Diagnosing and Treating Borderline Personality Disorder

Is There a Borderline Personality Disorder Test?

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Borderline personality disorder (BPD) is a mental health condition that causes people to have difficulty regulating their emotions. The primary symptoms of the condition are dramatic mood swings, impulsive behaviors, poor self-esteem, and persistent difficulties in personal and professional relationships.

People dealing with borderline personality disorder often experience a different perception of reality and in particular, may feel a strong sense of abandonment by loved ones.

BPD can lead to additional mental health difficulties, such as self-harm and suicide. 

Cause of BPD

It is not yet known exactly what causes BPD, but a combination of genetics, neurological, and social factors are most likely at play in people with the condition. For example, people with a first-degree relative who has the condition are about five times more likely to suffer from BPD. In addition, many people with BPD experienced trauma at some point in their lives. And imaging studies have shown that people with BPD demonstrate structural and functional differences in their brains compared to those who don't have the condition. 

Diagnosing Borderline Personality Disorder

Only a qualified mental health professional can diagnose BPD. Usually, a diagnosis is made after a comprehensive assessment, which is much more than a simple test. The process may include consultations and conversations with previous caregivers, family members, and friends.

Ultimately, a diagnosis requires at least five of the nine primary symptoms of BPD to be present:

  1. Fear of abandonment
  2. Difficult interpersonal relationships
  3. Uncertainty about self-image or identity
  4. Impulsive behavior
  5. Self-injurious behavior
  6. Emotional changeability or hyperactivity
  7. Feelings of emptiness
  8. Difficulty controlling intense anger
  1. Transient suspiciousness or “disconnectedness”

Often, ordinary activities and events can precipitate symptoms in a person with BPD. For example, when a close friend or relative takes a vacation or has to cancel plans due to a work conflict, a person with BPD may become very upset and angry, fearing abandonment. 

Treating Borderline Personality Disorder

Treatments plans for BPD typically involve some combination of therapy, medication, and social support. Therapy may include dialectical behavioral therapy, cognitive behavioral therapy, and psychodynamic psychotherapy. Medications that may be useful include mood stabilizers, antidepressants, or antipsychotics. Often, treatment plans need to be adjusted based on trial and error. 

In addition, adhering to some of the following lifestyle modifications may be useful in recovering from BPD:

  • Maintain a regular eating and sleeping schedule
  • Exercise regularly
  • Spend time with friends and family and build trusting relationships with people you can confide in
  • Inform friends, family, and co-workers about what may trigger symptoms
  • Be patient with your progress
  • Learn about your condition and stay informed about treatment options
  • Avoid alcohol and drugs

Source:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

American Psychiatric Association. "Practice Guideline for the Treatment of Patients with Borderline Personality Disorder." American Journal of Psychiatry, 158:1-52, 2001.

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