Borderline in men

Borderline Personality Disorder in Men

Borderline Personality Disorder (BPD) is a condition that affects suffers’ ability to control their emotions, maintain relationships, and engage in impulsive and self-harming behaviors.  In the past, BPD was more frequently diagnosed in women than in men.

There are a couple reasons that may have influenced BPD diagnoses: first, pre-established societal biases, which commonly refer to women as being more “emotional” compared to men; and second, women are more likely to seek out mental health treatment while men are more likely to end up in trouble with the authorities for being aggressive and/or violent.

Additionally, men who displayed intense emotions were often misdiagnosed with other disorders instead, such as conduct disorder, attention deficit disorder, oppositional defiant disorder, bipolar disorder, or psychosis. BPD can be challenging to diagnose in women and even more so in men.
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Symptoms of Borderline Personality Disorder

BPD can manifest itself differently in men than in women.   Men with BPD may exhibit paranoid, narcissistic, and antisocial behaviors. BPD in Men may also be expressed through substance abuse or addiction to sex, shopping, or gambling.

Other Signs of BPD in Men

Inability to Commit: While both men and women with BPD experience relationship struggles, some males with BPD may date many women at the same time while refusing to commit to any of their partners out of fear of abandonment. Others may scare their lovers away with aggressive behaviors, extreme jealousy, and quick tempers. Some men may begin to reject all relationships, including friendships.

Blame Shifting: Blame shifting can happen when a man with BPD attributes feelings of failure, disapproval, guilt, and deficiency to other people they hold responsible, often toward those they love. In many cases, the person receiving the blame is either not at fault or contributed to the struggle unknowingly. Men with BPD may struggle to accept responsibility if they are at fault, not knowing how to cope with their overwhelming feelings of guilt and despair.

Being Emotionally Sensitive: Men with BPD may be emotionally sensitive, perceiving most everything as personal attacks, and feeling criticized by any remarks made about them.  I wouldn’t use that word here. It sounds pretty judgmental.

Narcissistic and Controlling Behaviors: Many men with BPD are subconsciously inclined to compensate for the lack of control they feel, or that they experienced as children, by attempting to control all of their adult relationships.  They may make extreme threats to demonstrate their feelings, such as threatening a partner with an affair or actually acting out sexually with others to gain attention.

Boundary Issues: Some men with BPD may struggle to accept boundaries placed on them, sometimes acting forcefully but unwilling to self-regulate.

Treatment for Men with BPD

Men struggling with BPD can find help through proper treatment. Dialectical behavior therapy (DBT) is the most common treatment of borderline personality disorder. It is based on cognitive principles that aim to teach BPD patients how to control the emotions that cause problems in their lives and relationships. DBT consists of both individual sessions and group skills training. Many therapists make themselves available when not in session in the event of any crises and can often be reached by telephone. Treatment may improve your feelings about yourself along with your ability to function.

If you or a loved one exhibits any symptoms of borderline personality disorder, professional treatment can help. If you have a co-occurring problem with drug or alcohol addiction, a residential treatment center could be the best place to begin your recovery. Or, you may need assistance through outpatient treatment programs that teach you how to manage your emotions, behaviors, and thoughts.  Please call us at (310) 455-5258 or submit the form below to learn more about our treatment programs in Los Angeles.

Borderline Personality Disorder in Men

Some mental health conditions are thought to be more prevalent in women. However, men can be just as challenged with the struggles of mental illness. Given the stigma associated with mental health conditions, men are less likely to acknowledge their issues and to seek treatment. Borderline personality disorder in men is a condition that needs more attention, particularly for those men needing help with its impact on their lives.

Difficulty Regulating Emotion

When an individual has difficulties regulating their emotions, they may be diagnosed with a condition known as borderline personality disorder. Those who experience this condition will feel their emotions intensely for long periods of time. It is usually more difficult for them to return to a stable baseline after they’ve gone through an emotionally triggering event.

