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Borderline Personality Disorder

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Abstract

Borderline Personality Disorder (BPD) is a mental health condition characterized by

difficulties in emotion regulation. People with borderline personality disorder often exhibit

numerous symptoms, which makes it hard for them to lead normal lives. Symptoms like

mood swings between strong emotions, fear of abandonment, use of extreme black and white

thinking, and self-injurious behaviors often make it difficult for people with a borderline

personality disorder to establish healthy relationships with other people in the community.

The exact cause of borderline personality disorder remains a mystery; however, it is believed

that borderline personality disorder can arise due combination of varied reasons. The main

reason that can lead to the development of borderline personality disorder is traumatic

childhood experiences, like abandonment by a parent (s), adoption, sexual, physical, or

emotional abuse. Such traumatic life experiences can lead to one developing certain coping

strategies or beliefs about themselves and other people, which can impair their ability to

balance their emotions. Borderline personality disorder can also arise due to biological

factors affecting the development and structure of the brain. Despite the lack of a known

cause for borderline personality disorder, there are currently numerous treatment options for

people with the health condition. Psychotherapy which entails speaking to a therapist to help

one get a better understanding of their feelings and way of thinking, is currently the most

common intervention given to people with this disorder. In certain cases, patients may also be

given drugs like antidepressants or antipsychotics to help address some of their symptoms as

a way of stabilizing their emotions. Patients with incessant behavior of self-harm can also be

institutionalized in psychiatric hospitals to protect them from harming themselves or those

around them. 

Key words: disorder, health, patients, moods.

Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a mental health condition that is

characterized by difficulties in the regulation of emotions. According to Krause-Utz et al.

(2018), people with borderline personality disorder often experience emotion deregulation,

insatiable cognitions, impulsivity, interpersonal disturbances, and dissociations, which makes

it hard for them to lead normal lives. A borderline personality disorder is known to affect

how people think and feel about themselves and others which can negatively affect their daily

functioning. The overly sensitive nature of people with borderline personality disorder is

associated with high levels of emotional and physical pain, which increases the chances of

self-harm and suicide. The diagnosis and treatment of borderline personality disorder is a

huge challenge for many healthcare practitioners due to the lack of a known cause or

approved drugs for this condition. 

Symptoms

Borderline Personality Disorder is a mental health condition that often manifests itself

in numerous ways. People with BPD often experience unstable mood swings between intense

emotions, which makes them emotionally volatile (Krause-Utz et al., 2018). The mood

swings that people with BPD often experience can sometimes be triggered by events that

even the person is unaware of, which makes it hard for them to maintain healthy relationships

with others because in one moment, everything may be fine, but in the next, everything may

be bad.

People with BPD are also known to perceive things using extreme black and white

thinking, such as all good or all bad, which, when combined with the regular mood swings,

can make them highly unstable and hard to deal with (Kramer, 2017). Therefore, people with

BPD can easily shift their opinions about someone or something in a split second, which
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makes it hard for them to maintain stable relationships with other people because what is

considered good now may be seen as bad in the next minute.  

Another key symptom of borderline personality disorder is the fear of abandonment.

People with BPD are often insecure about themselves, which makes them always anticipate

being abandoned by others due to varied reasons. To avert this fear, people with BPD tend to

either quickly initiate an emotional or physically intimate relationship with others or cut off

communication to avoid being overwhelmed with feelings of abandonment (Luyten et al.,

2020). A borderline personality disorder is also associated with high levels of suicidal threats

and self-harm behavior. People with BPD often engage in self-harm as a way of dulling their

emotional pain, regaining control of their emotions, punishing others or themselves, or

showing others how they feel. 

Other symptoms of borderline personality disorder often include:

 Chronic feeling of emptiness

 Unstable body image issues

 Explosive anger

 Impulsive, self-destructive behavior

 Difficulty trusting

 Feelings of dissociation

Causes

Borderline personality disorder can develop due to a combination of numerous

factors, even though there is still no clear cause for this disorder. The first factor that can lead

to the development of Borderline Personality Disorder is traumatic or stressful life

experiences. People who have experienced traumatic life experiences like abandonment by a
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parent, neglect, adoption, or sexual, physical, or emotional abuse, especially during their

childhood, are often more susceptible to developing BPD (Luyten et al., 2020). Traumatic

experiences during childhood can make a person develop certain coping strategies or beliefs

about themselves and other people, which can impair their ability to balance their emotions.

