Social aversion disorder

Avoidant Personality Disorder: Symptoms, Treatments, and Complications

Written by Susan Quilty

In this Article

  • Avoidant Personality Disorder Symptoms
  • Social Impact of Avoidant Personality Disorder
  • Avoidant Personality Disorder Treatments
  • Avoidant Personality Disorder and Other Conditions

Avoidant personality disorder is characterized by feelings of extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. Yet the symptoms involve more than simply being shy or socially awkward. Avoidant personality disorder causes significant problems that affect the ability to interact with others and maintain relationships in day-to-day life. About 1% of the general population has avoidant personality disorder.

Avoidant Personality Disorder Symptoms

Avoidant personality disorder symptoms include a variety of behaviors, such as:

  • Avoiding work, social, or school activities for fear of criticism or rejection. It may feel as if you are frequently unwelcome in social situations, even when that is not the case. This is because people with avoidant personality disorder have a low threshold for criticism and often imagine themselves to be inferior to others.
  • Low self-esteem
  • Self-isolation

When in social situations, a person with avoidant personality disorder may be afraid to speak up for fear of saying the wrong thing, blushing, stammering, or otherwise getting embarrassed. You may also spend a great deal of time anxiously studying those around you for signs of approval or rejection.

A person who has an avoidant personality disorder is aware of being uncomfortable in social situations and often feels socially inept. Despite this self-awareness, comments by others about your shyness or nervousness in social settings may feel like criticism or rejection. This is especially true if you are teased, even in a good-natured way, about your avoidance of social situations.

Social Impact of Avoidant Personality Disorder

Avoidant personality disorder causes a fear of rejection that often makes it difficult to connect with other people. You may be hesitant to seek out friendships, unless you are certain that the other person will like you. When you are involved in a relationship, you may be afraid to share personal information or talk about your feelings. This can make it difficult to maintain intimate relationships or close friendships.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person diagnosed with avoidant personality disorder needs to show at least four of the following criteria:

  • Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.
  • Is unwilling to get involved with people unless they are certain of being liked.
  • Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
  • Is preoccupied with being criticized or rejected in social situations.
  • Is inhibited in new interpersonal situations because of feelings of inadequacy.
  • Views self as socially inept, personally unappealing, or inferior to others.
  • Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Avoidant behavior may commonly be seen in children or adolescents, but a diagnosis of a personality disorder cannot be made in childhood because shyness, fear of strangers, social awkwardness, or being sensitive to criticism are often a normal part of child and adolescent development.

A mental health professional can assess your symptoms, make an accurate diagnosis, and suggest the appropriate treatment options.

Avoidant Personality Disorder Treatments

As with other personality disorders, a mental health professional will design a treatment plan that is appropriate for you. Avoidant personality disorder treatments vary, but they will likely include talk therapy. If a co-existing condition, such as depression or anxiety disorder, is also diagnosed, appropriate medications may also be used.

Avoidant Personality Disorder and Other Conditions

Other mental health disorders can occur along with avoidant personality disorder. Treatments in these cases will be designed to help with the symptoms of each disorder. A few of the conditions that most frequently occur with avoidant personality disorder include:

  • Social phobia, in which a person experiences overwhelming anxiety and self-consciousness in common social situations.
  • Dependent personality disorder, in which people rely excessively on others for advice or to make decisions for them.
  • Borderline personality disorder, in which people have difficulties in many areas including social relationships, behavior, mood, and self-image.

Many avoidant personality disorder symptoms are commonly shared among these other conditions, particularly in the case of generalized social phobia. Because of this, the disorders can be easily confused. It may take some time for a mental health professional to make a clear diagnosis and choose the appropriate treatments for you.

Mental Health: Paranoid Personality Disorder

Written by WebMD Editorial Contributors

In this Article

  • What Are the Symptoms of Paranoid Personality Disorder?
  • What Causes Paranoid Personality Disorder?
  • How Is Paranoid Personality Disorder Diagnosed?
  • How Is Paranoid Personality Disorder Treated?
  • What Complications Are Associated With Paranoid Personality Disorder?
  • What Is the Outlook for People With Paranoid Personality Disorder?
  • Can Paranoid Personality Disorder Be Prevented?


Paranoid personality disorder (PPD) is one of a group of conditions called "Cluster A" personality disorders which involve odd or eccentric ways of thinking. People with PPD also suffer from paranoia, an unrelenting mistrust and suspicion of others, even when there is no reason to be suspicious.

This disorder usually begins by early adulthood and appears to be more common in men than in women.

What Are the Symptoms of Paranoid Personality Disorder?

