What Is Borderline Personality Disorder? - Symptoms, Treatment & Therapy

Instructor: Alyssa Gilston
Borderline Personality Disorder (BPD) is an Axis II Personality Disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Key features of BPD include a pervasive pattern of instability in self image, interpersonal relationships and mood.

Borderline Personality Disorder (BPD) is an Axis II Personality Disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) . The main feature of Borderline Personality Disorder is a pervasive pattern of instability in self image, interpersonal relationships and affect or mood. Most commonly, Borderline Personality Disorder begins by early adulthood and is a predominantly female disorder, with about 75% of BPD patients being female.

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All personality disorders are divided by Clusters. BPD is a Cluster B Personality Disorder. Individuals with Cluster B Personality Disorders are often emotional, erratic and dramatic in their presentation.

One of the most prevalent symptoms of BPD tends to be the intense and unstable interpersonal relationship patterns. Those with BPD will run very hot and cold when it comes to mood. Interpersonal relationships will alter between extremes of idealization and devaluation. For example, one moment a BPD person may think you are her best friend, and the next minute, she will find you to be her worst enemy. Given that they are highly prone to very sudden and extreme shifts in their view of self and others, it is easy to see why patients with BPD have great difficulty developing and maintaining any relationships or friendships.

People with BPD will try at all costs to avoid either real or imagined abandonment. The idea of rejection or abandonment will lead to profound changes in self image, as well as changes in affect and behavior. These individuals are also very sensitive to the reactions and behaviors of others, and will often misinterpret and overreact with inappropriate anger when there are unavoidable changes in the plans. For example, a person with BPD may become extremely hostile and agitated when someone cancels a date or appointment with them, even if the reason is completely valid and necessary. They believe this to be an example of abandonment and view themselves as being bad. This also connects with their feelings and fears of being alone, which is almost intolerable. In order to avoid what they view to be abandonment, they may engage in impulsive, self mutilating or suicidal behaviors.

Individuals with BPD will also display impulsivity in multiple areas of their lives that can be self damaging. For example, BPD individuals may binge eat, abuse a variety of substances, engage in sexual behaviors that can be dangerous and even life threatening, both gamble and spend money recklessly and irresponsibly, and engage in dangerous behaviors like driving erratically or unsafely. BPD individuals also display a disturbance in identity where they have an unstable self image and sense of self. They display chronic feelings of emptiness and inappropriate and intense anger.

BPD people often engage in suicidal behaviors. They display suicidal thoughts, plans, gestures and threats on a regular basis. They also engage in self mutilating behaviors such as cutting and burning themselves. Suicide attempts and threats are very common with clients with borderline personality disorder, thus treatment with a professional is very important.

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