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I Love You, I Hate You, Don't Leave Me: Understanding Borderline Personality Disorder

Understanding that 6-10 million Americans have been diagnosed with Borderline Personality Disorder (BPD). There can be a stigma to every Personality Disorder but this one is not as understood.

The name Borderline Personality Disorder (BPD) originated in 1938 by Adolph Stern. He described a group of patients that didn’t quite fit an existing diagnosis. These patients were classified as past the neurotic stage but not quite psychotic. However these days this disorder is seen in a different way but the name still given the same BPD name.



BPD is relatively common, nearly 20% of psychiatric hospitalizations stem from BPD. It affects 10-14% of the general population. Women commonly suffer from depression more often than men and the frequency of BPD in women is two to three times greater than men.



A person with BPD can experience depression and anxiety that may last only an hour or at most, a day. While people that suffer with depression or bipolar disorder typically endure the same mood can last for several weeks at a time.



Symptoms of Borderline Personality Disorder:

• Impulsive aggression

• Self injury

• Strong feelings of anxiety

• Feelings of low self worth

• Drug or alcohol abuse

• Impulsive behaviors

• Feelings of being misunderstood

• Experience unstable relationships



This mood instability and poor self-image can bring on bouts of anger, eating disorders, panic attacks and anxiety. Sometimes people suffering from BPD view themselves essentially as bad people or unworthy. Very intense emotional turmoil appears to be a way of life for those afflicted by it.



Often times a person with BPD can present as a bright, intelligent individual with a warm, friendly nature. They can maintain this appearance for a number of years until their defense mechanism breaks down, usually caused by a severe stressor like a relationship breakup or death of a loved one.



People with BPD often formulate highly unstable relationship patterns. They may feel isolated and empty which may result in frantic efforts to avoid being alone. While their relationships with family and friends can be very intense their attitude can switch dramatically and suddenly from great admiration and love to profound anger and distaste. Often times they form an immediate attachment to another person but when even a slight conflict or separation occurs they switch suddenly to the opposite attachment extreme and accuse the other person of not really caring about them at all. They are very sensitive to any sign (real or imagined) of rejection and can react quickly with anger and distress when their expectations are not met.



Over the years treatments for BPD have improved with group and individual psychotherapy at least partially effective for a great number of patients. Dialectic Behavior Therapy, see http://en.wikipedia.org/wiki/Dialectical_behavior_therapy has proven to be helpful in regulating moods. Working with an empathetic and accepting therapist on a consistent and regular basis about present challenges and past experiences, has proven effective. Patients are encouraged to talk about their feelings rather than act them out them in their usual self-defeating manner.



Sometimes medications such as antidepressants, and supplements are helpful in treatment of BPD. Brief hospitalization for BPD may be necessary during acutely stressful episodes or if self-destructive behavior threatens to erupt.



The goals of ongoing therapy and/or treatments would be to increase an individual’s tolerance of anxiety as well as increase self awareness and build more stability into relationships. With increased self awareness and introspection, it is hoped that individuals with BPD will be able to change rigid patterns of behavior set earlier in life which in turn will help prevent these patterns from repeating themselves in future generations.



Renee Madison acknowledges that each person is extraordinary in their own right and that having therapy can encourage and empower individuals to gain clarity and move forward to become their very best! To learn more about help for BPD call Renee Madison, MA, LPC, CSAT is a counselor in Colorado.  She can be reached for appointments at 303-257-7623 or 970-324-6928.

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