How many types of borderline personality disorder are there
The Four Types of Borderline Personality Disorder - OPI Residential Treatment Center for Young Adults
Borderline personality disorder, commonly known as BPD, is a mental disorder usually diagnosed in young or early adulthood and affecting between 1.6 and 5.9 percent of Americans, according to Psych Central. It is commonly misdiagnosed or missed altogether as some of the symptoms can mirror other disorders, and BPD often coexists with another disorder. The major indicators of BPD are an inability to maintain healthy relationships, intense mood swings, and impulsivity leading to risky behavior.
Symptoms of BPD
In order to be diagnosed with Borderline Personality Disorder, at least five of the following BPD symptoms must be present and also form a chronic and repetitive pattern:
- Extreme fear of rejection and abandonment, both real and imagined
- Stormy personal relationships swinging from idealization to devaluation
- Unstable self-image
- Inappropriate bouts of intense anger
- Chronic feelings of boredom or emptiness
- Emotional instability, including irritability and anxiety
- Paranoid and dissociative thoughts
- Impulsivity leading to reckless and harmful behavior
Sufferers of BPD tend to do whatever they can to avoid any form of perceived abandonment or rejection, having extreme reactions to things such as a vacation or someone being a few minutes late to an appointment. These feelings can trigger intense anger and lead to impulsive and self-harming behavior. Sometimes these behaviors include suicidal tendencies, although usually, the intent is not to follow through.
Relationships are tough for those who suffer from BPD as feelings can quickly shift from one of intense love to a feeling of the recipient not caring enough or not being there for them. Usually, BPD causes turmoil in all relationships, not just personal ones, but can extend into the workplace as well. Those who suffer from BPD are extremely sensitive to their environment, and seemingly innocuous events can be a trigger.
Impulsive thoughts and actions can lead to self-harming actions like substance abuse, reckless driving, eating disorders, self-mutilation, risky sexual behavior, and inappropriate spending. According to Psychiatric Times, 50 to 70 percent of individuals diagnosed with borderline personality disorder also suffer from a substance abuse disorder, usually involving alcohol abuse.
An unstable sense of self, or self-image is indicative of BPD also. This can lead to quick changes in goals, careers and the like. Opinions of self tend to fluctuate from high to low rapidly. Sufferers of BPD sometimes describe “out-of-body” experiences and feelings of separateness.
Types of Borderline Personality Disorder
According to field expert Theodore Millon, there are four different types of borderline personality disorder:
- Discouraged borderline personality disorder
- Impulsive borderline personality disorder
- Petulant borderline
- Self-destructive borderline
Someone suffering from BPD may or may not fall into one of these subcategories, and some may even fall into more than one category. Over time, these symptoms can change and manifest differently as well.
The discouraged borderline exhibits clingy and codependent behavior, tending to follow along in a group setting although seeming dejected. They are usually brimming with disappointment and anger under the surface directed at those around them. Discouraged borderlines are more likely to engage in self-mutilation and even suicide. They seek approval but also tend to avoid people, feel unworthy, and can trend toward depression.
An impulsive borderline is often highly charismatic, energetic and engaging. They can be superficial, flirtatious and elusive, seeking thrills and becoming quickly bored. Impulsive borderlines thrive on attention and excitement and often get themselves into trouble after acting first and thinking later. This can lead to substance abuse and self-injurious behavior as they seek approval from those around them and seek to avoid disappointment and abandonment.
Unpredictability, irritability, defiance and impatience signify the petulant borderline. They tend to be stubborn, pessimistic and resentful as well. They teeter between extreme feelings of being unworthy and anger. They can explode with these episodes of anger. Petulant borderlines fear being disappointed by others but also can’t seem to help wanting to rely on them. They tend to be passive-aggressive and can display self-harming behavior to get attention.
The self-destructive borderline engages in self-destructive behavior. At times they may or may not even be aware of its destructive nature. They are bitter and self-loathing. They have no sense of self and are terrified of being abandoned. They may hurt themselves in an effort to feel something. A self-destructive borderline is most likely to engage in risky behavior like reckless driving and degrading sexual acts.
