Portrayal Of A Patient With Borderline Personality Disorder

The person I am going to discuss in this case study paper, suffers from a psychological disorder called borderline personality disorder. Someone with borderline personality disorder often has characteristics

The use of the term borderline has however, resulted in a heated controversy between the health care fraternity and patients. Patients argue that this term appears to be somehow discriminatory and that it should be removed and the disorder renamed. Patients point out that an alternative name, such as emotionally unstable personality disorder, should be adopted instead of borderline personality disorder. Clinicians, on the other hand, argue that there is nothing wrong with the use of the term borderline. Opponents of this term argue that the terms used to describe persons suffering from this disorder, such as demanding, treatment resistant, and difficult among others, are discriminatory. These terms may create a negative feeling of health professionals towards patients, an aspect that may lead to adoption of negative responses that may trigger self-destructive behavior (Giesen-Bloo et al, 2006). The fact however, is that the term borderline has been misunderstood and misused so much that any attempt to redefine it is pointless leaving scrapping the term as the only option.

One of the biggest contributors for poor healthcare is the stigma against mental health. This stigma allows healthcare providers to view those with a mental illness as having low relevance, thus creating disinclination towards providing adequate resources and/or care. This negative stance, based on misinformation and prejudice creates those that have a mental illness to lose their self confidence. Because of this loss, people with mental illness decide not to contribute to their health or livelihood. In the past fifty years, many advances have been made in mental healthcare. However, with the attached stigma, many people choose to not seek out treatment.

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

Borderline personality disorder (BPD) is a serious psychiatric illness. People that are diagnosed with this disorder suffer from an intense pattern of affective instability, extreme difficulties in interpersonal relationships, problems with behavioral or impulse control, and disrupted cognitive processes. The estimated prevalence of BPD in the general adult population is about 2%, mostly affecting young women.

Borderline personality disorder can include many aspects: instability in mood regulation, impulse control, difficulties in interpersonal relationships and self-image. (Lieb et al, 2004) Jaynelle has experienced all of these at some time in her life. She grew up stealing from Safeway to be able to eat, uprooting her family to move with multiple boyfriends, and she overreacts when she thinks she is being slighted by social services. She is quick to anger and lashes out when provoked.

Borderline Personality Disorder was first listed in the DSM in 1980. It is classified as a cluster B personality disorder. Before then it was unsure if it was a disorder on its own, if it only coexisted with other disorders, or only mocked other disorders. Most people suffering from BPD have problems regulating emotions and thoughts, have impulsive and reckless behavior, and have unstable relations with others. High rates of comorbidity occur with this disorder including; depression, anxiety disorders, substance abuse, and eating disorders.

Abstract: This paper will discuss the causes and psychological impact of borderline personality disorder. It will also talk about how to treat those impacted by borderline personality disorder.

“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.

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

In the Diagnostic and Statistical Manuel of Mental Disorders Fifth Edition, Borderline personality disorder is described as having a pervasive pattern of instability of interpersonal relationships, self-image, affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts. In order to be diagnosed with borderline personality disorder, the individual must demonstrate five or more of the nine behaviors experienced within the disorder. The nine criterion behaviors within the disorder include: (1) frantic efforts to avoid abandonment, (2) a pattern of unstable and intense 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 such as sexuality, spending, substance abuse, binge eating or reckless driving, (5) recurrent suicidal behavior, gestures, threats, or self mutilating behavior, (6) affective

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:

Becky experiences many of the criteria for borderline personality disorder. The first she describes is her need for physical contact, which exemplifies the fear of abandonment expressed in many of those with BPD, and she describes this need for contact as overwhelming and constant. The feelings that this need create in her, and the feelings after not having this need met, lead her to cut herself. Self-injury is another symptom evident in those with the disorder. Becky has unstable interpersonal relationships which are further damaged by her intense emotional outbursts. Lastly, she describes herself as having no secure identity.

According to the DSM-IV(2000), Borderline Personality Disorder is 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

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.