicidal ideation than olanzapine did. the authors found that some drugs may impact certain associated symptoms or the symptoms of comorbid conditions. aripiprazole may reduce interpersonal problems.

org/wiki/Borderline_personality_disorder long-term use has not been assessed. some with the diagnosis of BPD have reported that the term "BPD" felt like a pejorative label rather than a helpful diagnosis. They accounted for about 20 percent of psychiatric hospitalizations in one survey. While vocational achievement was generally more limited even compared to those with other personality disorders. a sustained work/school history.[77] Attempts are made to improve public and staff attitudes. such as inpatient admission. A majority of psychiatric staff report finding individuals with BPD moderately to extremely difficult to work with. those whose symptoms had remitted were significantly more likely to have a good relationship with a spouse/partner and at least one parent.[78][79] 10 of 24 1/14/2012 6:12 PM .Borderline personality disorder . that self-destructive behaviour was incorrectly perceived as manipulative.[72] Prognosis Data indicate that people with BPD often make good progress.[71] Assessing suicide risk can be a challenge for mental health services (and patients themselves tend to underestimate the lethality of self-injurious behaviours) with typically a chronically elevated risk of suicide much above that of the general population and a history of multiple attempts when in crisis. allowing them to understand they are not alone. declines with time. but the number using the more restrictive and costly forms of treatment. good work/school performance.[70] Experience of services varies.[73] A longitudinal study found that. On the other hand."[68] Services Individuals with BPD sometimes use mental health services extensively.[76] Some clients feel a diagnosis is helpful.wikipedia. with around half achieving recovery defined as being free of symptoms and achieving certain levels of both social and vocational functioning. Around a third (depending on criteria used) of people diagnosed with BPD achieve remission within a year or two.Wikipedia. and to connect with others who have BPD and who have developed helpful coping mechanisms.[67] Because of the weakness of the evidence and the potential for serious side effects from some drug therapies. 86% of patients had sustained remission of symptoms. with the aim of reducing and stopping unnecessary drug treatment. six years after being diagnosed with BPD. the free encyclopedia http://en." and suggests "review of the treatment of people with borderline personality disorder who do not have a diagnosed comorbid mental or physical illness and who are currently being prescribed drugs. and that they had limited access to care.[75] Particular difficulties have been observed in the relationship between some care providers and some individuals diagnosed with BPD.[74] Another study found that ten years from baseline (during a hospitalization). and more difficult than other client groups. good global functioning and good psychosocial functioning. the UK National Institute for Health and Clinical Excellence (NICE) 2009 clinical guideline for the treatment and management of BPD recommends: "Drug treatment should not be used specifically for borderline personality disorder or for the individual symptoms or behaviour associated with the disorder" but "drug treatment may be considered in the overall treatment of comorbid conditions.[69] The majority of BPD patients continue to use outpatient treatment in a sustained manner for several years. 56% had good psychosocial functioning compared to 26% at baseline.

by as much as 3:1. cyclothymia and dysthymia. using the term folie maniaco-mélancolique.[83] referring to a group of patients with what was thought to be a mild form of schizophrenia. on the borderline between neurosis and psychosis.[81] The prevalence of BPD in the United States has been calculated as 1 percent to 3 percent of the adult population. The 1960s and 1970s saw a shift from thinking of the borderline syndrome as borderline schizophrenia to thinking of it as a borderline affective disorder (mood disorder). theorists who focused on the operation of social forces were recognized as well. according to the DSM-IV-TR.[84] Standardized criteria were developed[85] to distinguish BPD from affective disorders and other Axis I disorders.[n 8] 11 of 24 1/14/2012 6:12 PM .[citation needed] History Since the earliest record of medical history. melancholia and mania within a single person. it was revived by Swiss physician Théophile Bonet in 1684. His observations were followed by those of other writers who noted the same pattern. In DSM-II. identified an "excitable personality" that closely parallels the borderline features outlined in the current concept of borderline. Increasingly.[73] The diagnosis was formulated predominantly in terms of mood and behavior. and BPD became a personality disorder diagnosis in 1980 with the publication of DSM-III. the coexistence of intense.[84] The final terminology in use by the DSM today was decided by the DSM-IV Axis II Work Group of the American Psychiatric Association. Hippocrates and Aretaeus.Wikipedia.org/wiki/Borderline_personality_disorder Epidemiology The prevalence of BPD in the general population ranges from 1 to 2 percent.[1] although the reasons for this are not clear. who described "borderline insanity"[citation needed]. the free encyclopedia http://en. stressing the affective components. who.[73][80] The diagnosis appears to be several times more common in (especially young) women than in men.[82] It has been found to account for 20 percent of psychiatric hospitalizations. describing an intermediate level of personality organization[n 1] between neurotic and psychotic processes.wikipedia. Hughes in 1884 and J.C. Kraepelin. the last describing the vacillating presence of impulsive anger.[4] with approximately 75 percent of those diagnosed being female. distinguished from sub-syndromal schizophrenia which was termed "Schizotypal personality disorder". After medieval suppression of the concept. a loosely conceived designation mostly used by theorists of the psychoanalytic and biological schools of thought[citation needed]. on the fringes of manic depression. psychoanalysts such as Otto Kernberg were using it to refer to a broad spectrum of issues. including writers such as the American psychiatrist C.Borderline personality disorder . For the next decade the term was in popular and colloquial use. it was called cyclothymic personality (affective personality). in 1921. Rosse in 1890.[n 1] Adolf Stern wrote the first significant psychoanalytic work to use the term "borderline" in 1938.[n 7] noted the erratic and unstable moods with periodic highs and lows that rarely followed a regular course. divergent moods within an individual has been recognized by such writers as Homer.[1] In parallel to this evolution of the term "borderline" to refer to a distinct category of disorder.

