What Is Borderline Personality Disorder;How To Treat And Diagnose

Borderline Personality Disorder (BPD) affects how one thinks, perceives, and relates to others. It is a serious mental illness that is characterized by a prevalent instability of mood, interpersonal relationships, self-image and behavior. This causes mal-adjustments and behaviors that deviate from social norms. The essential characteristic of personality disorder borderline disorder is a general pattern of instability associated with interpersonal relationships, self-image, and affect.

The Borderline Personality Disorder  – TPB(also known as “emotionally unstable personality disorder”) is manifested essentially by a pattern of behavior marked by impulsiveness and instability of affect, interpersonal relationships, and self-image . This pattern occurs in a variety of situations and contexts, even when the situation seems quite disproportionate to the affective response.

Main Symptoms of Borderline Personality Disorder

Enormous fear and consequent effort to avoid abandonment (real or imagined);
• A pattern of intense and unstable relationships with family and friends, often moving from extreme closeness and love (idealization) to extreme anger (devaluation);
• Self-image or distorted and unstable self-feeling;
• Impulsive behaviors, such as spending too much money, unsafe sex, substance abuse, reckless driving, and compulsion;
• Recurrent suicidal behavior or threats or self-mutilating behaviors, such as cuts;
• Highly variable mood, changing within a few hours to a few days;
• Tend to have paranoid thoughts (of persecution) when stressed;
• Dissociative symptoms, such as feeling out of body or losing touch with reality.

What Is Borderline Personality Disorder;How To Treat And Diagnose

The most salient symptom ascribed to these personalities is the depth and variability of their moods. Borderlines typically experience extended periods of dejection and disillusionment, interspersed on occasion with brief excursions of euphoria and significantly more frequent episodes of irritability, self-destructive acts, and impulsive anger. Most individuals with this personality will have had checkered histories in either personal relationships or in school or work performance. Few persevere to attain mature goals, and many exhibit an extreme unevenness in fulfilling normal social functions and responsibilities.

“People with TPL suddenly and dramatically change their self-image, their professional goals, values ​​and aspirations.

Theodore Millon formulated the following diagnostic criteria for the borderline individual in Disorders of personality:

1. Intense endogenous moods (e.g., continually fails to accord mood with external events; is either depressed or excited or has recurring periods of dejection and apathy interspersed with spells of anger, anxiety, or euphoria)
2. Dysregulated activation (e.g., experiences desultory energy level and irregular sleep-wake cycle; describes time periods that suggest that affective-activation equilibrium is constantly in jeopardy)
3. Self-condemnatory conscience (e.g., reveals recurring self-mutilating and suicidal thoughts; periodically redeems moody behavior through contrition and self-derogation)
4. Dependency anxiety (e.g.. is preoccupied with securing affection and maintaining emotional support; reacts intensely to separation and reports haunting fear of isolation and loss).
Cognitive-affective ambivalence (e.g., repeatedly struggles to express attitudes contrary to inner feelings; simultaneously experiences conflicting emotions and thoughts toward self and others, notably love, rage, and guilt).

Treatment of Borderline Personality Disorder:

TPB has always been seen as a difficult disorder to treat. However, as a better understanding of the disease and with proper treatment and treatment, many people show improvement (decreased frequency and severity of symptoms). Even so, there are no miracles, and sometimes a lot of time elapses between the start of treatment and clinical improvement. It is therefore important that borderline people and their families have information and notion of the difficulty of treating this disorder. It is important to keep in mind that people with BPD can recover and live much better!

Psychotherapy (or “talk therapy”) is the main treatment for BPD; it can relieve some symptoms and the client will learn to better understand their emotions and interact better with others. There are some psychotherapeutic lines more efficient in the treatment of BPD, such as cognitive behavioral therapy (CBT), behavioral dialectic therapy (DBT), schema therapy, among others.

It is important to trust and have affinity with your therapist, however for the very nature of the disorder, it can be difficult for people with this disorder to develop and maintain a comfortable and confident bond with their therapist.

Medications should not be used as the main treatment but may help treat specific symptoms such as mood swings, depression, or other disorders that may occur with the disorder. The drug may be particularly important for coping with suicide risk and self-mutilation.

The treatment of this disorder continues being a difficult subject for health professionals due to its complexity and form of manifestation. Emotional instability hampers treatment, which is often abandoned.

The therapeutic approach currently used responds to the following guidelines:

  • Treatment with psychoactive drugs.
  • Psychotherapy.
  • Intervention in crises through hospitalization.
  • Creation of a support network: family and professionals.


Psychotherapeutic interventions combine different modalities: individual and group.Highly structured, multidisciplinary and inclusive programs are developed.

In this context, cognitive-behavioral techniques, social skills training and psychoeducation have demonstrated their effectiveness. One type of therapy that is also bringing good results is Marsha Lineham’s Behavioral Dialectic Therapy.

The expected results with this therapy are as follows:

  • Increase the level of adaptive skills and functional capabilities (self-care, job search, community access, home management, establishing friendships .
  • Reduce impulsive.
  • Increase the sense of conscious presence in the here and now.
  • Increase physical and psychological well-being.

by Abdullah Sam
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