A deep look into Borderline Personality Disorder

There are some situations in which everyone cannot cope or struggle to survive. Not all situations are physical. Borderline Personality Disorder is a behavioural condition in which one feels strong and intense emotions. These are very hard for a patient to live with. Patients remain distressed and annoyed most of the time. The cause of BPD is untraceable in most cases. It can be genetic reasons or childhood trauma. However, diagnostic test for Borderline personality disorder is available. And it is comparatively easy to treat the condition.

What is BPD?

Experts categorise BPD as a 'personality disorder'. This disorder directly affects one's emotions and causes problems in relationships and personal life. The probability of finding the disorder in our close friends or ourselves is very high. The presence of the condition is common in all genders. Still, the studies prove that women and sexual minorities are more vulnerable to the disorder. This is mostly due to the experiences many had during childhood. Conversion therapies for LGBTQ+ have also played a role in the lives of many BPD patients. 

Like any other mental disorder, BPD also has several symptoms.

 If one has BPD, he may feel the following.

• Very difficult to bear the stress.
• Hard to understand other people's points of view.
• Get addicted to illegal activities and drugs.
• Getting used to staying at work.
• Feeling isolated and excluded by others.
• Comfort in loneliness.
• Frequently failing in relationships.
•  Self-harming mentality and suicidal thoughts.
• Strong hard to control emotions.
• A long-term fondness for someone.
• Tendency to misuse alcohol, drugs and prescribed medicines.

The psychological existence of the disorder lies between two different conditions, which is the reason behind the term borderline. The two conditions or disorders are Psychosis and Neurosis. As it got more attention and scientific visibility, doctors no longer use the term borderline to describe this specific behavioural condition. It is mostly known as Emotionally Unstable Personality Disorder (EUPD). Doctors find this name more suitable for this condition.

While interacting with patients, doctors are advised not to use the term as the patient feels more annoyed, insulted and speculated. Also, doctors will make the patients aware that they are not guilty of the disease and ensure they have not judged themselves. 

Where to get tested for a borderline personality disorder?

Diagnosing the disease can be done by your general practitioner. He can suggest a good psychiatrist who is trustworthy and has a better experience with similar patients. 

WHO( International Classification of Diseases (ICD-10)) and the American Psychiatric Association (Diagnostic and statistical manual of mental disorders (DSM-5)) have published some specified guidelines for psychiatrists. It specifies the procedures Doctors have to follow throughout the diagnostic test for Borderline Personality Disorder.

These guidelines will provide the doctor with sufficient information and aids for diagnosing. If you feel any of the following symptoms, there is a high chance that you are suffering from BPD.

• Intense mood swings.
• A suicide tendency 
• Haunting thoughts of loneliness and emptiness, sometimes the feeling of abandonment.
• Inability to have a stable relationship with others.
• Confusing about life's purpose leads to an extremely dry area of thought.
• The inability to control anger.
• Substance abuse, careless and irresponsible sex, extravagance, binge eating and careless driving.
• Paranoia when stressed.

As a part of the test for borderline personality disorder, Psychiatrists will seek every help they can get. They will reach out to your friends, family, neighbours even school teachers to get information about you. They will ask you about your past and the beautiful moments you had in your life. After collecting all the data, they will start the test for borderline personality disorder.

In earlier times, an age restriction prevailed among Psychiatrists to diagnose BPD, which was 18 years old. But now, they have begun to conduct diagnostic tests for Borderline Personality Disorder in young patients.

Which are the different kinds of BPD?

Borderline personality disorder (BPD) and Emotionally Unstable Personality Disorder (EUPD) are two different names for the same disorder. Some countries like England use both BPD and EUPD in the medical field.

Sometimes doctors might say the term 'borderline' or 'impulsive', which means emotionally unstable personality disorder (EUPD), except there is a small difference between them.

Borderline type-

In the case of borderline EUPD, you will find difficulties in keeping a relationship for a long time, and you will keep having self-harm thoughts and feelings of loneliness.

Impulsive type-

If you have an impulsive type EUPD, your feelings of being angry and your impulsive behaviour will affect you badly. In addition, you will find difficulties controlling those emotions.

What are the causes? And What are the treatment options?

The doctors can't identify a single reason for an individual developing borderline personality disorder. A diagnostic test for Borderline Personality Disorder is the only way to diagnose its presence. But, the cause cannot be identified with this test. According to recent research, the cause of BPD is either genetic reasons or childhood traumas or both combinations.