the United States House of Representatives declared the month of May as Borderline Personality Disorder Awareness Month. with Winona Ryder as Kaysen). the first two cases show a person more aggressive to others than to herself.[90] Other films attempting to depict characters with the disorder include The Crush. Her memoir Girl. Interiors. Bui also found Anakin a useful example to explain BPD to medical students.[94] Author Susanna Kaysen was diagnosed with BPD. In Lois McMaster Bujold's science fiction novel Komarr. Malicious. Psychologist and founder of Dialectical Behavioral Therapy.[87] The film Borderline. the free encyclopedia http://en. The Cable Guy and Cracks. Psychiatrists Eric Bui and Rachel Rodgers have argued that the character meets six of the nine diagnostic criteria. abandonment leads to drastic measures.[91] Awareness In early 2008. as with the last two films.Wikipedia. Literature The memoir Songs of Three Islands by Millicent Monks is a meditation on how BPD affects several generations of the wealthy Carnegie family. Marsha Linehan. In particular.org/wiki/Borderline_personality_disorder Society and culture Film and television Several films portraying characters either explicitly diagnosed or with traits strongly suggestive of mental illness have been the subject of discussion by certain psychiatrists and film experts. Interrupted chronicles her time at the hospital. Notes On a Scandal. which in fact is less typical.wikipedia.Borderline personality disorder .[92][93] Notable people NFL Player Brandon Marshall was diagnosed with BPD.[87] as is the memoir Girl. Each of these films suggests the emotional instability of the disorder. Tien Vorsoisson has BPD. based on the book of the same name by Marie-Sissi Labrèche.[88] The 1992 film Single White Female suggests different aspects of the disorder: the character Hedy suffers from a markedly disturbed sense of identity and. 12 of 24 1/14/2012 6:12 PM . his disorder drives a large part of the story. uncertainty over his identity and violent dissociative episodes. attempts to explore BPD through its main character. Bui points to the character's abandonment issues. Interrupted by Susanna Kaysen (and the movie based on it.[89] The character of Anakin Skywalker/Darth Vader in the Star Wars films has been "diagnosed" as having BPD. during her time at McLean Hospital. however. Kiki. The films Play Misty for Me[86] and Fatal Attraction are two examples. has recently spoken out [95] about her past as an individual who suffered and still struggles with BPD. The memoir was later adapted into a film starring Winona Ryder as Susanna.

