Comorbidities and Borderline Personality Disorder

BPD is Difficult Because Few People Have Only One Disorder

If you have borderline personality disorder (BPD), you may find that comprehensive treatment plans are difficult to find. Many cases of BPD are treated on a one-by-one basis because few people have only one illness. Most people affected by BPD have other disorders, known as comorbidities. 

What is a Comorbidity?

A comorbidity refers to the existence of two or more diseases or conditions in the same individual at the same time.Some of the most common comorbidities that occur alongside BPD are depression, anxiety and post-traumatic stress disorder.

A person who has both BPD and depression would be referred to as a "comorbid depression and BPD" patient. 

While by definition comorbid disorders must exist at the same time, it may be the case that one of the conditions or disorders may have started before the other. For example, someone may develop PTSD in childhood, then later develop BPD as an adolescent. Or, both conditions may develop at the same time, but one may end while the other continues or worsens.

For as long as the symptoms of both disorder overlap in time, they are considered to be comorbid.

What Makes Comorbidities Dangerous?

Comorbidities can be dangerous, particularly if you have BPD. The other illnesses, like depression or anxiety, are more easily recognized and are more regularly treated. Many people are not appropriately diagnosed with BPD because the other illnesses "hide" the BPD symptoms. This means that the personality disorder symptoms go untreated and unchecked.

While depression and anxiety may be treated with medication, there is no medication approved for BPD. If BPD is not recognized, your disorder can go undiagnosed and untreated for months or even years, making you feel even worse and putting your health at risk. 

How Should Comorbidities and BPD Be Treated?

Regardless of the comorbidities that exist, BPD needs to be addressed as a distinct and unique disorder.

While other illnesses can be treated and managed with a pill, BPD usually requires a more intensive approach. Many forms of psychotherapy have shown significant positive results in clinical studies, especially dialectical behavior therapy. 

Therapy is an essential part of managing BPD. Look for a therapist who understands comorbidities and who specializes in BPD to develop an effective treatment plan for you. In some cases of comorbidities, you may need multiple physicians and therapists to handle every aspect of BPD and the other disorders. In this case, it's important that all of your healthcare providers know what's going on with other aspects of your treatments. If there are any changes to your therapy plan or medication regimen, make sure everyone on your medical team is aware. 

Clear communication between the whole group can prevent misunderstandings or mix-ups that could interrupt your recovery. Particularly with BPD, splitting is possible, so keeping communication open between parties will ensure your therapy moves forward appropriately.

 

While comorbidities can make BPD more difficult to diagnose and manage, understanding the other disorders and how they impact BPD is essential to developing an effective treatment plan. If you are unsure if you have other disorders or think you are at risk of developing a comorbidity, talk with your doctor or therapist to be evaluated. 

Source:

Biskin, R. "Comorbidities in Borderline Personality Disorder". Psychiatric Times, 2013. .

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