personality disorder Archives

Norman In Borderline Personality Disorder

How To Cope With The Fear Of Abandonment In 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.

Norman In Borderline Personality Disorder

DBT: A Powerful Therapy For 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 complex psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships. This instability interferes with one’s ability to function in his or her daily life, long-term planning, as well as an individual’s sense of identity. Individuals diagnosed with borderline personality disorder often experience swift mood swings, including intense episodes of depression, anger, and/ or anxiety that may range in duration, lasting as short as a couple of hours to several days. The symptoms associated with BPD frequently result in highly unstable patterns of social relationships. This chronic condition is also associated with high rates of self-injury and suicidal behavior. The treatment for BPD often includes long-term participation in psychodynamic models of psychotherapy.

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that emphasizes the psychosocial aspects of treatment. It is founded on the principals of cognitive behavioral therapy (CBT) and blends Eastern mindfulness techniques (e.g., awareness, mindfulness, and attentiveness to current situations and emotional experiences) to encourage acceptance and change. Psychologist Marsha M. Linehan developed DBT in the late 1980s as a treatment method specifically designed for chronically suicidal individuals diagnosed 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 is a rigidly structured therapeutic approach that is carried out in three therapeutic settings: weekly individual therapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching. This allows participants to engage in individualized and collective treatment while focusing on the four modules of DBT, which are:

Core mindfulness: the practice of being completely present and aware in the moment.
Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it.
Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions.
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.

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. This gives individuals struggling with BPD the opportunity to build meaningful and stable lives. Dialectical behavior therapy aims to help an individual learn strategies, techniques, and tools to effectively manage the symptoms associated with borderline personality disorder, reduce the severity of symptoms experienced, and enhance one’s quality of life.

Treatment In Calabasas

Norman In Borderline Personality Disorder

How Can You Tell If Someone Has Borderline Personality Disorder?

Borderline personality disorder (BPD) 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 cluster 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 belongs to cluster B and is specifically characterized by “hypersensitivity to rejection and resulting instability of interpersonal relationships, self-image, affect, and behavior.” Borderline personality disorder is associated with a diverse range of signs and symptoms. There is no way to definitively tell if someone has BPD without a proper diagnosis.

Differential Diagnosis

Borderline personality disorder is known as a differential diagnosis. A differential diagnosis implies that there are other possible diagnoses, and requires the diagnostician to differentiate between these possibilities to determine the actual diagnosis and appropriate treatment plan. To begin the diagnosis process, an individual must undergo a physical exam, including a complete medical history. Although there are currently no laboratory tests or scans used to detect or diagnose BPD, some tests (e.g., blood tests) may be used in the diagnosis process to check for any underlying health conditions that may be causing symptoms. If no signs of physical illness are determined, the process continues with an assessment conducted by a mental health professional that specializes in diagnosing and treating mental illnesses (e.g., psychiatrist, psychologist, etc.). Mental health experts rely on the diagnostic criteria provided in the DSM-5.

DSM-5 Diagnostic Criteria

According to the 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.

BPD is notorious for being an incredibly challenging mental health disorder to both diagnose and treat. 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 suggests that 1.6% of the population in the United States has BPD, which is equal to over four million Americans.

Treatment In Calabasas

Norman In Borderline Personality Disorder

Can You Work With A Personality Disorder?

The World Health Organization describe personality disorders as “deeply ingrained and enduring behavior patterns, manifesting themselves as inflexible responses to a broad range of personal and social situations’; they represent ‘either extreme or significant deviations from the way the average individual in a given culture perceives, thinks, feels, and particularly relates to others’ and are ‘developmental conditions, which appear in childhood or adolescence and continue into adulthood.” 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). According to the American Academy of Family Physicians (AAFP) cluster A personality disorders are characterized by eccentric, odd thinking, or behavior; cluster B personality disorders are characterized by overly emotional, dramatic, or unpredictable thinking or behavior; and cluster C personality disorders are characterized by fearful, anxious thinking or behavior. An estimated 9% of U.S. adults have at least one personality disorder.

Untreated personality disorders can adversely affect every facet of an individual’s life (e.g., occupationally, professionally, personally, etc.). For example, it can be very difficult for an individual with an untreated personality disorder to maintain steady employment. Participating in some type of formal treatment is required to minimize the effects a personality disorder can have on one’s professional life. The first step in the treatment process is to obtain an accurate diagnosis from a qualified mental healthcare provider. According to the Mayo Clinic, a personality disorder diagnosis will be determined by a physical exam, a psychiatric evaluation, and diagnostic criteria provided in the DSM-5. The diagnosis of a personality disorder, according to the DSM-5 and explicitly outlined by the Mayo Clinic generally include “long-term marked deviation from cultural expectations that lead to significant distress or impairment” in a minimum of two of the following areas:

The way you perceive and interpret yourself, other people, and events.
The appropriateness of your emotional responses.
How well you function when dealing with other people and in relationships.
Whether you can control your impulses.

