What is Borderline Personality Disorder?

About 36 years ago, I had a classmate in pre-med whose mood could swing from friendliness to extreme outbursts of anger over trifle issues within a matter of hours. We labeled him queer and always dealt with him with caution. In our fifth year in the medical school, during our Psychiatry posting, while treating the topic of Bipolar diseases, we believed his problem must be Manic-Depressive Psychosis. With the benefit of what I know now, I believe he probably had Borderline Personality Disorder.

Diagnostic and Statistical Manual of Mental disorders [DSM-IV] lists Borderline Personality Disorder as a psychiatric diagnosis and defines it as a prolonged disturbance of personality function. Adolph Stern used the term in 1938 to describe it because it lies on the borderline between neurosis and psychosis.

It is a serious disorder of the mind that causes affected persons to nurse a paralyzing fear of being abandoned by a loved one. The affected person manifests a siege mentality that makes him/her exhibit a bewildering range of emotions from idealizations like great admiration and love to devaluation such as intense anger and dislike within a short span of time. Such a person exhibits outbursts of rage that lead to verbal and physical abuse against others. They read meaning into little matters and personalize issues becoming so extremely sensitive that they cannot sustain family relationships or workplace relationships. Borderline Personality Disorder is basically a disorder of emotion control. A woman suffering from this condition could make life unbearable for the husband for coming late from work for any reason because she believes he must be having an affair.

The instability of mood in Borderline Personality Disorder results in unstable behaviour, poor self-image and a distorted identity, all of which lead to social isolation. The level of frustration can be so high that it leads to self-injury of all sorts, attempted suicides and successful suicides in some cases. The extreme feeling of insecurity makes them want love and pushes them in to sexual promiscuity and substance abuse. Divorce rate is high for the few who get married and did not seek professional help because of their chronic inability to manage their emotions.

In the United States, about 2% of adults mostly females [75%] suffer from it and it is responsible for 20% of hospital psychiatric admissions. The causes of Borderline Personality Disorder like many other ailments have been attributed to environmental and genetic factors. However predisposing factors are a history of separation from significant persons early in life, history of physical and emotional abuse, 40 to 71% report a history of sexual abuse by a non-care giver. Recent research findings have linked Borderline Personality Disorder to impaired regulation of the neural circuits that modulate emotions. Amygdala, a part of the brain is part of this neural circuit. Onset of the illness may be at adolescence or young adulthood. Triggers for precipitating this disorder include traumatic events like violence of all sorts, rape, alcoholism and substance abuse.

The outlook for this condition is good because it is amenable to proper mental health care and persons suffering from it can lead productive normal lives with appropriate care. Symptoms may persist for years, but majority of symptoms decrease in severity over the years with some persons recovering fully from it. Therapy ranges from individual and group psychotherapy to Dialectical Behaviour Therapy, a new psychosocial therapy developed specifically for Borderline Personality Disorder. Antidepressants and mood stabilizers are effective as symptomatic treatments for sufferers of this condition.

This article was written by Dr Francis Edo Olotu, Physician, Family Counselor, Author, Conference Speaker and host of the Blog Empowering Dads.

Email address: empoweringdads@gmail.com.

Visit his blog http://www.empoweringdads.wordpress.com for a rich diversity of articles on family and health issues.

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