BORDERLINE personality DISORDER: what is it, causes, symptoms and treatment

If you know or are one of those people who takes everything to the limit, who likes to experience the limits which your personality and the behaviors and reactions of others can reach, perhaps this article will interest.

The personality border line It is one of the personality disorders that we observe the most in consultation since, despite its difficulties and alterations, are the ones who most ask professionals for help due to the discomfort caused by the symptoms Present. So if this sounds like an interesting disorder, you think you might have it, or you know someone who might fit the bill, keep reading! In this Psychology-Online article, we explain in more detail what the personality disorder borderlinee: what is it, causes, symptoms and treatment.

Index

1. What is borderline personality disorder
2. Symptoms of borderline personality disorder
3. Causes of borderline personality disorder
4. Treatment of borderline personality disorder
5. Differential diagnosis of borderline personality disorder

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V)^[1], personality disorder border line o Borderline Personality Disorder (BPD) is attributed to those people who perform impulsive actions with an unstable mood, minimal planning ability and outbursts of anger with minimal self-control.

In this disorder there is a point of union between psychosis and neurosis. The concept of border line from which the limit derives begins to be used in patients who have schizophrenic symptoms, without being invalidating and/or lasting enough. Some authors consider it a bridge personality between the infantile or primitive personality and the immature.

When identifying it, it is important to know the characteristics of the personality disorder border line and what behaviors people who suffer from it have. We see them below:

• Intense fears of being abandoned: could be related to the intolerance of being alone and the need to be accompanied by other people. Vacuum sensation.
• Likely to idealize the people who care for them or their lovers in the first times they meet them. It is common for them to share very intimate details quickly and demand attention so that they are by their side.
• Dramatic changes in opinion of others They tend to reflect disappointment and dissatisfaction because they do not understand or satisfy their demands, they feel that they are going to be rejected or that they do not pay enough attention to them.
• Lack of impulse control and intense sensation seeking.
• Sudden and dramatic changes in your self-image, opinion, future plans, sexual identity, scale of values ​​and type of friendships that are given as a reason for the perception of lack of significant relationships of help and support. Feeling of non-existence or presence.
• They may engage in risky behavior: irresponsible money management, binge eating, substance abuse, unsafe sex, or reckless driving.
• Completed suicide in 8-10%: Suicide threats and self-mutilation are also very common.
• Dysphoric type basic mood: can be interrupted by periods of anger, anguish or despair. Anger may be triggered when they view a caregiver or lover as neglectful, repressive, uncaring, or abandoning them. It is followed by sorrow and guilt.
• May show extreme sarcasm, persistent bitterness or verbal explosions.
• May appear symptoms such as paranoid ideation that subside when the person's attention returns.
• Poor job or school performance, due to their emotional instability, and get bored very easily. If this happens to you, we recommend you read this article about how to be more productive at work.

Discussing the principles of personality and associated disorders, Millon, T. E., (1997)^[2] emphasizes that personality develops from the interaction between genetic and environmental factors. If we take into account the above, the causes of personality disorder border line they are the result of the imbalance of the systems that make it up, neither one nor the other being decisive.

In addition, it is also important to note that the cause of a personality disorder is independent of the level of education and socioeconomic status.

personality disorder border line It's one of the personality disorders with the largest number of studies on effective treatments.

Although it is true that there are many therapies that have proven effective, such as analytical psychotherapy in therapies focused on transference and in mentalization therapy, the treatments that have been shown to be most effective for this type of disorder are the cognitive behavioral therapy, specifically the following two therapies:

• Marsh Linehan Dialectical Behavior Therapy: based on problem solving, changing the basic response pattern, and training in social and emotional skills.
• Jeffrey Young Schema Therapy: based on the existence of maladaptive schemes. It is an integrative therapy of various models.