[99] Some feminist writers have suggested it would be better to give these women the diagnosis of a post-traumatic disorder as this would acknowledge their abuse. people with BPD often evoke intense emotions in those around them. Pejorative terms to describe persons with BPD such as “difficult.. that women who have survived sexual abuse in childhood are therefore sometimes re-traumatized by any such abusive mental health service. the criteria of "a pattern of unstable personal relationships.[98] One feminist critique suggests that BPD is a stigmatizing diagnosis that can sometimes evoke negative responses from health care providers. Thus the diagnosis "often says more about the clinician's negative reaction to the patient than it does about the patient . borderline explains away the breakdown in empathy between the therapist and the patient and becomes an institutional epithet in the guise of pseudoscientific jargon" (Aronson. and may become a self-fulfilling prophecy as the clinician's negative response triggers further self-destructive behaviour. unstable self-image.org/wiki/Borderline_personality_disorder Controversies Gender The diagnosis of BPD has been criticized from a feminist perspective. requiring a high degree of skill and training in the psychiatrists.” “manipulative.wikipedia. successful or sexually active. and/or inaccurate.[105] One critique says that some who are labeled "Borderline Personality Disorder" feel this name is unhelpful. alternatively if a woman presents with psychiatric symptoms but does not conform to a traditional passive sick role. and instability of mood. this stigmatization may be thought to reflect countertransference (when a therapist projects their own feelings on to a client). As a result.[84] This inadvertent counter transference can give rise to inappropriate clinical responses including excessive use of medication.[103] People with BPD are seen as among the most challenging groups of patients.Wikipedia. inappropriate mothering and punitive use of limit setting and interpretation. the free encyclopedia http://en." can all be linked to the stereotype that women are "neither decisive nor constant". For example. she may be labelled as a "difficult" patient and given the stigmatizing diagnosis of BPD.” “demanding” and “attention seeking" are often used.[n 9] Some think that people with BPD commonly have a history of sexual abuse in childhood.[105] 13 of 24 1/14/2012 6:12 PM .[97] The question has also been raised of why women are three times more likely to be diagnosed with BPD than men. and additionally. intense unstable interpersonal relationships. stigmatizing. as people with BPD are prone to use defense mechanisms such as splitting and projective identification.” “treatment resistant.[101] Stigma The features of BPD include emotional instability.[96] This is because some of the diagnostic criteria/symptoms of the disorder uphold common gender stereotypes about women.. as an expression of counter transference hate.[100] Women may be more likely to receive a personality disorder diagnosis if they reject the female role by being hostile. a need for relatedness and a fear of rejection. p 217).[102] In psychoanalytic theory.Borderline personality disorder .[104] While some clinicians agree with the diagnosis under the name "borderline personality disorder". therapists and nurses involved in their treatment. some would like the name to be changed. but others have argued that the use of the PTSD diagnosis merely medicalizes abuse rather than addressing the root causes in society.

^ a b c d "Borderline personality disorder" (http://www. ^ a b c Arntz A (September 2005).psychiatryonline.jbtep. Harvey PD.doi. and reinforces existing stigma.06. 8. Retrieved 8 February 2010.5.jbtep. by psychiatrist Carolyn Quadrio) is post traumatic personality disorganization (PTPD). there is ongoing debate about renaming BPD.ajp.org /10. 255–310. attachment experiences.ajp. 7.com /main/name_change. ^ Meyer B.com /main/name_change. Behav Ther Exp Psychiatry 36 (3): 167–72.784) . Impulse disorder and interpersonal regulatory disorder are other valid alternatives.5.psychiatryonline. doi:10.06.1176/appi.de/veroeffentlichungen /borderline.wikipedia.nih. and because of a move away from the original theoretical basis for the term (see history).htm . Terminology Because of the above concerns.. 3.org /cgi/pmidlookup?view=long&pmid=11986132) .1016%2Fj.doi. 4. Alternative suggestions for names include emotional regulation disorder or emotional dysregulation disorder.[106] The paper How Advocacy is Bringing BPD into the Light[107] reports that "the name BPD is confusing.2005.nlm. http://ajp. Retrieved 15 May 2008.gov /pubmed/11986132) .nih. PMID 11986132 (http://www.org/wiki/Borderline_personality_disorder The Treatment and Research Advancements National Association for Personality Disorders (TARA-APD) campaigns to change the name and designation of BPD in DSM-5.ncbi. "Characterizing affective instability in borderline personality disorder" (http://ajp.borderlinepersonalitytoday. PMID 16018875 (http://www.[108] Another term (for example. Disordered Personalities.htm) .com/health/borderlinepersonality-disorder/DS00442/DSECTION=3 . Mitropoulou V.ncbi.Borderline personality disorder . wilhelm-griesingerinstitut. Ajchenbrenner M.behavenet.borderlinepersonalitytoday. (May 2002). 6. 5. imparts no relevant or descriptive information.de.gov /pubmed/16018875) . Bowles DP (December 2005).[49] Some people do not report any kind of traumatic event. Am J Psychiatry 159 (5): 784–8. ^ "New Theses about the Borderline Personality" (http://wilhelm-griesingerinstitut.nlm. et al.org /10.2005. pp.html) . according to John Gunderson of McLean Hospital in the United States. ^ a b Robinson..".784 (http://dx.html .com.engl. the free encyclopedia http://en.Wikipedia.org /cgi/pmidlookup?view=long&pmid=11986132 .1176%2Fappi.159. ^ Koenigsberg HW. David J. ISBN 1-894328-09-4.engl.159. "Introduction to special issue: cognition and emotion in borderline personality disorder".Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000) 2. Rapid Psychler Press. http://www.com/health/borderlinepersonality-disorder/DS00442/DSECTION=3) . ^ "Borderline Personality Disorder: Proposal to include a supplementary name in the DSM-IV text revision" (http://www. http://www. reflecting the condition's status as (often) both a form of chronic post traumatic stress disorder (PTSD) and a personality disorder in the belief that it is a common outcome of developmental or attachment trauma. (2005).htm) . and rejection responses among adults with borderline and 1/14/2012 6:12 PM . MayoClinic.1016/j. doi:10. http://wilhelm-griesinger14 of 24 institut. Retrieved 31 January 2009.com/capsules/disorders /borderlinepd. Borderline Personality Today. "Sensory sensitivity.[n 10] Notes 1.001 (http://dx.001) .de/veroeffentlichungen /borderline.mayoclinic.mayoclinic. ^ a b c d e f Borderline personality disorder (http://www.

