November 29, 2014

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What is BPD?

Is this you? Someone you know?

Borderline personality disorder (BPD) is a serious mental illness that centers on the inability to manage emotions effectively.  The disorder occurs in the context of relationships:  sometimes all relationships are affected, sometimes only one.

While some persons with BPD are high functioning in certain settings, their private lives may be in turmoil.  Other disorders, such as depression, anxiety disorders, eating disorders, substance abuse and other personality disorders. can often exist along with BPD

The diagnosis of BPD is frequently missed  and a  misdiagnosis of the BPD diagnosis has been shown to delay and/or prevent recovery.   Bipolar disorder is one example of a misdiagnosis as it also includes mood instability.

Officially recognized in 1980 by the psychiatric community, BPD is more than two decades behind in research, treatment options, and family psycho-education compared to other major psychiatric disorders. BPD has historically met with widespread misunderstanding and blatant stigma.  However, evidenced-based treatments have emerged over the past two decades bringing hope to those diagnosed with the disorder and their loved ones.

Diagnostic Criteria

A pervasive pattern of instability of interpersonal relationships, self image and affects, and marked impulsivity beginning by early adulthood  and present in a variety of contexts, as indicated by five (or more) of the following:

1)   Frantic efforts to avoid real or imagined abandonment.

2)   A pattern of unstable and intense interpersonal relationships characterized by alternating between  extremes of idealization and devaluation.

3)  Identity disturbance:  markedly and persistently unstable self-image or sense of self.

4)   Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

5)   Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

6)   Affective [mood] instability.

7)   Chronic feelings of emptiness.

8)   Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9)   Transient, stress-related paranoid ideation or severe dissociative symptoms.

*Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association

Officially recognized in 1980 by the psychiatric community, BPD is more than two decades behind in research, treatment options, and family psycho-education compared to other major psychiatric disorders. BPD has historically met with widespread misunderstanding and blatant stigma.  However, evidenced-based treatments have emerged over the past two decades bringing hope to those diagnosed with the disorder and their loved ones.

 Prevalence:

  • BPD afflicts up to 5.9% of adults (approximately 14 million Americans)
  • BPD is more common than schizophrenia and bipolar disorder
  • 20% of inpatients admitted to psychiatric hospitals, 10% of outpatients have BPD

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