Personality Disorders and Other Mental

Personality Disorders and other Mental Disturbances: A Comparison of Borderline Personality Disorder and Schizophrenia

There exists a very wide range in the types and cases of psychological disorders that have been identified and studies by the medical and psychological communities, and at times an overlap in certain symptoms or apparent behaviors can lead to a conflated diagnosis of several different disorders. This is not so much a problem for practiced psychological practitioners, of course, but for the lay community and those just beginning their study of psychology, the differences between types of disorders and specific disorders themselves can require some clarification. This paper draws a comparison between personality disorders, specifically borderline personality disorder, and a somewhat more serious and less treatable psychological condition, schizophrenia, to demonstrate the different causes, effects, and methods of handling these very different yet in some ways similar disorders.

Personality disorders themselves come in a wide range of forms, with varying effects on those who suffer from them. There are some common characteristics to personality disorders that be summarized here, however: all are pervasive, meaning that they affect most areas of life (according to the DSM-IV, "pervasive" means influencing at least two of the four areas of cognition, affectivity or emotional response, interpersonal functioning and impulse control) (Antony & Barlow 2004, pp. 459). They can also be very difficult to accurately and concretely diagnose due to the subjective nature of the patient's perceptions and responses (Antony & Barlow 2004, pp. 457-70.

Schizophrenia, on the other hand, is much more well-defined than is the general class of personality disorders, and there are specific symptoms that must be present -- as well as specific symptoms that must be absent -- before a diagnosis of schizophrenia can be made (Antony & Barlow 2004, pp. 374). While personality disorders generally reflect a difference in how n individual perceives and relates to the real world, schizophrenia is marked by a certain level of disconnect with the real world, and those suffering from schizophrenic disorders often find themselves trapped in worlds created by their own minds (Antony & Barlow 2004, pp. 373-82). All areas of life are affected by schizophrenia, with cognition, perception, and emotionality all in some way altered such that certain elements not present in non-sufferers persist for schizophrenics, and others are missing.

Borderline Personality Disorder

There is a general consensus among practicing therapists and psychologists that patients with borderline personality disorders are especially difficult to treat precisely because of the psychological condition they suffer from (Barlow 2008, pp. 365). Attempts to treat such individuals might actually have suffered due to this stigma, and recent figures suggest that up to three-quarters of individuals that meet the criteria for borderline personality disorder have a history of suicide attempts -- a number that might be reduced by more vigorous treatment (Barlow 2008, pp. 365). The fact that he disorder is characterized by feelings of victimization, a lack of personal responsibility, and high impulsivity and mood swings does not help matters (Paris 2007, pp. 457-8).

Essentially, those suffering from borderline personality disorder tend to see the world in extremes of either good or bad, and they generally see themselves as helpless to influence the course of their lives -- either wonderfully good things befall them or terribly bad things are done to them, and little or none of it is their fault (Barlow 2008; Paris 2007). This can make treatment difficult because alternative perspectives are discounted, and the desires of the patient -- however unhealthy and even irrational -- are continually and effectively rationalized, such that the patient does not see themselves as needing help but rather sees the world as something that needs to be fixed for them (Barlow 2008, pp. 406-11). Though borderline personality disorder is increasingly well understood, it remains highly difficult to treat as so much of it has to do with engrained perceptions and not physiological causes (Paris 2007, pp. 468).

Schizophrenia

Hallucinations, both visual and auditory, are common things for those suffering from schizophrenia; a belief that they are being controlled, hunted, or in some other way persecuted by a force outside themselves is often a feature in these hallucinations, which has made the disorder ripe fodder for television shows and movies needing a "blameless victim" (Frith & Corcoran 1996, pp. 523). The voices that schizophrenics hear might indeed persuade them to commit criminal and even violent acts, and the delusions of persecution might also lead to such behaviors when schizophrenics encounter individuals that they believe to be "enemies" within their framework of delusion (Hirsch & Weinberger 2003, pp. 25-7).

In addition to these rather extreme symptoms of schizophrenia, other milder signs often accompany the disorder and can appear as precursors to the full blown development of the disorder. An emotional "flatness" or lack of response to normal emotional stimuli is a typical aspect of schizophrenia in many of its stages, which contrasts sharply to the depths of fear, rage, and paranoia that schizophrenics can exhibit at the extremes of their delusions (Hirsch & Weinberger 2003, pp. 26-30). This is mirrored by a semi-catatonic physical state, where body movements become lessened, there is again reduced physical response to external stimuli, and even a marked reduction in sensitivity to pain (Hirsch & Weinberger 2003, pp. 25). Schizophrenics, simply put, no longer fully inhabit the same reality as do those not suffering from the disorder, but respond more to stimuli that is the creation of their own minds, rather than the simple and direct stimuli that truly exists in their lives.

Comparing Disorders

Borderline personality disorders, like all personality disorders, is primarily if not entirely an issue of perspective -- those with the disorder refuse to see themselves responsible for the circumstances of their lives, and have massive mood swings that they justify by seeing the world in extremes of black and white, good and bad, etc. (Paris 2007, pp. 460-1). Schizophrenics, on the other hand, truly see a different reality -- it is not merely the relationships between events, other people, and their own person that is subjectively skewed, but what their brain actually perceives in these persons and events is different (Firth & Corcoran 1996).