Mental health topics: what is borderline personality disorder?

Borderline Personality Disorder (BPD) can be a difficult mental condition to diagnose, but most psychiatrists do agree it is a legitimate complaint. In general, Borderline Personality Disorder is defined as a mental condition in which the sufferer has little to no control over the extremes of his or her emotions. Those with borderline personalities tend to view their world as a chaotic place filled with pure evil and pure good. BPD sufferers can become extremely volatile at the slightest provocation, so those who interact with them tend to tread lightly. Even though borderline personality types tend to see their friends and family in very black and white terms, their perceptions of an individual may change from day to day. Someone who was a villain on Monday may become a hero on Wednesday, until he or she offends again. The process of dividing friends and family into defined categories is called 'splitting' and is a common trait among BPD sufferers.

Borderline Personality Disorder quite often appears in conjunction with other mental illnesses such as obsessive-compulsive disorder, post traumatic stress disorder and manic depression. This can make it very challenging to treat these other conditions, because BPD is not thought to be organically-based. Borderline personalities develop primarily as emotional defense mechanisms, not definable chemical imbalances. While a bipolar or clinically depressed patient may benefit from drug therapy, those with Borderline Personality Disorder must rely on a long-term course of psychotherapy. BPD sufferers may be high-functioning individuals capable of supporting themselves and living somewhat normal lives. The worst of their symptoms may never appear until they are among intimate friends or family. Those who are closest to borderline personalities may realize how troubled they are, but many BPD sufferers learn to mask their symptoms in public. Some BPD patients are not quite as fortunate in that sense however. They are defined as low-functioning, and must spend their time under the direct care of mental health professionals. Low-functioning BPD patients may disconnect completely from the outside world and become suicidal or catatonic. These patients are usually housed in secured mental facilities for their own protection.

One of the problems associated with Borderline Personality Disorder is diagnosis. Most of us will at one time or another match some of the criteria for BPD, especially during adolescence. It's not unusual or unhealthy to feel confused by the changing morality of the world around us, or to occasionally shift our opinions of those around us. Frustration can cause otherwise healthy people to become agitated or volatile at times. But the difference between ordinary anger and BPD is the intensity of those emotions. Borderline personalities cannot let go of the feelings which sparked the initial confrontation. They will not feel satisfied until everyone is aware of the depth of their anger or disappointment. Emotionally, most BPD sufferers are living in a state of permanent adolescence- a time when emotional outbursts and extreme feelings are often the norm. True borderline personalities rarely deviate from their preferred ways of handling conflict- situations will always be a trigger for extreme reactions.

One criticism of the Borderline Personality Disorder diagnosis has been a perceived over eagerness by mental health professionals to label their patients. Much like fibromyalgia in the physical world, BPD is occasionally seen as a 'generic' condition not fully supported by scientific evidence. There are critics who suggest that certain psychiatrists have diagnosed BPD simply to put a definition on a patient's conflicting symptoms. Borderline personalities tend to appear most prominently in young adult women, possibly as a direct result of early childhood sexual trauma. Men can also form borderline personalities, but the majority of sufferers are female. By the time a potential BPD sufferer approaches a mental health professional for the first time, his or her behavior has most likely been problematic. Borderline personalities have difficulty maintaining long-term romantic relationships, so they may become very promiscuous. Work records may be very spotty, with sudden outbursts and numerous reprimands. Self-mutilations and suicide attempts are common among BPD sufferers. Separating these aspects of a difficult personality type and forming a diagnosis can be extremely difficult for mental health professionals.

Borderline personalities are not easily cured or controlled, but they can be managed. BPD patients can benefit from intensive counseling and treatment for other mental conditions which may exist. Sufferers can participate in support groups and learn to recognize the early warning signals of an emotional outburst. Family members can also educate themselves on how to approach a BPD sufferer without triggering an attack. Borderline personalities generally fear abandonment, so they may function best in the company of supportive friends or family. Although high-functioning borderline personalities are capable of finding gainful employment and living independently, they may need to be supervised remotely. Medications prescribed for other mental conditions may keep their emotions in check, but borderline personalities must constantly fight against uncontrolled outbursts, obsessive-compulsive behavior and anxiety attacks.