Borderline_Personality_Disorder

Abstract This paper attempts to define Borderline Personality Disorder (BPD) as according to the Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition, and the American Psychiatric Association. Also compiled and addressed are the statistics dealing with the prevalence, origins, and known risk factors for BPD. A number of treatment options and likely prognosis will also be laid out. Concluding with a brief discussion on the stigma often associated with treating BPD, as well as advocacy for persons with the disorder. Borderline Personality Disorder Borderline personality disorder (BPD) is a condition in which people have long-term patterns of unstable or turbulent emotions, such as feelings about themselves and others. These inner experiences often cause them to take impulsive actions and have chaotic relationships (Pubmed, 2010). BPD is a serious mental illness that centers on the inability to manage emotions effectively. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition, better known as the DSM-IV, diagnostic criteria for borderline personality disorder is indicated by five (or more) of the following:  abandonment fears, unstable intense relationships, identity disturbance, impulsivity, suicidal or self-injurious behaviors, affective (emotional) instability, emptiness, anger, and psychotic-like perceptual distortions (Gunderson, 2011). BPD afflicts up to 6% of adults (approximately 14 million Americans), making it more common than schizophrenia and bipolar disorder. This disorder tends to occur more often in women, approximately 2 to 3 times greater than men, and among hospitalized psychiatric patients. BPD accounts for 20% of inpatients admitted to psychiatric hospitals and 10% of psychiatric outpatients. 10% of adults with BPD commit suicide, 55-85% of adults with BPD self-injure their bodies, and 33% of youth who commit suicide have features of BPD (NEABPD, 2011). The causes of BPD aren’t fully understood. Factors that seem likely to play a role include genetics, environment, and brain abnormalities. Some studies of twins and families suggest that personality disorders may be inherited. Also, many people with borderline personality disorder have a history of childhood abuse (physical or sexual), neglect, and separation or abandonment from caregivers or loved ones. Some research has shown changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression. In addition, certain brain chemicals that help regulate mood, such as serotonin, may not function properly (Mayo Clinic, 2010). Treatment includes therapy which allows the patient to talk about both present difficulties and past experiences in the presence of an empathetic, accepting and non-judgmental therapist. Sometimes medications such as antidepressants, lithium, or antipsychotic medication are useful for certain patients or during certain times in the treatment of individual patients. Medications can't cure borderline personality disorder, but they can help associated problems, such as depression, impulsivity and anxiety. Treatment of any alcohol or drug abuse problems is often needed if the therapy is to be able to continue. Brief hospitalization may sometimes be necessary during acute episodes of stress or if suicide or other self-destructive behavior threatens to erupt. Hospitalization may provide as a temporary removal from external stress. Outpatient treatment is usually difficult and long-term - sometimes over several years (Corelli, na). People with BPD must overcome a resistance to treatment from healthcare providers. Knowing people with BPD have long-term patterns of unstable emotions and impulsive actions, they are often seen as among the most challenging groups of patients, requiring a high degree of skill and training in the psychiatrists, therapists and nurses involved in their treatment. The Treatment and Research Advancements National Association for Personality Disorders (TARA-APD) campaigns to change the name and designation of BPD in the DSM-5, due 2013. The paper How Advocacy is Bringing BPD into the Light reports that "the name BPD is confusing, imparts no relevant or descriptive information, and reinforces existing stigma..." (Wikipedia, 2011). In 2009, the US Congress passed a resolution calling for more awareness of this disorder and more investment into its research and treatment. To date this has not occurred (Gunderson, 2010). Understanding the characteristics of BPD may help to shed light on the disorder, make clinicians more open to treating those with BPD, and remove the stigma of “treatment resistant” and “manipulative”, labels persons with BPD often carry through countertransference. Borderline Personality Disorder. (2010). Pubmed. Retrieved October 14, 2011, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001931/ Gunderson, J. (2011). A BPD Brief. National Education Alliance Borderline Personality Disorder. Retrieved October 14, 2011, from http:// www.borderlinepersonalitydisorder.com/understading-bpd/a-bpd-brief BPD Fact Sheet. (2011). National Education Alliance Borderline Personality Disorder. Retrieved October 14, 2011, from http://www.borderlinepersonalitydisorder.com/ understading-bpd/bpd-fact-sheet Borderline Personality Disorder. (2010). Mayo Clinic. Retrieved October 15, 2011, from http://www.mayoclinic.com/health/borderline-personality-disorder/DS00442 Corelli, R. (na). Borderline Personality Disorder. Stanford University. Retrieved October 15, 2011, from http://www.stanford.edu/~corelli/borderline.html Borderline Personality Disorder. (2011). Wikipedia. Retrieved October 15, 2011, from http://en.wikipedia.org/wiki/Borderline_personality_disorder