Education is important in treating any type of borderline personality disorder. The more you know, the easier it can be to address the issue. Defining a subtype or learning you don’t fit a specific one can help in learning how to cope and treat BPD.
The 4 Types of Borderline Personality Disorder — Talkspace
Borderline personality disorder (BPD) is a mental health condition (personality disorder) that affects roughly 1.6% of the population. Symptoms can result in distress due to an inability to effectively regulate emotions, conflict within interpersonal relationships, a low sense of self-worth, and an enhanced tendency for impulsivity. Further, BPD is linked to self-harm and higher rates of suicide. According to research, this complex condition is often associated with major depressive disorder and dysthymia (high-functioning depression).
People who experience BPD often face difficult relationship issues and have severely skewed views of themself and the world around them. BPD can be difficult to diagnose because not all symptoms appear with every diagnosis. Adding to the challenge, there are several subcategories of BPD, and some BPD symptoms can overlap with each other and with other mental health conditions (like bipolar disorder, depression, and certain eating disorders).
The research of noted psychologist and author Theodore Millon helped classify four distinct BPD types. The different types of BPD have specific characteristics in common, but each also has its own symptoms, challenges, and optimal treatment techniques.
What are the Different Types of BPD?
While continued research indicates the likelihood of even more subcategories for the various BPD types, here we’re focusing on the 4 borderline personality disorder types characterized by Millon’s research.
- Discouraged borderline personality disorder (quiet BPD)
- Impulsive borderline personality disorder
- Petulant borderline personality disorder
- Self-destructive borderline personality disorder
“Learning the signs and symptoms of borderline personality disorder can feel both overwhelming and empowering – knowing what you need to best support, like the right therapist and psychiatrist, can be incredibly beneficial to your health and your life. You deserve support!”
Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC
1. Discouraged borderline personality disorder
Millon described discouraged borderline personality disorder (also known as quiet BPD) as being marked by frequent feelings of shame, guilt, emotional attachments, social anxiety, feelings of inadequacy, and obsessions.
Symptoms of discouraged borderline personality disorder
- Marked interpersonal difficulties
- Fear of abandonment
- Unstable self-image
- Feelings of emptiness
- Being emotionally attached
- Paranoid ideation
- Obsessive-compulsive tendencies
- Social retreat
2.Impulsive borderline personality disorder
Impulsivity is a common trait in BPD in general, but it’s prevalent enough in some people to be considered one of the 4 types of BPD addressed by Millon. Those with impulsive borderline personality disorder have an intense need for immediate gratification and often discount delayed rewards. They tend to experience intense emotions of rejection and anger.
Symptoms of impulsive borderline personality disorder
- Preference for immediate gratification
- Discounting long-term results
- Feelings of rejection
- Feelings of anger
3. Petulant borderline personality disorder
People with petulant BPD can display outbursts of anger that aren’t appropriate for a given situation. They might have an unstable self-image accompanied by feelings of being unloved. They feel a strong urge to manipulate or control others and tend to become possessive, resulting in difficulty maintaining interpersonal relationships. Overall, they’re likely to lack emotional stability.
Symptoms of petulant borderline personality disorder
- Inability to enjoy harmonious relationships
- Difficult to satisfy
- Feelings of extreme anger and frustration
- Frequent irrational, emotional outbursts
- Impatience with others in normal social situations
- Seldom can admit they are wrong
- Often behave in a passive-aggressive manner
4. Self-destructive borderline personality disorder
These BPD types can be their own worst enemies. People with self-destructive borderline personality disorder frequently self-sabotage relationships with family members and friends. They might engage in dangerous or risky behaviors, and generally have little regard for the consequences of their actions.
Symptoms of self-destructive borderline personality disorder
- Substance abuse
- Self-harming behavior
- Frequent depression
- Feelings of bitterness
- Suicidal thoughts
- Emotional bitterness
How to Treat the 4 Types of BPD
The different types of BPD use slightly different treatment modalities, which can include a combination of medications for specific BPD symptoms combined with various modalities of talk therapy.
