Borderline Personality Disorder: Causes and Symptoms

Borderline disorder is more common than, for example, schizophrenia or bipolar affective disorder. However, so far it remains one of the least studied. It is characterized mainly by unstable relationships with other people, serious difficulties in managing emotions, low self-esteem, impulsiveness. People suffering from this disorder have a powerful fear of being abandoned by the object of attachment, suffer from a chronic feeling of inner emptiness, suicidal behavior.

Features

A. Langle compared borderline personality disorder (BPD) with a greasy stain that was eaten into clothing. If after washing it can disappear, then the image of this spot can be a metaphor for this neurotic disorder. Neurosis does not change the structure of processes taking place in the mental life. PRL is like a stain that is so deeply embedded in the fabric that it is not clear what color it used to be. It affects the structure of perception of reality, on the features of perception of external events.

This disorder is often associated with an atmosphere of distrust, lies in the family. Children with BPD feel that they have the right to life, but only as a subject, a means to solve other people's problems. Nobody needs them as people who have their own feelings - only as a tool. When a person grows with such experiences, this is the basis for the future “splitting”. The impulses of the patient with PRL are completely healthy, they are directed against external aggression. In other words, they separate it from the outside, and inside there is a constant response to this situation - this creates tension.

The main symptoms

The following are the main symptoms of borderline personality disorder:

• Instability of judgments about oneself, loss of self-determination.
• Behavior that seeks to avoid imaginary abandonment by other people. As a rule, it is demonstrative in nature: it is an irrational waste of large sums of money, careless driving a car to tickle your nerves, a constant change of sexual partners, alcoholism, etc.
• Voicing aloud thoughts of suicide and real attempts to commit suicide.
• Self-mutilation - burns, cuts, and even fractures.
• Too strong emotional reactions - anger, irritability, constant anxiety.
• Depressive conditions. Feeling of inner emptiness.
• Paranoia - outbreaks of suspicion about the actions and intentions of others.

Character Properties

PRL contributes to the disadaptation of personality in society and significantly reduces the quality of life. This is a fairly common disorder. They often suffer from people who were abandoned by their parents in the period from 1 year to 3 years. In childhood, parents did not respond to their needs and requests. The cry of the child, his smile or words could be ignored. This period is very important for the normal growth and development of the individual. The omission in this period often leads to tragedy in adulthood. Psychologists identify several character traits inherent in people with BPD:

• Hypersensitivity to the events of the world. M. Linehan writes that their emotional reaction is similar to as if a person had no skin. Too strong sensitivity to criticism and separation from loved ones can even provoke suicide attempts. When it comes to stressful events, then the experiences can be so strong that they seem to destroy a person from the inside. This is a particularly powerful emotional pain, and the inability to control anger and aggression, and a sharp change of joy with sadness - as if on a swing.
• Inability to endure parting. One of the main signs of borderline personality disorder. Sometimes the need for isolation from a loved one can be so strong that a person suffering from BPD makes a suicide attempt. During this period, their behavior is seriously changing. They become angry, aggressive, incredulous. They are also acutely worried when they are rejected by a loved one. On the one hand, loyalty is very important to them. They are attached not only to people, but also to things - for example, they may not throw away the old phone until they buy a new one.
• Ambivalence of feelings. During stress, people suffering from BPD can both love and hate. Their feelings can be characterized with the help of antagonism and intensity. One and the same person can be both a friend and an enemy for a “border guard”.
• Idealization and depreciation. Another characteristic tendency. A person can simultaneously see in others the top of perfection, and for some time completely depreciate what seemed beautiful to him. In other words, an adequate representation of people with BPD is either absent or seriously reduced.
• Shame. Often such people are deeply ashamed of their own behavior or suicidal tendency, which they cannot control. Often, people around them can hear from them: "I am very ashamed of myself."
• The inability to be in a close relationship for a long time. People with borderline personality disorder experience deep anxiety and panic, trying to leave the relationship. They often tend to change the object of their affection or to be in completely chaotic relationships.
• Low self-esteem. A man from childhood considers himself unworthy of respect. In childhood, they often experienced neglect from their own parents, and this seriously affects their worldview as an adult. They can do a lot and are often gifted in any field. However, due to the peculiarities of worldview, lack of faith in one's own strengths and low level of internal resources, they may not notice their capabilities.