The inability to regulate emotion can lead to poor self-image, difficult relationships, impulsiveness, and an intensely emotional response to stressors. When a person struggles with self-regulation, they can also engage in dangerous behaviors, including self-harm.

Misdiagnosed in Men

About 1.4% of adults in the US experience borderline personality disorder. Almost three-fourths of those diagnosed are women. However, research suggests that men may be equally affected by the condition but are often misdiagnosed with other mental health conditions such as attention deficit disorder (ADD), conduct disorder, depression, or post-traumatic stress disorder (PTSD).

The National Alliance on Mental Illness (NAMI) suggests that, rather than looking at each symptom separately in a man, the key may be to look at the collection of symptoms as a whole as well as the intensity of the emotions he experiences.

Signs of Borderline Personality Disorder in Men

Borderline personality disorder in men may manifest itself in the following symptoms, which are considered red flags to look for by NAMI.

Numerous and frequent relationships, often close together. A man with borderline personality disorder will experience a fear of abandonment and, as a result, refuse to commit to a romantic relationship. He may have multiple relationships, close together, that end after an argument or when he scares his partner away with a quick temper and possible physical aggression. He will have issues with controlling his emotions which often results in a quick ending to the relationship. He will then move on to a new relationship relatively quickly.

Behaviors and attitudes filled with drama. Women are usually thought of as being dramatic, but men can be so as well. Their drama will look a little different, though. A man with borderline personality disorder will have fluctuating emotions that can range from respect and idealizing someone to becoming emotionally detached and resentful. This drama can also affect a man’s frequent and turbulent romantic relationships.

Thoughts, behaviors, and emotions that are constantly up and down. A man with borderline personality disorder can change quickly from being warm and loving to being cold and distant, even angry and hostile. He can exhibit a stable and consistent pattern of behavior for a while and then suddenly change into what may seem like a completely different person.

Behaviors that seem designed to draw attention. Men with borderline personality disorder seem to want attention. They will engage in self-destructive behaviors, such as cutting, and then draw attention to the fact that they have done so. They may exhibit a loud attitude, make accusations of being unloved and abandoned, or be aggressive in an effort to gain attention. Other risky behaviors can be unprotected sex, fathering children with different women, and making threats to keep everyone afraid of him.

Dependency and co-dependency. An individual’s fear of abandonment can make it difficult for him to maintain a healthy, safe, and satisfying relationship. In contrast, he may engage in a dependent or co-dependent relationship with someone who relies on him, emotionally and psychologically. The relationship is dependent on his partner, who may be just as psychologically and emotionally unstable as the man with borderline personality disorder.

Manipulating loved ones with suicide threats or attempts. In an effort to manipulate a loved one or to convince them that he is lovable, a man with borderline personality disorder may threaten suicide. For example, a man who becomes jealous of his wife talking to another man may threaten suicide if she does not stop talking to him.

Suicidal thoughts that alleviate the pain. Some men will seriously consider suicide when the symptoms of their mental health condition cause difficulties in their life. Their pain and their fear of abandonment is so intensified that their suicidal thoughts may temporarily comfort them.  

Mental Health Treatment for Men at PACE

When you are experiencing the symptoms of a mental health condition such as borderline personality disorder, it is time to reach out to the professionals at PACE Recovery. Asking for help is a sign of strength. We optimize your recovery success with integrated treatment that will address both your mental health and substance use issues. We address your whole person, including your spiritual, medical, psychosocial, and relational facets.

At PACE, we understand the challenges you are facing during this period of isolation and uncertainty. We’re here to help. Our men’s-only programming has transformed hundreds of lives over the years, and we believe that you can recover. To learn more about our mental health and addiction services, contact our Admissions team.