Other mental health conditions are also found among the people affected by BPD.

 BPD patients are more vulnerable to other mental disorders. Sometimes, the individual who suffers from BPD has other mental health disorders. So, this can also be a driving factor that plays a part as a cause of the condition.

Life of a patient

Borderline personality disorder symptoms look less severe than many other mental disorders. And it is comparatively easier to treat, and the recovery rates are much higher than many other mental and behavioural conditions. However, BPD symptoms are socially awkward and make the social lives of its victims a nightmare.

Famous BPD activist, influencer and author Rosie Cappuccino in her book  Talking About BPD: A Stigma-Free Guide to Living a Calmer, Happier Life with Borderline Personality Disorder, shares the difficulties she had to face as a BPD patient.

She faced discrimination from the common folks and, shockingly, fellow patients and medical practitioners. He had also mentioned being mocked for the symptoms of her condition. She mentioned an example of being called a drama queen when suicide or self-harming tendencies were shown. 

Because of this, many suffering from BPD do not seek help or decide to continue with the condition based on their previous experiences.

How to treat it?

Only you and the doctor you consult will determine what kind of procedure to try. Talking therapy, another name for psychological therapy, is the primary cure for Borderline Personality Disorder (BPD).

Mentioned below are several kinds of psychiatric therapy for BPD. These therapies might not be available on the NHS in your area.  

Dialectical Behaviour Therapy (DBT)

For individuals with BPD, DBT will be very helpful. DBT encourages a patient to develop skills to cope with anxiety and distress. This is considered 'emotional management' by therapists. DBT can regulate Unhealthy methods, such as self-harming or consuming drugs or alcohol, dealing with anxiety etc.

Mindfulness-based cognitive therapy

It is a type of psychotherapy in which mindfulness meditative practices are included. This therapy is highly beneficial for BPD patients as it helps them control their emotions. In addition, It gives a patient to analyse oneself and improvise one's image.

Cognitive Analytical Therapy (CAT)

CAT encourages you to consider your concerns in your relationships with others. The therapist will work with you to understand and attempt to alter your social habits. This could be beneficial when you switch between loving and hating people who are very friendly to you. This can help you build a better social life.

Mentalisation-Based-Therapy (MBT)

If you make conclusions about what other individuals feel or think about you or anything very often. Then, this sort of counselling will benefit you. Instead of more plausible theories, you could base these conclusions on the worst-case scenario. For instance, if someone you care about tries to do things independently, you may think they have no interest in you, don't like you, or never want to be with you. These feelings may make you angry and have bitter feelings about them.

Mentalizing is about understanding other people's behaviour and how you react to it. In addition, you are maybe doing this by thinking about your feelings, intentions, needs, and expectations. Further, this will teach you to take a more realistic perspective of what could happen in other people's minds. Therefore, if your main worry is abandonment, this form of therapy might help you.

Schema therapy

Schema therapy looks into mental and emotional states and behaviour patterns. In different situations, you might behave differently, and your therapist calls these different 'modes'. The counselling aims to find the appropriate 'mode' for you, and it will show you the best way to help you cope with your circumstances.

Psychodynamic psychotherapy

This treatment reflects on the subconscious level of your mind. Your subconscious level is the part of the brain or mind that, without giving any information to you, regulates your thoughts, feelings and behaviours.

 Therapists think your memories influence your subconscious mind, especially those in adolescence and childhood. Psychiatrists will try to link the present struggles with previous experiences. It will help you understand why you feel the way you do.

Therapeutic Communities

The therapeutic community itself is not a medication-providing facility. In addition, there are places where you can go and get help. For a certain group of people, there are specific therapeutic communities. For instance, who have alcohol or opioid issues, there will be a specific therapeutic group. In most cases, they will have a religious connection.

The Therapeutic communities usually are not strict with anything. You can stay for months or weeks, even visit there for just a few hours every week or whenever you are comfortable. You can have sessions for group counselling and self-help. Other community events, such as gardening and training for everyday life skills, are also provided.

Medication

No medication is available to cure Borderline Personality Disorder (BPD). But if you have any other psychiatric disorders, such as anxiety or depression, you can take medication for them. This will, in turn, ease the symptoms and make the patient feel much better.

How can NHS treat the disorder?

