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An overview

Personality comprises the behavioural pattern, how we react, our views & thoughts, feelings, and our ability to understand and cope with a situation. A healthy personality enables a person to function efficiently in daily life. But what happens when we can’t manage our personality and end up messing up our lives and relationships? This condition is medically termed as a Personality Disorder

When an individual has a personality disorder, responding to changes, managing the demands of life and maintaining relationships become much harder. It often results in social isolation and depression.

Psychiatrists categorize personality disorder into three groups depending on their symptoms – Suspicious; Emotional & impulsive; and Anxious. Borderline personality disorder (BPD) is a disorder of the emotional & impulsive category.

Borderline Personality Disorder (BPD) is a severe mental illness that revolves around the inability to manage emotions effectively. It is the most commonly recognized personality disorder. It affects the way individuals see themselves,

People suffering from Borderline Personality Disorder may experience intense episodes of anger, depression, and anxiety as it is difficult for them to manage their emotions. There’s a constant fear of instability and abandonment, difficulty being alone, and severe concerns about self-image among others. 

These experiences of inappropriate anger, impulsiveness and frequent mood swings can bring in long-term patterns of unstable or turbulent emotions often leading to impulsivity and chaotic relationships with the people close to them. 

This disorder usually begins during adolescence or early adulthood. Borderline personality symptoms in adults are easy to manage as diagnosis and treatment are quite possible. The symptoms of borderline personality disorder in teens are confusing, frustrating, and hard for loved ones, especially for parents to understand. Teens with BPD lack a clear sense of self, feel chaotic and stressed, and eventually become isolated and desperate. Therefore, the treatment that should be relatively easy becomes extremely difficult to manage. Teen borderline personality disorder signs and symptoms include –

  • Extremely inappropriate and disproportionate emotional reactions
  • A damaged identity
  • Inability to feel empathetic toward others
  • Intense narcissism
  • A persistent fear of rejection and abandonment
  • Severe mood changes without a clear cause
  • Substance abuse as a coping mechanism
  • Overwhelming anxiety and worry
  • Impulsive and risky behaviours, mostly self-destructive
  • Acting out sexually
  • Self-harm and suicidal tendency or attempts

The reason why this mental disorder is called ‘borderline’ is quite historical. Earlier mental illnesses were categorised as ‘Psychoses’ or ‘Neuroses’. Psychosis is a severe mental illness characterized by loss of contact with reality, whereas Neurosis is a mild functional neuro-psychical disorder. When psychiatrists first stated about BPD, it didn’t fit into either category. ‘Borderline’ became the imaginary line between these two groups of illnesses to define the disease BPD. 

Theodore Millon, a renowned field expert, has distinguished BPD into four different types. According to him, there is no presumption that a person will suffer the symptoms of only one subtype.

Discouraged borderline personality disorder – Individuals exhibiting this disorder often seem needy and dependent are more likely than other BPD sufferers to resort to self-harm as a coping mechanism.

Impulsive borderline personality disorder – People suffering from this type of BPD  are energetic, charismatic, and exciting to be around but they are easily bored and are quick to become angry or upset.

Petulant borderline – They are often irritable and prone to outbursts of anger and frustration. They are also very impatient in nature and can quickly become delusional.

Self-destructive borderline – As the name suggests, they exhibit self-destructive borderline symptoms and are said to be their own enemy.

Feelings like anxiety, fear, worry, or self-loathe are a part and parcel of daily life. But if these feelings are consistent, unstable, and intense and cause significant problems in day to day work, it is advisable to seek medical help.

Symptoms

People with BPD tend to view things in extremes, either something is too good or too bad. They find it difficult to regulate emotions. They experience major mood swings and display uncertainty about their role among others. Off late borderline personality disorder in teens is being diagnosed early helping in better patient outcomes. The risk of self-harm or suicidal behaviour is also reduced, the earlier the disease is detected. Borderline Personality Disorder symptoms include:

  • Poorly developed or unstable self-image
  • Always being self-critical
  • Dissociative feelings of disconnection from your thoughts or sense of identity
  • Experiencing a persistent feeling of being ‘empty’ inside
  • An unstable and constant change of goals, values, aspirations, or career plans
  • Inappropriate, intense anger or problems controlling anger
  • Not able to recognize the feelings and needs of others
  • Lack of empathy for family and friends
  • Being very unsure about yourself and not really knowing who you are or what to think about yourself
  • Difficulty in intimacy
  • Unstable relationships marked by conflict, mistrust, neediness
  • The constant fear of rejection and being abandoned
  • Feelings of isolation, boredom and emptiness
  • Impulsive, risky, self-destructive and dangerous behaviours
  • Alcohol, drug, or substance abuse
  • Recurring thoughts of suicidal behaviours or threats
  • Experiencing other mental health problems due to BPD
  • Feeling paranoid
  • Having psychotic experiences, such as seeing or hearing things that other people don’t
  • Feeling numb or ‘checked out’ and not remembering things very well – a condition called dissociation.

People with BPD develop other mental health problems with time, such as:

  • Alcoholism
  • Generalised anxiety disorder
  • Bipolar disorder
  • Chronic depression
  • Misusing drugs or other substance
  • Eating disorder, such as Anorexia or Bulimia
  • Other disorders, such as antisocial personality disorder etc.

Borderline personality disorder symptoms in males are quite different from females for many reasons. They possess aggressively thin skin to criticism and control a scenario through strong criticism of others. They tend to compensate for the lack of control they experienced in childhood or any trauma by overly controlling their adult relationships. They are often misdiagnosed with other disorders as they put forward strong irrational behaviours.

Borderline personality disorder can damage an individual’s life in many ways. It can negatively affect academic career, jobs, intimate relationships, social activities and self-image, resulting in:

  • Not completing an education
  • Frequent job changes or loss
  • Multiple legal issues, such as jail time
  • Conflict-filled relationships, marital stress or divorce
  • Self-injury, such as cutting or burning, and frequent hospitalizations
  • Involvement in abusive relationships
  • Unplanned pregnancies, sexually transmitted infections, motor vehicle accidents and physical fights due to impulsive and risky behaviour
  • Attempted or completed suicide

Causes:

For starters, there is no singular cause for borderline personality disorder, it’s mostly caused due to a combination of factors.

Genetics:

The genetic makeup that you inherit from your parents can make you vulnerable to BPD. There have been studies that show that if one twin has BPD then there are high chances that the other twin will develop symptoms of BPD as well. But, you have to treat these results with caution because no set gene carries the BPD trait. If you or a loved one is diagnosed with Borderline Personality disorder then you can get Borderline Personality Disorder treatment in India.

Problem with neurotransmitters:

Another cause for BPD is having problems with brain chemicals. It’s assumed that most people who suffer from borderline personality disorder have a dysfunction in the neurotransmitter of their brain, especially with the serotonin levels. Neurotransmitters are “messenger chemicals” that the brain utilizes to send signals between brain cells and major body organs. Fluctuating serotonin levels have been linked to depression, aggressive behavior, and having difficulty controlling destructive urges. Treatment facilities for Borderline Personality Disorder will help narrow down the cause and diagnose your illness, in a professional and skilled environment.

Stunted brain development:

Medical professionals have used MRI to study patients diagnosed with borderline personality disorder. MRI scans tend to use magnetic fields and radio waves to create a detailed image inside the body. The scan revealed that patients suffering from BPD will have three parts of the brain that are either smaller than normal or have unusual activity. The parts that are affected are responsible for regulating negative emotions, self-control, planning and decision making, and behavior. Problems with these three parts can contribute towards symptoms of BPD. The development of these emotions is affected during early childhood and they are responsible for mood regulation. To get a satisfactory examination and diagnosis ensure that you check-in at the best personality disorder treatment in India.

The causes of BPD are unclear, but it appears to be a result of a combination of different factors. and might depend on the following factors which are believed to play a role in BPD development – 

Genetics – Studies on families with twins suggest that BPD might be inherited or strongly associated with other mental health disorders among family members.

Brain abnormalities – Changes in certain areas of the brain involved in emotion regulation might trigger borderline personality disorder symptoms such as impulsivity and aggression.

Environmental or Social factors – People having a childhood filled with traumatic events, parental neglect or physical, sexual or emotional abuse often develop BPD. 

Hereditary predisposition – One might be at a higher risk of developing BPD, if their immediate family member – mother, father, brother or sister has a similar disorder.