People with PPD are always on guard, believing that others are constantly trying to demean, harm, or threaten them. These generally unfounded beliefs, as well as their habits of blame and distrust, might interfere with their ability to form close relationships. People with this disorder:

  • Doubt the commitment, loyalty, or trustworthiness of others, believing others are using or deceiving them
  • Are reluctant to confide in others or reveal personal information due to a fear that the information will be used against them
  • Are unforgiving and hold grudges
  • Are hypersensitive and take criticism poorly
  • Read hidden meanings in the innocent remarks or casual looks of others
  • Perceive attacks on their character that are not apparent to others; they generally react with anger and are quick to retaliate
  • Have recurrent suspicions, without reason, that their spouses or lovers are being unfaithful
  • Are generally cold and distant in their relationships with others, and might become controlling and jealous
  • Cannot see their role in problems or conflicts and believe they are always right
  • Have difficulty relaxing
  • Are hostile, stubborn, and argumentative

What Causes Paranoid Personality Disorder?

The exact cause of PPD is not known, but it likely involves a combination of biological and psychological factors. The fact that PPD is more common in people who have close relatives with schizophrenia suggests a genetic link between the two disorders. Early childhood experiences, including physical or emotional trauma, are also suspected to play a role in the development of PPD.

How Is Paranoid Personality Disorder Diagnosed?

If physical symptoms are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history and, if indicated, a physical exam. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, they might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

How Is Paranoid Personality Disorder Treated?

People with PPD often do not seek treatment on their own because they do not see themselves as having a problem. When treatment is sought, psychotherapy (a form of counseling) is the treatment of choice for PPD. Treatment likely will focus on increasing general coping skills, as well as on improving social interaction, communication, and self-esteem.

Because trust is an important factor of psychotherapy, treatment is challenging since people with PPD have such distrust of others. As a result, many people with PPD do not follow their treatment plan.

Medication generally is not a major focus of treatment for PPD. However, medications, such as anti-anxiety, antidepressant or antipsychotic drugs, might be prescribed if the person's symptoms are extreme, or if they also suffer from an associated psychological problem, such as anxiety or depression.

What Complications Are Associated With Paranoid Personality Disorder?

The thinking and behaviors associated with PPD can interfere with a person's ability to maintain relationships, as well as their ability to function socially and in work situations. In many cases, people with PPD become involved in legal battles, suing people or companies they believe are "out to get them."

What Is the Outlook for People With Paranoid Personality Disorder?

The outlook for people with PPD varies. It is a chronic disorder, which means it tends to last throughout a person's life. Although some people can function fairly well with PPD and are able to marry and hold jobs, others are completely disabled by the disorder. Because people with PPD tend to resist treatment, the outcome often is poor.

Can Paranoid Personality Disorder Be Prevented?

Although prevention of PDD might not be possible, treatment can sometimes allow a person who is prone to this condition to learn more productive ways of dealing with situations.


Types of personality disorders and features of their treatment. Paranoid, schizoid, dissocial, hysterical disorder, obsessive-compulsive, obsessive-compulsive, anxious, narcissistic

The main feature of personality disorders are pronounced maladaptive features of the psyche - such patients do not know how and cannot get along with others, adapt to new conditions. Previously, personality disorders were called psychopathy, but over time, experts adopted a Western point of view - psychopathy is still a separate mental disorder. There are several types of personality disorders, sometimes there are mixed types of the disease. Treatment should only be carried out by experienced professionals, but the main problem with this disorder is that patients for the most part do not recognize their mental problems.

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Types of personality disorders and features of their treatment

Every fifteenth inhabitant of our planet suffers from a personality disorder. Moreover, he himself hardly perceives his condition as a disease that requires an appeal to specialists. He will justify all his actions and consider his behavior normal. Treatment denies, and the consequences are unpredictable.

Personality disorder: adjustment difficulties

Personality disorder is a maladaptive pattern of behavior caused by a persistent mental disorder that is not associated with a physical or neurological disease. This pathology is difficult to correct, because the patient does not believe that he needs treatment. There is no motivation, which is a catalyst for positive changes. The individual himself does not seek to get rid of the violation and does not make good contact with psychotherapists. Late appeal to specialists leads to the fact that the patient gets an appointment with a psychiatrist already in the stage of deep neglect of the disease. It can be difficult to relieve symptoms and cure. The first signs of the disease are actively manifested in adolescence. Before this period, individual episodes are possible, but only after the period of puberty can we talk about the problem. Individuals with cognitive personality disorder do not understand why others talk about any of their problems. After all, they believe that behavior and actions are normal. People with personality disorders are poorly perceived in society. They often have difficulties in personal communication. But at the same time, patients do not feel pangs of remorse and have no sympathy for others. After a certain time, their relationship with the world is built not according to the principle of personal adaptation to society, but according to the scheme, when the society is forced to accept or not accept a problematic person. The lack of motivation and desire to be treated exacerbates the problem, since not every doctor can find an approach to such a patient, relieve the symptoms of exacerbation and help get rid of the problem.

