by Tami Port MS

Created on: August 16, 2008

According to the DSM-TR-IV, psychology's diagnostic "bible," BPD is a type of psychological personality disorder that interferes with an individual's ability to regulate emotion. The characteristic emotional instability results in dramatic and abrupt shifts in mood, impulsivity, poor self-image and tumultuous interpersonal relationships.

People with this disorder are prone to unpredictable outbursts of anger, which sometimes manifest in self-injurious behavior. Borderlines are highly sensitive to rejection, and fear of abandonment may result in frantic efforts to avoid being left alone, such as suicide threats and attempts.

Borderline Behavior
Those suffering from BPD are also prone to other impulsive behaviors, such as excessive spending, binge eating, risky sex, and drug and alcohol abuse. They often exhibit additional psychiatric problems, particularly bipolar disorder, depression, anxiety, and other personality disorders. Symptoms typically begin in early adulthood, and once present, can interfere with relationships, work performance, long-term planning, and the individual's sense of self-identity.

BPD or Emotional Regulation Disorder?
The term "borderline" was originally used to describe mental health patients that appeared to be on the border between neurosis and psychosis. The diagnostic label has been long subject to misuse, and is occasionally used as a "catch-all" diagnosis for individuals who are difficult to diagnose (Friedel 2004). The disorder is also referred to as Emotional Regulation Disorder (ERD), which many feel more accurately describes the true nature of the illness.

Diagnosis of Borderline Personality Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders, a patient must fit the following criteria in order to be diagnosed with BPD:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects; marked by impulsivity beginning by early adulthood, as indicated by five (or more) of the following:

* frantic efforts to avoid real or imagined abandonment
* pattern of unstable and intense interpersonal relationships
* identity disturbance: markedly and persistently unstable self-image
* impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
* recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
* affective instability due to a marked reactivity of mood (extreme changes in mood typically lasting

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