Borderline Personality Disorder

July 28, 2016

 
Taken from Borderline Personality Disorder Demystified by Robert O. Friedel, M.D.

To some, the term borderline personality disorder does not evoke pleasant images.  It reminds people of someone who is crying, yelling, screaming.  It can feel like a  death sentence to be diagnosed as borderline especially since there is little information out there that is based on facts.   There are four hallmarks of BPD, which are: 1) poorly regulated emotions, 2) impulsivity, 3) impaired perception and reasoning, and 4) markedly disturbed relationships.

The causes of borderline personality disorder (BPD) is a result of psychosocial stressors and chemical disturbances in certain brain pathways that control brain functions.   People are born with the chemical disturbances, which are amplified later in life.   BPD affects about two percent of the population and occurs 3 x more in women.

There are biological risk factors and environmental risk factors for having BDP.   Research has found genetic mutations in the neural systems that control core behaviors, emotion regulation, control, and reasoning.  The neuronal connections in these systems are misaligned.  Misfiring also occurs in these neuronal networks.  Dopamine, serotonin, acetylcholine, norepinephrine, glutamate are disrupted.  The amygdala the anger control system is formed differently in those with BDP.  As is the anterior cingulate and orbital prefrontal cortex that controls impulse behavior and dorsolateral prefrontal cortex that manages cognitive perception and reasoning.  Environmental risk factors include 50% chance of having BPD if there is childhood trauma or early childhood separation from parents.   Those with BPD had experienced significant loss, trauma, depressive disorders, and ineffective parenting.  

The key elements for treatment BPD are long-term therapy and medications.  There is no magic bullet, but medication will help reduce symptoms and help with getting the best out of psychotherapy.  Medications are helpful because it stabilizes emotion reactions, reduces impulsivity.   Furthermore, drugs treat other emotional disorders associated with a borderline personality such as depression, panic attacks, and migraine headaches.  It reduces paranoid thinking and helps think rationally especially when it comes to romantic partner’s behaviors, friendships, family, and coworkers.  In psychotherapy, a person will learn new behavioral habits and other ways to perceive events.  Dialectical behavioral therapy (DBT) is evidenced-based treatment model for BPD.  DBT’s mission is to help the individual feel validated about his/her feelings, but be pushed to make changes and learn how to manage emotions more effectively.   

If you need to find out more, please check our your local resources.  See if there are any DBT specialists in your area.  Feel free to contact me if you would like to learn more. 

 


 

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Natalie A. Ma, PhD

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