Borderline Personality Disorders: A Case Study

What is Borderline Personality Disorder? Defined by the website www.borderlinepersonalitydisorder.com, “Borderline personality disorder (BPD) is a serious mental illness that causes unstable moods, behavior, and relationships. It usually begins during adolescence or early adulthood.” One may wonder what can be the cause of this disorder. BPD can be detected by an in-person interview about the symptoms that are occurring. The input from family and close friends of the individual that is being treated can also help detect the symptoms. The causes for BPD are not fully

Psychiatric research on Borderline Personality Disorder (BPD) has increased in popularity over the past few decades. It was included into the Diagnostic and Statistical Manual for Mental Disorders (Third Edition) in 1980. Over the years, professionals have found dramatically effective treatments for a disorder that was once considered disabling. Even though Borderline Personality Disorder can be hard to treat, it’s usually comorbid with other disorders like depression and anxiety. Throughout this paper, I will be focusing on background information, symptoms, and treatments of Borderline Personality Disorder.

Borderline Personality Disorder (BPD) can be described in simple terms as a condition in which sufferers experience long periods of emotional instability and troubled feelings about themselves and other people. These troubled feelings allow individuals to take impulsive measures and have trouble in their relationships (Bouchard, Sabourin, Lussier & Villeneuve, 2009). BPD basically comprises of unusual intensities of instability in mood and irrational thinking also referred to as splitting. Splitting in BPD involves a switch between negative perception of others and idealization (Sperry, 2003). This usually occurs along with irregular mood swings and can negatively impact on the existing relationships such as family,

A personality disorder is characterized by a distinct pattern of behavior that does not meet normal standards of behavior within one’s culture. This pattern is ingrained as the norm to the person affected, and the characteristics of the affected person deviate markedly from societal standards (Hebblethwaite, 2009). The two main features that help to identify a personality disorder are chronic interpersonal difficulties and persons with one’s identity or sense of self (Livesly, 2001). Within this set of mental health disorders lie several other subsets, including one of the most prominent personality disorders - Borderline Personality Disorder (BPD). BPD is a severe, long-lasting disorder that has an incidence of occurrence approximately equal to that of bipolar disorder and schizophrenia combined (Grant, Chou, Goldstein et al., 2008). BPD also puts those affected at risk for damage in many areas of their life if not properly diagnosed and treated, including personal relationships, school, work, and self-imagine. Furthermore, this disorder has a high co-morbidity with other disorders such as depression, substance abuse, eating disorders, and social phobia, among many more (Hebblethwaite, 2009). Misdiagnosis of borderline personality disorder can have serious clinical implications. This paper looks to identify the risk factors associated with BPD, the affects on various aspects of the person’s life, treatments, and give recommendations as to how to properly identify and

“The essential feature of borderline personality disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts” (APA, 2013; p. 663). The DSM-5 further elucidates this definition with nine criteria, five or more of which must be present for an individual to receive a diagnosis of BPD. These nine criteria can effectively be grouped into symptoms relating to affect, impulsivity, suicidality, interpersonal relationships, and cognition (Cartwright,

6) MacIntosh, H. B., Godbout, N., & Dubash, N. (2015). Borderline personality disorder: Disorder of trauma or personality, a review of the empirical literature. Canadian Psychology, 56(2), 227-241. Retrieved from

Although patients with Borderline Personality Disorder are considered difficult to treat, treatment approaches include psychotherapy, transference-focused psychotherapy, and mentalization-based therapy.

“Personality disorders have been documented in approximately 9 percent of the general U.S. population” (Angstman, Rasmussen, 2011). Emotional dysregulation disorder or its common name borderline personality disorder is a very serious and chronic disorder. The Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) describes borderline personality disorder as “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts” (Gardner, 2006). Within the last 20 years, psychologists and other mental health professionals have made tremendous strides in research on what exactly borderline personality disorder, some of its triggers and possible effective treatment options. Borderline personality disorder is defined as a disorder that generates severe emotional instability which can be a springboard that can lead to other stress induced mental and behavioral problems.