M. Inc. Rosenbaum JF. URAC's accreditation program is an independent audit to verify that A.ch).A..A.M. Copyright © 2011. Also reviewed by David Zieve.nih.D. A.. can successfully treat BPD. © 1997–2011 A.PubMed Health http://www.D. 2 of 2 1/14/2012 6:15 PM .ncbi. MD. A. such as dialectical behavioral therapy (DBT).M. family.. medications can help level mood swings and treat depression or other disorders that may occur with this condition. Any duplication or distribution of the information contained herein is strictly prohibited. eds. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.M. MD. 1st ed.D. is accredited by URAC.D. University of Washington School of Medicine.D. NY. References 1.org).A. Blais MA. Department of Psychiatry.A.gov/pubmedhealth/PMH0001931/ Repeated crises and acts of self-injury. In: Stern TA. group therapy can help change self-destructive behaviors.A. Learn more about A. follows rigorous standards of quality and accountability.M. Inc. Columbia University Medical Center.D. MHA. such as wrist cutting or overdosing Signs and tests Like other personality disorders.A.. and social relationships Suicide attempts and actual suicide Calling your health care provider Call your health care provider if you or your child has symptoms of borderline personality disorder. Inc. Biederman J. In some cases.M. With long-term talk therapy. Treatment Many types of individual talk therapy. Personality and personality disorders. Groves JE. Reviewed by: Linda Vorvick. Medical Director. also known as the American Accreditation HealthCare Commission (www. Medical Director. Complications Depression Drug abuse Problems with work.A. MD. New York. editorial process and privacy policy. In addition.A. Pa: Mosby Elsevier. Assistant Clinical Professor of Psychiatry. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.M.urac.nlm. Disclaimer A. Merrill. Review Date: 11/15/2010. A.'s editorial policy. Inc. Massachusetts General Hospital Comprehensive Clinical Psychiatry. Rauch SL. Rivas-Vazquez RA. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. Fava M. A.hon.M. Expectations (prognosis) The outlook depends on how severe the condition is and whether the person is willing to accept help.Borderline personality disorder . is among the first to achieve this important distinction for online health information and services. MEDEX Northwest Division of Physician Assistant Studies. Call 911 for all medical emergencies. A.A. and David B. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.M. Philadelphia..D.D. the person will often gradually improve. BPD is diagnosed based on a psychological evaluation and the history and severity of the symptoms.D.2008:chap 39. It is especially important to seek help right away if you or your child is having thoughts of suicide. Smallwood P.

