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DBT Skills for Distress Tolerance in BPD

Distress Tolerance

Distress tolerance is one of the four key areas, also known as modules, that make up the psychotherapeutic intervention known as dialectical behavior therapy (DBT). Psychologist Marsha M. Linehan developed DBT in the late 1980s as a means to help better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). Distress tolerance is often conceptualized as “one’s ability to tolerate and withstand negative or uncomfortable emotional states.” DBT skills for distress tolerance, also known as crisis survival skills, aim to help individuals learn how to cope with feelings that do not have an immediately known resolution. There are many different distress tolerance skills taught in DBT, some of which include the following:

  • Radical acceptance: This skill entails making a conscious choice to accept the state of things as they are, without working to change them. 
  • TIPP skills: TIPP is an acronym for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. TIPP skills quickly calm the limbic system and lower the state of emotional arousal.
  • Weigh the pros and cons: Noting the pros and cons can help an individual pause and take a moment to think logically about a situation and the subsequent steps.
  • Failing forward: Failing forward eliminates the fear of failure by recognizing and celebrating it as an opportunity for growth. It allows an individual to see that failure does not imply that they have failed as a person, and simultaneously reinforces the notion that growth is always possible.
  • STOP skill: STOP is an acronym for Stop, Take a step back, Observe, and Proceed mindfully, which can help an individual avoid engaging in impulsive behavior.
  • Self-soothing techniques: There are a variety of self-soothing techniques that can be used to ground oneself mentally and emotionally.
  • Square breathing: This is a guided breathing exercise that can be used by anyone to manage stress and anxiety, as it has been shown to relax the nervous system. Try it out by following these simple directions:
    • Inhale to a count of 4.
    • Hold your breath to a count of 4.
    • Exhale to a count of 4.
    • Hold it for a count of 4.
  • IMPROVE skills: IMPROVE is an acronym for Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacation, and Encouragement, all of which can help with improving the moment.
  • Distraction: During moments of intense overwhelm, temporary distractions (e.g., calling a friend, reading a book, watching TV, etc.) can provide brief relief from the distressing situation.

The skills focused on during the distress tolerance module of DBT include various short-term coping strategies intended to help an individual with BPD manage emotional pain to avoid destructive behavior.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

The Link Between Childhood Trauma and BPD

Childhood-Trauma

Borderline personality disorder (BPD) is a chronic, complex psychological condition that is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is characterized by a pervasive pattern of high affective instability, impulsive behaviors, unstable interpersonal relationships, and an inconsistent self-concept. Borderline personality disorder is associated with a diverse range of signs and symptoms. The cause of borderline personality disorder remains unknown. However, the National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder.” Recent research has shown that 1.6% of the population in the United States has BPD, which amounts to over four million Americans.

Trauma is defined as any type of distressing event or experience that can have an impact on a young person’s ability to cope and function. According to the National Institute of Mental Health (NIMH), childhood trauma is defined as “the experience of an event by a child that is emotionally painful or distressful, which often results in lasting mental and physical effects.” Childhood trauma may be caused by examples such as abuse (such as sexual or physical), witnessing domestic violence, neglect, accidents, chronic or sudden medical illness, a death in the family or parental illness, substance use, divorce, or incarceration. Any experience that threatens a child’s sense of security and leaves a young person feeling overwhelmed and isolated can be traumatic. Data indicates that one in four children living in the United States experiences a traumatic event before reaching adulthood.

