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Borderline Personality Disorder

Definition

Borderline personality disorder (BPD) is a serious psychiatric condition. A personality disorder is a general term for an abnormal, lifelong pattern of behavior and thoughts. People with a borderline personality are unstable in their self-image, moods, behavior, and relationships with others.

What is going on in the body?

No one knows what causes borderline personality disorder. The disorder may be associated with abnormalities in the structures and pathways in the brain that regulate emotion.

Risks

What are the causes and risks of the condition?

The exact cause of borderline personality disorder is unknown. Most experts believe that the disorder is caused by a combination of the following factors:
  • being a victim of violence, such as rape
  • genetic factors
  • a history of child abuse
  • a series of traumatic events as a young adult
  • vulnerability to stress
People with BPD are more likely to have other psychiatric disorders, including:
  • alcohol abuse
  • anxiety disorders
  • bipolar disorder
  • depression
  • drug abuse
  • other types of personality disorders

Prevention

What can be done to prevent the condition?

There are no known ways to prevent this condition. A stable and loving home life during childhood is thought to reduce the risk of personality disorders.

Diagnosed

How is the condition diagnosed?

Diagnosis of borderline personality disorder begins with a medical history and physical exam. There is no one test that can make the diagnosis. A written survey of symptoms or a psychological test may be used to help make the diagnosis.

Long Term Effects

What are the long-term effects of the condition?

Long-term effects are mostly related to the person's behavior. This may include financial, legal, and social problems. A person with BPD may commit suicide, or may engage in risk-taking behavior that results in death unintentionally.

Other Risks

What are the risks to others?

Borderline personality disorder is not contagious. Sometimes, a person with BPD may injure someone else while acting out.

Treatments

What are the treatments for the condition?

Treatment options for borderline personality disorder have improved greatly in the past few years. Effective treatments include the following:
  • antidepressant medicines
  • antipsychotic medicines to treat distorted thinking
  • dialectical behavior therapy, which is a unique combination of behavioral and cognitive therapy designed for people with this disorder
  • group or individual psychotherapy
  • medicines that stabilize the person's mood
Unfortunately, many people with BPD are not compliant with their treatment plans.

Side Effects

What are the side effects of the treatments?

Medicines used to treat the disorder may cause drowsiness, dry mouth, and allergic reactions.

After Treatment

What happens after treatment for the condition?

Most people with borderline personality disorder have lifelong problems. As people get older, they often become somewhat more stable. Most people with this disorder need help and therapy for life, if they are willing to accept it.

Monitor

How is the condition monitored?

Regular visits to a therapist are usually advised. Regular blood tests may be ordered to monitor medicine levels. Any new or worsening symptoms should be reported to the healthcare provider.

Sources

Comprehensive Textbook of Psychiatry, 2000, Kaplan et al.

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