Specific personality disorders

In Soviet times, overly emotional individuals were often called psychopaths. Such a characterization and classification was not inherent in Western psychiatry. Psychopathy is a serious violation of a behavioral nature, in which, against the background of underdevelopment of a number of personality traits, one clearly dominates. This includes a number of deviations. Types of personality disorders:

  • § Paranoid - the patient is dominated by overvalued ideas. He attaches special importance to his personality. But he treats others with hostility, suspecting them of malicious intent. A person with a pathology does not recognize its presence. When relatives or friends pay attention to a cognitive deviation and try to take him to a specialist, he will assure that everything is in order with him and deny the existence of a problem. Very sensitive to criticism.
  • § Schizoid - this diagnosis is characterized by introversion, isolation, decreased interest in life's things. The patient does not perceive the accepted norms of social behavior, often behaves eccentrically. Schizoid personality disorders are associated with a great passion for some kind of activity in which the individual succeeds. For example, he may be pathologically addicted to various health systems, to the point of attracting other people to his interests. Experts believe that in this way a certain asociality is replaced. Also, such patients may have problems with alcohol, drugs or other types of addiction.
  • § Dissocial - a characteristic feature of this personality disorder is the patient's cognitive defiant behavior in order to get what he wants. With all this, such patients are able to win over people, including doctors. This type is especially pronounced in late adolescence.
  • § Hysterical - the main goal of such patients is to draw attention to their person in any way, including defiant behavior. The diagnosis is more typical for women. Atypical capriciousness, inconstancy of desires, extravagance, deceit are observed. In order to attract attention, the patient invents non-existent diseases for himself, the symptoms of which can be given out by the autonomic system and which is difficult to remove.
  • § Obsessive-compulsive - patients with this type of personality disorder pathologically strive for order and perfection. They have no sense of humor, they try to be perfect in everything. When the set ideal goals are not achieved, they can fall into depressive states.
  • § Anxiety - such a personality disorder is characterized by the cultivation of a personal inferiority complex. Patients are in a state of perpetual anxiety and uncertainty. From childhood, such patients are shy and timid. Often suspect others of hostility. They are prone to depression.
  • § Narcissistic - a deviation in which a person manifests narcissism from childhood, a desire to be constantly admired. Such a patient does not accept criticism: he reacts to it either with resentment or with aggression. Indifferent to the feelings of other people, prone to exploiting them to achieve their own goals.

Different forms of psychopathy require an individual approach to treatment. Personality disorders should not be confused with character accentuation. In the latter case, a person also has behavioral features, but they lie within the upper limit of the norm. In addition, it is adapted to social conditions. The classification of classical psychopathy is inappropriate here. Diagnosis and types are different.

Causes that cause personality and behavioral disorders

All specific personality disorders are usually divided into three clusters. Their classification:

  • § types of cluster A psychopathy: paranoid and schizoid;
  • § Cluster B psychopathy: hysterical, asocial, narcissistic;
  • § Types of cluster B psychopathy: obsessive-compulsive, depressive.

The causes of cluster A psychopathy are considered to be genetic and hereditary. The fact is that among the relatives of patients who have a personality disorder, as a rule, there is at least one with schizophrenia. A hereditary predisposition to pathologies can also be traced in cluster B and C psychopathy. The first option can also be aggravated by problems with alcohol: in families of people who drink, children often develop with disorders. There is a version that cognitive specific personality disorders may be associated with hormonal disorders in the body. If a person has elevated levels of testosterone, estrone and estradiol, the consequences of this are manifested in the form of aggression. In addition, he does not produce enough endorphins, which, in turn, leads to depressive disorders. The social factor also plays an important role in the formation of the psychotype. For active children, space is important. If they are forced to be brought up in a closed space, small areas, this leads to the appearance of hyperactivity. Anxious babies from birth can become balanced if they are raised by emotionally stable parents. A calm mother can help a child become confident, and an anxious one can not remove, but increase his personal anxiety state. Character traits become noticeable already in early childhood. In adolescence, they can already develop as a personality disorder. Cognitive impairment is manifested in a decrease in memory, increased fatigue. Pathologies of the nervous system are observed more often in people with an asocial temperament.