Borderline personality disorder: symptoms, treatment, communication tips

  • What is it
  • Test
  • Symptoms
  • Causes and risk factors
  • Is it being treated
  • How to communicate with a person with BPD
  • Expert commentary

What is borderline personality disorder

Borderline personality disorder (BPD) inevitably affects how a person thinks and feels, how he interacts with others [1]. The diagnosis is recorded in the ICD-10 and is considered a subspecies of an emotionally unstable personality disorder. The disorder manifests itself in problems with self-esteem, the management of emotions and behavior, high anxiety and desocialization, and leads to unstable relationships with others. With borderline personality disorder, a person experiences a fear of being alone or abandoned. Misplaced anger, impulsiveness, frequent mood swings can alienate potential partners. nine0021

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Deviations are usually recorded in young people and may worsen with age. However, many patients diagnosed with BPD are able to live a full life, having worked through the main problems.

Borderline Personality Disorder Test

Some of the symptoms may point directly to BPD, but only the attending physician will give exact information. If you suspect you have a disorder, answer a few questions:

  1. Do you have a fear of being alone that makes you act inappropriately? For example, constantly call a partner, try to be always near him.
  2. Have you had to change your mind drastically in relation to your partner, to move from love to hatred for no particular reason?
  3. Have you ever felt that you do not have a clear idea of ​​yourself, that you are not sure of your self-worth?
  4. Have you committed impulsive dangerous acts? For example, have you taken drugs, spent large sums of money recklessly, or had unprotected sex? nine0004
  5. Have you harmed yourself, threatened suicide in the presence of loved ones?
  6. Do you experience severe mood swings, from anxiety and irritability to days of depression and apathy?
  7. Do you find it difficult to control your anger?
  8. When you find yourself in a stressful situation, do you feel as if you are disconnected from reality and your own body, do not control your thoughts and behavior?

If you answered "yes" to more questions, it makes sense to talk to a psychotherapist. Symptoms do not always point to borderline personality disorder and may be due to other health problems. Only a specialist can make a correct diagnosis and give competent advice. nine0021

© Yuris Alhumaydy/Unsplash

Symptoms of borderline personality disorder

BPD affects how a person relates to himself and others, and how he behaves in society. Signs and symptoms vary, there may be several or just a couple from the list [2]:

  1. Strong fear of being abandoned. A person is ready to go to extreme measures to avoid the real or imagined withdrawal or rejection of a partner.
  2. Tendency to unstable relationships. For example, a person idealizes a partner, but at some point suddenly decides that the latter is cruel and unfair. nine0004
  3. Rapid changes in self-identification and self-esteem. Goals and values ​​switch disproportionately to the circumstances - abruptly and for no particular reason. A person tends to consider himself bad, he needs impulses from the outside in order to feel alive and needed.
  4. Stress related paranoia. Loss of contact with reality lasting from several minutes to several hours.
  5. Impulsive behavior, propensity to take risks. Gambling, reckless driving, unsafe sex, alcohol abuse, overeating, drugs. nine0004
  6. Success sabotage. Sudden unreasonable rejection of positive relationships, good work.
  7. Self-mutilation, suicidal tendencies. Often occur in response to separation anxiety or partner rejection.
  8. Sudden mood swings lasting from several hours to several days. Bright, hypertrophied emotions: happiness, anxiety, shame and irritability.
  9. Constantly accompanying feeling of emptiness, lack of interest in what is happening. nine0004
  10. Aggression - strong anger, cruel sarcastic remarks to interlocutors, fights.

Causes and risk factors

As with other mental health problems, the causes of borderline personality disorder are not fully understood. In addition to circumstances such as childhood abuse or neglect, borderline personality disorder may be associated with the following factors.

  1. Genetics. Studies involving twins and their relatives suggest that BPD may be inherited and be part of a mental health complex [3]. nine0004
  2. Anomalies of the brain. Several studies have confirmed changes in certain parts of the brain involved in the regulation of emotions, especially impulsivity and aggression [4]. Patients with BPD may have malfunctions in the regulation of chemicals, such as the production of serotonin, which affects mood.

