"To stave off the panic associated with the absence of a primary object, borderline patients frequently will impulsively engage in behaviors that numb the panic and establish contact with and control over some new object.” — Christine Lawson
The Origin of BPD
The American psychoanalyst Adolph Stern first described borderline personality disorder in 1938. He was the first to coin the term "borderline" to describe a condition he observed in women he viewed as being highly "neurotic" but not quite "psychotic".
However, under certain conditions such as extreme stress or abandonment these women could cross over into psychosis and experience feelings of paranoia, and disassociation. Thus, they existed "on the border” between neurotic and psychotic. We now know that men are just as likely to suffer with BPD as are women.
In 1980 BPD was officially recognized by the American Psychiatric Association and listed in the DSM (Diagnostic and Statistical Manual) as an AXIS II personality disorder.
The Prevalence of Borderline Personality
Borderline disorder was once believed to affect one to two percent of the adult population. It is now believed to be much more prevalent affecting as many as six percent or ten million American adults.
The Cause of Borderline Personality
The best evidence suggests that this disorder results from a combination of both biological (genetic) and environmental (social) factors. Specifically, individuals who develop borderline disorder have differences in the area of their brain that controls and regulates their emotions. (the amygdala and the orbitofrontal cortex)
In addition, these individuals seem to be born with a more sensitive temperament. The environmental or social aspect of developing this disorder normally involves a caregiver, usually a mother, who is emotionally invalidating, non-responsive, or neglecting. The father is often absent during early childhood either physically or emotionally.
A common misconception is that all borderlines were molested as children. This is simply not the case and sexual molestation or rape does not cause BPD.
Signs and symptoms of BPD
The following are NOT the clinical symptoms of BPD found in the Psychiatric DSM. They are rather a compilation of behaviors and symptoms that are common among those with BPD; they are by no means a complete list:
- Mood swings
- Anxiety and depression.
- Panic attacks.
- Unstable intense relationships.
- Impulsive behavior
- Reckless behavior
- Lying and manipulation
- Angry outbursts
- Black and white thinking
- Feelings of boredom and emptiness
- Fear of being abandoned or left alone.
- Sexual promiscuity
- Fear of intimacy
- Highly romantic
- Love obsessed
- Relationship anxiety
- Substance abuse
- Highly sensitive temperament
- Suicidal thoughts, gestures, and behavior
- Suicide attempts
- Self-injury (cutting)
- Poor self-image (low self-esteem)
- Idealizing others, particularly in romantic relationships.
- Devaluing others, particularly in romantic relationships
- Body image issues, body dysmorphia
- Eating disorders, bulimia, binge eating.
- Arrested emotional development
- Preoccupation with youth and beauty
- Unstable identity or self-image
- Paranoia and suspiciousness
- Inability to accept blame.
Treatment for BPD
There is currently no cure or single treatment for this disorder, however remission does occur. In addition, many symptoms will lessen in intensity over time.
Medications such as antidepressants, mood stabilizers, atypical anti-psychotics, and anxiolytics are used to treat symptoms.
Borderline personality disorder also responds well to talk therapy, particularly cognitive behavioral therapy and a newer type of therapy known as DBT (dialectical behavioral therapy.)
For more information on Borderline personality disorder please refer to the book Wounded Personalities by G. Pacana.
Source Material: APA 2000, DSM-IV, NIH.gov, BPD Central, Gettinbetter.com