"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 used the word borderline to describe a condition among women he viewed as being highly “neurotic” but not quite psychotic.
However, under certain conditions these women could cross over into psychosis and experience feelings of paranoia, suspiciousness, and disassociation. Thus, they existed on the “border” between neurotic (anxious) and psychotic. We now know that men are just as likely to suffer with bpd as women are.
In 1980 bpd was officially recognized by the American Psychiatric Association and listed in the DSM (Diagnostic and Statistical Manual) as an AXIS II disorder.
The Prevalence of BPD
Borderline disorder was once believed to affect 1 to 2 percent of the adult population. It is now believed to be much more prevalent affecting as many as 6 percent or ten million American adults. Just as an example, 2 percent is equivalent to 1 in 50, whereas 6 percent equates to roughly 1 in 16 adults, meaning most of us likely know at least one person who suffers with this disorder.
The Cause of BPD
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 emotions.
In addition, these individuals tend to have 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
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 for this disorder, however remission does occur. In addition, many symptoms will lessen in intensity over time.
Medications such as antidepressants, mood stabilizers, anti-psychotics, and anxiolytics are often used to treat symptoms. There is however no “one pill” solution for bpd.
Borderline personality disorder also responds well to talk therapy, particularly cognitive behavioral therapy and DBT (dialectical behavioral therapy.)
For more information on borderline personality disorder, visit BPD Central or review the additional articles suggested below by the author.
Source Material: APA 2000, DSM-IV, NIH.gov, BPD Central, Gettinbetter.com