BPD (Borderline Personality Disorder), Causes, Diagnosis, Treatment, Prevention, Complications

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BPD (Borderline Personality Disorder), Causes, Diagnosis, Treatment, Prevention, Complications

 

Borderline personality disorder (BPD) is a serious mental disorder that affects how sufferers feel and think. This condition is characterized by moods and self-image that is constantly changing and difficult to control, as well as impulsive behavior.

Someone who has a personality disorder has a different way of thinking, perspective, and feelings compared to people in general. This condition often also causes problems in daily life and in relationships with other people.

About 1–4% of people in the world experience BPD. This disorder generally appears in late adolescence or young adulthood and is more common in women.

Causes of BPD (Borderline Personality Disorder)


The exact cause of borderline personality disorder is not clearly known. However, the following factors are thought to trigger BPD:

  • Environment

A number of negative environmental conditions are thought to play a role in causing this personality disorder. Examples include childhood abuse or abuse and the loss or abandonment of a parent. In addition, poor communication within the family can also increase the risk of developing BPD.

  • Genetics

According to some studies, personality disorders can be passed down genetically or from parents to children. So, someone who has a family member with borderline personality disorder is more at risk of developing this condition.

  • Abnormalities in the brain

Based on research, people with BPD have abnormalities in brain structure and function, especially in areas that regulate behavior and emotions. People with BPD are also suspected of having abnormalities in the function of brain chemicals that play a role in regulating emotions.

The above factors can indeed increase the risk of BPD. However, it does not mean that someone who has these risk factors will definitely experience BPD. The reason is, BPD is also not impossible for someone who does not have any of the risk factors above.

Symptoms of BPD (Borderline Personality Disorder)


Borderline personality disorder can affect relationships with other people, self-image, feelings, behavior, and the way the sufferer thinks. Symptoms usually appear in adolescence towards adulthood and persist into adulthood. These symptoms can be mild to severe.

Symptoms of BPD can be classified into four parts, which consist of:

Unstable mood or mood

People with BPD can experience drastic changes in their feelings (mood swings) towards themselves, their environment, or the people around them for no apparent reason. Mood changes can occur from positive to negative feelings or vice versa.

When experiencing a negative mood, people with BPD may experience feelings of anger, emptiness, sadness, worthlessness, shame, panic or fear, and profound loneliness.

Impaired thought patterns and perceptions

BPD can cause sufferers to think that they are bad, guilty, or insignificant. This thought can come and go, making the sufferer frantic and trying to find justification or defense to the people around him to make sure that he is not bad.

Sufferers can also experience hallucinations, for example hearing voices outside themselves asking them to hurt themselves. In addition, sufferers can also have strong beliefs about something that actually doesn't make sense (delusions), such as the belief that they are being chased by assassins.

Impulsive behavior

This behavior is likely to be self-injurious, or to be reckless and irresponsible. Examples include self-harm, attempting suicide, having risky sex, drinking to excess, or gambling without thinking about the risk of losing.

Intense, but unstable relationship

BPD can cause sufferers to fear being ignored by others. However, at other times people with BPD can also feel uncomfortable or uncomfortable if someone is too close or pays too much attention to them. This can damage the relationships people with BPD have with other people.

Not all people with BPD experience all of the above symptoms. Some experience only a few symptoms. The severity, how often it occurs, and how long the symptoms last for each patient can also vary.

Generally, BPD symptoms will subside on their own as the patient ages. Symptoms will usually decrease when the patient enters the age of 40 years.

When to go to the doctor

Seek immediate medical attention or consult a psychiatrist if you have thoughts or thoughts of harming yourself or even committing suicide.

Check with your doctor if you think you have the symptoms of BPD mentioned above. Early detection can prevent the long-term effects that may arise from this condition.

If you notice that a family member or relative is experiencing symptoms of BPD, it is highly recommended to talk to them and take them to the doctor.

Keep in mind that persuading people with BPD should be slow and without coercion. If in this process you feel pressured or stressed, it is advisable to consult an expert, such as a psychologist.

Diagnosis of BPD (Borderline Personality Disorder)


The diagnosis of borderline personality disorder (BPD) is started by the doctor with a question and answer session about the complaints and feelings experienced by the patient. In addition, the doctor will also ask about the patient's and family's medical history, including a history of mental disorders.

To find out the patient's psychological condition, the doctor may ask the patient to fill out a questionnaire. If necessary, the doctor may also perform a physical examination and laboratory tests to support the diagnosis.

