Borderline Personality Disorder
May is Borderline Personality Disorder Awareness month and, in honor of that, Deenie shares about how this disorder affects those who have it and the history behind it.
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Borderline Personality Disorder
Borderline Personality Disorder
By Deenie Bulyalert
By Deenie Bulyalert
Disclaimer: This article discusses mental health topics that could include the mention of self-harm, suicide, and more. The goal of this article is to spread awareness and educate individuals on mental health disorders that could be affecting anyone, even the people in our school. Please proceed with caution.
According to the National Education Alliance for Borderline Personality Disorder, they state, "On April 1, 2008, the U.S. House of Representatives passed, by a vote of 414-0, House Resolution 1005 which supports the month of May as Borderline Personality Disorder Awareness Month." Now, years later, we still continue to acknowledge that May is the month of Borderline Personality Disorder Awareness.
May is also Mental Health Awareness month. Abigail Woody wrote an article under the Informative tab in this month's issue if you would like to check that out.
What is borderline personaility disorder?
What is borderline personaility disorder?
The National Alliance on Mental Health characterizes Borderline Personality Disorder, shortened as BPD, with the difficulty of “regulating emotion.” Harvard Medical School Affiliate (McLean) describes Borderline Personality Disorder (BPD) as “a complex mental health condition in which people often struggle with self-image, mood swings, impulse control, an intense fear of abandonment, and low feelings of self-worth.” Also stated by McLean, “It’s not unusual for people with BPD to live with other mental health conditions, such as eating disorders, anxiety, depression, and substance use disorder.”
Mental health disorders are categorized by mood disorders, anxiety disorders, personality disorders, psychotic disorders, eating disorders, trauma-related disorders, and substance abuse disorder.
Borderline is categorized as a personality disorder. The American Psychiatric Association states that "a personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problem functioning, and lasts over time."
The American Psychiatric Association also classifies 10 specific types of personality disorders. Antisocial, Avoidant, Borderline, Dependent, Histrionic, Narcissistic, Obsessive-Compulsive, Paranoid, Schizoid, and Schizotypal personality disorder.
Personality disorders come in what experts call "clusters," which groups personality disorders into a type A, B, or C. Borderline personality disorder is in cluster B. The MayoClinic describes, "Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder."
Like most mental disorders, BPD is difficult to diagnose. A lot of the symptoms that come with BPD overlap with other mental disorders. According to Cleveland Clinic, in order to get a diagnosis for Borderline personality disorder a "provider may do a physical exam or order a blood test to rule out health conditions that may [cause] symptoms." Cleveland Clinic also states that a diagnosis must come after interviews have been conducted. "The interviews will include questions about your symptoms. relationships, behaviors, and mental health history." BPD is also typically paired with other mental health conditions.
HISTORY
HISTORY
Most personality disorders were first coined in Europe, but Borderline personality disorder was different. In 1938, Adolph Stern first coined the term borderline personality in the United States. He was a psychoanalyst who "described a group of patients who 'fit frankly neither into a psychotic nor into a psychoneurotic group' and introduced the term borderline to describe what he observed because it bordered on other conditions," as stated by the National Library of Medicine.
Otto Kernberg, a psychoanalyst in 1967, eventually defined borderline as a middle level of personality organization bounded on one side by sicker patients who had psychotic personality organization and on the other by those who were healthier and had neurotic personality organization. Kernberg introduced the term Borderline personality organization. This "refer[ed] to a consistent pattern of functioning and behavior characterized by instability and reflecting a disturbed psychological self-organization." It was used to describe a broad form of psychopathology defined by primitive defenses (splitting, projective identification), identity diffusion, and lapses in reality testing. Kernberg then went on to suggest that these patients could be successfully treated with psychoanalytic psychotherapy," stated the National Library of Medicine.
By 1980, Borderline personality disorder was included in the Third Edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-III). This inclusion of BPD allowed individuals to finally get diagnosed for the mental disorder and seek treatment for it. This also pushed for more research on the disorder and, although it is the most misdiagnosed personality disorder, it is also the most researched personality disorder.
wHO DOES IT AFFECT?
wHO DOES IT AFFECT?