Research suggests that each of the 4 types of borderline personality disorder seems to reflect biologically determined temperaments that could be linked to neuro-biologically based predispositions and vulnerabilities. While we don’t fully understand what causes borderline personality disorder, we are learning more every day about how to treat borderline personality disorder. Some people want to know how to treat BPD naturally,so treatment can vary not only depending on the type of BPD someone has, but also on their personal treatment plan.
Borderline personality disorder is not necessarily treatable with medication. That is, no medication has been discovered that can cure the mental health condition itself. However, people diagnosed with the various types of BPD can be prescribed medication to help them manage symptoms, like anxiety and mood swings, that stem from BPD. BPD medication can also be effective in decreasing the likelihood of self-harm and may help prevent suicide.
“If you or someone you care about might be experiencing symptoms of borderline personality disorder, consult with a therapist who specializes in this so you can get the best evaluation and treatment recommendations.”
Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC
Treatment for discouraged BPD
Psychotherapy is the predominant treatment modality for treating discouraged BPD types. Dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT), and mentalization-based therapy have all been found effective therapy. Therapeutic interventions like antidepressant medications might be recommended if comorbidity with depression presents.
Treatment for impulsive BPD
Impulsive BPD types can be effectively treated with cognitive behavioral therapy and dialectical behavioral therapy (DBT).
Treatment for petulant BPD
Therapy is also recommended to treat petulant BPD. Dialectical behavior therapy is the most recommended form of BPD therapy and can teach things like emotion regulation and distress tolerance. It can also help with interpersonal skills. Other forms of therapy that are known to be effective include cognitive behavioral therapy (CBT), mentalization-based therapy, and psychodynamic therapy.
Treatment for self-destructive BPD
Dialectical behavioral therapy and another form of therapy that uses elements of CBT, known as schema-focused therapy, have been found effective in treating self-destructive BPD. Therapy can help identify triggers, which makes a huge difference in learning to manage any type of mental health condition, including self-destructive BPD. Medication is also commonly recommended.
Which Type of BPD Do I Have?
Self-diagnosis is never recommended to diagnose any of the borderline personality disorder types. Unfortunately, there isn’t any one single test that can accurately determine if someone has BPD, let alone which type they may have. Thorough testing by a qualified mental health professional is the only reliable method of diagnosis. As noted, making a BPD diagnosis can be difficult given the possibly overlapping nature of symptoms. If you want to learn more about your symptoms you can even take a BPD test as a first step. However, be sure to seek in-person or online therapy to get a proper diagnosis.
Identifying types of BPD can involve using a variety of testing and assessment measures, including the Personality Assessment Inventory (PAI) and the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The DSM-5 offers a detailed list of criteria used to identify traits and symptoms that must be present in order to make an accurate diagnosis. Also included in the diagnostic process can be health assessments and interviews.
While there’s no clinical recognition in terms of diagnosing each type of BPD, narrowing them down can help a mental health provider decide on the most effective treatment plan, which can be essential is overall BPD treatment success. Zeroing in on the precise types of BPD that need attention is the best way to gauge the most effective treatment modalities.
Using Millon’s BPD subtype concepts has the potential to help people living with borderline personality disorder figure out the most important areas of concern. Then, they can quickly focus on the most needed, most effective type of treatment. New investigations into the subtypes of BPD, as outlined by Millon, continue with the goal of finding better BPD treatment solutions for optimal care and possibly, one day, a cure.
- Chapman J, Jamil R, Fleisher C. Borderline Personality Disorder. Ncbi.nlm.nih.gov.
- Paris, MD J. Why Psychiatrists are Reluctant to Diagnose.
- Lawrence K, Allen J, Chanen A. Impulsivity in Borderline Personality Disorder: Reward-Based Decision-Making and its Relationship to Emotional Distress.
