Two types of borderline personality disorder

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
Self-blame
Rage
Feelings of emptiness
Being emotionally attached
Helplessness
Paranoid ideation
Obsessive-compulsive tendencies
Social retreat
Perfectionism
Anxiety

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-hatred
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.

See references

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.

Borderline personality disorder

Borderline personality disorder is associated with unstable mood and behavior that has a significant impact on a person's daily life

Borderline personality disorder is a type of personality disorder in which a person experiences periods of tension, unstable moods and behaviors, and an altered "feeling of self". 1 All of these can result in impulsive actions and relationship problems with friends and family members, impairing the person's ability to cope with everyday life. ^1.2

Borderline personality disorder is a serious illness associated with self-harm and suicidal attempts. One in ten patients complete suicide. ²

Facts About Borderline Personality Disorder

Borderline personality disorder is a type of personality disorder in which a person experiences periods of tension, unstable mood and behavior, and an altered sense of self. ¹

^{One in ten patients complete suicide. ²}

Patients with borderline personality disorder are very sensitive to changes in their environment, and may respond inappropriately and acutely to such changes. They may, for example, be afraid of being abandoned by a loved one. 2 If the person whom patient
is expecting arrives late, the patient easily changes the feeling of attachment to dislike or anger.1,2 This reflects the extreme perception of the world by the patient, who sees everything and everyone - including oneself – either good or bad.1,2

People with borderline personality disorder are often insecure and may suddenly change their life goals and outlook on careers, values, and friends. .2 They may develop intense unwarranted anger or feelings of emptiness, and are prone to self-harm.2 Patients with borderline personality disorder may also experience depression and anxiety.1,2

Facts about Borderline Personality Disorder

Estimates of the proportion of people who have borderline personality disorder vary from less than 1% to around 6%. ^2-4

Borderline personality disorder affects a roughly equal number of men and women, but appears to be more disabling in women the same frequency in men and women, but in women it is more severe. 3

Symptoms of borderline personality disorder most often first appear during adolescence.4 The disease is most severe and problematic in young adults and tends to improve with age.2 Symptoms may persist throughout life, but most patients with borderline personality disorder by the age of 30-40 have a stable job and a home.2

People with borderline personality disorder are emotionally and functionally unstable, which places a significant burden on their families.5 Mood swings are a source of stress for both the patient and his/her others, which can lead to the development of mental disorders in the latter.1,5

People who are concerned that they – or their loved ones – are experiencing symptoms of borderline personality disorder should see their doctor for help and advice.

Borderline personality disorder is diagnosed by a mental health professional using interviews and discussions about symptoms and medical history. ¹

Psychotherapy can help people with borderline personality disorder by, for example, teaching them how to interact with others and to express their thoughts and feelings more clearly. ¹ It may also be beneficial for caregivers and family members of those affected to receive therapy and guidance on how best to care for a person with borderline personality disorder. ¹ There is currently no cure, but one study showed that, after 10 years, 50% of people with borderline personality disorder had recovered, being able to function at work and maintain personal relationships. ⁶

National Institute of Mental Health. borderline personality disorder. NIH publication number QF 17-4928. Available from: https://www.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtml [accessed 30 September 2019].
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2008;69(4):533–545.
National Institute for Health and Clinical Excellence. Borderline personality disorder: recognition and management. 2009. Available from: https://www.nice.org.uk/guidance/cg78/resources/borderline-personality-disorder-recognition-and-management-pdf-975635141317 [accessed 30 September 2019].
Bailey RC, Grenyer BFS. Burden and support needs of carers of persons with borderline personality disorder: a systematic review. Harv Rev Psychiatry. 2013;21(5):248–258.
Zanarini MC, Frankenburg FR, Reich DB, Fitzmaurice G. Time to attainment of recovery from borderline personality disorder and stability of recovery: a 10-year prospective follow-up study. Am J Psychiatry. 2010;167(6):663–667.

1. National Institute of Mental Health. borderline personality disorder. NIH publication number QF 17-4928. Available from: https://www.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtml [accessed 30 September 2019].
2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
3. Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2008;69(4):533–545.
4. National Institute for Health and Clinical Excellence. Borderline personality disorder: recognition and management. 2009. Available from: https://www.nice.org.uk/guidance/cg78/resources/borderline-personality-disorder-recognition-and-management-pdf-975635141317 [accessed 30 September 2019].

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Borderline personality disorder, symptoms, causes, diagnosis, treatment

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

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

Symptoms of borderline personality disorder (BPD)

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

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

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

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

Types of spontaneous actions that accompany mental borderline personality disorders

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

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

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

Besherednichenko Andrey Nikolaevich

Chief physician of the Korsakov Medical Center network, psychiatrist-narcologist

more than 11 years

Consultation

Records for reception

Emotionally unstable personality disorder

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

BPD pathogenesis

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

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

Causes of BPD

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

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

Unfavorable social environment

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

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

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

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

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

Physiology

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

Heredity

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

Borderline mental state in psychiatry and severity of personality disorders

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

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

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

How to reliably identify borderline personality disorder (BPD)

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

Borderline personality disorder BPD test

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

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

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

Treatment of borderline personality disorder (BPD)

Cherednichenko Andrey Nikolaevich

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

Experience over 11 years

Consultation

Appointment

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

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

Selective inhibitors of are aimed at preventing depressive episodes and reducing anxiety/panic/borderline states.
Mood stabilizers .
One of the most popular remedies is Lamotrigine. It is also used to neutralize depression, mood lability and impulsivity.
Atypical antipsychotics .
Now the 2nd generation of drugs of this cluster has already been developed, which have proven themselves well in neutralizing the symptoms of the cognitive sphere, such as: aggression, distortion of perception of reality, paranoia, dichotomy of thinking and disorganization.

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

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

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

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

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