also called diagnostic criteria. How is borderline personality disorder diagnosed? http://www. The mental-health practitioner will therefore often inquire about when the person has most recently had a physical examination. dependent personality disorder or histrionic personality disorder. Causes. 1 of 1 1/14/2012 6:22 PM . There is no specific definitive test. it is of great importance that the practitioner know to conduct a thorough assessment. People who are concerned that they may suffer from BPD might explore the possibility by taking a self-test. and any other tests that a medical professional deems necessary to ensure that the individual is not suffering from a medical condition instead of or in addition to emotional symptoms. including mood problems like depression. practitioners conduct a mentalhealth interview that looks for the presence of the symptoms. Due to the use of a mental-health interview in making the diagnosis and the fact that this disorder can be quite resistant to treatment.com/borderline_personality_disorder/.medicinenet. that can accurately assess that a person has BPD... the practitioner will usually work toward ruling out other mental disorders. This is to assure that the person is not incorrectly assessed as having BPD when he or she does not. To determine the presence of this disorder. As with any mentalhealth assessment. either an online or printable test. substance-abuse problems as well as problems being in touch with reality. like schizophrenia or delusional disorder. Treatment. previously described. types of other personality disorders like narcissistic personality disorder.Borderline Personality Disorder Symptoms. anxiety disorders including anxiety attacks or generalized anxiety.. The professional will also likely try to ensure that the individual is not suffering from a medical problem that may cause emotional symptoms. like a blood test.. comprehensive blood testing.

or a low level of conscientiousness have been found to be associated with a greater likelihood of symptoms of BPD returning (relapse).medicinenet. Simultaneously suffering from depression. Complications of BPD also often involve families of the person with the disorder. What is the prognosis of people with borderline personality disorder? As with any illness. People who engage in self-mutilation are more likely to commit suicide compared to those who do not self-mutilate. and eliciting more normal feelings. an appropriate question about BPD is if it is curable. Causes. Conversely. have previous history of violent behavior. having steady employment or school status once symptoms of BPD subside (remit) tends to protect BPD sufferers from experiencing a future relapse. distracting oneself. as well as whether or not the person receives appropriate treatment. the symptoms of BPD do tend to diminish with time. In contrast. That risk is also increased for individuals who suffer from antisocial personality disorder. http://www. those who suffer from BPD have a somewhat increased risk for such behaviors.. 1 of 1 1/14/2012 6:23 PM . How well or poorly people with BPD progress over time seems to be influenced by how severe the disorder is at the time that treatment starts. frequent use of sedative medications. punishing oneself. as well as for attempting or completing suicide. For example. a parent with BPD is vulnerable to having depressive symptoms in their children. For example. whether or not the sufferer has a history of being abused as a child. Individuals with BPD are at risk for self-mutilation.. or experience several changes in their psychiatric medications in general. the state of the individual's current personal relationships. While improvement in any personality disorder is not synonymous with being cured. Treatment. it is thought that self-mutilating behaviors are more an expression of anger. While both self-mutilating and suicidal behaviors seem to be associated with alleviating negative feelings.com/borderline_personality_disorder/. What are borderline personality disorder complications? The presence of BPD can often worsen the course of another mental condition with which it occurs. other emotional problems. Although most individuals with a mental disorder do not engage in violent behavior.. it tends to change the symptoms of posttraumatic stress disorder and to worsen depression..Borderline Personality Disorder Symptoms. suicide attempts are thought to be more often associated with feeling survivors will be better off for their death.

dislikes. or attempts Chronic feelings of emptiness Inappropriate. euphoria. Treatment. an individual must have at least five of the following symptoms: Unstable self-image. or in the use of substances) Recurring suicidal behaviors.. sexual behaviors. strengths. threats. Unstable relationships. whether the abandonment is real or imagined Significant impulsivity. driving behaviors.com/borderline_personality_disorder/. even if the stresses may be seen as minor or negligible to others Desperate efforts to avoid being abandoned. stress-related paranoia or severe dissociation (lapses in memory) 1 of 1 1/14/2012 6:21 PM . in that the sufferer experiences marked. joy.Borderline Personality Disorder Symptoms. weaknesses. rapid changes in feelings (for example. in that the person with BPD tends to act before thinking to the point that it is self-damaging (for example.medicinenet. Treatment Revision) definition .. and intrinsic value as a person http://www. including panic attacks and depression) that are stress related. severe anger. anxiety. in order to qualify for the diagnosis of BPD. intense anger or difficulty managing their anger when it occurs Transient. eating habits. What are borderline personality disorder symptoms and signs? As per the DSM (Diagnostic and Statistical Manual of Mental Disorders. Causes. goals.. in that they may drastically and rapidly change in the way they perceive their own likes. and often frequently change from seeing another person as nearly perfect (idealizing) to seeing the other person as being virtually worthless (devaluing) Unstable emotions (affects).. drastically. in that individuals with this disorder rapidly. spending habits. Fourth Edition.