- Kolbeck K, Moritz S, Bierbrodt J, Andreou C. Borderline Personality Disorder: Associations Between Dimensional Personality Profiles and Self-Destructive Behaviors.
- Bornovalova M, Hicks B, Iacono W, McGue M.
- Bornovalova M, Hicks B, Iacono W, McGue M. Stability, change, and heritability of borderline personality disorder traits from adolescence to adulthood: A longitudinal twin study.
- Bell-Pringle V, Pate J, Brown R. Assessment of Borderline Personality Disorder Using the MMPI-2 and the Personality Assessment Inventory. Assessment.
- Lubit, MD, PhD R. What are the DSM-5 diagnostic criteria for borderline personality disorder (BPD)?. Medscape.com.
What are the types of borderline personality disorder?
May 30, 2021 comments 0
Impulsivity, moodiness, unstable self-esteem, inappropriate temper tantrums, intense and turbulent relationships, self-harm or thoughts of self-harm... Although people with borderline personality disorder may have some of the same symptoms, they are not all the same. nine0005
Theodore Millon, an APA award winner whose theories have helped shape how scientists think about personality and personality disorders, identified four distinct subtypes of borderline personality disorder. These subtype concepts can help people with borderline personality disorder and their therapists identify specific issues that need special attention.
While someone with BPD may or may not fall into one of these subcategories, others may even fall into more than one of them. Symptoms can change over time and present differently in different people. nine0003
What are the types of borderline personality disorder and their individual characteristics?
- Impulsive Borderline Personality: People with impulsive borderline disorder are perceived as thrill-seekers, risk takers, unpredictable, charismatic, very energetic and easily bored. Their endless appetite for attention and adventure often leads them to act without any appreciation of the consequences. These people often act without thinking and are also prone to self-harm and suicidal thoughts and actions. nine0020
- Discouraged Borderline: These people tend to appear clingy, dependent, and less assertive. Their strong desire for approval and acceptance, as well as their feelings of inferiority and inferiority towards others, often make them prone to depression. They are more likely than other BDP types to use self-harm as a coping mechanism. They may eventually become suicidal if they don't get the help they need. nine0020
- Touchy Borderline: This subtype is characterized by being critical, pessimistic, impatient, unpredictable, irritable and prone to outbursts of anger or frustration, especially when they are disappointed by other people. They waver between trusting people and keeping their distance, fearing disappointment. Their feelings of unworthiness and anger can make them quite explosive. It's really hard for them to admit they're wrong. They tend to be headstrong, often stubborn and defensive, using passive-aggressive behavior as a way to lash out at people they don't like. These people also show symptoms of depression as well as a paranoid personality. nine0020
. They tend to conform to other people's beliefs and expectations due to the rejection of intense fear. They have common features of depression. Their self-destructive behavior can be presented in many ways, such as poor medical care, reckless driving, etc. They are prone to a high rate of suicide. nine0020 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 Visit us now at www.acandassociates.com to schedule a real-time video consultation with a healthcare professional to help you diagnose and choose the best treatment plan for you. You can also find us on our social networks: Instagram Facebook Twitter We look forward to helping you on your journey of healing and well-being!
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
Visit us now at www.acandassociates.com to schedule a real-time video consultation with a healthcare professional to help you diagnose and choose the best treatment plan for you.
You can also find us on our social networks:
We look forward to helping you on your journey of healing and well-being!
July 25, 2021 comments 0
My Cancer, My Blessing - Lessons and advice from a cancer survivor.
June 28, 2021 comments 0
Despite the benefits of using mobility aids, many people who might benefit from these devices choose not to use them. One of the reasons? Social stigma! nine0005
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:
- The dominant affect is anger.
- Inability to build interpersonal relationships.
- Self rejection.
- 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
- 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
- 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:
- genetic predisposition.
- 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.
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
- 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".
- 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.
- 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
- 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:
- 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
- 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.
- 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
- 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:
- 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
- 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.
- 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.
- 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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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
- 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.
- 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
- 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.
- 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.
- 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
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
- McWilliams N., “Psychoanalytic diagnostics.