National Educational Alliance for Borderline Personality Disorder
So Do I or My Loved One Suffer from BPD?
BPD is a personality disorder uniquely characterized by heightened sensitivity to stimulae, intense reactivity, and a slow return to baseline calm. These three characteristics lead to sufferers having extreme difficulty controlling their emotions or, in other words, pervasive emotional dysregulation.
Physicians diagnosing BPD look for nine characteristic traits, with five being necessary for the full diagnosis. Among these nine are the frantic attempt to escape real or imagined abandonment, a pattern of intense, unstable interpersonal relationships, attempted suicide or self-harm, profound and chronic emptiness, and impulsivity, and risk-taking. Or, in other words, BPD sufferers’ emotional dysregulation manifests itself in their pervasive instability in moods, interpersonal relationships, self-image, cognition, and behavior.
As you might expect, given the number of traits, the varying degrees of intensity, and the subsequent number of possible trait combinations, BPD does not always manifest itself in the same way. In fact, there are 256 ways the disorder can manifest itself. Indeed, one clinician has noted that there is a continuum of Borderline psychopathogy:
- Some people recover spontaneously and are never patients.
- Some use nonintensive outpatient treatment and are never hospitalized.
- Others become severely ill and use large amounts of mental health services, including repeated inpatient stays.
She estimates that 80% of sufferers fall in the first two categories.
Furthermore, there is an ongoing debate in the psychiatric community over whether BPD can be diagnosed under the age of eighteen. Fortunately, the naysayers have been increasingly challenged in recent years, allowing adolescents to receive treatment earlier and perhaps saving them from years of suffering. An experienced diagnostician can and should be able to make the diagnosis, or at least a differential diagnosis, so that treatment can be sought.
Please note that even if your loved one does not meet the five of nine necessary criteria for BPD, intense emotional dysregulation combined with a number of the aforementioned traits can make life difficult both for your loved one and yourself, so please read on for how we might be able to help.
So What Can I Do?
Dialectical Behavior Therapy (DBT), Mentallization, Schema-focused Therapy,Transference-focused Psychotherapy (TFP), and Good Psychiatric Management (GPM) are currently the principal treatment approaches. DBT has the distinction of having undergone extensive scientific study, and as such is the most evidence-based of the five. While you are busy searching for ways to help your loved one, do not forget to help yourself as well. You are also suffering from living with this illness and in order to maintain your strength and a positive outlook, you must also nurture yourself.
So How Can We Help You?
The NEABPD, Israel is committed to providing information about the best-treatment options available in Israel and throughout the world, and to supporting family members by running the Family Connections (FC) program, developed and field-tested by the American NEABPD. For more information about this free program, visit this page.