and problems in relating to others. Psychoanalytic therapy. Talk therapy that focuses on helping the person understand how their thoughts and behaviors affect each other (cognitive behavioral therapy or CBT) has also been found to be effective treatment for BPD. distress tolerance. Also.. some women who suffer from both BPD and bipolar disorder may experience a decrease in how irritable and angry they feel. In addition to providing a safe environment and frequent monitoring by mental-health professionals. To address those areas. mood instability.medicinenet.Borderline Personality Disorder Symptoms. Contrary to earlier beliefs. or trazodone [Desyrel]). as well as developing improved relationships with others.. While funding for a long-term stay in a partial hospitalization facility may be difficult. duloxetine [Cymbalta].com/borderline_personality_disorder/. Causes. divalproex sodium [Depakote]. Treatment. sertraline [Zoloft]. treatment with DBT tries to build four major behavioral skill areas: mindfulness. citalopram [Celexa]. On the other hand. partial hospitalization programs allow for more frequent mental-health interventions like professional assessments. impulsive behaviors. which seeks to help the individual understand and better manage his or her ways of defending against negative emotions. paliperidone [Invega] or asenapine [Saphris]) may be useful in addressing some of the symptoms of BPD but do not manage the illness in its entirety. or lamotrigine [Lamictal]). especially when the therapist is more active or vocal than in traditional psychoanalytic treatment and when this approach is used in the context of current rather than past relationships. olanzapine [Zyprexa]. For example. What is the treatment for borderline personality disorder? http://www. great care is taken to avoid the medications that can be dangerous in overdose. while people with BPD may experience suicidal behaviors no more often than other individuals with a severe mental illness. aripiprazole [Abilify]. venlafaxine [Effexor]. risperidone [Risperdal]. emotional regulation. fluoxetine [Prozac]. or antipsychotics (for example. psychotherapy medication treatment. the use of medications in the treatment of symptoms in individuals with BPD may sometimes cause more harm than good. research shows that when it is provided using a psychoanalytic approach it may help the person with BPD enjoy a decrease in the severity of anxiety and depression. the frequency of suicide attempts and full hospitalizations. as well as a decrease in how often and severely they become aggressive when treated with a mood stabilizer like Depakote. BPD has been found to significantly improve in response to treatment with appropriate inpatient hospitalization.. Loved ones of individuals with BPD might 1 of 2 1/14/2012 6:23 PM . IPT is an approach that focuses on how the person's symptoms are related to the problems that person has in relating to others. as well as development of a treatment plan for after discharge from the facility. has been found to be effective in addressing BPD. Partial hospitalization is an intervention that involves the individual with mental illness being in a hospital-like treatment center during the day but returning home each evening.. mood stabilizers (for example. escitalopram [Lexapro]. Different forms of psychotherapy have been found to effectively treat BPD. The use of psychiatric treatment medications. On the positive side. given how frequently many sufferers of BPD experience suicidal feelings. and interpersonal effectiveness. Other psychotherapy approaches that have been used to address BPD include interpersonal psychotherapy (IPT) and psychoanalytic therapy. carbamazepine [Tegretol]. they often receive more medications and therefore suffer from more side effects. like antidepressants (for example. Dialectical behavior therapy (DBT) is an approach to psychotherapy in which the therapist specifically addresses four areas that tend to be particularly problematic for individuals with BPD: self-image.

