How many types of borderline personality disorder are there

About 70% of people with borderline personality disorder make at least one suicide attempt during their lifetime. Seeking help in a timely manner can prevent you or your loved one from being part of these statistics.

Although there is no cure for borderline personality disorder, therapy and certain medications (such as antidepressants, mood stabilizers, and neuroleptics) can reduce the frightening and overwhelming symptoms of this serious disorder. If you or your loved one suffers from any of the BPD subtypes presented here, you must find an effective treatment plan. nine0003

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Borderline Personality Disorder (BPD) | Rehab Family Clinic

It is impossible to say that borderline personality disorder affects a certain layer of society. It affects both men and women, and adults, and children. It needs to be diagnosed in time, because the statistics of this disease are depressing - 1 out of 10 patients with this disorder commits suicide.

What is borderline personality disorder?

Borderline Personality Disorder (BPD) is a mental disorder in which a person is characterized by emotional instability and low self-control. A patient with this diagnosis is inherent in the fear of loneliness, at the same time he is absolutely not social - it is difficult for him to establish relationships with people, he is afraid of being misunderstood and rejected. nine0003

In general, abnormal behavior in BPD can be confused with another disorder, but this disease is distinguished by the fact that all the negative emotions of a person are directed at themselves. He does not seek to harm the people around him - they simply scare him. But he also cannot be left alone with himself.

Borderline disorder can be recognized by a non-standard attitude to the outside world: a person is overly impulsive, any failure, even the smallest one, will be perceived as a huge tragedy. For example, a person with BPD who is a couple of minutes late for a meeting will not be able to behave calmly at the event itself - he will be nervous and blame himself for ruining everything. Although, in fact, this is not the case. nine0003

The instability of emotions is also inherent in these people - nervousness is felt in all actions, they can react emphatically cheerfully to some positive events, but the reaction is very similar to a simulated one. Negative emotions are also experienced very sharply, others may think that a person with BPD is trying to attract attention to himself.

Always side by side with borderline personality disorder is social maladaptation. People with BPD are very dependent on the opinions of others, they blame themselves for all the troubles, so at some point it becomes easier for them to protect themselves from society, but they cannot be alone either, so a personal collapse occurs. In general, the "border guard" in any society is bored, he cannot find a place for himself in a noisy company. nine0003

BPD divides the sufferer's personality in two - constant fluctuations between self-hatred and excessive idealization also distinguish people with this disorder.

According to ICD-10, borderline personality disorder is a subspecies of emotionally unstable personality disorder. The diagnosis is officially recognized by psychiatrists all over the world. Although, a few decades ago, he was stigmatized both in the world of psychiatry and in society. Today the situation has changed, and the attitude towards BPD has become much more conscious and attentive. nine0003

The term appeared thanks to a group of American psychologists who conducted research in 1968-1980. The result of these works was the recognition of BPD as a separate mental disorder. And borderline personality disorder in the ICD-10 was included by specialists.

Any patient with this disorder is very sensitive in relation to other people - he is sensitive to any fluctuations in society, worries about what opinion others build towards him. Due to frequent lifestyle changes and emotional swings, people with BPD feel insecure in life. Often, thinking about their lives, they are overwhelmed with despair, which in most cases leads to depression. It is difficult for people with this disorder to choose their own life path. They are characterized by uncertainty about their personality, which has no core. nine0003

Borderline mental personality disorder generates high impulsiveness in a person. This leads to behavior that causes great damage to the patient: many dabble in gambling, may become addicted to alcohol or drugs, become prone to eating disorders, and commit theft. BPD can take many forms. It is characterized by instability, strong and sudden changes in feelings, mood, relationships, self-image and behavior. A person's impulsivity is expressed in affective instability and can manifest itself in at least two areas that, for a person with a borderline mental disorder, are potentially self-damaging: spending money, sex, drug addiction, theft, reckless driving, carousing. nine0003

It is wrong to assume that people with BPD manipulate loved ones with whims and threats of suicide. They thus express their lack of additional support and acceptance. They do not behave this way on purpose, they do not deliberately try to attract attention, to get some kind of benefit. Most often, they try to eradicate these feelings in themselves so that others do not consider such behavior demonstrative.

Borderline personality disorder (ICD code for it with the letter F) causes a person to oscillate between two extremes - "everything is very good" or "everything is very bad." That is how they feel about themselves. Therefore, one of the main researchers of this disorder, A. Stern, introduced the term "narcissism" - this is the idealization that occurs in a person with BPD in the stage of self-love. The scientist also appeals to the concept of "mental bleeding". It correlates with impotence in crisis situations, implies a tendency to compliance. nine0003

Borderline disorder, in simple terms, is a mental illness that can take many forms. It is characterized by instability, strong and sudden changes in feelings, mood, relationships, self-image and behavior.

