I Love You, I Hate You But Do not Go: Understanding Borderline Personality Disorder

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It amazes me that 6-10 million Americans have been diagnosed with this isolating disorder. What’;s amazing about this is that not much is written about BPD much less talked about. Almost like there is a stigma attached to the very name.

The name Borderline Personality Disorder originated in 1938 by Adolph Stern. He was describing a group of patients that did not quite fit an existing diagnosis; patients that were classified as past the neurotic stage but not quite psychotic. However these days this disorder is seen in a different way but the name BPD has stuck.

BPD is relatively common, affecting 10-14% of the general population. Women commonly suffer from depression more often than men and the frequency of BPD in women is two to three times greater than men. Nearly 20% of psychiatric hospitals stem from BPD.

While people that suffer with depression or bipolar disorder typically end the same mood for several weeks at a time, a person with BPD can experience depression and anxiety that may last only an hour or at most, a day.

Symptoms of Borderline Personality Disorder

o Impulsive aggression

o Self injury

o Strong feelings of anxiety

o Feelings of low self worth

o Drug or alcohol abuse

o Impulsive behaviors

o Feelings of being misunderstood

o Experience unstable relationships

Sometimes people suffering from BPD view themselves essentially as bad people or unworthy. This mood instability and poor self-image can bring on bouts of anger, eating disorders, panic attacks and anxiety. Very intense emotional turmoil appears to be a way of life for those afflicted by it.

However, often times a person with BPD can present as a bright, intelligent individual with a warm, friendly nature. They can maintain this appearance for a number of years until their defense mechanism breaks down, usually because of a very stressful situation like a relationship breakup or death of a loved one.

They may feel isolated and empty which may result in frantic efforts to avoid being alone. People with BPD often formulate highly unstable relationship patterns. While their relationships with family and friends can be very intense their attitude can change dramatically and suddenly from great admiration and love to surround anger and distaste. Often times they will form an immediate attachment to another person but when even a slight conflict or separation occurs they shift suddenly to the other extreme and accuse the other person of not really caring about them at all. They are highly sensitive to any sign (real or imagined) of rejection and react quickly with anger and distress when their expectations are not met.

Over the years treatments for BPD have improved with group and individual psychotherapy at least partly effective for a great number of patients. Talking about present challenges and past experiences with an empathetic and accepting therapist on a consistent and regular basis has proven effective. Patients are encouraged to talk about their feelings rather than expel them in their usual self-defeating manner.

Sometimes medicines such as antidepressants or lithium carbonate are helpful in treatment of BPD and brief hospitalization may be necessary during acutely stressful episodes or if self-destructive behavior strains to erupt.

The goals of ongoing therapy and / or treatments would be to increase an individual’;s tolerance of anxiety as well as increase self awareness and build more stability into relationships. With increased self awareness and introspection, it is treated that individuals with BPD will be able to change rigid patterns of behavior set earlier in life which in turn will help prevent these patterns from repeating themselves in future generations.