Is there a cure for borderline personality disorder

BPD is difficult to treat. But with the help of modern, evidence-based therapies, people with the disorder can be helped to manage their symptoms and improve their quality of life. It is good if the treatment is carried out by a licensed doctor who specializes in this disease. Sometimes the patient will need to interact not only with a psychiatrist, but also with a social worker who will help to adapt in the absence of loved ones. nine0021

The doctor usually conducts an interview and discusses the person's symptoms. Then there is a thorough medical examination and testing, which allows you to exclude other diseases. Comorbid disorders can make BPD difficult to diagnose and treat, especially if their symptoms overlap. For example, a person may show signs of depression, bipolar disorder, anxiety, substance use problems, or eating disorders. If a patient with borderline personality disorder does not receive proper treatment, they are more likely to develop chronic illnesses. And not only mentally, but also physically - patients with BPD tend to make choices in favor of an unhealthy lifestyle and self-harm. nine0021

Psychotherapy is the first line of treatment for a person with BPD. It can take place both individually and in a group. The second option helps the patient to interact with other people and express himself in society. Most often, the doctor uses one of two therapy options, or combines them:

  1. Dialectical Behavioral Therapy (DBT). It uses the concepts of awareness and acceptance of the current situation and emotional state. DBT also teaches skills to control and reduce self-destructive behavior. nine0004
  2. Cognitive behavioral therapy (CBT). This type of assistance allows you to identify and change the core beliefs that underlie inaccurate acceptance of yourself and others, as well as problems associated with communication.

Because their benefits are unclear, medications are not commonly used as the primary treatment for borderline personality disorder. However, in some cases, a psychiatrist may recommend medications to treat certain symptoms, such as controlling mood swings and depression. The psychotherapist should specialize in borderline personality disorder, that is, receive additional education in this area. nine0021

How to communicate with a person with BPD

People with BPD are often very suspicious and vulnerable. They need support, and it is important for them to realize that they have someone to turn to in case of exacerbations. Eliza Gordezki, a writer, artist and queer feminist with BPD, has developed a manual for interacting with people who have been diagnosed with BPD [5]. Here are the main recommendations.

Tell loved ones that you will take care of them

People with BPD tend to think that if they do not hear this confirmation, then others around them are indifferent. Suitable phrases:

  • "Just writing to you to tell you I care about you."
  • "I wanted you to know that I'm thinking of you right now."
  • "I really like having you in my life and I wanted to make sure you knew that."

Take an interest in well-being and affairs

For people with BPD, this is a vicious circle: they are afraid of being rejected, so they do not share their experiences in order to eliminate the risks of negative reactions from others. Asking how you are doing is a good strategy for making contact. nine0021

  • “Hi, how are you?”
  • “I saw you posted a sad post on Facebook. I wanted to make sure you were okay."

Soften bad news with support and sympathy

When you tell your loved one some unpleasant information, try to remind him that he is important to you and that you will support him in any case. A person with BPD needs to be aware that his feelings are taken into account and not perceived as something feigned.

  • "It's not easy for me to support you in this crisis, but I need to know what to do to make it easier for you to deal with it."

Match words

Marsha Linehan, who developed the Dialectical Behavior Model (one of the most common treatments for people with BPD), uses specific vocabulary in her manuals [6]. Rather than characterize a person or their actions with judgmental words, she prefers adjectives such as "efficient, skillful, and wise" (or the reverse, "inefficient, inept, and unwise"). These words separate a person from his behavior, they name qualities that can be changed. If someone is being violent, negative, or insulting, you can say something like:

  • “I can see you're upset. I understand why you are upset, but these actions are very inefficient and will not bring you the desired results. Let's think together how we can achieve greater sense and achieve the desired prospects.

