People with borderline personality disorder have stormy and unpredictable ways of relating to other people. This behavior covers up poor self-esteem and feelings of anger and of not deserving anything good. Such people have ways of thinking, feeling, and behaving that cause them many problems at work, in school, and socially.
What are the basic features of this disorder?
The basic features, which begin in adolescence or early adulthood, may include:
* unstable personal relationships that switch back and forth between hate and love
* frantic efforts to avoid being abandoned
* an unstable sense of self
* acting without thinking, doing things on impulse that could be harmful to themselves like reckless driving, drug or alcohol abuse, and careless sexual behavior
* suicidal behavior
* intense ups and downs in mood
* feeling empty much of the time
* trouble controlling anger
* distrust of others, paranoia, and feeling separate from themselves
What is the outlook for someone with this disorder?
Many people with this disorder may require lifelong treatment with medication, psychotherapy, or both. The biggest help friends and family can provide is to get the person into good treatment with an expert in therapy who either knows medication management or can arrange to consult with someone who does. Treatment can make a big difference in the overall quality of a person's life.
Why is this disorder called "Borderline"?
People with this disorder feel they are living on the border between life and death, between sanity and insanity, between being and not being competent in the world. The life of someone with borderline personality disorder may look normal to others, but the person with the disorder doesn't feel normal all the time. The most stable thing about such a person may be how unstable he or she is.
What is it like to have this disorder?
People with this disorder may feel that they and the world are in extremes: good/bad; love/hate; "your fault"/"my fault"; there is no middle ground.
* They may feel hopeless, powerless, anxious and depressed.
* It may be impossible for them to have pleasure without feeling guilty about it
* They may have sexual problems. They may be unsure about which sex they are attracted to, or in some cases, even be confused about their own gender. They may have no sexual feelings at all, or they may need to fill an inner sense of emptiness by having a lot of sex
* They often have a hard time understanding what others are feeling, and may often feel frightened that others don't like or respect them. They have a lot of trouble trusting others
* They often feel like misfits, as if they are different, damaged, or flawed in some way
* They may struggle with very strong anger or rage at others
* In times of increased stress, they may have a hard time caring for themselves, in even basic ways such as eating, bathing, and sleeping regularly
* They may fear that their only hope of getting their needs met by others is to manipulate them
* They sometimes lose touch with reality. They may hear voices at times or feel paranoid. These symptoms usually aren't permanent but come and go depending on stress levels
What causes it?
Experts believe that borderline personality disorder, like most psychiatric disorders, is caused by a combination of genetic and biological factors and experiences.
How common is it?
Depending on the group being studied (the general population versus a mental health care outpatient clinic population) is it estimated that as few as 1% to as many as 14% of people are affected. It affects more women than men.
How is it treated?
This is a very difficult disorder to treat, but the following can be helpful in reducing symptoms such as impulsive behavior and unstable relationships:
* medications, especially for symptoms of anxiety, panic, or depression
* short-term, structured time in the hospital for self-destructive behavior, such as suicide attempts, self-cutting, or self-burning.
* day treament programs, which the person attends every day to take part in structured activities and group therapy