Childhood Trauma and BPD

Empirical evidence confirms the notion that humans store memories, experience, and emotions on a cellular level. Hence, early childhood experiences play a large role in how the brain develops and functions. A report from the Center on the Developing Child at Harvard University asserts that childhood trauma can derail healthy development and cause damaging effects on learning, behavior, and health across the lifespan. Trauma and adversity in childhood raise the risk of numerous health problems (e.g., diabetes, heart disease, cancer, mental illness, etc.) in adulthood. Further, the effects of childhood trauma have repeatedly been linked to the development of maladaptive personality traits and personality disorders. According to University of Manchester research, people with borderline personality disorder are 13 times more likely to report childhood trauma than people without any mental health problems.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

How To Cope With The Fear Of Abandonment In BPD

BPD

Psychology Today characterizes fear of abandonment as “a lingering feeling of insecurity, contributing to intrusive thoughts, emptiness, unstable sense of self, clinginess, neediness, extreme mood fluctuations, and frequent relationship conflicts.” Although, fear of abandonment itself is not a pathology, it is a core feature of certain mental health disorders, such as borderline personality disorder (BPD). Borderline personality disorder is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health disorder. It is a serious psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships which interfere with one’s ability to function in everyday life. As is explained by Harvard Medical School, “People with borderline personality disorder have a deep fear of abandonment… they compete for social acceptance, are terrified of rejection and often feel lonely even in the context of an intimate relationship.” Even with the strong desire to have loving, and lasting relationships, the symptoms of BPD such as inappropriate anger, impulsiveness, and frequent mood swings often push others away, which reinforces the fear of abandonment. Verywell Mind offers several strategies that can help individuals with BPD cope with the fear of abandonment, some of which include:

  • Challenge your negative, unwanted thoughts: Identify the anxious thoughts that surface when you think of being alone, analyze them, and challenge them to discern if your initial reaction is truly how you feel or if you are just assuming the worst.
  • Prioritize your health: Taking care of your body can improve your mental and physical health. Be sure to exercise regularly, obtain ample nightly sleep, eat nutritiously, stay hydrated, etc.
  • Explore different relaxation tactics: Try different mindfulness exercises like yoga or meditation. Research has found that meditation can help lower blood pressure, reduce feelings of anxiety and depression, improve insomnia, etc.
  • Acknowledge that you are experiencing heavy emotions: By recognizing, acknowledging, and naming your negative emotions you can begin to face them, feel them, and let them go.
  • Have a plan to deescalate and ground yourself: Identifying ways that make you feel safe, secure, and calm, and implementing them in times of need, can help increase your resilience.
  • Do not be afraid to ask for help: Recognize when you need additional support and do not hesitate to pursue professional guidance. There is a vast network of highly qualified mental health providers that have expert knowledge and extensive experience in working with individuals diagnosed with borderline personality disorder.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

How Do I Leave BPD?

Borderline personality disorder

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health disorder. It is a serious psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships which interfere with one’s ability to function in everyday life. BPD directly affects how one feels about him or herself, one’s behaviors as well as how an individual can relate to others. As is explained by the Mayo Clinic individuals with borderline personality disorder have an intense fear of abandonment or instability, and are often unable to tolerate being alone. Even with the strong desire to have loving, and lasting relationships, the symptoms of BPD (e.g., inappropriate anger, impulsiveness, frequent mood swings, etc.) often push others away. Making the decision to end a relationship with a partner diagnosed with borderline personality disorder can be difficult. To help you end your relationship amicably and leave with integrity consider the following suggestions, provided by Psychology Today:

  • Speak clearly, gently, and with compassion: When communicating it is important to be direct and use short sentences, in a calm and non-threatening voice.
    • Remain calm and respectful: It is common for individuals with BPD to lash out when feeling attacked, frustrated, or rejected. Avoid reacting impulsively and do not be sarcastic, snarky, or demeaning.
  • Avoid blame: The constructive conversations that often occur between two healthy people exploring why their relationship did not work, is unlikely to happen when one of the partners has borderline personality disorder. In attempt to understand why the relationship failed, an individual with BPD is likely to ask what they did wrong. However, rather than accepting their partner’s feedback at face value, they instead hear these explanations as attacks on their character and become defensive or even hostile.
  • Be a source of validation: Whenever possible, acknowledge and validate their feelings, even if you do not fully agree with their beliefs.
  • Set and enforce boundaries as necessary: When you break up with someone diagnosed with BPD, they are likely to lash out at you. You have made the choice to end the relationship and to uphold this decision you must set and maintain clear boundaries by stating what you will and will not accept.

