THE FACTS ON BORDERLINE PERSONALITY DISORDER

What is the technical definition of Borderline Personality Disorder?

  • A complex and debilitating disorder of understanding and regulating one’s own emotions that leads to impulsivity, distortions of thought, identity disturbance, stormy interpersonal relationships, rage outbursts, self-harm, self-injury & suicidality.

How does it feel to live with borderline personality disorder (BPD) from a patient’s perspective?

  • Driving an emotional vehicle that is accelerating and cannot hit the brakes
  • Riding an emotional rollercoaster with ups and downs multiple times in one day
  • Constant feeling of shame and worthlessness, and self-loathing without an identifiable trigger
  • As smart as you are, you can’t outsmart BPD

How is BPD affecting our population?

  • 6 people out of every 100 (6%) will develop this disorder in his/her lifetime
  • Men and women are equally affected
  • 10% commit suicide
  • 50- 80% have substance abuse disorder
  • 15-30% of those suffering from substance abuse disorder have BPD
  • 25 -50% of prison inmates have BPD
  • Impairment in functioning is as great as that due to bipolar disorder

How is BPD different than Bipolar Disorder?

  • In BPD there are frequent and intense rapid cycling of emotions, such as anger, anxiety and sadness that are long-standing.  BPD is more appropriately treated with psychotherapy rather than medication.
  • Bipolar disorder has episodes of mood disturbance and increased energy or activity known as mania and hypomania which persist for several days or longer and are associated with other symptoms such as physical restlessness, rapid speech, and sleeping only a few hours per night and not feeling tired. 

How are caretakers affected?

  • Studies have shown that caretakers of BPD patients suffer a significantly higher degree of grief, burden, loss of empowerment, depression and anxiety than caretakers of people with other serious mental illnesses.

What are the proven effective treatments for BPD?

  • Dialectical Behavioral Therapy, Transference-Focused Therapy, Mentalization Based Therapy, General Psychiatric Management
  • There is no proven pharmacologic therapy, yet patients are often on multiple medications

What are the societal issues people suffering from BPD are facing?

  • Stigma that those suffering are “acting out” and manipulative
  • Lack of recognition that this is a real disorder leads to lack of diagnosis
  • Although there are effective treatments, many areas lack trained therapists
  • BPD gets 1/10th the funding of bipolar disorder from NIMH, yet is at least as prevalent
  • BPD is not a billable diagnosis and therefore does not get covered by insurance

 

References

  • Bailey, RC. Burden and support needs of carers of persons with borderline personality disorder: a systematic review. Harv Rev Psychiatry. 2013; 21: 248 – 58.
  • Ball SA, et al. Personality, temperament, and character dimensions and the DSM-IV personality disorders in substance abusers. Journal of Abnormal Psychology. 1997; 106: 545 – 553.
  • Cacciola JS, et al. Psychiatric comorbidity in patients with substance use disorders: do not forget Axis II disorders. Psychiatry Annals. 2001; 31: 321 – 331.
  • Grant BF, et al. Prevalence, correlates, disability, comorbidity of DSM-IV borderline personality disorder:results from the wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry. 2008; 69: 533 – 545.
  • Marco, Jose H, et al. Meaning in Life in People with Borderline Personality Disorder. Clinical Psychology& Psychotherapy (2015). Doi: 10.1002/cpp.1991.
  • National Institute of Mental Health. (2016). http://www.nimh.nih.gov/health/statistics/prevalence/bipolar-disorder- among-adults.shtml
  • Trull TJ, et al. Borderline personality disorder and substance use disorders: a review and integration.
  • Clinical Psychology Review. 2000; 20: 235 – 253.
  • Zimmerman, Mark. Borderline Personality Disorder: A disorder in search of advocacy. J. Nerv. Ment. Dis. 2015; 203: 8 – 12.