Borderline personality disorder can be a debilitating personality disorder that may have profound adverse effects on the life of individuals suffering with this condition. This personality disorder involves a disruption in identity and strong negative self-image with intense fear of abandonment/rejection. It entails a chronic pattern of instability in interpersonal relationships and mood and tends to include impulsive, acting out behaviour.
The prevalence of Borderline Personality Disorder appears to be somewhere between 1.6% and 5.9% and in the opinion of many clinicians is on the increase.
The diagnostic criteria of BPD as included in the DSM-V include the following:
- Fears of abandonment and strong efforts to avoid this rejection or abandonment
Intense and unstable interpersonal relationships with extreme shifts between idealizing and devaluing other people.
- A disturbance in identity that tends to take the form of a marked and persistently unstable self-image or sense of self.
- Impulsive / acting out behaviour that might include behaviours such as compulsive sex, spending, drug or alcohol abuse, binge eating or reckless driving)
- Frequent suicidal behaviour or threats, or self-mutilating behaviour.
- Unstable mood such as intense sadness, anxiety or irritability that generally resolves in a few hours to a few days
- Frequent feelings of emptiness.
- Intense, disproportionate feelings of anger or difficulty controlling aggression
- There can also be more psychotic type features such as stress-related paranoid ideation or severe dissociative symptoms, though these are transient, not consistent as they are in say, schizophrenia.
Borderline Personality Disorder has been historically very difficult to treat and made more so by the poor interpersonal boundaries that people suffering from this condition often have. However, in the last two decades, there have been major breakthroughs in treatment with some very encouraging results particularly in the realm of Cognitive Therapy. Modes of treatment within Cognitive Therapy that have proven to be especially efficacious either as standalone treatments or in combination, include Schema Therapy, Dialectic Behaviour Therapy, Mindfulness Based Cognitive Therapy and Cognitive Behaviour Therapy.
Because of this I see quite a large number of individuals in my private practice that are struggling with this challenging condition.