This is the second section and covers:
– The symptoms of borderline personality disorder
– Treating borderline personality disorder
The symptoms of borderline personality disorder
BPD is a complex disorder that can include a variety of symptoms. Some people may experience a set of symptoms that is different from another person with BPD. If the person has at least 5 (or more) of the following symptoms, they can be diagnosed with BPD:
Constant feeling of emptiness
Going through extreme emotions (e.g., anger, sadness, anxiety, irritability) from day to day or within a few hours
Constant worrying about being abandoned by others
The lack of strong sense of self (e.g., they change depending on who is around)
Impulsive behaviour that could cause harm (e.g., reckless driving, binge eating, substance use)
Suicidal feelings or self-harm
Intense anger that is difficult to control
A pattern of constantly having problems in relationships with others
Paranoid delusions or detaching from emotions and others around, during times of high stress
Benjamin is 23 years old. Growing up, he was a victim of severe neglect. Despite enjoying periods of intense and pleasant interactions in relationships, he eventually starts doubting people’s intentions and gets very upset at any sign that they might leave him. In the past, he threatened his partner using self-harm. When feeling upset he will go for a fast drive, often under the influence of alcohol. He can feel good and confident one moment and angry or sad the next. He reports feeling quite empty most of the time. He is thinking about talking to a professional that can help him to cope better.
Treating borderline personality disorder
Psychological therapies are known to be the most effective treatment for BPD. This usually takes place on a long-term basis. These therapies might include:
Dialectical behaviour therapy
Dialectical behaviour therapy (DBT) is a specialized therapy developed for people with BPD. It focuses on helping the person to develop acceptance towards their emotions and to become more flexibility in the way they view situations and/or others. This might be delivered individually or in a group setting, depending on the person’s preference.
Mentalisation-based therapy (MBT) is also used to treat people with BPD. This focuses on helping people to understand their own mental states and those of others, and how this relates to behaviour. This type of therapy can help those with BPD to develop a better understanding of situations before reacting.
Other psychological therapies
There are many other types of psychological therapies that could be used to treat BPD. These might include cognitive behavioural therapy, cognitive analytic therapy, schema-focused therapy, interpersonal psychotherapy, psychodynamic therapy, and art therapies.
Medication is not recommended for the symptoms of BPD. However, the person with BPD can be prescribed medication for the treatment of other mental illnesses (e.g., anxiety, depression) they might have, alongside BPD. Medication might also be prescribed in crisis situations, to help the person calm down.
Admission to hospital
In crisis situations, the person might need to admit to the acute psychiatric or emergency services, if they are self-harming or experiencing psychotic symptoms. This is where they will receive care that is focused on helping them calm down and ensuring their safety.