• feeling isolated or abandoned by others,
• self-harming or suicidal thoughts,
• coping with stress,
• getting on with other people,
• strong emotions that you find hard to cope with,
• misusing alcohol and prescription drugs,
• illegal drugs and substances,
• understanding other people’s points of view,
• staying in work,
• having a long-term relationship, or
• being able to maintain a home.
It is called ‘borderline’ because doctors used to think it was on the border between two different disorders: neurosis and psychosis. Doctors no longer like to use these terms to describe mental illness. It is sometimes called Emotionally Unstable Personality Disorder (EUPD). Some people feel that this describes the illness better.
Some people with a personality disorder think that the name is insulting or makes them feel labelled. But doctors do not use this term to make you feel judged or suggest that the illness is your fault. It is meant to describe the way the illness develops.
Borderline personality disorder greatly affects a person’s behaviour, with intense feelings of insecurity. Some of the symptoms to look out for include:
• Severe fear of being abandoned, which could lead to the person acting out in order to avoid a situation whether it is real or just in their imagination.
• Unstable relationships, the person has intense feelings of love one moment and hate the next.
• A wavering self-image that affects a person’s mood, goals and values
• Behaviour that is impulsive and possibly destructive, such as gambling, drugs, suddenly quitting a good job or spending too much money.
• Threatening to harm themselves or commit suicide
• Negative emotions and anxiety that last for days.
• Feelings of emptiness
• Intense anger or irritability. Losing your temper followed by guilt and shame
• A loss of identity and connection with reality, becoming paranoid.
There’s no single reason why some people develop borderline personality disorder (BPD). Professionals can’t use things like blood tests or brain scans to help diagnose people.
Often people who live with BPD have experienced difficult, traumatic or abusive childhoods. But that’s not always the case.
Sometimes people who live with BPD have other mental health conditions too. So, they can be a factor that plays a part. Another factor can be experiencing difficult or traumatic life events.
You’re more likely to be diagnosed with BPD if a close family member has too. But it’s hard for professionals to know if the traits associated with BPD are inherited from your parents. Or if they’re developed because of other factors. A combination of factors could be involved.
BPD can be a serious condition, and many people with the condition self-harm and attempt suicide. The prognosis is reasonably positive over time, and psychological or medical treatment can help.
Treatment options include:
• Cognitive Behavioural Therapy (CBT)
• Dialectical Behaviour Therapy
• Schema Focused Therapy
Therapy can be also provided one-on-one with a psychologist or via a group. Therapist-led group sessions may teach people with BPD how to interact with others and to express themselves effectively.
Many people with BPD are treated with medication as well as psychotherapy. While medications don’t cure BPD, some may be helpful in managing symptoms. Medication can help reduce symptoms such as anxiety, depression, or aggression.
Medication can, however, cause different side effects in different people. People who have BPD should talk to their prescribing doctor about what to expect.
You and your doctor or healthcare team should agree on a treatment plan that works best for you.
If your GP feels you have a complex personality disorder, they may refer you to a:
• community mental health team or a community Clinic that has mental health facilities, or
• specialist personality disorder service or unit, if there is one locally.
These services are made up of professionals such as psychologists, psychiatrists and therapists. They will have experience in helping people with personality disorders.
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