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Borderline personality disorder
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Borderline personality disorder
Borderline personality disorder (BPD) is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, acute fear of abandonment, and intense emotional outbursts. People with BPD frequently exhibit self-harming behaviours and engage in risky activities, primarily caused by difficulties in regulating emotions. Symptoms such as dissociation, a pervasive sense of emptiness, and distorted sense of self are prevalent.
Onset of symptoms can be triggered by events others perceive as normal, with the disorder typically manifesting in early adulthood and persisting across diverse contexts. BPD is often comorbid with substance use disorders, depressive disorders, and eating disorders. Studies estimate up to 10 percent of people with BPD die by suicide. BPD faces significant stigmatization in media portrayals and the psychiatric field, leading to underdiagnosis and insufficient treatment.
Causes of BPD are unclear and complex, implicating genetic, neurological, and psychosocial conditions in its development. The current hypothesis suggests BPD is caused by an interaction between genetic factors and adverse childhood experiences. BPD is significantly more common in people with a family history of BPD, particularly immediate relatives, suggesting genetic predisposition. There is a risk of misdiagnosis, with BPD commonly confused with a mood disorder, substance use disorder, or other mental health disorders. Therapeutic interventions predominantly involve psychotherapy, with dialectical behavior therapy (DBT) and schema therapy being the most effective. Although pharmacotherapy cannot cure BPD, it may be employed to mitigate symptoms, with atypical antipsychotics and selective serotonin reuptake inhibitor (SSRI) antidepressants commonly prescribed. Medications are used cautiously, show limited efficacy, and have minimal impact on neural function. Despite the high utilization of healthcare resources by people with BPD, up to half may show significant improvement over ten years with appropriate treatment.
Estimation of BPD's prevalence varies. In the US, around 1% of the population are diagnosed with it. BPD is more prevalent among adolescents and young adults than elderly, and symptoms may remit with age. The term ‘borderline’ is debated, as it referred to concepts of borderline insanity and patients on the border between neurosis and psychosis, which are now considered clinically imprecise.
The distinguishing characteristics of borderline personality disorder (BPD) include a pervasive pattern of instability in one's interpersonal relationships and in one's self-image, with frequent oscillation between extremes of idealization and devaluation of others, alongside fluctuating moods and difficulty regulating intense emotional reactions. Dangerous or impulsive behaviors are commonly associated with BPD.
Additional symptoms may encompass uncertainty about one's identity, values, morals, and beliefs; experiencing paranoid thoughts under stress; episodes of depersonalization; and, in moderate to severe cases, stress-induced breaks with reality or episodes of psychosis. It is also common for individuals with BPD to have comorbid conditions such as depressive or bipolar disorders, substance use disorders, eating disorders, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD).
Emotional dysregulation is a core feature of BPD and it is characterized by a difficulty in effectively managing emotional states.It may involve high sensitivity to emotional stimuli, heightened emotional intensity, large and rapid mood shifts, tendency for negative emotions, and a slow return to baseline after emotional arousal. Emotional dysregulation extends beyond emotions, affecting cognition, relationships, and behaviour.
Deficits in emotion regulation strategies are observed in BPD. These include resistance to accepting emotional responses, low flexibility to changing strategies, difficulty in identifying emotions, as well as a deficit in goal-directed behaviour, and in using healthy coping strategies. Maladaptive strategies to regulate their emotions include self-harm, rumination, avoidance, and thought suppression.
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Borderline personality disorder
Borderline personality disorder (BPD) is a personality disorder characterized by a pervasive, long-term pattern of significant interpersonal relationship instability, acute fear of abandonment, and intense emotional outbursts. People with BPD frequently exhibit self-harming behaviours and engage in risky activities, primarily caused by difficulties in regulating emotions. Symptoms such as dissociation, a pervasive sense of emptiness, and distorted sense of self are prevalent.
Onset of symptoms can be triggered by events others perceive as normal, with the disorder typically manifesting in early adulthood and persisting across diverse contexts. BPD is often comorbid with substance use disorders, depressive disorders, and eating disorders. Studies estimate up to 10 percent of people with BPD die by suicide. BPD faces significant stigmatization in media portrayals and the psychiatric field, leading to underdiagnosis and insufficient treatment.
Causes of BPD are unclear and complex, implicating genetic, neurological, and psychosocial conditions in its development. The current hypothesis suggests BPD is caused by an interaction between genetic factors and adverse childhood experiences. BPD is significantly more common in people with a family history of BPD, particularly immediate relatives, suggesting genetic predisposition. There is a risk of misdiagnosis, with BPD commonly confused with a mood disorder, substance use disorder, or other mental health disorders. Therapeutic interventions predominantly involve psychotherapy, with dialectical behavior therapy (DBT) and schema therapy being the most effective. Although pharmacotherapy cannot cure BPD, it may be employed to mitigate symptoms, with atypical antipsychotics and selective serotonin reuptake inhibitor (SSRI) antidepressants commonly prescribed. Medications are used cautiously, show limited efficacy, and have minimal impact on neural function. Despite the high utilization of healthcare resources by people with BPD, up to half may show significant improvement over ten years with appropriate treatment.
Estimation of BPD's prevalence varies. In the US, around 1% of the population are diagnosed with it. BPD is more prevalent among adolescents and young adults than elderly, and symptoms may remit with age. The term ‘borderline’ is debated, as it referred to concepts of borderline insanity and patients on the border between neurosis and psychosis, which are now considered clinically imprecise.
The distinguishing characteristics of borderline personality disorder (BPD) include a pervasive pattern of instability in one's interpersonal relationships and in one's self-image, with frequent oscillation between extremes of idealization and devaluation of others, alongside fluctuating moods and difficulty regulating intense emotional reactions. Dangerous or impulsive behaviors are commonly associated with BPD.
Additional symptoms may encompass uncertainty about one's identity, values, morals, and beliefs; experiencing paranoid thoughts under stress; episodes of depersonalization; and, in moderate to severe cases, stress-induced breaks with reality or episodes of psychosis. It is also common for individuals with BPD to have comorbid conditions such as depressive or bipolar disorders, substance use disorders, eating disorders, post-traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD).
Emotional dysregulation is a core feature of BPD and it is characterized by a difficulty in effectively managing emotional states.It may involve high sensitivity to emotional stimuli, heightened emotional intensity, large and rapid mood shifts, tendency for negative emotions, and a slow return to baseline after emotional arousal. Emotional dysregulation extends beyond emotions, affecting cognition, relationships, and behaviour.
Deficits in emotion regulation strategies are observed in BPD. These include resistance to accepting emotional responses, low flexibility to changing strategies, difficulty in identifying emotions, as well as a deficit in goal-directed behaviour, and in using healthy coping strategies. Maladaptive strategies to regulate their emotions include self-harm, rumination, avoidance, and thought suppression.
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