Emotional dependence in Borderline Personality Disorder

A personality disorder is defined as a mismatch based on a rigid and unhealthy pattern of thinking. This term encompasses a set of disturbances or abnormalities that occur in affective dimensions, of social relationship with individuals and motivational areas. Up to 60% of psychiatric patients have some type of personality disorder, so it is considered the most common diagnosis in psychiatry.

Borderline Personality Disorder (BPD or BPD, for its English translation Borderline Personality Disorder) is defined as a personality disorder characterized by emotional instability, extremely polarized and dichotomous thoughts, chaotic interpersonal relationships and marked impulsivity. It is included within cluster-B at the diagnostic level, within the so-called “dramatic-emotional” disorders. It shares a category with histrionic personality disorder, narcissistic and antisocial.

The prevalence of BPD is estimated to be 1.6% within the general population, but it represents 20% of psychiatric patients. These figures could be biased and the prevalences are probably much higher, due to the social stigma that (unfortunately) still entails being diagnosed with a psychological disorder. In the following lines,

We explore the relationship of emotional dependence in Borderline Personality Disorder. Do not miss it.

• Related article: "Borderline Personality Disorder: causes, symptoms and treatment"

Diagnosis of Borderline Personality Disorder (BPD)

Before diving into the correlation between the two events, we see it necessary to give the public a series of brushstrokes on the characteristics of Borderline Personality Disorder. The Diagnostic and Statistical Manual of Mental Disorders (DMS-5), ratified in 2013 by the Association of Psychiatry (APA) sits chair in the diagnosis of mental disorders is refers.

According to this source, the patient with BPD must present at least 5 of the following features for more than a year:

• Frantic efforts to avoid abandonment, be it real or imagined.
• A pattern of unstable interpersonal relationships, characterized by extreme poles of idealization and devaluation of people.
• Alteration of identity: constant changes in the perception that the patient has of himself.
• Impulsiveness in at least two areas that can be harmful to the patient: spending too much money, substance abuse, eating to fill, etc.
• Affective instability, marked by the reactivity of the character. For example, episodes of dysphoria, anxiety, or irritability, lasting only a few hours, are typical.
• A chronic feeling of emptiness.
• Difficulty controlling feelings of anger and aggressiveness. Fights and direct confrontations are common in these patients.
• Transitory paranoid ideas.

In addition to all these data of interest, medical research such as Borderline Personality Disorder (StatPearls, NCBI) state that Borderline Personality Disorder arises as a combination of genetic predisposition combined with events during childhood and certain neurobiological dysfunctions. It has been detected that the heritability pattern of BPD is 50%, even more than depressive disorders. On the other hand, up to 70% of patients have experienced violence, sexual abuse or neglect during childhood.

• You may be interested in: "Emotional dependence: the pathological addiction to your sentimental partner"

Emotional dependence and BPD

In the first of the points of the diagnosis of this pathology, it is evidenced that emotional dependence and Borderline Personality Disorder are widely linked. The BPD patient is characterized by a marked feeling of emptiness and, furthermore, has an irrational (and unjustified) fear of being abandoned by the people around him. In any case, beyond "obvious" causalities, we require scientific sources to confirm our suspicions.

The study Dependency, mood instability, and inconsequence traits for discriminating borderline personality disorder, published in 2019, explores the correlation of BPD with emotional dependence, emotional instability and inconsistency. For this, a total of 305 patients were taken divided into 3 groups: diagnosed with BPD, patients with other personality disorders and a standard sample group, that is, a sector of the population does not pathological.

After that, a standardized survey (IDCP-2) was carried out on each of the people in all groups. sample, made up of 206 questions that could be rated from 1 to 4, from "it has nothing to do with me" to "Defines me." This questionnaire quantifies the factors most related to Borderline Personality Disorder, such as self-devaluation, insecurity, anxiety, fear of abandonment, self-image problems, impulsivity, decision-making risky, etc.

Statistical analysis showed a significant correlation between BPD patients and emotional dependence, but also with emotional instability and inconsistency. In addition, it was observed that, within the factors encompassed in the “dependency” sector (self-devaluation, fear of abandonment and insecurity), fear of abandonment was the best predictor of all. This makes a lot of sense on a psychological level, since insecurity, low self-esteem and impulsiveness are easily associated with the fear of being alone.

The scientific article Interpersonal dependency in borderline personality disorder: clinical context and empirical evidence goes even further, as it stipulates that there is a clear comorbidity between Borderline Personality Disorder and Dependent Personality Disorder. It is estimated that BPD occurs with other emotional disorders in 80-96% of cases, so it is to be expected that common points will be found between several of these entities in many patients.

A clear causality

With these scientific data, we have shown that the correlation between BPD and emotional dependence is more than clear. Fear of abandonment is a very powerful diagnostic criterion when identifying a patient with Borderline Personality Disorder, so the need not to lose loved ones is a typical trait of people who suffer from this pathology.

Finally, we want to emphasize that BPD and other disorders can be treated. In this specific case, there is no medication approved by the Food and Drug Administration (FDA) for pathology, since the effect of antidepressants, antipsychotics and other drugs is quite limited. In any case, the usefulness of psychotherapy has been shown to improve the symptoms of patients, so before this alteration it is important to go to the psychologist.

Bibliographic references:

• Carvalho, L. D. F., & Pianowski, G. (2019). Dependency, mood instability, and inconsequence traits for discriminating borderline personality disorder. Trends in psychiatry and psychotherapy, (AHEAD).
• Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. The Lancet, 364 (9432): 453-461.
• Borderline Personality Disorder, Jennifer Chapman; Radia T. Jamil; Carl Fleisher (2020). StatPearls.
• Bornstein, R. F., Becker-Matero, N., Winarick, D. J., & Reichman, A. L. (2010). Interpersonal dependency in borderline personality disorder: Clinical context and empirical evidence. Journal of Personality Disorders, 24 (1), 109-127.