Diagnosing and Treating Borderline Personality Disorder

Borderline Personality Disorder Borderline personality disorder (BPD) is defined as a condition wherein the patient suffers from a difficulty in regulating his or her emotions (NAMI, 2018). Individuals suffering from BPD can lack impulse control, have a poor self-image, and experience severe emotional responses when stressed. The inability to regulate the emotions can lead the individual to lash out at the self and engage in self-harm in some cases (NAMI, 2018).

Though three-quarters of individuals diagnosed with BPD are women, some research indicates that an equal number of men may also suffer from the disorder and simply not be diagnosed.

Symptoms of BPD include: strong sense of abandonment by friends or family, real or imagined; very unstable relationships with others, consisting of wild swings between intense love and intense hate; distortion of a sense of one’s self that leads to depression or delusions of grandeur; poor impulse control; self-harm or suicide ideation; chronic feelings of boredom; intense anger; dissociation and paranoia. Currently there is no single definitive diagnostic test for BPD.

Those diagnosed with BPD are done so by a mental health care provider using a clinical interview process that may include discussions with others, friends, family, and an examination of a medical record. The doctor will diagnose the patient based on “affectivity, interpersonal functioning, impulse control and cognitive” domains, and the patient must meet at least more than half of 9 specific criteria according to the Diagnostic and Statistical Manual of Mental Disorder (Biskin & Paris, 2012). Psychotropic medications for treating the disorder could be prescribed.

Mood stabilizers and anti-depressants may be effective in helping the patient to stabilize and resist wild swings in his or her emotional state.

However, another possible therapeutic approach could be the use of cognitive behavioral therapy, which can help the patient to learn to process emotions, identify triggers or potential stressors and avoid them, and develop a plan for regulation of the emotions by identifying behavioral goals that have positive ramifications and working towards ways to achieve those goals routinely and on a daily basis so that they become normative (Eiraldi et al., 2016). For some patients, learning that they have a mental or emotional disorder can be challenging for them and even traumatic.

They may not understand why or how such a thing could happen to them. There are actually many factors that could be related to the onset of the disorder, including genetics and environmental factors; however, with a therapeutic approach like cognitive behavioral therapy the patient and provider do not necessarily need to worry about what causes or caused the borderline personality disorder; instead, they can focus on addressing the issue by learning new behavioral responses and how to implement them positively.

The method to use when communicating a diagnosis of this sort with the patient is to use simple, clear language that explains the disorder and does so in a way so that there is no stigma or taboo attached to the communication. A patient should never be made to feel as though he or she were now going to.