BPD is characterized by recurrent suicidal thoughts in the patient, attempts to injure and mutilate oneself (cuts, cauterization), frequent emotional overreactions, or abrupt mood swings, including depression, irritability, or anxiety. These shifts usually last for several hours, and in some cases from 1 to 2 days. Borderline mental disorders give rise to a feeling of emptiness in a person. Sometimes paranoia can appear - suspicion of other people and a sense of loss of reality. nine0003

The disorder can occur most often in adulthood, statistics indicate a border between 17 and 25 years of age. The first signs of BPD may appear as early as childhood. Due to the fact that the psyche of children has not yet been formed, this disorder is diagnosed not in childhood, but in adolescence.

To fully appreciate the severity of the disease, it would be appropriate to give statistics on the connection between suicide and BPD:

• A third of all suicides are committed by people with borderline psychological disorders. nine0020
• The lifetime risk of suicide for people with BPD is as high as 10%.
• The greatest risk of suicide in violation is at a young age (15-30 years).
• Suicide in the disorder can have a particular burden on others: 44% of BPD suicides are committed in the presence of other people, compared with 17% for people with other diagnoses.

The disorder is difficult to diagnose because it can manifest itself in many forms that are often difficult to compare. nine0003

The general classification of all types of this type of disorder is as follows:

1. The dominant affect is anger.
2. Inability to build interpersonal relationships.
3. Self rejection.
4. One of the main manifestations is depression.

The essence of borderline personality disorder lies in the fact that a person experiences great difficulties with self-identification. This leaves an imprint on his relationship with other people, self-acceptance and creates significant problems in many areas of life. nine0003

Symptoms of borderline disorder

The comparison by US psychologist M. Lainen is very true - she said that people with BPD do not have “emotional skin”. And this statement perfectly describes all the symptoms of borderline disorder in the aggregate.

A person can be suspected of having BPD if four or more signs of the disease can be traced in his behavior. It is very important that impulsiveness is clearly expressed. It is also worth watching for stability - if the symptoms make themselves felt every day, then you need to see a specialist. nine0003

Every potential patient with BPD will experience dramatic emotional swings and mood swings. This is called lability. For example, when a fit of anger and uncontrolled aggression changes dramatically with regret and remorse for one's behavior.

Symptoms of borderline personality disorder:

• Emotional instability, significant mood reactivity.
• Unstable and tense interpersonal relationships with everyone around. nine0020
• Impulsiveness.
• Attempts to avoid the real or imagined possibility of being neglected by loved ones.
• Suicidal thoughts and conversations, even attempts are possible, which are repeated from time to time.
• Aggression, hostility.
• Violation of the mental identity of the individual.
• Chronic feeling of spiritual emptiness.
• Transient paranoid ideas associated with stress.

Symptoms and signs of borderline personality disorder also include a pronounced and persistent identity disorder, which manifests itself in insecurity in at least two of the following: nine0003

• values;
• sexual orientation;
• ranking friends by preference;
• self-esteem and self-image;
• setting long-term goals.

A person with BPD may be self-limiting, deliberately beating himself up and worrying about his diagnosis. It will seem to him that he is not like everyone else, that the presence of a disease makes him different, special, but this feature has a negative connotation. nine0003

The signs of borderline disorder always take on the color of hyperbole - if a person is sad, then this sadness borders on depression, if he is happy, then he does it too emotionally, and negative events can cause aggression.

Why Borderline Disorder Occurs

The psychiatric community believes that a person must have certain prerequisites for the development of BPD. That is, it is a disease that occurs as a result of the action of a number of factors. nine0003

The causes of borderline personality disorder can be different:

• Violation of identity - persistent hostility to one's image, rejection of it.
• The tendency to engage in unstable and polar relationships with people is the idealization of a person or, conversely, his depreciation.
• Impulsivity, which manifests itself in a number of areas and involves self-harm - in addition to suicide, it can be unprotected sex, drug use, overeating. nine0020
• Character traits - low self-esteem, increased anxiety, a tendency to pessimistic forecasts, low resistance to stress.

These prerequisites relate rather to the characteristics of the character or type of personality of a person, but there are causes of borderline disorder that do not depend on personality factors:

1. genetic predisposition.
2. Gender affiliation. Women suffer from BPD more often than men.

People at risk are advised to visit a psychologist periodically in order to prevent the development of BPD and establish a painless connection with the outside world.