It is possible for a person to present with symptoms associated with more than one personality disorder. There are a variety of mental health treatment options, and the path of recovery will not be the same for everyone. An individual struggling with a personality disorder will benefit most from a customized treatment plan. For some, integrating a combination of one or more psychotherapeutic approaches such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), psychodynamic psychotherapy, interpersonal therapy (IPT), and more, along with medication into one’s treatment plan may provide optimum chances for a successful outcome. Treatment plans may also include refining one’s daily habits (e.g., practicing mindfulness techniques, exercising regularly, developing healthy sleeping habits, eating nutritiously, etc.) to further improve one’s overall health and wellbeing. While some mental health conditions are curable, meaning after medical treatment, the person no longer has that condition, personality disorders are chronic mental health conditions. The purpose of treatment for personality disorders is not to reverse a diagnosis, rather treatment aims to help an individual learn to manage its symptoms, decrease distressing emotions and behaviors, reduce harmful actions, and meaningfully improve his or her ability to function in all aspects of his or her life.

Treatment In Calabasas

Norman In Borderline Personality Disorder

Borderline Personality Disorder and Fear of Abandonment

Psychologists and neuroscientists explain and understand the fear of abandonment through the lens of attachment theories. People with anxious-preoccupied attachment, for example, tend to feel fear of abandonment and rejection more consciously. This leads them to develop persistent emotional and behavioral patterns around these fears more so than people with other attachment styles. Fear of abandonment may cause a person to experience deep feelings of sadness and hollowness when a person to whom they are attached is not physically by their side. It may cause an unexplainable fear that a loved one will be hurt, killed, or disappear suddenly. Although, fear of abandonment itself is not a pathology, it is a core feature of certain mental health disorders.

Borderline Personality Disorder

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 are characterized by dramatic, overly emotional or unpredictable thinking or behavior. BPD is specifically characterized by “hypersensitivity to rejection and resulting instability of interpersonal relationships, self-image, affect, and behavior.” A hallmark of BPD is a pattern of instability in personal relationships. 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.

Treatment In Calabasas

Norman In Borderline Personality Disorder

5 Things To Remember When You Have BPD

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 complex psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships. This instability interferes with one’s ability to function in his or her daily life, long-term planning, as well as an individual’s sense of identity. Fortunately, there are a variety of treatment options available for a person diagnosed with borderline personality disorder. Still, having a diagnosis of and living with BDP can be challenging. Therefore, it can be helpful to bear the following in mind:

You are not manipulative or attention-seeking: A hallmark symptom of BPD is to experience a rapid onset of intense emotions. As a result, people with this condition can quickly become extremely distressed. When someone with BPD is upset, it is because they are genuinely distressed and struggling to cope with those feelings, while trying to manage an incredibly complex mental health condition. You deserve to have your distress listened to, respected, validated, and taken seriously.
You are loveable and can be in a healthy relationship: Relationships can feel like a whirlwind at times, because when someone with BPD, especially those struggling with chronic feelings of emptiness or loneliness, develops a real connection, the intensity is akin to any other emotion they experience. Your BPD, emotional sensitivity or mental health difficulties do not mean there is something unlovable about you. On the flip side, people with BPD have a lot of love to give, so much that it can be overwhelming. People with BPD can have successful long-term relationships, lasting for decades.

Do not believe everything you read: The is an array of content, across all entertainment platforms (e.g., websites, videos, movies, podcasts, etc.) that depict people with BPD in a negative light (e.g., abusers, monsters, bullies, etc.). Additionally, some books and research papers portray people with BPD as helpless, vengeful, or vindictive. Whilst mental health ailments are becoming better understood and more accurately represented, this shift seems to be occurring much more slowly for personality disorders, such as BPD, and the stigma continues to cause detrimental consequences.
You did not cause BPD: Although the cause of borderline personality disorder remains unknown, 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.”
You are not alone: Borderline personality disorder is not an uncommon disorder, as an 1.4% of the adult population in America experience BPD.

Treatment In Calabasas

Rahul In Borderline Personality Disorder

How Do I Know If Someone Has Borderline Personality Disorder?

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, 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.

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. The cause of borderline personality disorder remains unknown, but the 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.” Although there are several warning signs that can be indicative of BPD, without a comprehensive evaluation that is conducted by one or more qualified mental health professionals, it is essentially impossible to truly know if someone has borderline personality disorder.

