May is Mental Health Awareness Month, therefore my blogs will be focusing on these issues. Ten years ago when my daughter was first diagnosed with a mental health issue, I knew nothing about these things. After that I began to learn all I could. In my last post, on May 14, I addressed Major Depression.  Today’s  topic is Borderline Personality Disorder. I am not an expert, so I turn to the best in the field, the National Alliance on Mental Illness, nami.org. On their website you will find many additional articles on each of these disorders and much more.

The following information was written by Ken Duckworth, M.D.

Borderline Personality Disorder (BPD) is characterized by impulsivity and instability in mood, self-image, and personal relationships. It is fairly common and is more common in women than men.  It’s a disorder of emotional dysregulation which can be difficult to diagnose, affecting between one and two percent of the general population. Rarely standing alone, it has a high  frequency of co-occuring disorders.

Symptoms

• Marked mood swings with periods of intense depression, irritability, and/or anxiety lasting a few hours to a few days.
• Anger that is intense, uncontrolled and/or not understood.
• Impulsiveness in spending, sex, substance abuse, shoplifting, reckless driving, or binge eating.
• Recurring suicidal threats or self-injurious behavior.
• Unstable, intense personal relationships with intense, categorical views of people and experiences, sometimes alternating between “all good” idealization and “all bad” devaluation.
• Marked, persistent uncertainty about self-image, long-term goals, friendships, and values.
• Chronic boredom or feelings of emptiness.
• Frantic efforts to avoid abandonment, either real or imagined.

Causes

This is unclear, although psychological and biological factors may be involved. Originally thought to “border on” schizophrenia, it also appears to be related to serious depressive illness. In some cases, neurological disorders play a role. Biological factors may cause mood instability and lack of impulse control, which in turn may contribute to troubled relationships. Difficulties in psychological development during childhood, perhaps associated with neglect, abuse, or inconsistent parenting, may create identity and personality problems. More research is needed.

Treatment

A combination of psychotherapy and medication appears to provide the best results. Medications can be useful in reducing anxiety, depression, and disruptive impulses. Relief of such symptoms may help the individual be able to deal with harmful patterns of thinking and interacting.

Long-term outpatient therapy can be helpful. Short-term hospitalization may be necessary during times of extreme stress, impulsive behavior, or substance abuse. More structured cognitive interventions like dialectical behavioral therapy (DBT) are now widely used.

Borderline Personality Disorder may be accompanied by serious depressive illness (including bipolar disorder), eating disorders, and alcohol or drug abuse. It’s critical to determine this prior to treatment. About 50 percent of people living with BPD experience episodes of serious depression. At these times, the “usual” depression becomes more intense and steady, and sleep and appetite disturbances may occur or worsen. These symptoms, and the other illnesses mentioned above, may require specific treatment. A neurological evaluation may be necessary for some individuals.

Medication

Antidepressants, anticonvulsants, and the new atypical antipsychotics are commonly used. Decisions about medication should be made cooperatively between the individual and their doctor. Issues to be considered are the person’s willingness to cooperate with taking the medication, and the possible benefits, risks, and side effects, particularly the risk of overdose. (This is where Dr. Duckworth’s article ends.)

Recovery

Most people living with BPD who are engaged in a personalized treatment plan that includes effective medication along with other treatment supports, find that their symptoms are reduced enough to help them achieve fulfilled recovery. Did you hear that?

Recovery is possible.

Sources of Help

The National Alliance on Mental Illness (NAMI), The National Education Alliance for Borderline Personality Disorder (NEA-BPD), The Depression and Bipolar Support Association (DBSA) and the Mental Health Association(MHA) offer programs across the country.

Family training and support programs such as NAMI’s Family to Family  and NEA- BPD’s Family Connections  (www.neabpd.org) are in great demand.

This can all sound pretty frightening, but we must keep our eyes on God.  Ultimately, He is our source of help and hope. If your loved one is resistant to taking medication or cooperating with a treatment plan, a great book you need is I Am Not Sick, I Don’t Need Help by Dr. Xavier Amador.  His website also offers videos of people using his very effective LEAP method.  leapinstitute.com  

Be encouraged by these Scriptures:

May your unfailing love be with us, Lord, even as we put our hope in you.  (Psalm 33:22) NIV

Our help is in the name of the Lord, the Maker of heaven and earth.   (Psalm 124:8) NIV