In general, people with BPD are characterized by isolation, distrust of other people, a feeling of failure, life-threatening behavior, stress.

Social disorder

Manifestations of emotional instability in people with BPD always occur in the context of their relationships with other people. For example, if you place a patient with schizophrenia on an uninhabited island, he will show the same symptoms as during his life in society. However, if a person with BPD is completely alone, then he is unlikely to have any symptoms noticeable. His disorder always manifests itself in the context of interaction with other people.

Differential diagnosis

The symptoms and signs of borderline personality disorder are often overlooked by psychotherapists. Or pathology is completely mistakenly diagnosed as bipolar disorder. Psychotherapists mislead various symptoms, including mood instability. At the same time, a change in the emotional state in people with BPD and bipolar disorder varies in duration. If the latter one or another emotional background can last for several weeks or months, then in patients with PRL, ups and downs can occur in the short term - for example, right at the table during dinner.

As if to complicate the diagnosis of borderline personality disorder, the symptoms and signs of this deviation are quenched in the signals of other diseases. BPD is often complicated by depression, anxiety disorders. For example, major depression occurs in more than 80% of patients with BPD; various disturbing disorders - in 90%; bulimia and PTSD - in 26%. 21% of patients with BPD suffer from anorexia. One study showed that about 2/3 of patients with this diagnosis can use drugs or alcohol.

Langle emphasized that this distinguishes this disorder from neurosis. A person with sociophobia or, conversely, a fear of being left alone may know that something is wrong with him. However, a suffering BPD may not believe that something is wrong with him, even if others will tell him about it for ten to twenty years. He will perceive his reactions as completely normal. In this regard, a patient with a borderline type of personality disorder is close to people with another group of disorders - psychoses. But unlike the latter, he has a good connection with reality. PRL does not provoke the occurrence of hallucinations - neither sound nor visual. If a psychotic lives in his own world, and other people feel it, then a patient with BPD can work effectively, have a family, and hobbies.

Research

In order to diagnose borderline personality disorder, the following methods are used:

• graphic (drawing), oral and written testing;
• blood tests that determine the level of hormones;
• a long conversation with a psychologist, during which the nuances of the course of the disease, its beginning, factors that cause relapse, personal fears and dreams are clarified.

Treatment

Therapy of borderline personality disorder is the process of ridding the patient of the usual destructive patterns of behavior. It is aimed at preventing suicidal attempts, mental self-destruction, intentional harm to oneself or to other people.

Typically, the following approaches are used:

• Cognitive behavioral therapy. It allows a person to change ideas about himself, patterns of behavior, learn to control his condition.
• Dialectical. The main goal of this type of treatment of borderline personality disorder is to eliminate destructive forms of interaction with other people.
• Psychodynamic. The causes of a mental disorder are derived from an unconscious form into consciousness so that the patient has the opportunity to overcome them.

Psychopharmacology

In the process of treating this disorder, several types of drugs are usually used.

• Mood stabilizers. They help reduce aggression, control outbreaks of aggression.
• Antipsychotics (antipsychotics). Treatment of borderline personality disorder with the help of drugs of this group helps to reduce depressive symptoms, eliminates sudden mood swings.
• Selective MAO inhibitors help reduce anxiety, prevent attacks of fear, increase appetite.

Necessary measures at home

It is important for a person suffering from borderline personality disorder to:

• prolonged sleep;
• regular meals containing vitamins;
• physical activity - it can be running, swimming, Pilates.

In addition, it is necessary to exclude alcohol, narcotic substances, various kinds of energy drinks. The relationship should be acceptance, emotional warmth.

The main difficulty is to prevent relapse of the disease. Complete elimination of symptoms is a very complex and long process, sometimes it can take up to 10 years.

PRL: what is it for loved ones?

People who have to live next to the patient often use the general expression: "to tiptoe." It is it that most fully describes what it feels like to be near a suffering PRL. The emotional experiences of the patient can undergo very rapid changes. Even the most harmless commentary can cause a nervous breakdown.

