by Paula Mead

Created on: July 24, 2007   Last Updated: September 26, 2007

The term 'personality' refers to the ongoing pattern of behavior, feelings and thoughts that make us each who we are. Originally, the term 'borderline' was used to describe people on the border of being diagnosed as schizophrenic, although borderline personality disorder is distinct from this diagnosis. BPD is a condition that doesn't get diagnosed until adulthood because personality is still developing until then. It is estimated that three quarters of those diagnosed are female.

The symptoms of Borderline Personality Disorder can include, but are not limited to:

Self harm or repeated attempts to commit suicide or insistent expressions of desire to do so. Those diagnosed with BPD are at greater risk or committing suicide that the general population

Relationship problems. People diagnosed with BPD can cling to damaging relationships, idolizing the partner one minute and then finding them wholly unsatisfactory then next. The patterns of their relationships are particularly intense, unsteady and chaotic

An uncertain self image and a shaky sense of self, coupled with possible doubts regarding sexuality

Frantic efforts to avoid being left alone and an intense fear of being abandoned. Other people may not see these fears as justified

Inappropriate or intense anger that is hard to control

Moods that are difficult to get out of i.e. long periods of extreme restlessness, irritability, unhappiness or anxiety that can last hours

Behavior that could be seen as impulsive or harmful i.e. drug or alcohol abuse, binge eating, promiscuity and unprotected sex, or extravagant spending resulting in heavy debts.

There are different theories regarding the causes of BPD. Some psychiatrists believe that BPD is a neurological illness and that it can be managed by a combination of appropriate medication and talking therapies. Others say that people diagnosed often turn out to have had a very traumatic experience during childhood, perhaps the premature loss of a parent or an event such as sexual or physical abuse. Difficult life events are very common in those with BPD.

Caring for someone with BPD can be terribly difficult as they can have periods of rage or act recklessly; their fear of being left alone and abandoned can be interpreted as being needy and controlling by inexperienced carers. Those with BPD can have extremely low self esteem and it is important not to see someone purely in terms of their diagnosis.

It is often thought that personality problems are too deeply rooted to be treatable but this is contradicted by evidence that many people's symptoms decrease as they get older. Some research even says that after ten years or so as many as half those diagnosed with BPD do no longer display enough symptoms to deserve diagnosis. Psychotherapy is a long term talking treatment that aims to identify the beginnings of present feelings. This can help break unhelpful patterns of behavior. Psychodynamic counseling places emphasis on childhood experiences. Cognitive behavior therapy is a short term treatment that provides problem solving techniques to help tackle day to day difficulties. It identifies negative thinking patterns and helps replace them with more positive ones.
Medication can also help. Low levels of chemical serotonin have been found in those diagnosed with BPD who have committed compulsive acts of violence. Some antidepressants can increase levels of serotonin. Antipsychotic, also referred to as major tranquilizers, may be prescribed to help with feelings of unreality and paranoia, although these can have distressing side effects.

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