Compare this phrase with those that many people are used to using in similar situations: “It's not normal if you react like that!”, “It's impossible to communicate with you, there is too much drama”, “Why are you overreacting? You are always so sensitive!” nine0021

© Pavel Danilyuk/Pexels

Be attentive to triggers

The only way to determine what is bothering a loved one is to ask and observe. Among people with BPD, two triggers are common (eng. trigger - a reason, a trigger; in psychology - an irritant that causes a certain reaction) - to be thrown and to be rejected. Simple situations that most people are used to can cause a strong negative reaction with borderline personality disorder. For example, if you reschedule a meeting or began to devote more time to other things, did not respond to a message for a long time, or forgot to call. Of course, changing plans is normal, but when communicating with a person with BPD, it is worth taking a little time to explain your actions to him:

  • “I remember that we planned to meet on Friday and have dinner together, and I'm sorry, but I have to cancel this meeting. I was assigned to make an urgent report, and I will be at work all evening. It will be great if, along with the cancellation of plans, you offer a quick alternative: “But I really want to spend time with you! Maybe we can meet on Saturday for lunch?

Repeat and confirm

People with BPD need to be reminded of your positive attitude. Frequent reinforcement and support is an important part of their well-being and confidence in the world. Be patient and focus on good moments, convince your loved one if he breaks into negative emotions, even if it seems to you that they are unreasonable. For example, your friend is upset that they don't reply to a message. At this point, he may seriously believe that the interlocutor hates him. Inform that this is not the case, most likely, the person is just busy, he will definitely write or call as soon as he has time. nine0021

What works well for one person may not work for another, so it's always best to talk to your loved ones and ask what they need.

Expert comment

Andrey Yudin, psychologist, Gestalt therapist, co-founder of Stemning Gestalt Center

It is not always possible to build relationships with a person with BPD [7]. But if it's not a destructive abusive relationship and it's important for you to keep the relationship going, you need to put in a lot of effort. First of all, set boundaries - when you can come or call, whether you can shout. Sometimes it can take years to rebuild, especially when it comes to older relatives. It will take a lot of labor and therapeutic support. nine0021

Borderline personality disorder is one of the three basic personality disorders in modern psychotherapy, the other two being schizoid and narcissistic. BPD is the most well studied and isolated, it is in the public eye due to its clinical manifestations. The disorder is included in the ICD-10, but the difficulty lies in the lack of uniform criteria for the diagnosis. There are three obvious signs of borderline personality disorder:

  • The person does not take care of himself. For example, he does not visit doctors, while experiencing guilt and shame for his choice. This factor applies to both hygiene and personal relationships. nine0004
  • Approach speed. People with BPD tend to quickly make contacts and just as quickly become disillusioned with new acquaintances, friends, and romantic relationships.
  • Extreme fear of rejection. If a person is afraid of being abandoned, being rejected by relatives, friends or partners, then this is a clear sign of BPD.

In BPD, there is a clear lack of self-activation - inducing oneself to some kind of action. At the same time, it is difficult for a person to explain to himself why he cannot do this. Trying to rouse himself to action, he begins to worry. Borderline personality disorder begins in childhood, between 16 and 24 months. It is often the result of severe abuse, physical, emotional or sexual abuse, or a parent's negative response to a child's need for emotional closeness. In the case of premature separation, a mental structure is formed from two separate parts, which normally should be integrated into each other, but in BPD these are two separate modules. nine0021

BPD is often associated with drug addiction. Suffering, feelings of frustration, dissatisfaction encourage a person to chemically regulate his emotional state. This is alcohol, and drugs, and self-damaging behavior, and not only in relation to the body. For example, a person can spend all the money on payday.

With regard to BPD during adolescence, for this stage of human development, many of the "symptoms" are actually normal behavior. Severe emotional experiences, dulling the sense of self-preservation, experiments with substances and partners. But from the age of 16-18, when the transitional stage has been passed, the persistence of these signs may be a reason to contact a specialist. nine0021

Those close to people with BPD face, first of all, their emotional instability. The biggest difficulty is the chaotic influence on the lives of others. If a person with a narcissistic disorder extends his suspiciousness to the assessments of others, then with BPD people tend to have a different focus - love / not love, rejection / acceptance. A person may try to return the location of the partner or play ahead of the curve - break off the relationship, if he assumes that he may be abandoned. People with BPD may become abusers because of the unbearable emotional experiences they are trying to change in this way. nine0021

In the professional field, BPD can be suspected, for example, in rock stars. Moreover, the presence of such a feature for people in this profession will even be a plus. There will be a lot of life and pain in their work, it is very sincere and can be healing for other people.

