Personality Disorders Plymouth

Borderline Personality Disorder

 

What is Borderline Personality Disorder?

 

Borderline personality disorder is a disorder of mood (instability) and interaction with others (unstable relationships). It is more common in women, but this could be because some men are less likely to seek treatment.

 

Here is a video of Frank Yeomans: 'Understanding the BPD Mind'

https://www.youtube.com/watch?v=B_--SCmZ9Fc

 

More information can be found at: www.counselling-directory.org.uk/borderline.html

 

Difference between Borderline Personality Disorder and Bipolar

 

There is often confusion between bipolar and borderline personality disorder. This is because they both include problems with mood regulation. Mood states are experienced more severely than in other people.

 

For those with borderline personality disorder ineffective patterns of interactions with other people have always been a problem since a very young age. So this behaviour is typical of them at all times.

• They experience episodes of intense emotions and these moods change hourly or daily.

• These moods are usually anger, emptiness, sadness or anxiousness (as well as others), but not euphoria.

• Impulsive actions and difficulty controlling behaviour happens everyday.

 

For those with bipolar disorder emotional and behavioural patterns occur which are different from their typical self.

• They experience moods lasting for days or weeks, these manic or depressive symptoms are a change from their typical self.

• Mania or hypomania are experienced by those with bipolar disorder, and they have euphoric episodes.

• Impulsive acts occur in states of mania or hypomania so are not typical.

 

Symptoms

 

BPD can cause symptoms such as:

• Intense negative emotions, mood swings, anger – emotional instability

• Self-harm, reckless drinking, eating or sex – impulsive behaviour

• Feeling abandoned or smothered - unstable relationships

• Hallucinations and delusions – disturbed thinking

 

Most people with BPD experience some of these symptoms and you do not have to experience all of them to be diagnosed with BPD.

 

Causes

 

• About 8 out of 10 people with BPD have experienced neglect or physical, sexual or emotional abuse in childhood.

• The genes inherited by parents can also make you more vulnerable to developing BPD. When you are already vulnerable and then experience a certain environment BPD symptoms can start to show.

• Neurotransmitters which are ‘messenger chemicals’ between brain cells in the brain can affect your mood and behaviour.

  • Serotonin is linked to depression and aggression.

  • Dopamine and noradrenaline are linked to emotional instability.

• MRI scans have shown that some people with BPD have abnormal brain structure and functioning. Differences in these brain areas have been shown in some BPD patients:

  • The amygdala, which helps to control emotions, especially ‘negative’ emotions

  • The hippocampus, which helps to control behaviour

  • The orbitofrontal cortex, which is involved in decision making.

 

 

 

Outlook

 

For many people with BPD self-help, coping skills or therapy can help them reduce symptoms over a long period of time and most of the therapies will be long term.

Studies have also shown that 50% of people with BPD live symptom free and function well over time.

For some people BPD can be a serious condition which leads to self-harm and attempted suicide (about 65%). But if this is the case and symptoms are moderate to severe you can be started on a care programme approach.

There are four stages:

• Health and social needs assessment

• Create a care plan for those needs

• Be given a care co-ordinator (social worker/nurse)

• Have regular reviews of your care plan

 

Treatments

 

Techniques which are particularly effective for BPD include:

 

• Dialectical behaviour therapy

• Mentalisation-based therapy

• Therapeutic communities

 

Access the Treatments page for more information