Borderline Personality Disorder

________________________________________________________________________

KEY POINTS

• Borderline personality disorder is a condition that causes you to have stormy relationships with other people. You see the world in terms of extremes: good/bad; love/hate; or your fault/my fault.
• This disorder changes the way you relate to others and the way you think about everyday activities. Therapy may help.
• Get emergency care if you have serious thoughts of suicide or harming others.

________________________________________________________________________

What is borderline personality disorder?

Borderline personality disorder (BPD) is a condition that causes you to have stormy relationships with other people. You see the world in terms of extremes: good/bad; love/hate; or your fault/my fault. There is no middle ground. These ways of thinking, feeling, and acting cause many problems at work, in school, and in relationships.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Stress plays a part. You may be at higher risk due to problems such as abuse, financial stresses, or the death of loved ones.
• Problems in the family may increase the likelihood that you will develop this disorder, for example, being neglected or having parents who were unpredictable.

It usually begins in the teen years or early adulthood. It affects more women than men.

What are the symptoms?

Symptoms may include:

• Having intense emotions and mood swings
• Having stormy relationships with family, friends, and loved ones, because you swing between loving them and hating them
• Having sudden changes in opinions, plans, or goals because you don’t have a strong sense of who you are and feel empty and worthless
• Doing things on impulse, such as binge eating, going on spending sprees, having unsafe sex, or reckless driving
• Feeling frantic at the thought of being left alone, which may cause you to reject others before they can reject you, or to do things to keep other people from leaving you
• Having problems with anger, such as violent temper tantrums
• Hurting yourself, such as cutting or burning yourself, or trying to commit suicide
• Feeling like people are out to get you or that you are losing touch with reality

How is it diagnosed?

Your healthcare provider or a mental health therapist will ask about your symptoms and any drug or alcohol use. He or she may also:

• Ask about your relationships with family, friends, and coworkers
• Give you a personality test
• Make sure medicines are not causing or increasing your symptoms

You may have lab tests to rule out medical problems.

How is it treated?

Medicine

Several types of medicines may help. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.

Therapy

This disorder changes the way you relate to others and the way you think about everyday activities. Several types of treatment may help.

• Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns.
• Dialectical behavior therapy helps you be aware of your thoughts and behavior, learn how to express your needs, deal with stressful situations, and manage your emotions.
• Treatment for any alcohol or drug abuse problems
• Day treatment programs, including structured activities and group therapy every day
• Treatment in a hospital if you are hurting yourself, such as self-cutting, self-burning, or attempting suicide

How can I take care of myself?

• Get support. Talk with family and friends. Consider joining a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, try to quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

For more information, contact:

• National Institute of Mental Health
  866-615-6464
  http://www.nimh.nih.gov/
• Mental Health America
  800-969-6642
  http://www.mentalhealthamerica.net/