Definition Borderline personality disorder is a mental health disorder that impacts the way you think and feel about yourself and others, causing problems functioning in everyday life. It includes a pattern of unstable intense relationships, distorted self-image, extreme emotions, and impulsiveness. With borderline personality disorder, you have an intense fear of abandonment or instability, and you may have difficulty tolerating being alone. Yet inappropriate anger, impulsiveness, and frequent mood swings may push others away, even though you want to have loving and lasting relationships.

Though several personality disorders are highly complex and a challenge to treat, there are effective treatments available (“Treating Borderline” 1). The various treatments are broken down by method, the first of which being cognitive behavioral therapy, which attempts to alter the conscious thoughts and behavioral patterns of patients (Daniel); (“Treating Borderline” 2). Cognitive behavior therapy itself is broken down into two therapies, dialectical behavioral therapy and schema-focused therapy (“Treating Borderline” 2). Dialectical behavioral therapy, developed by Dr. Linehan, is centered on the basis that personality disorders are formed when hypersensitive patients are in situations which lack the emotional support they require, therefore leading to their “inability to regulate emotions” (“Treating Borderline” 2). Thus, the treatment serves to help the patient gain control over their emotion and behavior (“Treating Borderline” 2). The treatment itself consists of group and individual sessions and typically lasts approximately one year (“Treating Borderline” 2). During the group sessions, patients learn to become more aware of their behaviors and emotions through sessions pertaining to “problem solving, mindfulness meditation, and breath training“(“Treating Borderline” 2). In personal sessions, referred to as psychotherapy, the psychiatrist explains to the patient how the lessons from the group therapy sessions are applicable

Assessment of the patient with borderline personality disorder is inclusive of the patient's: (1) physical; (2) emotional; (3) cognitive; (4) social; and (5) spiritual characteristics. These are assessed based on the patient's: (1) subjective reports; (2) interview records; and (3) behavioral

Marsha Linehan a psychologist who developed this form of therapy from the cognitive-behavioral treatment model (Comer, 2016, p. 439). The cognitive-behavioral techniques include “…homework assignments, psychoeducation, the teaching of social and other skills…clear goal setting, and reinforcement for appropriate behaviors…”(Comer, 2016, p. 439). One of the most important aspects of DBT is the social skill-building groups for individuals who have been diagnosed with Borderline Personality Disorder. The psychoeducation aspect of this treatment will allow Estelle to improve with her impulsivity and unstable relationships as well. Another key component that DBT will provide for the patient is a way to implement opposite action in which she will be able to act opposite to the way she feels when an emotion is inappropriate (Comer, 2016, p.

Another sign that relates to borderline personality disorder is loneliness. People with BPD fear of abandonment and being alone. Loneliness causes severe stress on them and can affect their health. It was stated that “persistent loneliness is one of the key experiences reported by individuals with borderline personality disorder (BPD)” (Liebke, 2017). In the Diagnostic Statistical Manual of Disorder III (1980), the intolerance of aloneness is so characteristic for BPD patients that it was even one of the diagnostic criteria for BPD when it first came up as independent

According to the DSM-5, Personality Disorders are characterized by “impairments in personality functioning and the presence of pathological personality traits”. Borderline Personality Disorder is one of ten personality disorders listed in the DSM-5. The DSM-5 lists several criteria that must be met in order for someone to be diagnosed with Borderline Personality Disorder. They are quoted as follows:

Borderline personality disorder is associated with a variety of different components and symptoms. The two main areas that borderline personality disorder is related to are moods and relationships; both of these areas tend to be quite unstable. The element about borderline personality disorder that I was not aware of was the increased risk that they have of injury or even death by their own hands. It is a common stereotype that is depicted in the media that those with psychological disorders are always acting sporadically and causing harm. It was discussed in this unit that the main reason these individuals are risks to themselves is because of instability, dysfunction, and impulsivity. Though these elements may sound like they match what is portrayed in the media, there are deeper meanings behind them that can cause dangerous behaviors. Instability is associated with relationships; individuals with borderline personality disorder often have unstable relationships because of their lack of emotional control, which can then lead to a constant fear of abandonment. Dysfunction is associated with unstable emotions and is often a good predictor of potential suicidal thoughts and