BPD sufferers are more likely to have a learning problem or certain temperaments as children. trouble managing anger. women more than men in treatment populations. like a blood test. men as often as women in general. In order to be diagnosed with BPD. and relating to others. relationships or emotions. eating disorders in women. The presence of BPD tends to worsen the symptoms of other mental illnesses and increase the risk for self-mutilation. it is understood to be the result of a combination of biological vulnerabilities. the sufferer must experience at least five of the following symptoms: unstable self-image. and antipsychotics may be useful in addressing some of the symptoms of BPD but do not manage the illness in its entirety. As with other mental disorders. inappropriate anger. how well or poorly people with BPD progress over time seems to be influenced by the severity of the symptoms. interpersonal therapy... or to come from families of origin where divorce. BPD affects 6% of adults. The use of psychiatric medications like antidepressants. and anxious and odd personality disorders in adolescents tend to co-occur with BPD. and psychoanalytic psychotherapy. People with BPD are at somewhat higher risk for engaging in violent behavior. ways of thinking. behaving. as well as whether or not the individual receives appropriate treatment. the individual's current personal relationships. BPD is associated with unstable self-image. substance abuse. cognitive behavioral therapy. but in many countries. whether or not the sufferer has a history of being abused as a child. Borderline Personality Disorder At A Glance http://www. That risk is further increased when the individual with BPD also is suffering from antisocial personality disorder. Causes. Therefore.com/borderline_personality_disorder/. repeated suicidal behaviors or threats. substance-abuse problems in men. has a previous history of violent behavior. Like most other mental disorders. to diagnose BPD. sexual abuse. chronic feelings of emptiness. frequently uses sedative medications. practitioners conduct a mentalhealth interview that looks for the presence of the symptoms previously described and usually explore the person's history for any medical problem or other emotional problem that may show symptoms of the disorder. or experiences several changes in their psychiatric medications. and interacting.medicinenet. and social stressors (biopsychosocial model). feelings. Borderline personality disorder is a personality disorder characterized by consistently problematic ways of thinking. neglect. Psychotherapy approaches that have been helpful in treating BPD include dialectical behavior therapy. severe impulsivity. or transient paranoia or dissociation.. feeling. while allowing the sufferer to go home each evening. mood stabilizers. Partial hospitalization can help treat BPD by providing frequent supervision and assessment in a safe environment. there is no specific definitive test.Borderline Personality Disorder Symptoms. Steady employment or school status once symptoms of BPD subside (remit) tends to protect BPD sufferers from experiencing a future relapse. 1 of 1 1/14/2012 6:18 PM . or death occurred. While they symptoms of BPD tends to diminish over years for many people.. there is more agreement on the existence of BPD. as well as for attempting or completing suicide. Treatment. There has been some controversy about whether or not BPD is its own disorder or a variation of bipolar disorder. Antisocial personality disorder in adults.

BPD has been thought to be a set of symptoms that include both mood problems (neuroses) and distortions of reality (psychosis).. feeling. It is most closely diagnosed as emotionally unstable personality disorder in the International Classification of Disease. However. its existence is not formally recognized. BPD tends to co-occur with more anxious and odd personality disorders like schizotypal and passive aggressive personality disorder. feeling.. and relating to others that markedly interferes with the individual's ability to function. the person is usually an adolescent or adult before they can be assessed as meeting full symptom criteria for BPD. BPD tends to be associated with a pattern of unstable ways of seeing oneself. behaving.. Although countries like China and India recognize mental disorders that have some symptoms in common with BPD. Trea. 1 of 2 1/14/2012 6:20 PM . In adolescents. Medication. BPD is now understood to occur equally in men and women in general. research supports the theory that BPD. BPD is more likely to be associated with eating disorders symptoms in women. Although there has been some controversy as to whether or not BPD is truly its own disorder or a variation of bipolar disorder. even people who have some symptoms (traits) of BPD but do not meet full diagnostic criteria for the disorder can experience both traits of BPD and narcissistic personality disorder. affecting nearly 6% of adults over the course of a lifetime. Historically. it is now understood that while the symptoms of BPD may straddle those symptom complexes. and interacting with others and with the world that tends to cause significant problems for the sufferer. Also. Interestingly. while primarily in women in groups of people who are receiving mental-health treatment (treatment populations).Borderline Personality Disorder Symptoms. Specifically. http://www. this illness is more closely related to other personality disorders in terms of how it may develop and occur within families. Still others will appear to have BPD but really qualify for the diagnosis of bipolar disorder and visa versa. Contrary to what the medical community thought in the past. some individuals with BPD will have that disorder alone. What other disorders often occur with BPD? While men with BPD are more likely to also have a substance-use disorder. as with other personality disorders. What is borderline personality disorder? Borderline personality disorder (BPD) is a mental disorder that belongs to the group of mental illnesses called personality disorders. The frequency with which this disorder occurs is also thought to be considerably higher than previously thought.medicinenet. formerly also called sociopaths. BPD is not recognized worldwide.. like virtually every medical or other mental-health disorder can appear (present) in nearly as many unique and complex ways as there are people who have it. Therefore. and therefore was thought to be on the borderline between mood problems and schizophrenia. it is characterized by a consistent pattern of thinking. like other personality disorders. while others will have it in combination with bipolar or another mental disorder. In other words. may be more likely to also have BPD. Adults who have antisocial personality disorder. respectively. or ICD-10.com/borderline_personality_disorder/a.

