Borderline Personality Disorder (BPD) occurs in approximately 2% of the population. It is a disorder in which a person has a pattern of unstable personal relationships, a self-image that is not well formed, and poor impulse control in areas such as spending, sexual conduct, driving, eating, and substance abuse. Additionally, the person suffering from BPD fears abandonment and will go to any length to prevent this. They feel chronic emptiness.
One of the hallmarks of BPD is known as “splitting”. This is where the person with BPD will swing between idealizing and devaluing people in relationships. They will pit people against one another, making one group the “white hats” and the other the “black hats”. A person is either good or bad, the person with BPD being unable to reconcile that there is both good and bad within a person. And this categorization of a person may shift from day to day, the person being good one day and bad the next.
There may be suicidal threats, gestures or attempts made by the person with BPD. There may also be self-mutilation that occurs. Their mood may be very prone to outside stress, with feelings of depression and anger readily provoked, with anxiety also a common occurrence. With extreme stress, the person with BPD may experience paranoid ideation, or may have dissociative symptoms such as “running on automatic” and disconnecting from reality.
The treatment for BPD may consist of medication and therapy. Antidepressants may help with depression while specific SSRI’s (prozac, zoloft, etc) may help with impulse control. Mood stabilizers (antiepileptics such as tegretol, depakote) can help with mood swings and irritability. Cognitive Behavioral Therapy, and the related Dialectical Behavior Therapy are the two most common therapies used in the treatment of BPD.