Stressful Childhood – Trauma like sexual or physical abuse, neglected childhood, parents getting separated or divorced, lost or separated from parents, alcoholic parents or caregivers can often aid in developing BPD in a person.  

Diagnosis

In the past, Borderline Personality Disorder diagnosis and treatment were not available as there was no proven or effective remedy present, and neither there were enough treatment facilities for borderline personality disorder. But now Borderline Personality Disorder treatment and management is possible. The healing process in BPD is a matter of breaking the dysfunctional patterns of feeling, thinking, and behaving which are primarily caused by distress. However, BPD may require patients to take lifelong treatment similar to any chronic condition. 

Due to the difficulties in diagnosing BPD, it is often underdiagnosed or misdiagnosed. As BPD shares common symptoms with several other mental illnesses, your doctor will need to rule these out before being able to make a BPD diagnosis. A licensed mental health professional, such as a borderline personality disorder psychiatrist or psychologist can diagnose borderline personality disorder through a:

  • Detailed interview regarding medical history and examinations with your mental healthcare provider
  • Psychological evaluation, where you might be asked to fill in questionnaires
  • Discussion of signs and symptoms

There are various types of free Borderline Personality Disorder tests available online which are research-backed and are easy to use. These tests can help identify the primary stage of BPD. Though this type of test is good for self-analysis, it is strongly recommended that in case you are looking for a proper diagnosis and treatment, seek out professional medical help. You can book an appointment for free at Cadabams to get the best borderline personality disorder treatment in India.

Treatment

Psychological and medical treatment can help manage symptoms of Borderline Personality Disorder. With prolonged treatment and becoming a part of borderline personality disorder treatment centres people with BPD often overcome their symptoms and recover.  Borderline Personality Disorder help and treatment includes – 

Dialectical Behaviour Therapy (DBT)This is a form of therapy for borderline personality disorder that uses mindfulness which aids in being aware of and attentive to the current situations and moods. It teaches ways to reduce self-destructive behaviours, managing and controlling intense emotions, and improves relationships. 

Cognitive Behavioural Therapy (CBT) – This therapy provides awareness of disruptive thoughts and beliefs, leading patients toward more effectively managed emotions.

Mentalisation-based Therapy (MBT)An evidence-based therapy which helps to identify one’s own and others’ feelings and attitudes as a way of explaining behaviours.

Schema Focused Therapy (SFT)This therapy combines aspects of cognitive-behavioural therapy, experiential therapy and interpersonal therapy to deal with the negative thoughts of the patient.

Therapeutic Communities (TCs)TCs have a recovery orientation mainly focused on the person and his/her overall lifestyle changes. This orientation acknowledges the chronic and relapsing nature of the disorder.

Transference Focused Psychotherapy (TFP)It is an evidence-based psychodynamic therapy designed for BPD patients. TFP looks out for the difficulties in an individual’s psychological structure, which is responsible for perceiving images of self and others.

Systems Training for Emotional Predictability and Problem Solving (STEPPS) – A form of group therapy led by a social worker intended to aid other forms of treatment.

Good Psychiatric Management – This treatment approach relies on individual cases and their medical management. It focuses on making sense of emotionally difficult moments by considering the interpersonal context of a Psychiatrist and the patient, for feelings. It may also integrate medications, groups, family education and individual therapy.

Borderline personality disorder treatment aims to –

  • Diagnose what triggers BPD symptoms in an individual;
  • Overcome the associated emotional problems (such as anger, depression, and anxiety);
  • Motivate the individual towards proper goals and purpose in life (e.g. by making a positive contribution to their community or achieving the dream job);
  • Build better relationships;
  • Learn how to understand and live with self;
  • Improve physical health.

Your healthcare provider or Psychiatrist can prescribe medication to treat the clinical problems which occur parallelly with BPD. Few borderline personality disorder treatment medications to treat the symptoms associated with BPD include – 

Antipsychotics – Antipsychotic drugs are seen to be effective in reducing symptoms such as anger, hostility, paranoia, dissociation, etc.

Second-generation antipsychotics and mood stabilizers – These medications can stabilise brain chemicals that control behaviour and emotional temperament.

Antidepressants – Antidepressants are quite helpful to reduce symptoms like low mood, emotional instability, self-harm and impulsivity.