The end of any relationship can trigger a range of emotions and in partners with BPD terminating a relationship can cause particularly charged and heightened emotional reactions. Nevertheless, if there comes a point where you feel it best to end a relationship, although their BPD may be helpful in considering the most effective way to deliver this message to your partner, it is generally best to avoid delay.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

How To Deal With A BPD Diagnosis?

BPD

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental disorder. The Merck Manual explains that BPD is “characterized by a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations, and impulsivity.” Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses, which is a core feature of borderline personality disorder. The symptoms that manifest because of BPD often mimic those of other mental health disorders (e.g., histrionic personality disorder, narcissistic personality disorder, bipolar personality disorder, etc.), making it one of the most commonly misdiagnosed mental health conditions. Still, the National Institute of Mental Health (NIH) estimates that 1.4% of the adult population in America experience BPD. Borderline personality disorder is a mental health condition that requires long-term treatment.

Formal Treatment

Every individual is unique, and each will require a customized treatment plan that is directly informed by his or her nuanced mental health needs. These plans are typically comprised of a combination of different treatment approaches, and often include long-term participation in psychodynamic models of psychotherapy such as:

  • Dialectical behavior therapy (DBT) was developed specifically to treat individuals with BPD. It is a form of cognitive behavior therapy (CBT) that places greater emphasis on the psychosocial aspect of treatment. DBT focuses on how one’s thoughts and beliefs can lead to actions and behaviors. This skills-based approach teaches how to manage emotions, tolerate distress, and improve relationships through group and individual therapy sessions.
  • Schema-focused therapy incorporates aspects of CBT and psychoanalytic theories. It helps to identify unmet needs that have led to unhealthy ways of thinking about the world. Conducted in an individual setting or group setting, schema-focused therapy challenges maladaptive beliefs and behaviors and focuses on promoting positive life patterns.
  • Mentalization-based therapy (MBT) emphasizes thinking before reacting. This is accomplished through helping an individual identify his or her own thoughts and feelings and creating an alternate perspective on the situation.

The Food and Drug Administration (FDA) has yet to approve a medication explicitly designed to treat borderline personality disorder. There are, however, certain medications that can help to alleviate and/ or reduce some of the symptoms arising from BPD or co-occurring disorders (e.g., depression, anxiety, etc.). Common examples of types of medication prescribed as a component of one’s BPD treatment plan include:

  • Antidepressants: Celexa (citalopram), Prozac (fluoxetine)
  • Anticonvulsants/ mood stabilizers: Topamax (topiramate), Lamictal (lamotrigine)
  • Anti-anxiety medications/ anxiolytics: Lexapro (escitalopram), Zoloft (sertraline)
  • Antipsychotics: Rexulti (brexpiprazole)

The most effective way to deal with BPD is through learning to accept the condition, understanding the implications of treatment, and adhere to one’s recovery plan.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

How Do You Work With BPD?

BPD

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) list ten standalone personality disorders and based on similar characteristics, each personality disorder is grouped into one of three categories (cluster A, cluster B, and cluster C). Borderline personality disorder (BPD) belongs to cluster B, which according to the Mayo Clinic are “characterized by dramatic, overly emotional or unpredictable thinking or behavior.” More specifically, BPD is defined by the National Institute of Mental Health (NIH), as “an illness characterized by an ongoing pattern of varying moods, behavior, and self-image.” The signs and symptoms of borderline personality disorder are highlighted in the diagnostic criteria that is outlined in the DSM-5. Due to the illusive nature of its symptoms paired with the fact that many symptoms overlap with other mental health ailments, BPD is notoriously known as one of the most difficult mental health illnesses to both diagnose and treat.