If you encounter a person with BPD at work—a boss, a colleague, a subordinate—they are likely to have fairly loose boundaries because they find it difficult to set and maintain them. This may be a person who perfidiously treats other people's borders or, conversely, distances himself and avoids communication. People with BPD are very successful. Such bosses have reactive behavior, chaos in the department, and many will be uncomfortable. But there are qualities in BPD that are good for management: empathy, intuition, even being aggressive can be an asset for career advancement. nine0021

The diagnosis and treatment of borderline personality disorder requires a specific set of skills that are not taught in psychology departments, at least not in basic education programs. Most psychologists do not have such qualifications; a maximum of 10% of practicing specialists have it. Therefore, educational work is especially important so that people can find the understanding and support that are so needed. The peculiarity of therapy for BPD will be directed to the very two modules of consciousness (patterns) of the patient. A person with BPD may go to the doctor from their positive childhood pattern and talk about how well the treatment is working. He does this because he is used to being held in relationships in this way, he has learned that he must give positive emotional nourishment "so as not to be abandoned." The therapist must frustrate this pattern, help to go beyond it. At the other extreme, a person with BPD goes into denial, gets angry, behaves aggressively. It is important that the doctor is able to recognize these signs. nine0021

Any effective therapy for BPD is a progression along the spectrum towards normal functioning. The prognosis of treatment is quite positive, it is wrong to call BPD an incurable lifelong disorder, as was believed in past years. Much has changed, and in almost all cases, if a person has access to therapy and is willing to work, most of the symptoms can be eliminated within 2-4 years. With narcissism, successful therapy takes 5-7 years.

Borderline personality disorder, symptoms, causes, diagnosis, treatment

Borderline Personality Disorder (abbreviated as BPD ) is increasingly common among children today. The pathogenesis of this type of psychopathy is usually accompanied by a complex of unfavorable factors.

It is quite difficult to recognize this type of disease in everyday life. Often, it is confused with narcissism or simply the bad character of the individual, since the behavior of the "border guards" can be characterized by an extreme degree of unpredictability and hysteria, as well as a tendency to manipulation. For example, they confess their love to a partner, and after a couple of hours they leave “forever”, they can sincerely sympathize with someone, and then hit. It is also very common for patients of this type to constantly violate the boundaries of other people, shifting their problems onto them, and avoiding responsibility. Consider the symptoms of borderline in more detail. nine0021

Symptoms of borderline personality disorder (BPD)

The main symptomatic difference of this type of disorder is prolonged abnormal behavior of the patient .

While in many other psychopathy periods of instability alternate with remission, in the case of BPD the patient behaves destructively over a long period of time. In the field of psychological anomalies are such manifestations as:

  • aggressive behavior leading to problems in relationships,
  • unstable emotional background and inadequate self-image,
  • high anxiety,
  • total fear of loneliness and permanent feeling of boredom,
  • dichotomous thinking and changeable mood, dividing the world only into “black and white” (today I love, but tomorrow I hate).

Also among the main symptoms can be noted: sociopathy and fear of society associated with low self-esteem and, as a result, separation anxiety (it is experienced by a person when separated from home or loved ones). Patients often exhibit reckless irresponsible "risky" behavior, the extreme form of which may be self-harm or suicide attempt. nine0021

Types of spontaneous actions that accompany mental borderline personality disorders

Due to difficulties in self-identification, lack of one's own opinion and a tendency to polarity, spontaneous destructive actions are characteristic of BPD sufferers.

Panic fear of loneliness and lack of an inner core pushes them into contact with sociopathic personalities who are characterized by destructive behavior: gambling, theft, vandalism, promiscuous relationships, drug addiction. This also includes self-harm, which was mentioned above. nine0021

One of the reasons for this uncontrolled behavior is the problem with holding the inner impulse. The level of impulsivity is so high that a person is not able to control it.