Disease pathogenesis

This disease, like many other mental disorders, is considered not fully understood. But one thing is for sure - there is a connection between borderline disorder syndrome and emotional trauma in childhood. This point of view is shared by most researchers. Therefore, less attention is paid to the factors of neurobiology, dysfunction of brain regions and social causes (the influence of the environment in the process of growing up, building communication and interaction with various social groups). nine0003

The state of borderline disorder occurs because the amygdala, which is responsible for generating ideas, increases in volume. This provokes an increased manifestation of various states - a person is sad, happy and angry much brighter and more actively than people without a violation.

In the prefrontal cortex, in contrast, there is a decrease in activity during the disorder. It is most concentrated in the right anterior gyrus. This is due to the inability of the "border guards" to regulate their emotions, to stop them. It is the cortex that regulates the degree of arousal, and in the case of BPD, it is less involved. The level of cortisol, which is produced by the hypothalamus, also has a direct effect. This hormone is marked by an overestimated level of indicators in BPD, it provokes increased activity of the hypothalamic-pituitary-adrenal axis, which enters into a state of activity. As a result, there is an increased reaction to stress, and vulnerability to external factors appears. nine0003

Stages of borderline disorder

If you do not deal with the treatment of a mental disorder, then it will be aggravated. It is important to identify the symptoms of the disease as soon as possible and consult a doctor. If this is not done, then the signs of a violation will dominate the behavior of a person, he will increasingly move away from his relatives and society, he will begin to develop suicidal tendencies.

Once an indicator of borderline personality disorder is identified, the disease proceeds according to the following stages: nine0003

1. interpersonal instability. At this stage, a person tries to avoid abandonment, tries to seem normal, build social relationships, although this is not easy for him. This stage is also marked by the instability of relations - it is difficult for others to understand the "border guard".
2. Cognitive disorders, identity disorders. Signs of paranoia begin to appear, a person's idea of ​​himself and his place in the world around him is disturbed.
3. Violations of effective and emotional regulation. This is an indicator of borderline disorder of a more severe stage. There is mood instability, unreasonable anger, an inner feeling of emptiness. nine0020
4. Dysregulation of behavior - the last stage is marked by suicidal tendencies, the desire to injure oneself, uncontrolled emotional outbursts.

How can the disorder be classified

First of all, a classification was adopted in accordance with ICD-10:

• F4 - Neurotic disorders associated with stress and somatoform disorders.
• F5 - Behavioral syndromes associated with physiological disorders and physical factors
• F6 - Personality and behavioral disorders in adulthood.

The types of borderline disorder can be divided into 4 subgroups. They are arranged in order of severity, starting with the least:

1. Sad borderline disorder. It is characterized by submissive and compliant behavior. A person behaves very modestly, but inside he experiences helplessness, self-pity, a sense of his own worthlessness. Along with this, there is physical fatigue, unwillingness to do anything. nine0020
2. Touchy PR. The person is not as malleable as in the dull type. He can express negativity, take everything with hostility. The main distinguishing feature is resentment. A patient with this type is quickly disappointed in everything and everyone.
3. Impulsive PR. This is a type of borderline personality disorder in which a person with a disorder is naughty, shows hysterical inclinations, and demonstrates infantilism. He is characterized by unreasonable excitement, inability to concentrate, suicidal manifestations are possible. nine0020
4. Self-damaging PR. The most severe of the four subtypes. A person is suicidal and no longer hides his thoughts. He has a clear craving for self-destruction, inflicting damage on himself. In relation to others, he behaves ingratiatingly, but at the same time closed.

Levels of borderline personality disorder can vary and are classified according to severity. There are three in total:

1. Easy, when non-standard human behavior is not yet clearly distinguishable. There are difficulties in building relationships with society. And yet the ability to maintain adequate contact is not completely lost. With a mild form, the "border guard" does not express a desire to injure himself or harm others. nine0020
2. Average, when relationships with relatives and friends become more difficult. A person with a disability transfers these problems to other areas - he believes that everything in his career is compromised against him. In this form of borderline, there are threats of ending their lives, but they usually do not come to fruition.
3. Severe, when self-rejection is reflected in absolutely all areas of life, a person feels not accepted by society, ceases to function and try to establish relationships with other people. He is completely immersed in himself, blaming himself for all the failures. There is a high probability of causing bodily harm to yourself. Often it can lead to suicide. nine0020

The disease is not divided into gender and age groups. It can be said that borderline disorder is more common in women than in men. But there is no difference in approaches and treatment - a patient of either gender will undergo therapy in accordance with the severity. It is important to pay attention to the type of BPD, the person's genetics, lifestyle and personality characteristics.

