Borderline personality disorder (BPD) is a mental health disorder in which the persons struggle mostly to manage their emotions compared to the rest of the population. Individuals diagnosed with this condition are likely to experience intense emotions for a long period, and finds it challenging to return to a place of emotional stability after an emotional trigger. This group of individuals often exhibit patterns of negative thinking, self-esteem problems, impulsiveness, interpersonal relationship problems, no regard for boundaries, self-harm behaviour, such as cutting, and commonly present themselves to hospitals after suicide attempts.
According to the DSM-5 borderline personality disorder is prevalent among females with 75% and is usually diagnosed in early adulthood, from age 18 years. However, the symptoms could be present already during adolescent.
Typical symptoms to look out for are:
Self-harming behaviour including suicidal threats or attempts.
Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days.
Chronic feelings of boredom or emptiness.
Inappropriate, intense or uncontrollable anger—often followed by shame and guilt.
Frantic efforts to avoid real or imagined abandonment by friends and family.
Unstable personal relationships that alternate between idealisation (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as “splitting.”
Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships.
Impulsive behaviours that can have dangerous outcomes, such as excessive spending, unsafe sex, reckless driving, or misuse or overuse of substances.
Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes.
As with most mental conditions the causality of mental disorders is difficult to explain as they are multifaceted in its form. However, genetics, brain implications and environmental factors are considered with borderline personality disorder. American research indicates that if an immediate family member, such as parents, children or siblings suffer from the condition that anyone directly link is likely to inherit it. In addition, people who may have been exposed to physical and/or sexual abuse during childhood, such as neglect or separation from parents are likely to develop borderline personality disorder.
Of note, in the African contexts it’s quite popular for children to be raised by grandparents or other family members outside of the nuclear family; thus, it’s crucial to be cognisant as new parents of such implications on children’s development but at the same time to be aware not to attribute what is cultural acceptable norm behaviours to this specific disorder. Furthermore, brain functioning specifically, the prefrontal cortex that is involve with judgment, impulse control and emotional regulation is implicated in the development of borderline personality disorder. From a neuroscience perspective it makes sense why adolescents and early adulthood population are mostly affected by borderline personality disorder – their brain is still in the developing phase therefore; they are at risk to be diagnosed with this condition. However, DSM-5 indicates that from ages 30 to 40 years most people seem to achieve emotional stability in their relationships and occupations, which coincides with neuroscience notion that human brain develops until the age of 30.
Treating individuals with borderline personality disorder is complicated as they are often not compliant to treatment, but also may have other comorbid mental conditions such as ADHD, PTSD, depression and bipolar, eating disorders specifically bulimia nervosa and substance use. Despite these complexities, specific psychotherapy modalities and a combination of biomedical treatment are helpful in assisting individuals cope with their condition.
On that note I wish you a pleasant festive season and prosperous New Year. Continue to care for your mental health and those around you.