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Jun 19, 2006
Borderline Personality Disorder (BPD): Emotional Dysregulation
by SirGan
 Borderline Personality Disorder is one very specific and serious mental illness which is characterized by:
People with BPD suffer from a disorder of emotion regulation. This condition is called emotional Dysregulation disorder! The fact is also that there is very often a high rate of self-injury without suicide intent, as well as a significant rate of suicide attempts and, in severe cases, even suicide committed. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Borderline Personality Disorder is one of the most difficult and controversial personality disorders in all of psychiatry.
Incidence of the conditionOver the last 10 years, increasing awareness and research are helping improve the treatment and understanding of borderline personality disorder. If we talk about gender incidence, then it remains a controversial condition, particularly since so many more women than men are diagnosed with it. Although definitive data are lacking, it's estimated that 1 percent to 2 percent of American adults have borderline personality disorder. It occurs in about one in every 33 women, compared with one in every 100 men. Some feel the onset of this disorder is at puberty, some feel earlier. Most will not diagnose until adulthood claiming the angst of puberty can mimic some BPD. Some are diagnosing the BPD in puberty now.
Basics of BPD conditionWhat it is called “borderline”? it is easy- It is originally thought to be at the borderline between psychosis and neurosis. While less well-known than schizophrenia or bipolar disorder, BPD is more common, affecting two percent of adults, mostly young women.
Taking emotional dysregulation as the core feature of BPD, most experts propose that the disorder arises from impaired modulation of subcortical inputs to consciousness. They hypothesize that the amygdaloid complex and its connections with thalamus, cingulate cortex and insular cortex are critical in the development and maintenance of the disorder.
Signs and symptoms of Borderline Personality Disorder
Borderline personality disorder affects almost every aspect of human behavior! Simply putted - people with this disorder often have an unstable sense of who they are. They typically view themselves as evil or bad, and sometimes they may feel as if they don't exist at all.
People with this disorder often have highly unstable patterns of social relationships. This means that they can develop intense but stormy attachments, but their attitudes towards family, friends, and loved ones may suddenly shift from idealization to devaluation.
Relationships are usually in turmoil. This is because people with the disorder have difficulty accepting gray areas - usually things are either black or white.
Patients with this disorder often engage in impulsive and risky behavior and this usually leads to self-hurting, whether emotionally, financially or physically.
People with Borderline Personality Disorder often engage in suicidal behavior or deliberately injure themselves for some kind of emotional relief.
Other signs and symptoms of borderline personality disorder may include:
Possible causes of Borderline Personality DisorderThe causes of Borderline Personality Disorder are still not well understood, and, as in most mental disorders, it is likely that a number of factors are involved in its development. There were many theories that tried to explain the possible cause!
One biological theory is that early childhood traumatic experiences may cause the hippocampus, a part of the limbic area of the brain which is involved in learning and memory, to atrophy.
Meanwhile, the cause of BPD remains under investigation, and there's no known way to prevent it. Possible causes include:
Some studies of twins and families suggest that personality disorders may be inherited and that genetics could play a major role!
Many people with borderline personality disorder have a history of childhood abuse, neglect and separation from caregivers or loved ones. That’s why it is suggested that this could be the cause!
Some research done in the past have showed changes in certain areas of the brain involved in emotion regulation, impulsivity and aggression.
Risk factors for developing BPDSome researches done in the past have came to the conclusion that some factors related to personality development can increase the risk of developing borderline personality disorder. These include:
What exactly is Emotional Dysregulation?Emotional Dysregulation is one of the common symptoms of Borderline Personality Disorder! It is a term used in the mental health community to describe an individual that does not respond to a person, place, thing, or event in a manner that would generally be considered within the normal range of emotions. It could also be a part of Complex Post Traumatic Stress Disorder.
Diagnostic criteriaPersonality disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. Differentiate diagnosis between BPD and other personality disorders could be extremely difficult! It considers symptoms that fall under four main headings:
Affect
Cognition
Impulse action patterns
Interpersonal relationships
A commonly used mnemonic to remember the features of the borderline personality disorder is PRAISE:
Possible complications if left untreatedThis is one very serious mental disorder which can affect almost many areas of a person's life: relationships, jobs, school, social activities, self-image… That’s why most common complications are:
Treatment of Borderline Personality Disorder
Medication seems to be the first response to self-harm behavior, particularly when self-harm is linked to other symptoms, such as depression.
It has been suggested that antidepressant drugs and mood stabilizers may be helpful for depressive mood, mood swings, and impulsivity, however, the affective symptoms of BPD do not respond to antidepressants in the same way as the symptoms of mood disorders.
Antipsychotic drugs may be used when there are distortions in thinking or some psychotic symptoms. However, the commonly used mood stabilizer, valproic acid, may induce polycystic ovaries, so should not be used with young female BPD patients.
There are some important thing that should be known about hospitalizations! Although necessary in some severe cases, hospital admissions are expensive, and may be ineffective and counterproductive. Brief psychiatric hospitalization may be justified for protection against suicide risk, psychotic or dissociative symptoms, or dangerousness toward others or when the patient is experiencing an acute stressful life event or demonstrates symptoms of affective disorder.
The most important approach to the treatment of suicidal behavior is individual therapy. These include:
The idea is to give patients tools that they never acquired as children, typically to control and handle their emotions.
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