Andrey Nikolaevich Cherednichenko

The chief physician of the Korsakov medical centers network, psychiatrist-narcologist

  • Experience more than 11 years


Records for taking

Emotionally unstable personality disorder

in the ICD of the 10th review Border Guard personality disorder is defined as "Emotionally unstable personality disorder (F60.3)". In the clinical community on the territory of the Russian Federation, this name is used quite often and is used due to the fact that the main symptom, as described above, manifests itself in the form of an emotionally unstable mental state of a person. nine0021

Pathogenesis of BPD

In the pathogenesis of the disease lies an incorrectly or incompletely formed intrapersonal self-awareness, in other words, “self-identification”. Border guards hardly realize how they relate to the main areas of life. They have problems with the concept of their opinions, interests, hobbies, and their character as well. Hence the more common definition of the disorder - "borderline". In this aspect, it means maneuvering on the verge between psychopathy and a stable state. The word "borderline" in a particular case means a precarious state between the norm and deviation, as if a person lives on the verge between "mental illness" (psychosis) and "mental health". That is why, the slang name for patients of this type is “borderliners” (from the English expression “border line”, which literally translates as “border”). nine0021

In classical psychiatry, borderline personality disorder is also classified as an ego syntonic disorder. Ego syntonicity implies that the patient does not assess his condition as painful, is not critical of him and calmly accepts deviations in behavior, not believing that they harm him in any way. Moreover, the patient, as it were, “defends” his symptom, preventing his own cure due to the difficulty in identifying his own “I”.

Causes of BPD

The underlying causes of BPD are currently not clearly defined, however, like most other disorders, BPD is caused by a group of factors. nine0021

Hereditary (genetic determinism), physiological (disturbances in the brain) and social factors (low stress resistance and psychological traumatic factor).

Unfavorable social environment

According to statistics, groups of people exposed to an unfavorable social environment, for example, in the family, are more susceptible to the disease. These include:

  • difficult childhood,
  • abuse,
  • nine0003 tyranny,
  • physical or emotional domestic violence,
  • early loss of parents.

It is worth noting that "borderliness" occurs 3 times more often among women than among men.

Post-traumatic stress disorder (PTSD) , as a variation of an unfavorable social factor, can be not only a cause, but also a concomitant individual disease that is in a pathogenetic relationship with the diagnosis in question. nine0021

Childhood chronic emotional trauma can contribute to the development of BPD, but in rare cases it is the only cause. Personal qualities that are responsible for the ability to cope with a stressful situation in this aspect also play a big role. Here it is worth noting that, according to statistics, an injury received in childhood (especially before the age of 10) can lead to a subsequent disorder much more likely than an injury received at an older age. Also, scientists note that situations not associated with direct violence, such as natural disasters or catastrophes, are less likely to lead to the development of post-traumatic syndrome. nine0021


Another group of factors considers a possible cause of the development of the disease - disorders in the work of neural brain connections, namely the destruction of the functioning of the frontal-limbic neurons


diagnosis. It is quite difficult to achieve clear indicators in this vein, however, according to European studies, BPD is located in 3rd place out of 10 in terms of the genetic determinant among personality disorders. It is logical to note that deviations in the work of certain parts of the brain can be inherited and lead to a number of psychological problems, the development of which is aggravated by the social factor. Most studies show that most often borderlineness is transmitted from the mother. nine0021

Borderline mental state in psychiatry and severity of personality disorders

In clinical psychiatry, three levels of mental disorder are traditionally distinguished:

  • Neurotic . These include neuroses of a different nature, implying reversible temporary conditions that can be treated.
  • Psychopathic level . In its plane lie personality disorders, which include anomalies in the nature of various pathogenesis or painful changes in its features, with which nothing can be done, since they relate to the personality structure of the individual. nine0004
  • Finally, the deepest lesion of the psyche manifests itself at the psychotic level . This includes such manifestations as delirium, hallucinations, twilight consciousness.