Tips For Working With Clients With BPD

BPD directly impacts the way individuals interpret information, primarily as it relates to others’ intentions. Thus, it is highly common for people with BPD to feel rejected, abandoned, misunderstood, judged, inferior, and isolated. An individual with BPD experiences profound perceptual shifts and disordered reactions to those perceptions, which causes them to constantly precieve events and personal interactions differently than those around them. This can make treating someone with borderline personality disorder complicated. Nevertheless, there are several key principles that have been established and are important to bear in mind when working with an individual diagnosed with BPD. To guide your treatment protocol, experts suggest considering the following strategies:

  • Be compassionate.
  • Demonstrate empathy.
  • Listen to the person’s current experience.
  • Validate the person’s current emotional state.
  • Take the person’s experience seriously, noting verbal and non-verbal communications.
  • Maintain a non-judgmental approach.
  • Remain calm.
  • Remain respectful.
  • Remain caring.
  • Engage in open communication.
  • Be open and prepared to acknowledge both the serious and comical side of life, where appropriate.
  • Foster trust to allow strong emotions to be freely expressed.
  • Be clear, consistent, and reliable.
  • Convey encouragement and hope about their capacity for change.

Treatment for BPD aims to help an individual learn strategies, techniques, and tools to reduce the severity of symptoms while simultaneously cultivating an enhanced ability to effectively manage its associated symptoms.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Triggers A Person With Borderline Personality Disorder?

Borderline Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists ten standalone personality disorders based on similar characteristics, and each personality disorder is grouped into one of three categories (cluster A, cluster B, and cluster C). Borderline personality disorder (BPD) belongs to cluster B, which is characterized by “dramatic, overly emotional or unpredictable thinking or behavior.” More specifically BPD is characterized by “a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations, and impulsivity.” Individuals with a borderline personality disorder often struggle with relationship issues, lack self-esteem, have a poor self-image, and have an inability to appropriately self-regulate. A borderline personality disorder is not an uncommon disorder, as the National Institute of Mental Health (NIH) estimates that 1.4% of the adult population in America experience BPD.

Risk Factors

The exact cause of borderline personality disorder remains unknown. There are, however, several contributing factors that have been recognized as possibly playing a role in its development, potentially increasing one’s susceptibility to BPD. These factors may include, but are not limited to the following:

  • Environmental factors: growing up in an unstable, neglectful, and/ or abusive environment could increase one’s risk of developing BPD.
  • Genetics: people with a family history (e.g., parent, sibling, etc.) with BPD may be at increased risk of developing a borderline personality disorder. Psychology Today asserts that BPD is approximately five times more common among people with close biological relatives with BPD.
  • Brain factors: some studies have indicated that individuals diagnosed with BPD have structural and/ or functional abnormalities, specifically in the areas of the brain that reign emotional regulation and impulse control. Furthermore, deviations from typical serotonin (hormone that works to stabilize one’s mood, happiness, and feelings of well-being) production could increase one’s vulnerability to BPD.

There is no definitive medical test to diagnose borderline personality disorder. The diagnostic criteria outlined in the DSM-5 indicate that to be clinically diagnosed with BPD an individual must experience five or more symptoms, in a variety of contexts.

BPD Triggers

A trigger, in the context of BPD typically refers to something that precipitates the exacerbation of one’s BPD symptoms. Johns Hopkins Medicine explains that “triggers are external events or circumstances that may produce very uncomfortable emotional or psychiatric symptoms, such as anxiety, panic, discouragement, despair, or negative self-talk.” While BPD triggers can vary from person to person, there are some types of triggers that are more common in BPD, such as the following examples:

  • Perceived or real abandonment
  • Rejection of any kind
  • Loss of a job
  • Locations that invoke negative memories
  • Reminders of traumatic events
  • Ending a relationship

Many borderline personality disorder triggers arise from interpersonal distress. The symptoms that manifest because of borderline personality disorder often mimic those of other mental health disorders (e.g., histrionic personality disorder, narcissistic personality disorder, bipolar personality disorder, etc.). BPD symptoms pervasively interfere with an individual’s ability to function optimally in his or her daily life.