What are the possible complications

First of all, the complications of the disease are associated with destructive behavior - the patient, unwittingly, causes negative emotions in those around him, attempts to harm himself begin to appear. During this period, the manifestation of alcohol, drug addiction is possible, which negatively affects the overall health of the body. All organs and systems suffer, great damage is done to the psyche. nine0003

A person with BPD may be prone to overeating - hence the violations of the gastrointestinal tract and the corresponding mental disorders (bulimia, anorexia). Attempts to bring yourself physical harm turn into wounds, cuts, burns. During aggression, the patient can harm strangers, although cases of physical harm are very rare - the "border guard" mostly experiences aggression on his own, injuring himself or suffering from internal contradictions.

The worst thing that BPD can turn into is death. Indeed, according to statistics, about 70% of people with this disorder have made at least one suicidal attempt. These attempts can end in failure - due to the deliberate demonstration of suicide or through negligence. nine0003

When to see a doctor

The slightest deviation from normal behavior is a reason to visit a specialist. If a person notices any symptoms of BPD, feels lonely, cannot cope with uncontrolled aggression or mood swings, then it is likely that he is diagnosed with borderline disorder.

It is also important to listen to close people who note changes in the usual state of a person.

Many people with a violation try to cope on their own, as soon as they notice the first signs of a disorder in themselves, but only a professional can provide competent help.

Diagnosis of disorder

How to define borderline disorder? To do this, the doctor fully examines the history and identifies the criteria for BPD:

• a devastating feeling of loneliness;
• sudden impulsivity;
• affective instability and sudden reactions to stressful situations; nine0020
• emerging paranoia or severe dissociative symptoms;
• inadequate, unjustified anger, inability to cope with it;
• suicidal thoughts, threats, desire to harm oneself;
• unstable interpersonal relationships;
• violation of one's own identity.

A psychiatrist uses an interview to diagnose borderline personality disorder. It would be useful to conduct an external examination - if scars or scars are found on the skin, then the person is already in the severe stage of BPD. nine0003

The generally accepted criteria for making a diagnosis are those set by the American Psychiatric Association.

1. Violations that manifest themselves:

• in social functioning - close relationships become unstable, conflicts appear. A person with BPD considers himself abandoned and useless - this leaves an imprint on interaction with people. On the other hand, empathy appears: patients with this disorder are very sensitive and also relate to others, they express sincere sympathy in difficult situations; nine0020
• in a personal conflict - a person is characterized by excessive self-criticism, a feeling of instability and constant loneliness. There are no clear goals in life, the patient cannot focus on aspirations, he is removed from career plans.

• hostility to the outside world appears - the patient is irritated, experiences unreasonable anger;
• all emotions are colored negatively - a person is afraid of being rejected, constantly feels anxiety; nine0020
• a person is prone to impulsiveness, ready to take risks, and the patient does not think about the consequences of actions.

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BPD treatment

The treatment of borderline disorder primarily takes into account the needs of the person with BPD, to a lesser extent, the doctor relies on generally accepted standards. If the patient has a tendency to depression or increased anxiety, then they resort to drug treatment.

The psychiatric community is more inclined towards outpatient treatment than hospitalization - it has not proven itself as a rational approach to solving this problem.

Currently, there are several approaches to the treatment of borderline disorder, the appropriateness of which in a particular case is determined by the psychotherapist: nine0003

1. Transfer analysis. This is a type of psychotherapy for which a step-by-step recommendation has been developed that is used in the treatment of BPD.
2. Scheme therapy. It combines Gestalt therapy, cognitive behavioral therapy, attachment theory and psychoanalysis. This type of psychotherapy for borderline personality disorder takes into account the patient's childhood, an analysis of the likelihood of traumatic events and abuse. The doctor in this case focuses on the source of experiences, teaches to find ways out and cope with anxiety. nine0020
3. Dialectical-behavioral therapy. This is a long process that is used to relieve the symptoms of the disease, to save the patient from thoughts of suicide.
4. mentalization. Can be done individually or as part of a group. In this technique, the main focus is the level of meaningfulness - a person learns to find the meaning of life, control their emotions and prioritize needs.
5. Pharmacotherapy. Studies have proven that there are no effective medications for the treatment of BPD. There are no drugs that can relieve the feeling of emptiness. But the authors of scientific papers came to the conclusion that some drugs can act directionally, that is, get rid of the main symptoms of the disease. Among these drugs, Haloperidol (reduces aggression), Aripiprazole (relieves excessive impulsivity), Valproic acid salts (relieve manifestations of a depressive state) showed the greatest effectiveness. nine0020

Disease prevention

It is believed that you can get rid of the violation if you follow all the clinical recommendations for borderline personality disorder. It is not uncommon for patients to completely get rid of all the signs of BPD under the strict guidance of the attending physician.

To date, there are no ways that can prevent this mental disorder. Therefore, it is so important to take all measures to track the disease at an early stage and contact specialists. nine0003

References:

1. McWilliams N., “Psychoanalytic diagnostics.

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