Skip to main content
Tag

bpd Archives - Suzanne Wallach

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.

Back to top