The diagnosis is usually only established in adults, not in children or adolescents. This is because the symptoms of BPD in children or adolescents generally gradually improve by themselves along with the development of their emotional intelligence.

Treatment of BPD (Borderline Personality Disorder)


After being diagnosed with BPD, the patient should share the results of the diagnosis with family, friends, or trusted people. That way, the patient can straighten out relationship problems that may occur as a result of his behavior.

When people around the patient have been given an explanation, they can have a better understanding of the patient's condition and can support the patient to recover. This can make treatment more effective.

Treatment of borderline personality disorder aims to help patients know how to manage and cope with the symptoms they are experiencing. Not only that, treatment also aims to overcome other mental disorders that often accompany BPD, such as depression and drug abuse.

Treatment of BPD can be done with psychotherapy and medication. However, in more severe cases, hospitalization may be required.

Psychotherapy

There are several types of psychotherapy that can be used to treat BPD, namely:

1. Dialectical behavior therapy (DBT)

This therapy is done through dialogue with the aim that the patient can control emotions, accept pressure, and improve relationships with others. DBT can be done individually or in a consultation group.

2. Mentalization-based therapy (MBT)

This therapy focuses on the method of thinking before reacting. MBT helps BPD patients assess their own feelings and thoughts and creates a positive perspective of the situation at hand. This therapy also helps patients to understand the feelings of others and the consequences of their actions on the feelings of others.

MBT is usually done in the long term, which is about 18 months. Therapy begins with hospitalization so that the patient can have individual daily sessions with a psychiatrist. After a certain period of time, therapy can be continued on an outpatient basis.

3. Schema-focused therapy

This therapy helps BPD patients realize their unmet needs, which eventually lead to negative lifestyles. Therapy will focus on meeting these needs through healthier ways to build a positive lifestyle.

Just like DBT therapy, schema-focused therapy can be done individually or in groups.

4. Transference-focused psychotherapy

Transference-focused psychotherapy (TFP) or psychodynamic therapy helps patients understand the emotions and difficulties they experience in developing relationships with other people (interpersonal). TFP is done by fostering a relationship between the patient and the therapist. The results of the coaching can then be applied to the current situation.

5. Good psychiatric management

This therapy aims to increase the patient's understanding of emotional problems that occur by considering the feelings of others. Therapy can be combined with drug administration, group or individual therapy, and family counseling.

6. STEPPS

STEPPS or systems training for emotional predictability and problem-solving is a group therapy that can be done with family members, friends, partners, or caregivers. This therapy generally lasts for 20 weeks, and is usually used as an adjunct therapy with other psychotherapy.

Drugs

The use of drugs is not to treat BPD, but to reduce symptoms or complications that may arise, such as depression and anxiety disorders. Medicines used require a doctor's prescription. These drugs include:

  • Antidepressants
  • Antipsychotic
  • Mood balancing drug


Hospital treatment


In more serious conditions, such as feeling depressed to having a tendency to hurt themselves or even attempt suicide, BPD patients need to be treated in a hospital. The treatment will be tailored to the patient's condition and symptoms.

The recovery process for BPD is likely to take a long time and therapy can take months to years. Consulting with a psychiatrist who is experienced in dealing with BPD can help patients develop their personality in a better direction.

Complications of BPD (Borderline Personality Disorder)


If you don't get the right treatment, borderline personality disorder (BPD) is at risk of disrupting various aspects of the sufferer's life, such as conflict-laden relationships that result in severe stress, job loss, unplanned pregnancy or sexually transmitted diseases, and death due to suicide.

Not only that, people with BPD are also at risk for other mental disorders, such as:

  • Depression
  • Alcohol or drug abuse
  • Anxiety disorders
  • Bipolar disorder
  • Eating disorders
  • PTSD
  • ADHD


Prevention of BPD (Borderline Personality Disorder)


Borderline personality disorder (BPD) cannot be completely prevented. However, the risk can be reduced by taking the following measures:

  • Creating a harmonious family environment, especially for children
  • Regularly ask the child's condition or new things he has experienced, without waiting for him to tell the story first
  • Seek support from others when family conditions are unstable
  • Talk to a loved one or a psychiatrist when experiencing harassment, bullying, or physical violence


In addition, the examination as early as possible when symptoms arise can also be done to prevent the condition from getting worse.

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