For instance, a child that is brought up in an abusive home may grow up thinking that being

they are unworthy of love which makes them think less of themselves and struggle with

issues of insecurity and body image. 

Borderline personality disorder can also arise due to biological factors affecting the

development and structure of the brain. According to the National Institute of Mental Health

(NIMH, 2017), studies have shown that people with borderline personality disorder can

experience structural and functional changes in their brain's neurotransmitters, particularly

serotonin. Serotonin is a hormone responsible for regulating a person’s moods; therefore, any

alterations in this hormone can make a person more susceptible to developing a borderline

personality disorder. People with BPD also tend to have brains that are on high alert, which

makes it easier for their fight-or-flight switches to be easily tripped than those of other

people. When their brains enter into this mode, they can easily become irrational, leading

them to behave in certain ways that are not appropriate to the situation at hand ((NIMH,

2017).

Treatments

Psychotherapy

There are numerous treatment options available to people with a borderline

personality disorder. The first treatment option available to persons with BPD is

psychotherapy which entails taking time to talk to a trained therapist to help one get a better

understanding of their feelings and way of thinking. Psychotherapy allows patients with BPD

to focus on their function by learning how to manage their emotions when they experience
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mood swings. Different types of psychotherapy are often offered to patients with BPD. The

first type of psychotherapy offered to people with BPD is Dialectical Behavioral Therapy

(DBT). According to Jaeger et al., (2017).dialectical behavioral therapy is a type of therapy

designed to help people manage their emotions, tolerate distress, and improve their

relationships with others by accepting that their emotions and feeling are real and acceptable

The second type of psychotherapy that is offered to patients with BPD is

mentalization-based therapy (MBT). According to the National Institute of Mental Health

(2017), Mentalization-based therapy is a type of therapy that is designed to help persons with

BPD to recognize that other people also have emotions and beliefs, which they need to

consider before reacting. Through mentalization-based therapy, patients can learn how their

behaviors may affect others and the ways of managing their emotions to enable peaceful

coexistence with other people (Kramer, 2017). The third type of psychotherapy that can be

offered to patients with BPD is the use of therapeutic communities. Therapeutic communities

are places of residence where people with varied mental health issues can live together to

receive therapeutic interventions that help improve their relationships with others as well as

managing their own emotions.

Medication and Hospitalization

The second way to treat borderline personality disorder is through medication and, in

some cases, hospitalization. There are currently no approved drugs for the treatment of BPD;

however, patients can be given drugs to address certain symptoms of their disorder

(Wlodarczy et al., 2018). For instance, patients can be given antidepressant drugs to help

reduce their depression and anxiety levels, which are common symptoms of BPD. However,

in severe cases like when a person incessantly engages in bodily harm, they can be

institutionalized in a psychiatric hospital to help protect them from hurting themselves, or

they are loved

References

Jaeger, S., Steinert, T., Uhlmann, C., Flammer, E., Bichescu-Burian, D., & Tschöke, S.

(2017). Dissociation in patients with borderline personality disorder in acute inpatient

care–a latent profile analysis. Comprehensive Psychiatry, 78, 67-75.

Krause-Utz, A., Winter, D., Schriner, F., Chiu, C. D., Lis, S., Spinhoven, P., ... & Elzinga, B.

M. (2018). Reduced amygdala reactivity and impaired working memory during

dissociation in borderline personality disorder. European archives of psychiatry and

clinical neuroscience, 268(4), 401-415.

Kramer, U. (2017). The role of coping change in borderline personality disorder: A process‐

outcome analysis on dialectical-behavior skills training. Clinical psychology &

psychotherapy, 24(2), 302-311.

Luyten, P., Campbell, C., & Fonagy, P. (2020). Borderline personality disorder, complex

trauma, and problems with self and identity: A social‐communicative

approach. Journal of personality, 88(1), 88-105.

National Institute of Mental Health. (2017). NIMH » borderline personality disorder. NIMH

» Home. https://www.nimh.nih.gov/health/topics/borderline-personality-

disorder#part_2248

Wlodarczyk, J., Lawn, S., Powell, K., Crawford, G. B., McMahon, J., Burke, J., ... & Litt, J.

(2018). Exploring general practitioners’ views and experiences of providing care to

people with borderline personality disorder in primary care: a qualitative study in

Australia. International journal of environmental research and public health, 15(12),

2763.