..Borderline Personality Disorder Symptoms. Trea.medicinenet..com/borderline_personality_disorder/a. 2 of 2 1/14/2012 6:20 PM . http://www.. Medication. recognized.

promiscuity. Etiology It is a common disorder with estimates running as high as 10-14% of the general population. behavior and close personal relationships. This 1 of 3 1/14/2012 2:57 PM . There is also emotional instability with marked and frequent shifts to an empty lonely depression or to irritability and anxiety. Under extreme stress or in severe cases there can be brief psychotic episodes with loss of contact with reality or bizarre behavior or symptoms. damaged or bad in some way. Symptoms Relationships with others are intense but stormy and unstable with marked shifts of feelings and difficulties in maintaining intimate. feeling or behavior. There are also identity disturbances with confusion and uncertainty about self-identity. there is often significant disruption of relationships and work performance. close connections. friendships. A person with this disorder can often be bright and intelligent.html BORDERLINE PERSONALITY Diagnosis DISORDER A person with a borderline personality disorder often experiences a repetitive pattern of disorganization and instability in self-image. and appear warm. with a tendency to go to extremes in thinking. The person may manipulate others and often has difficulty with trusting others. The person may show inappropriate and intense anger or rage with temper tantrums. friendly and competent. feelings of deprivation. mood. shoplifting. gambling. drug or alcohol abuse. This can cause significant distress or impairment in friendships and work. overeating or physically self-damaging actions such as suicide gestures. life goals and values. Even in less severe instances. career choices. and a loss of control or fear of loss of control over angry feelings. There is a deep-seated feeling that one is flawed. sexuality. constant brooding and resentment. usually around a stressful situation like the breakup of a romantic relationship or the death of a parent.Borderline Personality Disorders http://www. There may be unpredictable and impulsive behavior which might include excessive spending.edu/~corelli/borderline. They sometimes can maintain this appearance for a number of years until their defense structure crumbles.stanford. defective. The depression which accompanies this disorder can cause much suffering and can lead to serious suicide attempts. The frequency in women is two to three times greater than men.

edu/~corelli/borderline. Therapy should help to alleviate psychotic or mood-disturbance symptoms and generally integrate the whole personality. it is hoped the patient will be able to change the rigid patterns tragically set earlier in life and prevent the pattern from repeating itself in the next generational cycle. sexual promiscuity. With this increased awareness and capacity for self-observation and introspection. 2 of 3 1/14/2012 2:57 PM . A positive result would be in one's increased tolerance of anxiety. with the patient encouraged to talk about his or her feelings rather than to discharge them in his or her usual self-defeating ways. Outpatient treatment is usually difficult and long-term . There may be an innate predisposition to this disorder in some people. with estimates running to up to one-fourth of all women. accepting and non-judgemental therapist. An association between this disorder and severe cases of premenstrual tension has been postulated.Borderline Personality Disorders http://www.sometimes over a number of years. consistent and regular. This is believed to occur ten times more often in women than in men. lithium carbonate. The increased frequency of borderline disorders among women may also be a consequence of the greater incidence of incestuous experiences during their childhood. Treatment Treatment includes psychotherapy which allows the patient to talk about both present difficulties and past experiences in the presence of an empathetic. Women commonly suffer from depression more often than men. inhibitions. Sometimes medications such as antidepressants. or antipsychotic medication are useful for certain patients or during certain times in the treatment of individual patients. Because of this there may ensue subsequent failures in development in the relationship between mother and infant particularly during the separation and identity-forming phases of childhood. The therapy needs to be structured. This chronic or periodic victimization and sometimes brutalization can later result in impaired relationships and mistrust of men and excessive preoccupation with sexuality. Hospitalization may provide a a temporary removal from external stress. deep-seated depression and a seriously damaged self-image.stanford.html may be related to genetic or hormonal influences. Brief hospitalization may sometimes be necessary during acutely stressful episodes or if suicide or other self-destructive behavior threatens to erupt. Treatment of any alcohol or drug abuse problems is often mandatory if the therapy is to be able to continue. The goals of treatment could include increased self-awareness with greater impulse control and increased stability of relationships.

stanford.D.edu/~corelli/borderline.Borderline Personality Disorders http://www.html Richard J. corelli@leland.stanford.edu 3 of 3 1/14/2012 2:57 PM . M. Corelli.

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