 National Institute for Health and Care Excellence (NICE) has advised that the NHS can provide you with treatment for BPD. You can visit www.nice.org.uk for guidance and instructions.

The NICE-recommended service won't be available at every NHS. Suppose your Borderline Personality Disorder causes you serious trouble. In that case, the NICE guidance says that your doctor should offer you therapy, and there is a time restriction for this therapy which is three months. For Women, if they self-harm frequently, the guidance says that the NHS will provide dialectal behaviour therapy (DBT).

If your symptoms worsen, you can get help from a specialist service. The NHS does not hesitate to give you specialist support when you are suffering.

What to do when I'm not happy with the ongoing BPD treatment?

Patient Advice and Liaison Service (PALS)

You could contact your local PALS if you are upset with your NHS care or treatment. They will answer your questions. And they will take necessary actions to sort out your grievances.

Diagnostic test for borderline personality disorder

You could ask for a second opinion if you are disappointed with your diagnostic test for borderline personality disorder. But, a second opinion does not grant you a legal right, so it is important to be certain whether it is important to you or not.

Advocates

There are independent advocates for mental health services. They will assist you with voicing your viewpoint and settling issues. Further, they will help you write letters and legal notices or go with you for appointments or meetings.

Complaints

You should make a report to get your issues investigated in depth if you cannot fix the issue.

How to self-test borderline personality disorder? And how to deal with it?

• If you believe that your interactions with others fail, talk to a psychiatrist.
• Do not pay too much attention to the disease's name. BPD is a normal disorder, and it does not mean there will be no improvement in your case.
• Give it a shot if someone offers you group counselling or help. It may sound overwhelming, but many people find it useful in the long run.
•  Try to find opportunities to rest for relaxation. Meditation, listening to music, techniques for breathing and exercise may be helpful.
• Search for patterns in how you respond to things that annoy you. This can assist you in working through relationship problems.
• Using a forum on mental wellbeing online will be very helpful. Make sure you verify the website's trustworthiness with useful details on BPD from a mental health provider.
• Dream of how improvements in your lifestyle would help you.
• Write about how you are feeling.
• Wait a while before responding to something that irritates or disturbs you.

What are the risks?

Self-harm

It is natural for BPD patients to self-harm. In addition, some individuals find that self-harming will help them cope with traumatic emotions. But it may cause major burns, scars, infections, or death by accident. Therefore, seeking other ways to cope with painful feelings is a major focus in BPD therapy.

Alcohol and Drugs

The following are symptoms found among BPD patients.

• Impulsive behaviour
• Misusing the prescribed drugs
• Consuming drugs
• Uncontrollable consumption of alcohol.

When suffering from BPD, you could be at a significantly high risk of being a full-time alcoholic and finding pleasure in drugs.

It is very difficult to treat BPD when you are an alcoholic or a drug addict. You won't find any need for help and support and think the use of drugs is the perfect cure for you.

Professionals call this 'dual diagnosis' because you have a mental disorder and a drinking or drug addiction.

Impulsive behaviours

Doctors term this 'impulsive' as patients make choices without considering the consequences. This can involve driving irresponsibly, having more than one sexual partner, and wasting money.

You might have sex without protection carelessly when you have BPD. This may lead to sexually transmitted infections or unintended and unwanted pregnancy.

Without worrying about the potential consequences, BPD can lead you to gamble. This will end up putting you in a huge debt.

Carers

What to do If I am a carer, relative or friend?

If you care for someone who might be a family member or friend suffering from BPD, you feel bad and helpless.

Learning about the disorder as much as possible will help greatly and be very useful.

• If your friends and relatives are suffering from BPD, support them and encourage them.
• Try to find out why they are acting differently and what kind of things are hurting them.
• Please find the most suitable way to interact with them by understanding what they like the most.

It is important to get professional support if they are struggling with it. In addition, please search for a locally available support group near you for help and keep in touch with them. In addition, the NHS recommended seeking the help of social services to evaluate the carer to check whether they can help.

Conclusion

Millions around us are suffering from BPD. It is not an extreme psychological condition like schizophrenia. It is just a behavioural condition which can be diagnosed with a diagnostic test for borderline personality disorder—and cured with medical care, counselling and patience. In this 21st century, it is important to ensure that nobody suffers from such a simple behavioural condition. It has to begin with a change in your mentality in addition to having proper awareness. Every BPD patient should be treated equally with consideration, understanding and love.