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It'S Time To Rethink Borderline Personality Disorder Scientific American
Borderline personality disorder (BPD) is a mental health condition. Sometimes, healthcare professionals can miss or misdiagnose BPD because its symptoms can overlap with those of other conditions. Therefore, knowing what characteristics to look out for can be helpful.Having BPD can mean that a person is unable to regulate their emotions properly. For example, BPD can lead to a person acting impulsively, experiencing intense emotions, or struggling with their self-image.There are certain characteristics that a person with BPD may have that can help a psychotherapist diagnose their condition. This article will cover a series of questions that a psychotherapist might ask a person to determine whether or not they have BPD.This article is a guideline only. Only a healthcare professional can make an official diagnosis of BPD.Some of the criteria that healthcare professionals may use to diagnose BPD are available in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) from the American Psychiatric Association. Based on the criteria in the DSM-5, a person may have BPD if they experience five or more of the following:It is important to remember that these questions are not a substitute for an official diagnosis of BPD. If a person thinks that they may have BPD, they should speak with a healthcare professional.If a person feels that they may have BPD, they can take the following steps.Contact a family doctorBefore the appointment or conversation, a person can keep a journal to record their feelings and symptoms. They might wish to note down things such as:their level of distressanything they may have done to try to reduce this distressrisks they might pose to other people or themselvesThe healthcare professional may then refer the person to a psychiatrist or psychologist.Speak with a psychiatrist or psychologistPsychiatrists and psychologists may use the diagnostic criteria above as guidelines. They may also ask a person about other symptoms that they have been having. They may also perform a medical examination or ask about the person’s family history of mental health conditions.They will also use this time to focus on:the person’s everyday management of life, relationships, and worktheir coping strategiestheir strengthsareas in their life they may struggle withany other mental health problems they may haveany other social issues they may experienceany social support needs they may requireany support they may need in their workplace or with finding a jobany psychological treatment they may requirethe needs of any dependent children they may haveIf a person meets five or more of the criteria in the previous section, they may wish to contact a healthcare professional about BPD.According to the National Alliance on Mental Illness (NAMI), around 1.4% of adults in the United States experience BPD. However, NAMI also notes that BPD is one of the most commonly misdiagnosed mental health conditions.BPD misdiagnosis may occur due to the similarity of the symptoms it shares with other mental health conditions. These include:However, each of these conditions requires specific treatments, so it is important that a person receives the correct diagnosis. If the person feels that they have received the wrong diagnosis or has any concerns regarding their diagnosis, they should contact a healthcare professional.Learn more about various aspects of mental health here.Living with BPD can be challenging for many people. The lack of information and potential difficulty associated with diagnosing BPD can lead to a person experiencing stigma regarding their condition. Additionally, certain characteristics of BPD can cause issues in personal relationships.According to the National Education Alliance for Borderline Personality Disorder (NEABPD), around 85% of people with BPD will also have another mental health condition. Some additional conditions that a person with BPD may experience include:However, the NEABPD states that the outcome for people with BPD can be quite positive. It notes that with specialized treatment, many people with BPD have reduced symptoms and improved lives.The NEABPD also says that people with BPD may find that their impulsive behaviors decrease after the age of 40 years. Finding helpHaving a good support network from friends and family can help when treating BPD. There are also online and phone services that a person with BPD can use if they need help with their condition.The National Institute of Mental Health (NIMH) has an extensive list of resources for a person who is having difficulty with their mental health.Discover more mental health resources here.There are various treatments that a person with BPD can try to reduce their symptoms. These include the following.PsychotherapyThe NIMH notes that psychotherapy, or talking therapy, is the main treatment option for a person with BPD. This can involve a person speaking with a therapist one-on-one or having therapy in a group setting. Group therapy for people with BPD can help them learn how to interact with other people and how to express themselves. It can also be comforting to share experiences with people who can relate to them firsthand.Two forms of psychotherapy that may help people with BPD are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).CBT helps people with BPD identify unhealthy thoughts and beliefs about themselves and others. A therapist can work with a person to change these beliefs and adjust any behaviors that cause them issues.DBT is a form of therapy designed specifically for people with BPD. DBT uses mindfulness to help a person become aware of and accept their current emotional state. DBT can also help a person control intense emotions, improve relationships, and reduce self-destructive behaviors.A therapist may recommend that a friend or relative joins the therapy sessions to help them understand and support the person with BPD. This form of therapy can also help the friend or relative understand the obstacles that someone caring for a person with BPD may encounter.MedicationsAccording to the NIMH, medications are not a common treatment option that healthcare professionals recommend to people with BPD. However, some medications can help treat certain symptoms of BPD, including:mood shiftsdepressionany additional mental health conditionA person with BPD should speak with a healthcare professional about the medication that may be best for them. When testing for BPD, a healthcare professional may ask a person certain questions to use as a diagnostic guideline. If a person meets five or more of the criteria in this article, they may benefit from speaking with a psychotherapist or psychologist.Before their appointment, a person may wish to keep a journal of their experiences and feelings to aid the diagnostic process.BPD is a mental health condition that can cause a person to have difficulty regulating their emotions. BPD can result in a person acting impulsively, having mood shifts, or self-harming.BPD can be difficult for a person to live with. However, there are many support options and treatments available. A person with BPD should speak with a healthcare professional about what treatment method is right for them.
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Rethinking BPD: A Clinician's View
Dr. Marsha Linehan was featured in a series of lectures on Borderline Personality Disorder hosted by the National Institute of Mental Health in Bethesda, Maryland. Dr. Linehan is a Professor of Psychology and Director of Behavioral and Therapy Clinics at the University of Washington in Seattle and is credited with developing Cognitive-Behavioral Treatment (CBT) for Borderline Personality Disorder.
If you are in a crisis situation, call 911 or the toll-free, 24-hour National Suicide Prevention Lifeline, 1-800-273-TALK (1-800-273-8255). A Lifeline Chat is also available at http://www.suicidepreventionlifeline.org/GetHelp/LifelineChat.aspx.
For more information on borderline personality disorder or other suicide prevention resources, email us at [email protected]
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