Modern psychoanalysis distinguishes 4 levels of deviations. Between the state of psychosis and neurosis, it is conditionally located just “ borderline level”, also called borderline state . A borderline state can mean both the disorder itself and the designation of the level of mental damage. nine0021

How to reliably identify borderline personality disorder (BPD)

Borderline personality disorder is extremely difficult to diagnose and differentiate, as it has a high level of comorbidity, in other words, it is combined with a large number of concomitant disorders. For example, panic anxiety, eating disorders, bipolar affective disorder, attention deficit disorder, sociopathy, and so on. In connection with the above, the patient has to undergo a long diagnostic process and special tests. nine0021

Borderline personality disorder BPD test

One of the fairly popular tools for detecting the presence of psychopathy are tests, which are, in fact, a personality questionnaire. Used in modern clinical psychology, a test for screening for the bright signs of BPD was developed in 2012 by a group of scientists. In their work, the authors relied on the basic criteria for differentiating borderline disorder.

The questionnaire edited by them is a fairly effective tool for diagnostic verification and confirmation of symptoms. It is used both in psychiatric and general clinical, and in other practices that are not directly related to medicine. nine0021

The test itself consists of 20 questions and asks the subject to answer only yes or no. For each answer, the system counts a certain number of points. The probability of diagnosing BPD appears if the respondent scored more than 25 points.

Treatment of borderline personality disorder (BPD)

Cherednichenko Andrey Nikolaevich

Chief physician of the network of medical centers "Korsakov", psychiatrist-narcologist

  • Experience over 11 years



Like most other mental disorders, borderline disorder is not treated at home and requires complex professional therapy, including both medication (taking antidepressants and antipsychotics) and psychotherapy. And only a psychiatrist, often in tandem with a clinical psychologist, can competently develop an effective course of treatment.

The drug course is developed in accordance with the individual characteristics of the patient's body and includes the following drug groups:

  1. Selective inhibitors are aimed at preventing depressive episodes and reducing anxiety/panic/borderline states.
  2. Mood stabilizers .

    One of the most popular remedies is Lamotrigine. It is also used to neutralize depression, mood lability and impulsivity.

  3. Atypical antipsychotics .

    Now the 2nd generation of drugs of this cluster has already been developed, which have proven themselves well in neutralizing the symptoms of the cognitive sphere, such as: aggression, distortion of reality perception, paranoia, thought dichotomy and disorganization. nine0021

    As for the group of benzodiazepines and stimulants, they are used in modern therapy extremely rarely due to the high risk of dependence and, accordingly, overdose.

Thus, the main task of drug therapy in borderline personality disorder is to reduce the severity of symptoms and alleviate the general condition of the patient.

It is worth noting that BPD is the most difficult to treat due to the patient's ego syntony, which we discussed above. It is the patient with BPD who is the most difficult to respond to any therapy due to the rigidity of the psyche and the clear conviction that everything is generally normal with them. nine0021

However, when it comes to Selective Inhibitors, Dialectical Behavioral Therapy (DBT), one of the varieties of Cognitive Behavioral Therapy (CBT), is considered the most effective method in the modern clinical community. As part of the treatment, the patient is taught to look at the problem from different points of view and evaluate the causal relationship in different ways. Due to satisfaction with their symptoms and rigidity, "border guards" are difficult to treat, so the psychotherapeutic process can be lengthy. nine0021

Most often, relatives suffer the most from relationships with patients with BPD, so another parameter that the specialist works on is the patient's socialization and adaptation, aimed at developing fundamental life skills and developing an adequate behavior for the situation. In psychiatry, this type of technique is called STEPPS (System Training Emotional Predictability & Problem Solution) and in translation means Systematic Training in Emotional Predictability and Problem Solving. nine0021

One of the well-established methods are meditation techniques aimed at teaching a person to control their emotions and the ability to relax.

Another effective method when working with a psychotraumatic factor is considered to be gelstat techniques, during which the patient returns to a stressful situation and looks at it from the other side, rebuilding the scenario or acting it out again. The task of a specialist in this aspect is to remove the negative emotional charge from the memory.

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