Borderline Personality Disorder: how it affects the patient and their environment

The borderline personality disorder (BPD) is a type of personality disorder (PD) characterized by a long-term pattern in the patient of unstable relationships, distorted self-perception, extremely polarized and dichotomous thinking, and stronger and more passionate emotional reactions than normal. In addition, BPD patients have a penchant for deep fear of loneliness and neglect.

Although it seems a condition confined to books and the psychiatric clinic, it should be noted that the prevalence of BPD in general society at any given time is 1.6% of the population, with a probability of occurring throughout the life of every individual of almost 6%. Despite the fact that gender biases have not been detected in the bulk of the population, it is known that gender female population go to the clinic more to treat this disorder, in a ratio of 3 women for every man affected.

With all these data, we want to show that borderline personality disorder is much more common than it seems, and it may even be that someone in your environment has received treatment to address it without know. You may even suffer from it, without still being aware of it. In order to empathize, know and understand, today we will delve into how borderline personality disorder affects the patient and her environment.

Criteria for borderline personality disorder

As we have already said, borderline personality disorder (BPD) is a mental condition in which a person has prolonged patterns of turbulent, disorganized, or unstable emotions. The patient's inner experiences repeatedly cause him to behave impulsively and show chaotic relationships with other people. As a condition / pathology / clinical entity that it is, BPD can be objectively quantified.

The American Psychological Association publishes, from time to time, its clinical work Diagnostic and Statistical Manual of Mental Disorders (DSM-V). As indicated in the latest update (2013) of this diagnostic guide, a patient with BPD must meet the following requirements:

• The patient makes frantic efforts not to be left alone, whether this dreaded loneliness is real or imagined.
• Interpersonal relationships are intense and unstable, oscillating between events of idealization and devaluation.
• Identity disturbance: the patient's self-perception fluctuates constantly.
• Impulsiveness in at least two areas that can be potentially dangerous (spending, sexual approaches, substance abuse, compulsive eating, etc.).
• Recurrent suicidal behaviors, whether in the form of plans, threats, gestures, or self-harm.
• Affective instability due to instability in mood (dysphoria, irritability or anxiety). These outbreaks usually last a few hours or a few days.
• Chronic feeling of emptiness.
• Inappropriate and intense anger or difficulty managing anger.
• Severe dissociative symptoms or paranoia transient stress-related.

All these symptoms are typical of the BPD patient, but you do not have to present all 9 to be diagnosed. According to the DSM-V, having 5 of them present from early adulthood to the moment of diagnosis is sufficient.

The scope of BPD in the life of the patient and their environment

The pathophysiology of borderline personality disorder appears to be based on a genetic component that encodes neurological abnormalities and a clear environmental influence. For example, neuroimaging studies have identified variations in the BPD patient in the tonsil, hippocampus and temporal lobes, compared to people who do not have the condition.

In addition, it should be noted that the patient with BPD is much more likely to show comorbidity with other pathologies, such as mood disorders (88% of patients), anxiety disorders (88%), Substances (64%), Eating Disorders (54%), ADHD (10-30%), Bipolar Disorder (15%), and Somatoform Disorders (10%).

Based on these figures, we can say that BPD affects the patient in many more areas than it might seem at first. One of the main features is undoubtedly the fear of abandonment and rejection. A person with typical BPD will feel, for example, that her life is not complete without her partner and that he cannot being without it, a trait that also leads to the symptoms of dependent personality disorder (TDP).

You will also be more likely to take actions that you later regret, such as spending too much, driving excessively. reckless, enter the world of gambling, sabotage success or suddenly cut off a relationship that was effectively positive. The environment, therefore, will perceive the BPD patient as a volatile, chaotic person with behaviors that are difficult to explain. Facing the outside world, BPD is synonymous with instability.

The environment can also perceive a clear emotional blackmail by the patient. As long as he is not alone, he can resort to threats, suicidal ideas or even self-harm, in order not to be abandoned at any time. Unconsciously, the person is holding third parties responsible for their pain who do not have to manage it, which fosters a very marked toxicity in interpersonal relationships in TLP.

In the most marked cases, the patient may not finish his studies, have legal problems due to her impulsiveness, get involved in abusive relationships, fall into some form of addiction (substance use disorder) and even live frequent hospitalizations due to self-harm at times critics. Clearly, this condition must be addressed before any of these events take place.

BPD can be treated

If you have BPD and have been reading these lines, do not be discouraged. You are not a worse person, less valid or less deserving of support and affection from the environment. Many people express this condition throughout their lives, and luckily, it can be treated.

The first step is always to go to psychotherapy: mentalization-based therapy (MBT), dialectical behavior therapy (DBT) and transference-focused psychotherapy (TFP) give very good results, in prolonged treatments of several months of duration.

On the other hand, the pharmacological field is also usually used in patients who require it. Although they do not treat the condition on their own, antidepressants (SSRIs), mood stabilizers, and antipsychotics can help with anxiety attacks, impulses for self-harm, and many more events. With proper medical therapy and support, this disorder can be regulated.

If you are interested in having therapeutic support for an addiction, we invite you to contact us to start a treatment process as soon as possible. At Despertares Psicólogos we have been working for many years in the field of mental health and therapy adapted to all types of disorders psychological, and we can help you from any of our centers distributed among the main cities of the Community of Madrid.