Understanding Borderline Personality Disorder (BPD)
- 23 Jun 2022
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Borderline personality disorder (BPD) has been perceived as a challenging, highly disabling mental disorder for much of its history (Biskin, 2015). Unfortunately, such perceptions have reinforced a stigmatized understanding of the mental health condition, however, research in the past two to three decades has indicated new insights in understanding the course of BPD development and its treatment options. This article aims to offer a simplified understanding of the disorder.
Borderline personality disorder is primarily characterized with emotional dysregulation difficulties, this results in symptoms and behaviors such as:
- Impulsivity including reckless behavior
- Parasuicidal behavior including self-harm
- Chronic feelings of emptiness
- Interpersonal dysfunction including difficulties to maintain relationships
- Disturbed sense of identity
- Disturbed patterns of thinking including intrusive negative thoughts
(Hallquist & Pilkonis, 2012; Choi-Kain et al., 2017; NHS, 2022).
Onset & Age range:
Such behaviors can begin becoming noticeable during adolescence or even childhood. According to Biskin (2015) if some of these symptoms or patterns of behaviors are persistent and pervasive for one year or more, as well as unrelated to a particular developmental phase then the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) permits a diagnosis of the personality disorder even if you are under 18 years old.
One may ask, at such an early age what may lead to the development of the disorder? The short answer to this is: a combination of genetic vulnerability and traumas associated with abuse.
According to Cattane, Rossi, Lanfredi, et al. (2017) there are neurobiological mechanisms involved in the development of BPD. Their research elaborates on how one of our neuroendocrine systems, the Hypothalamic-Pituitary-Adrenal (HPA) axis which mediates our physical stress response, can increase the risk of developing various types of illnesses, especially psychiatric disorders when overactivated by prolonged exposure to stress.
We may ask what type of prolonged stress does the borderline individual experience at an early age?
Kennerad (1983) would elaborate that abuse related traumas in childhood such as physical, verbal, sexual and psychological abuse are linked to destructive behaviors carried out by BPD individuals.
At this point, it can be understood that BPD is a combination of biological adaptive behaviors and traumas experienced in early life.
Researchers and clinicians for the past few decades explored multiple treatment routes for borderline personality disorder. One must remember that when dealing with BPD, the client and the therapist are working together to cope with the BPD symptoms. Therefore, multiple approaches have been developed to address these symptoms, most of which target developing healthier emotional regulation and increasing of distress tolerance.
Therapeutic approaches commonly used include:
- Dialectical Behavioral Therapy (DBT)
- Schema focused therapy (SFT)
- Mentalization based therapy (MBT)
- Therapeutic Community therapy (TC)
- Interpersonal Therapy (IT)
(Bateman, 2012; Choi-Kain et al., 2017; Yalom & Leszcz, 2005).
Each of these therapy approaches work differently with each person diagnosed with BPD. However, their availability and suggested efficacy only show that there is high hope in dealing with BPD symptoms.
What we must remember is that beyond labels, mental health conditions are a cluster of symptoms with roots and outcomes, once addressed and provided with appropriate treatment, improvement is inevitable.
If you or anyone you know is experiencing emotional difficulties don’t hesitate to seek help. Our platform is here to offer you psychological support.
- Bateman A.W. (2012). Interpersonal psychotherapy for borderline personality disorder. Clin Psychol Psychother. 19(2):124-33.
- Biskin R. S. (2015). The Lifetime Course of Borderline Personality Disorder. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 60 (7), 303–308. https://doi.org/10.1177/070674371506000702
- Cattane, N., Rossi, R., Lanfredi, M. et al. (2017). borderline personality disorder and childhood trauma: exploring the affected biological systems and mechanisms. BMC Psychiatry, 17, 221. https://doi.org/10.1186/s12888-017-1383-2
- Choi-Kain, W. L., Finch, E. F., Masland, S. R., et al. (2017). What works in the treatment of
- borderline personality disorder. Current Behavioral Neuroscience Reports, 4, 21-30.
- Hallquist, M. N., & Pilkonis, P. A. (2012). Refining the phenotype of borderline personality
- disorder: diagnostic criteria and beyond. Personality Disorders: Theory, Research, and
- Treatment, 3 (3), 228-246.
- Kennard, D. (1983). An introduction to therapeutic communities. J. Kingsley Publishers.
- National Health Services (NHS). (n.d.). Symptoms - Borderline personality disorder. NHS choices. Retrieved June 23, 2022, from https://www.nhs.uk/mental-health/conditions/borderline-personality-disorder/symptoms/
- Yalom I., D., & Leszcz, M. (2005). The theory and practice of group psychotherapy. (5th ed.). Basic Books.