What is borderline personality disorder?

Borderline personality disorder (BPD) is characterized by great instability in social relationships, personal image and emotions, as well as a marked impulsivity. People suffering from borderline personality disorder maintain very unstable and intense sentimental relationships, where there is a step from love and idealization to hate. They experience great concern about the possible end of the relationship, with frantic efforts to avoid real or imagined abandonment. As for the personal image, they have difficulties to define themselves, they present frequent changes in their values, their ideals, their personal and professional aspirations. Emotionally, they have frequent outbursts of anger, easily move from one emotion to another and often experience a feeling of chronic emptiness (meaninglessness in life).

What characterizes borderline personality disorder?

People with BPD usually exhibit some of these behaviors: impulsive acts related to excessive spending of money, theft, alcohol and drug use, risky sexual behavior, gambling, etc., violent behaviors related to anger attacks that arise unexpectedly , self-harm (cuts, burns …), threats of suicide and attempts to end one’s life, frantic efforts to curb both real and imagined sentimental abandonment, unpredictable actions, put an end to relationships on matters of minor importance and give Frequent solo walks to reflect.

Emotionally, they are usually characterized by experiencing intense emotions that vary in minutes or hours, a chronic feeling of emptiness and boredom, frequent attacks of anger that are difficult to control, feelings of admiration for people around you that in a few days give way to hate, contempt, rejection; they feel terror of loneliness, experience contradictory emotions during the same period of time, a constant feeling of lack of affection and attention, an intense feeling of shame, hatred and anger towards themselves and tend to inhibit the negative emotions especially associated with pain and loss (sadness, guilt, shame, anxiety or panic).

On a cognitive level, there are extreme assessments in the way of valuing themselves and others (good / bad, hero / villain, intelligent / stupid, etc.) that change in a matter of hours or days, constant fluctuations of expectations in the interpersonal relationships, anticipatory thoughts of abandonment, attribution of responsibility for negative events to the environment (family, friends, etc.), frequent self-reproaches, self-criticisms and self-criticisms, life values, variable and unstable personal and professional goals (for example, change career, religion, etc.), lack of a stable sense of who they are and difficulties in learning from past experiences. They may have a class of small psychotic episodes (hallucinations, delusions) when they are in stressful situations.

What are the consequences of borderline personality disorder in those who suffer from it?

Borderline personality disorder has negative consequences in almost all areas of the life of those who suffer from it. The constant changes of mood, the exorbitant sentimental expressions, the attacks of fury, the continuous demands and reproaches, the sway of feelings of love and hate towards those around him, make the relations (of couple, friendship, family) with a person with BPD are difficult to maintain. So many times they are really alone or with one or two people who form their social or support network.

At the occupational level, they may not stay in the studies, change jobs frequently, be fired for continued quarrels with their superiors or colleagues, small robberies, punctuality, etc.

On a personal level, people with BPD have difficulty understanding what emotions they are feeling and as a result of what they have produced. They find it almost impossible to maintain self-confidence, due to instability in their ideals, tastes, interests, identity. Numerous criticisms and self-reproaches are directed, so they usually have low self-esteem and little affection for themselves. They often feel hurt by others, vulnerable to the opinions of others, misunderstood.

In general, the BPD causes a feeling of almost constant discomfort and suffering in the person and an existential vacuum that can lead to suicidal behaviors and self-injurious acts (for example, cuts, burns).

Taking into account the consequences that the TLP can have on the person’s life, it is advisable to request professional help if you think you have a BPD (or if you think that someone close to you may suffer). An early evaluation and intervention benefits the prognosis and evolution of the disorder.

What other mental disorders can occur at the same time as borderline personality disorder?

People with BPD usually have other psychological disorders that occur in conjunction with the borderline disorder, the most common being: consumption of psychoactive substances, eating disorders (anorexia, bulimia, etc.), impulse control disorders (gambling, kleptomania, etc.), attention deficit disorder, posttraumatic stress disorder and major depression.

What are the causes of borderline personality disorder?

At present, the causes of BPD are still unknown. However, there are different proposals based on the high percentage of patients with BPD who present certain circumstances (or attributes) in their life history or personal characteristics. Among these circumstances are the separations in childhood of the people of attachment, alteration in terms of commitment to children and their care, history of child abuse, vulnerable or sensitive temperament; predisposition of the family to suffer from psychiatric disorders and neurological or biochemical alterations.

A biosocial model that would explain the origin of BPD argues that people with BPD biologically experience emotions in a more intense and lasting way than those who do not. This “emotional sensitivity” would be joined by a family environment in which these types of emotional responses are punished or disregarded. When the family environment invalidates these emotional responses, instead of teaching skills to properly handle emotions, the person has a high probability of having difficulties coping with disturbing feelings, feelings of guilt and stigmatization such as “I am a weirdo” may appear (for having a high emotionality) and they have to interpret the situations not based on what they feel but on how they think they should feel.

What could a person with borderline personality disorder do?

When you are diagnosed with a BPD, or think you are suffering from it, it is important to ask for psychological help. An early evaluation and intervention favors the prognosis of the disorder.

When a person with BPD goes to the psychologist, he is evaluated through a series of tests and one or more diagnostic interviews. This evaluation process is necessary to determine whether or not there is a BPD and see what other symptoms (of other possible disorders) the person presents. Once the evaluation is finished, the psychologist will design a specific treatment program to address the BPD as well as the associated symptomatology. In patients with BPD, therapy is primarily aimed at managing emotions and impulsive behaviors, as well as suicidal behaviors.

Psychological treatment for the family is also important. It is necessary that those who live with the patient understand what the BPD is and what may be some more appropriate ways of dealing with the characteristics of this disorder, so that they do not prevent him from continuing with his own life and in turn maintain better levels of relationship with your loved ones.

What treatments are there for borderline personality disorder?

The treatment of choice for BPD is psychological intervention. Specifically, therapy in patients with BPD should be aimed at containing impulsivity and managing emotions. There are currently different types of psychological intervention (for example, cognitive behavioral therapy, cognitive therapy, schema-centered therapy, mindfulness, mind-solving training, iconic therapy), however, the What has been most effective is dialectical behavior therapy (DBT). The DBT is based on many of the principles and techniques of the cognitive behavioral approach of Psychology and integrates the dialectical orientation and Zen practice. It is effective in significantly reducing suicidal behaviors, self-harm, income in mental health devices, feelings of hopelessness, adherence to treatment and social adjustment.