In the United States, it is estimated that 1.6% of adults in the United States have Borderline Personality disorder, according to Clearview. Clearview also states that "the number may actually be much higher than that, and many experts believe that the correct number may actually be closer to six percent."
The National Alliance on Mental Health expressed that "BPD is one of the most commonly misdiagnosed mental health conditions." Due to heavy stigma surrounding BPD, this could explain why experts believe that a significantly larger amount of individuals have Borderline personality disorder.
Symptoms, Causes, and Treatments
Symptoms, Causes, and Treatments
Borderline personality disorder originally referred to being on the border between neurosis and psychosis, but this is no longer the case. The National Institute of Mental Health offers a lot of information on symptoms, causes, and treatments for Borderline Personality Disorder. They share that some of the symptoms of BPD are "efforts to avoid real or imagined abandonment, such as rapidly initiating intimate (physical or emotional) relationships or cutting off communication with someone in anticipation of being abandoned." Other symptoms of BPD would include, "A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation), distorted and unstable self-image or sense of self, recurring thoughts of suicidal behaviors or threats, or chronic feelings of emptiness."
Borderline personality disorder is not completely understood and because of this, it doesn't have a ton of information on what causes it. Most mental illnesses have risk factors, similar to physical diseases like cancer. An individual is more at risk of having or getting a mental illness if an immediate family member has it. The difficult aspect of mental health is that it could be caused by intense trauma that occurred in the past, environmental and social factors play a tremendous role in mental health. The MayoClinic suggests that the cause of Borderline personality disorder is due to genetics and/or brain abnormalities. They state that "some studies of twins and families suggest that personality disorders may be inherited or strongly associated with other mental disorders among family members." Genetic factors tend to have a large role in determining whether an individual will or has a mental disorder. The National Institute of Mental Health describes the causes of Borderline personality disorder as being due to family history, brain factors, environmental, cultural, and social factors, which are similar to the causes stated by Mayoclinic. Mental health disorders are such a largely stigmatized subject and this stigma causes research to be not as prevalent compared to the research done on other more physical illnesses.
When it comes to treatment for Borderline personality disorder, talk treatment tends to always be the first option. The treatments that are often used to treat BPD are stated by the National Education Alliance for Borderline Personality Disorder, who happen to be the same organization that pushed for May being Borderline personality disorder awareness month. They state that some of the best treatments are Dialectical behavior therapy (DBT), Mentalization-based therapy (MBT), Transference-focused therapy (TFP), Good Psychiatric Management (GPM), Medications, which cannot cure BPD but can help treat other conditions that typically come with having BPD. DBT is a type of therapy that includes one on one sessions and skill training in group settings. It "focuses on the concept of mindfulness." It teaches regulation or control over emotions that also aid in reducing self-destructive behavior. "DBT is the most studied treatment for BPD and the one shown to be most effective." MBT is talk therapy. It " helps people identify and understand what others might be thinking and feeling." TFP is a therapy used to help people "understand their emotions and interpersonal problems through the relationship between the patient and therapist."
Importance of talking
Importance of talking
All mental disorders are stigmatized and misunderstood, from those who don't have it and don't want to understand it or from people who do have it and don't know how to cope with it. Personality disorders especially are disorders that people tend to not want to understand. Having discussions and talking about mental disorders allows for a space for people to not feel as alone in the situations that are put in. The National Library of Medicine says that "10% of BPD patients will die by suicide." With this, suicide prevention isn't as accesible for a lot of people and to reiterate again, conversation allows for more normalization, normalization allows for more accessibilty. Everyone deserves to live a pain free life and, through talking, people are able to work towards a better life for themselves.
Resources and Videos
Resources and Videos
Grants Pass High School:
Kris Stuart- Mental Health Counselor
National Suicide Prevention Lifeline:
1-800-273-8255
Crisis Text Hotline:
US: Text HOME to 741741 to be connected with a Crisis Counselor
They are there to help. If you need it, please ask. You do not have to fight this battle alone. Be gentle with yourself. You are trying your best and your best will always be enough.
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