Signs and Symptoms

Every individual is different and has the propensity to exhibit a unique combination of signs and symptoms related to borderline personality disorder. 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 (e.g., reckless driving, excessive gambling, binge eating, substance abuse, unsafe sex, etc.)
Intense fear of abandonment
Suicidal ideations
Self-injury
Severe mood swings (e.g., 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 indicates 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. 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 etc.). In fact, BPD is one of the most commonly misdiagnosed mental health conditions in America.

Rahul In Anxiety, Borderline Personality Disorder, Mental Health

What Are The Symptoms Of 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 complex 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. It can be difficult to determine who will develop borderline personality disorder as the cause of BPD remains unknown. 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.” BPD typically develops in early adulthood, often with more severe symptoms occurring in the early stages of onset.

Symptoms & Diagnostic Criteria

Borderline personality disorder directly affects how one feels about him or herself, one’s behavior as well as how an individual can relate to others. It is not uncommon for people with BPD to feel extremely intense emotions for extended periods of time. This makes returning to a stable emotional baseline far more challenging, especially after experiencing an emotionally triggering event. According to the DSM-5 key signs and symptoms of BPD may include:

Unstable personal relationships that alternate between idealization and devaluation, sometimes referred to as splitting

Frantic efforts to avoid real or imagined abandonment by family and friends

Impulsive behaviors resulting in dangerous outcomes (e.g., engaging in unsafe sex, reckless driving, abuse of drugs, etc.)

Distorted and unstable self-image, affecting one’s moods, relationships, goals, values, and/ or opinions

Self-harming behavior (e.g., suicidal threats)

Chronic feelings of emptiness and/ or boredom

Periods of intense depressed mood, irritability and/ or anxiety lasting anywhere from a few hours to a few days long

Dissociative feelings

Intense, inappropriate, and/ or uncontrollable anger, typically followed by feelings of guilt and/ or shame

More specifically, the diagnostic criteria outlined in the DSM-5, indicates that to be clinically diagnosed with BPD an individual 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 the quick changing nature of signs and symptoms associated with borderline personality disorder, it is notoriously known as a difficult to diagnose illness. The treatment for BPD often includes long-term participation in psychodynamic models of psychotherapy such as dialectical behavior therapy (DBT). DBT was developed by Marsha M. Linehan in the late 1980s, as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder. It is an evidence-based psychotherapy that combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices to foster the systematic learning of new emotional coping skills. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD.

Rahul In Anxiety, Borderline Personality Disorder, Mental Health

Main Cause Of Borderline Personality Disorder?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) list 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 according to the Mayo Clinic are “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.” The symptoms associated with borderline personality disorder can pervasively interfere with an individual’s ability to function optimally in his or her daily life. Most commonly, BPD develops in early adulthood, often with more severe symptoms occurring in the early stages of onset

BPD Triggers & Risk Factors

A trigger, in the context of BPD typically refers to something that precipitates the exacerbation of one’s BPD symptoms. Johns Hopkins Medicine explains “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. When it comes to understanding the specific cause of this disease, there is no solitary scientific reason behind why an individual develops borderline personality disorder. Rather there are 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, provided by the National Institute of Mental Health:

Genetics: people with a family history (e.g., parent, sibling, etc.) with BPD may be at increased risk of developing borderline personality disorder. Psychology Today assert that BPD is approximately five times more common among people with close biological relatives with BPD.
Environmental factors: growing up in an unstable, neglectful, and/ or abusive environment could increase one’s risk for developing 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.

Although the above factors may contribute to the development of BPD, exposure to one or more risk factors does not indicate an individual will inevitably to go on to develop borderline personality disorder. Since the root of borderline personality disorder remains unknown, it is impossible to isolate a single cause that accurately and universally explains its development.

personality disorder Archives - Suzanne Wallach

How To Cope With The Fear Of Abandonment In BPD

DBT: A Powerful Therapy For Borderline Personality Disorder

Dialectical Behavior Therapy

How Can You Tell If Someone Has Borderline Personality Disorder?

Differential Diagnosis

DSM-5 Diagnostic Criteria

Can You Work With A Personality Disorder?

Borderline Personality Disorder and Fear of Abandonment

Borderline Personality Disorder

5 Things To Remember When You Have BPD

How Do I Know If Someone Has Borderline Personality Disorder?

Signs and Symptoms

What Are The Symptoms Of Borderline Personality Disorder?

Symptoms & Diagnostic Criteria

Main Cause Of Borderline Personality Disorder?

BPD Triggers & Risk Factors

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