Case Study Borderline Personality Disorder

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

Chapman, PhD, A. L., & Fraser, S. (2006, September). Dialectical Behavior Therapy: Current Indications and Unique Elements PDF file., (), 62-68.

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,

Genetics- According to NIMH (nation institute of mental health) BPD is 5X more likely to occur if an immediate family member has it.

9.6 percent of the United States population have a mental disorder and 1.6 percent have borderline personality disorder. Borderline personality disorder is a mental illness that shows symtoms of not being able to regulate emotional responses and moods, impacting self image, relationships and behavior (National Institute of Mental Health,2016). The National Institute of Mental Health states that borderline personality disorder is experienced in a person when they are overwhelmed with emotions in the cognitive functioning. Symptoms of a person with borderline personality disorder could include explosive amount of anger, depression, and anxiety. People with borderline personality disorder could also have other mental disorders such as mood

The main feature of borderline personality disorder (BPD) is a pervasive pattern of instability in interpersonal relationships, self-image and emotions. People with borderline personality disorder are also usually very impulsive.

“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.

Borderline personality disorder (BPD) is a serious and complex mental disorder involving maladaptive behaviors and multiple symptoms. This disorder often occurs in the context of relationships and can have a chaotic effect not only on the individual with BPD but also on their loved ones. According to the NIMH, “borderline personality disorder (BPD) is a serious mental illness characterized by unstable moods, behavior, and relationship”.9 A primary character of BPD is behavioral and emotional dysregulation. These behaviors are difficult

The diagnostic process for personality disorders currently covers a broad scope of various tests and symptoms, causing a source of frustration for psychiatrists (Aldhous). The symptoms and side effects of several personality disorders can tend to blur together, making diagnosis challenging (Aldhous). Most psychiatric patients are diagnosed with several personality disorders at once, with twenty percent of people with personality disorders simply diagnosed with a “personality disorder not otherwise specified” (Aldhous). Using the Diagnostic and Statistical Manual of Mental Health Disorders, commonly referred to as the DSM, psychiatrists attempt with great difficulty to categorize their patients into a specific disorder, only to diagnose

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

With BPD there are often extremes in beliefs and views, such as all good or all bad. People with BPD are can be uncertain about whom they truly are as a person. With no self sense, interests and values may conflict as well as change rapidly. Their views of others may also change quickly. One day a certain person may be admired. The next day that same person may be despised or hated. Suddenly shifting feelings often foster relationships that are unstable and intense. There are numerous other identifiable traits someone with BPD may display. Some of these symptoms may include fear abandonment, feelings of emptiness and boredom, frequent displays of inappropriate anger, destructive impulsiveness, intolerance of being alone, as well as repeated self crises (i.e. self injury).

Likewise, the author read that Borderline Personality Disorder (BPD) is described as instability in interpersonal relationship, self-image and mood, a fast fluctuation between emotional states, impulsive behaviour and an inclination towards self-harm and suicidal thinking (NICE 2009).

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:

People with BPD also experience different co-occurring disorders depending on their genders. In a research by Johnson et al. (2003) women with BPD were more common to have co-occurring disorders such as Post Traumatic Stress Disorders (PTSD) and eating disorders, while men showed a greater tendency to have narcissistic,

Borderline Personality Disorder (BPD) is characterized by fluctuation of self-image, lack of stable interpersonal relationships and pronounced and unpredictable impulsivity. The Diagnostic and Statistical Manual of Mental Disorders 5 (2013) also lists fear of abandonment, suicidal or self-harming behaviors, intense or inappropriate anger that is difficult to control as well as paranoid ideation or dissociative symptoms. Morcos and Morcos (2016) wrote that patients with BPD are often misdiagnosed with other trauma related disorders, such as PTSD, depression or bipolar disorder. According to Beatson, et al. (2016) there are additional issues in diagnosing older patients, as the criteria indicates that symptoms would have been seen early in the patient’s life, not later. Beatson, et al. (2016) also noted that there is a considerable lack of studies and literature concerning BPD in older patients, making the diagnostic process more difficult. In this case study we will be working with an older patient, one that was well into midlife before Borderline Personality Disorder was included in the DSM, to see if she fits the criteria for BPD and what treatment options might be available.