 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, or give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

Helping A Partner Who Has BPD (Borderline Personality Disorder)

Helping A Partner Who Has BPD (Borderline Personality Disorder)

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental disorder. As defined by the National Institute of Mental Health (NIH), “borderline personality disorder is an illness characterized by an ongoing pattern of varying moods, behavior, and self-image.” Individuals with borderline personality disorder feel prolonged, intense emotions and are unable to return to a neutral emotional baseline after facing an emotionally charged experience in a timely manner. This can affect all areas of one’s life as the duration it takes an individual with BPD to process, integrate, and recover from emotional challenges is elongated. Individuals with borderline personality disorder often struggle with relationship issues, lack self-esteem, have a poor self-image, and have an inability to appropriately self-regulate. Borderline personality disorder is not an uncommon disorder, as the National Institute of Mental Health (NIH) estimates that 1.4% of the adults in America experience BPD. 

Diagnostic Criteria 

There is no definitive medical test to diagnose borderline personality disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), borderline personality disorder is diagnosed when an individual experiences “a pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood” and must experience five or more of the following symptoms in a variety of contexts:

  • Emotional instability
  • Feelings of emptiness
  • Efforts to avoid abandonment
  • Impulsive behaviors
  • Identity disturbances
  • Inappropriate, irrational and/ or intense bouts of anger
  • Transient paranoid and/ or dissociative symptoms
  • Unstable interpersonal relationships
  • Suicidal and/ or self-harming behaviors

Due to its illusive nature, borderline personality disorder can be extremely difficult to diagnose. As such, to obtain the most accurate mental health diagnosis it is imperative to undergo a comprehensive evaluation that is conducted by one or more qualified mental health professionals. 

What You Can Do

Despite the challenges that BPD can bring to a relationship maintaining self-care practices and utilizing effective communication skills are essential for both partners, and integral to the health of the relationship. Consider the following suggestions to help you navigate your partner’s BPD:

  • Increase empathy: learn as much as you can about borderline personality disorder to increase empathy in your partnership
  • Remain calm: do not engage in serious conversations unless your partner is calm 
  • Be supportive: provide your partner with emotional support and understanding, and be sure to let your partner know that you fully support their treatment 
  • Avoid shame and blame: remember that labeling and blaming is not productive nor will it help to de-escalate or resolve any situation
  • Take threats seriously: threats of self-harm should not be minimized or ignored, and should prompt you to seek immediate professional help

It is important to bear in mind that although BPD is a chronic condition, with proper support, is it possible for an individual diagnosed with borderline personality disorder to learn strategies, techniques, and tools to effectively manage the symptoms associated with BPD, reducing the severity of symptoms experienced and increasing one’s quality of life.

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Type Of Therapy Is Best For Borderline Personality Disorder?

Borderline Personality Disorder abbreviated

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health disorder. As defined by the National Institute of Mental Health (NIH), “borderline personality disorder is an illness characterized by an ongoing pattern of varying moods, behavior, and self-image.” It is highly common for individuals with BPD to lack the ability to foster and maintain meaningful, lasting relationships. The symptoms that are associated with borderline personality disorder make it difficult to diagnose. In order to secure the most effective treatment an individual must obtain an accurate diagnosis from a qualified mental healthcare provider. The Food and Drug Administration (FDA) has yet to approve a medication explicitly designed to treat borderline personality disorder. While there are other types of therapeutic modalities that can be helpful in treating someone with BPD (e.g., schema-focused therapy, mentalization-based therapy, etc.), the most frequently relied upon type of psychotherapy used to treat BPD is called dialectical behavior therapy (DBT). Treatment for BPD will help an individual learn strategies, techniques, and tools to effectively manage the symptoms associated with borderline personality disorder, reducing the severity of symptoms experienced and increasing one’s quality of life. 