At the pharmacological level, it has been shown to function effectively in response to antidepressants, antipsychotics, anxiolytics and mood stabilizers. Also, some mood stabilizers such as lithium, carbamazepine, valproic acid and, some newer ones such as topiramate, lamotrigine or pregabalin (lyrica), are also effective.

Other therapies such as electroconvulsive therapy or lobotomy have not shown significant or favorable effects for personality disorder borderlines, unlike the transcranial magnetic stimulation, which appears as an alternative to electroconvulsive therapy and seems to be useful for this and other cluster C personality disorders.

Borderline personality disorder or BPD has several comorbidly diagnosed disorders such as depression or schizoaffective disorder and other personality disorders such as the following:

• Cluster B is codiagnosed together with histrionic personality disorder or antisocial personality disorder.
• From cluster C as the dependent personality disorder.
• It can even be diagnosed together with cluster A personality disorders such as schizotypy.

To avoid confusion and the labels that come with having multiple diagnoses, it is important to make a good differential diagnosis and rule out other disorders. In the case of personality disorder border line, it will be important to differentiate it correctly from other personality or affective disorders:

• Differences with mood disorders: if both are manifested and the diagnostic criteria are met for both diagnoses, it will be effective. Yes, we will always avoid diagnosing BPD if the problem does not appear in adolescence or adulthood.
• Differences with histrionic personality disorder (HPD): Unlike TPH, BPD is more self-destructive, they make angry ruptures of interpersonal relationships and manifest chronic feelings of emptiness and loneliness.
• Differences with schizotypal personality disorder (SPD): in BPD we can observe the appearance of hallucinations or passing paranoid ideas and interpersonally are more reactive in response to external structures, unlike the TPE that does not manifest these signs.
• Differences with paranoid personality disorder (PPD) and narcissistic personality disorder (NPD): Both disorders (PPD and NPD), unlike BPD, show relative stability in their self-image and lack self-destructive behavior, impulsiveness, or abandonment concerns.
• Differences with antisocial personality disorder (APD): Although both use manipulation, the purpose is different. The goal of patients with BPD is to get attention and interest, while that of patients with APD is to make a profit.
• Differences with Dependent Personality Disorder (PDD): BPD reacts to abandonment with feelings of emptiness, anger and demands for attention, which leads to a pattern of intense and unstable relationships. On the other hand, after a breakup, the TPD quickly seeks a relationship to replace the one that ended and adopts submissive behaviors in their interpersonal relationships.

Differences between BPD and bipolar II disorder

The main differences between bipolar II disorder and personality disorder border line are:

• Beginning: Bipolar disorder has an abrupt onset with spontaneous mood swings, while personality disorder border line it has a gradual onset and mood swings are reactive.
• Symptoms: in the case of BPD, they are dissociative symptoms, and depersonalization, contradiction in speech, interpersonal hyperreactivity, punishment towards the other and self-harm may appear. In bipolar II disorder, psychotic symptoms appear, tachycardias, reactions to internal stimuli, morning depressive symptoms, guilt ideas and serious suicide attempts, with frequent dysfunction cognitive.
• Comorbid disorders: BPD can appear comorbid to sexual identity disorders, while bipolar disorder is more associated with sexual desire disorders.
• Treatment: personality disorder border line It gives a partially good pharmacological response to antidepressants and a poor response to lithium. In contrast, bipolar II disorder offers a good response to lithium and antidepressants for hypomanic phases.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Borderline personality disorder: what is it, causes, symptoms and treatment, we recommend that you enter our category of Personality.

1. American psychiatric association, (2014). Diagnostic and Statistical Manual of Mental Disorders DSM – 5. Madrid Spain. Pan American Medical Publishing.
2. Millon, T. AND. (1997). The Million inventories: Clinical and personality assessment. The Guilford Press.

• Belloch, A., Sandin, B., Ramos, F., (2009). Manual of psychopathology, volume II. Madrid. McGraw Hill / Interamericana de España, S.A.U.