Selective serotonin reuptake inhibitors (SSRIs) – This drug helps a BPD individual to control co-occurring anxiety or depressive disorder.

Omega-3’s – There is some evidence that omega-3 fatty acids, which are commonly found in fish oil, help stabilize mood, and reduce the symptoms of aggression and depression in BPD.

In some cases where the patient becomes aggressive suicidal, they require intensive care in specialized hospitals or psychiatric clinics. With a combination of psychotherapy sessions and BPD medication, inpatient treatment has often proved to be successful. Though it is highly unlikely for a BPD patient to be admitted to a hospital for a long time.

Cadabams has the best treatment facilities for borderline personality disorder and offers multiple residential treatment programs for borderline personality. If you’re looking for BPD treatment in India under the supervision of well-trained professionals visit Cadabam’s residential facility in Bangalore to chalk out your treatment plan.

Borderline Personality Disorder FAQ: All you need to know

How common is a borderline personality disorder?

As per clinical studies, Borderline Personality Disorder is known to have an average prevalence rate of 0.3 – 1.6%. The rates were found to be higher in university students (~19.1%), while in patients with substance use disorders, the ratio stands between 20 – 55%. The analysis also gave a high count of BPD cases in patients suffering from a variety of mental issues like anxiety, depression, mood disorders, etc.

What factors contribute to the development of borderline personality disorder?

Some common factors that trigger the development of borderline personality disorder in individuals include:

  • Being a victim of emotional, physical, or sexual abuse
  • Too long exposure to fear or distress in childhood days
  • Negligence of one or both parents
  • Genetics equally responsible
  • Serotonin (a chemical that regulates mood) isn’t functioning properly
  • Random changes in certain areas of the brain

How is borderline personality disorder treated?

Treating borderline personality disorder is made possible by using the following:

  • Relying on different types of psychotherapy sessions done under the supervision of experienced professionals
  • Medications (like Antidepressants or mood stabilizers) can often reduce the symptoms of the disorder
  • In severe cases, hospitalization is the best route to follow to ensure the patient gets proper care

How does Borderline Personality Disorder cause problems?

Some of the most common problems associated with Borderline Personality Disorder include:

  • A constant fear of abandonment
  • Shaky and unstable relationships
  • Impulsive and self-destructive behavior
  • Extreme emotional mood swings
  • A chronic feeling of living in a void or emptiness
  • Short temperament and intense anger
  • There’s a constant struggle with paranoia

Is Borderline Personality Disorder inherited?

Yes, the tendency to develop borderline personality disorder can run in families as genetics is a risk factor. Another possible reason could be when a child is mistreated in the family, prolonged abuse can manifest as BPD disorder later in life.

Why Cadabams?

Cadabam’s is reputed as the best residential treatment for borderline personality disorder in Bangalore. Everything that we do here is majorly focused on patient experience and clinical expertise. We understand that individuals have their unique needs, so we develop personalised treatment plans for everyone.

We deliver collaborative care. We work in collaboration with psychiatrists, physicians, mental health care team and your loved ones to deliver the best possible care.

We aim at making every visit of yours to our clinic a pleasurable experience. We help you fight your condition effectively by making you feel at home.

We know how tough it is to deal with borderline personality disorders and make the right choices for well-being. Our goal is to ensure that every resident receives support and reinforcement in areas of distress tolerance, reality acceptance skills, interpersonal skills and emotional regulation skills.

Luxurious Living

At Cadabams, we provide clean, modern, fully furnished accommodations with all the necessary creature comforts.

Modern Amenities

Kitchen and dining hall, laundry facilities, indoor games area, yoga and meditation hall, outdoor games area for cricket, badminton, Round the clock psychiatrist and counsellor support, 24×7 ambulance on demand.

Healthy Cuisine

Our everyday menu is curated by Dieticians aimed at providing healthy and nutritious and tasty meals to satisfy everyone’s palate.

Entertainment Options

Recreation facilities such as TV, sports, gym, picnics and outings and more.

People with BPD can have difficulty in:

Cluster A: Odd and Eccentric

Cluster B: Dramatic and Erratic

Cluster C: Anxious and Fearful

Medication:

Psycho-social therapies:

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