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What is BPD?

Borderline Personality Disorder (BPD) is a serious psychiatric illness. People with BPD have difficulty regulating their emotions and controlling their impulses. Their expression of emotion or impulses are often displayed through intense anger, self injury or suicidal behavior. Although self-injury often occurs without suicidal intent, a significant number of people with BPD die by suicide (10%). Despite the seriousness of the disorder, recent research indicates that treatment can lead to considerable improvement over time, and there is hope for recovery!

What are symptoms of BPD?

 

There are nine symptoms. You must have five to be diagnosed:

  1. Frantic efforts to avoid real or imagined abandonment

  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

  3. Identity disturbance: unstable self-image or sense of self

  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

  5. Suicidal behavior, gestures or threats; or self-injurious behavior

  6. Difficulty regulating mood (e.g., depression, irritability usually lasting a few hours and only rarely more than a few days)

  7. Chronic feelings of emptiness

  8. *Inappropriate, intense anger or difficulty controlling anger

  9. Paranoid thoughts or a feeling of being disconnected from your body or surrounding

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How can BPD be treated?

  • Dialectical Behavior Therapy (DBT-A, DBT-PE, DBT-SUD)

  • Mentalization-based treatment (MBT)

  • Schema-focused therapy (SFT)

  • Transference-focused psychotherapy (TFP)

  • Systems training for emotional predictability and problem solving (STEPPS)

  • Good psychiatric management (GPM)

Common Myths about BPD

 

MYTH: Borderline Personality Disorder is a permanent condition that cannot be treated or improve.

FACT: Research shows that people with BPD can recover with effective treatment. Recent reports state that up to 88% of people with the disorder experience significant improvement over time.

 

MYTH: The term “Borderline Personality Disorder” is based on up-to-date research reflecting the true nature of the disorder.

FACT: The term “borderline” was developed in the early 1900’s when psychoanalysts realized that BPD did not fit into their oversimplified way of categorizing mental illness – either as neurotic or psychotic. BPD was thought to be on the “borderline”. There is currently a move to have the name changed to something similar to Emotional Processing Disorder or Emotional Regulation Disorder in the next edition of the DSM.

MYTH: People with BPD have a flawed personality.

FACT: BPD is caused by a combination of  environmental and neuro-biological factors, not a personality flaw.

MYTH: People with Borderline Personality Disorder are attention seeking and manipulative.

FACT: The phrases “attention seeking” and “manipulative” imply that conscious and deliberate thought and planning is involved but most BPD behavior is not a deliberate attempt to manipulate people or get attention. It is an attempt to get needs met.