The discomfort that patients bring to other people can lead to the fact that people with BPD begin to cause harm to themselves. Or they participate in some other form of impulsive behavior aimed at mental or physical self-destruction. This can be including a big waste of money, a constant desire for intimate relationships, drug addiction, dangerous driving.

Often, the people who surround the patient gradually suspect that he has a borderline personality disorder. How to help a person in this case? Psychologists recommend maintaining goodwill in communication, but at the same time gently interrupt aggressive behavior. For example, a patient may be asked: “Do you need to behave in such an aggressive manner now? We may well discuss everything in a friendly atmosphere. ” Moreover, this proposal should not sound manipulative or accusatory, it really should be saturated with goodwill.

It is difficult to expect that the “border guard” will be able to fully recover if he learns to control his internal impulses. However, this can give him the opportunity to calm down a bit, feel security and stability. After all, you can not only maintain contact with the patient for a long time, but also build productive relationships with him. It will be very useful for relatives and close sick people to contact a psychologist and make an appointment for several meetings in order to learn the friendly manner of communicating with the “border guard”. During the course of psychotherapy, patients receive a chance to significantly improve their quality of life. And loved ones learn one of the most important things - to be a person who knows how to accept and understand their neighbor. Even in the event that it is significantly different in terms of mentality from the majority.

Borderline personality disorder: how to help yourself? Psychologists advice

A person with BPD first of all suffers from his impulsiveness and emotions. And therefore, many have a natural desire to make their life more comfortable. Many of the patients are interested in: how to live with borderline personality disorder? Consider the main recommendations.

1. The most important step is to make the correct diagnosis. It should be remembered that in very rare cases, self-diagnosis may be correct. Not always mood swings indicate the presence of this violation. Also, do not rely on the fact that you can cope with the disorder on your own. After all, the human psyche is designed in such a way that it seeks to constantly avoid “sharp corners”.
2. It is also important to be able to take everything that happens with you. Symptoms of borderline personality disorder are features of the human psyche, and not a curse, a consequence of poor education, etc.
3. Learning to control impulsive behavior is especially important. After all, a phase change can happen almost instantly and imperceptibly for the “border guard” himself. Before a change of mood, there is usually a moment of irritability, which can also be noticed by loved ones. They can make comments that a breakdown may occur. However, it is important that loved ones do not use such warnings to manipulate.
4. After the phase has changed, an uncontrollable surge of despair and anger may begin. This is also one of the features of the response. Here you need to learn to pull yourself together. If you get the impression that "everything is wrong" and all around you are ill-wishers, it is important to remind yourself that in reality things are different.
5. Typically, a change of mood occurs for a specific reason. A borderline personality disorder usually suffers from a number of such situations. It is necessary to clearly define these circumstances and develop an algorithm for working with them - to avoid or look for possible solutions.
6. You need to know your feelings and practice in determining them. When a name is given to an emotional state, it is, as it were, “objectified” and easier to control. Feelings can be different in strength and meaning. A useful skill is to learn how to determine the gradation of these conditions.
7. It is equally important to learn to relax. Meditative techniques and the method of progressive relaxation are well suited for this.
8. Suffering from borderline personality disorder it is useful to direct efforts in line with the search for yourself, the formation of your personality. After all, often they seem to “borrow” part of someone else's character. Their individuality is smeared, they know little about themselves. What is important in life? What is the main goal? What role do other people play?
9. Develop the ability to empathy, understanding of other people. Of course, “merging” with another person at the “border guard” is very good. However, one must learn to do this consciously, and in this case it will no longer be a merger, but conscious compassion.
10. It is also useful to read specialized books. Borderline personality disorder is covered in detail in such publications as The House of Cards by Irina Mlodik, Cognitive Behavioral Therapy of PRL by M. Layen, Restless Mind. My victory over bipolar disorder. ”Jamison Kay.

Despite all the difficulties that accompany therapy, a positive outcome is possible. But the patient must remember that this is a rather complex and lengthy process. There is no hope for rapid improvement. With the right choice of the method of psychotherapy, as well as the presence of a sensitive and competent psychologist, it is quite possible to achieve both large and small successes.