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that places greater emphasis on the psychosocial aspect of therapy. Marsha M. Linehan initially developed it in the 1980s, to help treat chronically suicidal people with borderline personality disorder. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD and has also proven effective in treating individuals with other mental health conditions. DBT utilizes four main strategies for teaching individuals’ skills that help with effectively changing their behaviors. They include the following, as provided by Behavioral Tech

  1. Core mindfulness: the practice of being completely present and aware in the moment. 
  2. Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it.
  3. Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions. 
  4. Interpersonal effectiveness: authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging.

DBT is comprised of three distinct settings: weekly individual therapy sessions, weekly DBT group skills training sessions, and as-needed phone coaching. The entire DBT program (provided skills modules are not repeated) usually lasts about six months long, as approximately six weeks are allocated to each of the four skills modules. DBT is based on the notion that change can be balanced with self-acceptance. It can help people learn how to regulate emotions and foster change. This gives individuals struggling with BPD the opportunity to build meaningful and stable lives. Although BPD is considered to be a chronic condition, there are a variety of treatment options available to a person diagnosed with borderline personality disorder. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

Common Signs Of Borderline Personality Disorder

man with borderline personality disorder

Borderline personality disorder is one of ten personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Each of the ten personality disorders is categorized into one of three clusters (cluster A, cluster B and cluster C). The personality disorders that make up each clusters share similar symptoms and have overlapping characteristics. According to the American Academy of Family Physicians (AAFP) cluster A is characterized as odd or eccentric personalities; cluster B is characterized as dramatic, emotional, or erratic personalities; and cluster C is characterized as anxious or fearful personalities. Borderline personality disorder is classified as a cluster C personality disorder. The National Institute of Mental Health explains, “Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior.” The cause of borderline personality disorder remains unknown. There are, however, certain risk factors (e.g. brain structure and function, genetics, environmental, cultural and social influences, etc.) that have been noted as potentially contributing to its development. Due to the illusive nature of its symptoms paired with the fact that many symptoms overlap with other mental health ailments, BPD is notoriously known as one of the most difficult mental health illnesses to diagnose. 

Signs and Symptoms

The symptoms of borderline personality disorder typically result in overarching interpersonal relationship complications and impulsive actions. The Mayo Clinic provides examples of signs and symptoms that are commonly exhibited in individuals with borderline personality disorder, some of which include, but are not limited to the following:

  • Engaging in risky and/ or impulsive behaviors (i.e. reckless driving, excessive gambling, binge eating, substance abuse, unsafe sex…etc.)
  • Intense fear of abandonment
  • Suicidal ideations
  • Self-injury
  • Severe mood swings (i.e. elation, irritability, shame, anxiety…etc.)
  • Pattern of unstable relationships
  • Irrational displays of anger
  • Distorted self image
  • Feelings of emptiness
  • Stress related paranoia

Some individuals may experience numerous symptoms of BPD, while others may only experience a few symptoms. Research has indicated that individuals with borderline personality disorder may experience intense episodes of depression, anxiety and/ or anger that could last from a few hours to several days long. Every individual is different and has the propensity to exhibit a unique combination of signs and symptoms related to borderline personality disorder.

Treatment

Although borderline personality disorder is considered a chronic mental health condition, there are a variety of treatment options available for individuals diagnosed with BPD, which can help individuals, learn to manage their symptoms. The most common method of treatment for borderline personality disorder is dialectical behavior therapy (DBT). Marsha M. Linehan developed DBT in the late 1980s, specifically to better treat chronically suicidal individuals with borderline personality disorder. Dialectical behavior therapy is based on the cognitive behavioral therapy (CBT) approach, and places greater emphasis on the psychosocial aspect of therapy. With proper treatment, an individual diagnosed with borderline personality disorder can learn to effectively navigate his or her symptoms of BPD and go on to lead a happy and fulfilling life. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment.

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