Mixed personality disorder

This type of psychopathy has been less studied than others. The classification has no special criteria. The patient manifests forms of one or the other type of disorders that are not persistent. Therefore, this type of disorder is also called mosaic psychopathy. But it is also difficult for a person with a mixed type of disorder to get along in society because of the peculiarities of their behavior. Instability of character is often the basis that contributes to the development of various types of addiction. Mixed personality disorder may be accompanied by alcoholism, drug addiction, gambling addiction. Mosaic psychopathy can combine symptoms of the schizoid and paranoid types. Such people do not know how to build social contacts in society, they are obsessed with overvalued ideas. With the predominance of paranoid symptoms, patients suffer from increased suspicion. They are prone to scandals, threats, like to write angry complaints about everyone and everything. Specialists are alarmed if signs (classification) of several disorders coexist in one patient: schizoid, hysterical, asthenic, excitable. In this case, there is a high risk of developing schizophrenia. Brain injuries or complications after a number of diseases can lead to mosaic types of pathology. This mixed personality disorder is considered acquired. If we consider the situation in detail, it will look like this: a person already has an innate tendency to mosaic psychopathy, which, due to certain circumstances, is superimposed by organic pathology. Mosaic disorder requires specific treatment only when symptoms worsen, or if there is organic build-up. Then neuroleptics, tranquilizers, vitamins can be prescribed by a specialist.

Infantile personality disorder

With this type of psychopathy, signs of social immaturity are pronounced. A person is not able to withstand stressful situations and relieve tension. In difficult circumstances, he does not control his emotions in the same way as children do. Infantile personality disorders for the first time clearly declare themselves in adolescence. Hormonal storms that occur at this time with a person cause changes in the psycho-emotional sphere. As you get older, the diagnosis can only progress. It is possible to finally talk about the presence of the disease only after reaching 16-17 years. In stressful circumstances, the patient manifests himself immature, poorly controls aggression, anxiety, fear. Such a person is not hired for military service, they are denied employment in law enforcement agencies. Permits to carry weapons or obtain a driver's license are decided on a limited and strictly case-by-case basis, according to an assessment of signs and condition.

Transient personality disorder

This diagnosis refers to borderline conditions, when the symptoms of deviation are difficult to attribute to any type of personality disorder. The main causes of psychopathy are long-term stressful situations. In the modern world, a person is surrounded by many unfavorable factors: troubles at work, military operations, difficult family circumstances, financial failures, moving... All this disrupts the usual way of life and unbalances. If such circumstances last too long, the human psyche does not always have a reserve to survive and overcome them. Transient personality disorder has its own characteristics:

  • § disorientation;
  • § hallucinations;
  • § nonsense;
  • § inhibition of verbal and motor functions.

Even one of the symptoms can already signal a disorder. This diagnosis is special in that the disease does not last too long: sometimes only a day, and sometimes a month. It suddenly arises and just as it passes. Sometimes a person can go to sleep with a disturbance, and get up in a normal emotional state with residual effects in the form of increased anxiety or sleep disturbances. With each new stress, a spontaneous return of pathology is possible. Such a diagnosis does not pass without a trace. In the event that there are signs of delirium or hallucinations, such a person requires special treatment, because his condition can also threaten those around him. In the period between exacerbations, the patient experiences emotional burnout, in which nerve cells are also destroyed. Therefore, even for preventive purposes, it is recommended to take vitamins and herbal remedies. As historical examples show, partial transient personality disorder is not a benign condition. Many of the famous serial killers and maniacs had this diagnosis. They led a normal life, had families, work, but during the period of exacerbations they committed crimes. When Western experts studied the brains of executed criminals, they did not find significant changes in it. All its parts corresponded to the norm of a healthy person. And only stressful conditions could lead to the appearance of signs of a personality disorder, which entailed antisocial acts. Perhaps, if during the period when the first signs of the disease appeared, there would have been a person nearby who noticed this and helped to contact a specialist, such consequences could have been avoided. Being face-to-face with continuous stressful situations, the psyche simply could not stand it. The mechanism of the development of the disease was launched.

Treatment for personality disorders

When a person is diagnosed with psychopathy, they rarely agree with it. The peculiarity of this disease is that the patient does not see problems in himself, but looks for them in others. Treatment in this case is always difficult. According to statistics, only one in five of them agree to accept help. Treatment of psychopathy is carried out individually. It includes sessions of psychotherapy and, if necessary, the use of drugs. In difficult cases, when the antisocial behavior of the patient poses a threat to others, treatment can be carried out in a hospital. Disputes among specialists are caused by the treatment of borderline conditions. Some believe that the patient needs help only during exacerbations, while others insist on constant support. In any case, the treatment of psychopathy has been going on for many years. With the patient's tendency to impulsive acts that can threaten life and health, psychotropic drugs are connected.

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.

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.

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.

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.

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 experts.

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.

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.

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.

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.

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.
  • 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.

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.

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.

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.
  • 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:

  • 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.

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.

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.
  • 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).

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.

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:

  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.
  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.
  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.
  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.
  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.

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.

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.

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;
  • 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.

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;
  • 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.
  • Pathology of personal qualities:
    • 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;
    • a person is prone to impulsiveness, ready to take risks, and the patient does not think about the consequences of actions.
  • Expression in the manifestation of emotions persists for a long time.
  • For a person of this age and gender category, all violations are not normal.
  • The patient is not under the influence of any drugs and his behavior is not due to their intake.
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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:

    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.
    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.

    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.

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