Psychology Paper

Ok, so I just finished writing a paper for my Psychology class about Borderline Personality Disorder. Tell me what you think...

Borderline Personality Disorder

Borderline Personality Disorder is an extremely difficult-to-handle and widely misunderstood condition that affects about 2% of the general population of the United States. Those suffering with Borderline comprise 10% of all mental health outpatients, and 20% of psychiatric inpatients. 75% of them have been abused in some way, and 54% struggle with substance abuse. Hence, it goes without saying that Borderline Personality Disorder is a deceptively serious condition that severely impacts the lives of not only the person with the condition, but everyone around them.

Borderline is a very controversial diagnosis in the psychological world, for several reasons. First, there has never been any real concrete definition behind it; all of its symptoms and behavioral patterns are mostly amorphous and loosely connected at best, and are also observed in other, often comorbid personality disorders. When Borderline was first recognized as a legitimate condition by Adolph Stern in 1938, it was mistakenly thought to border on or overlap with schizophrenia, psychosis, anxiety-related and depressive-related disorders. In fact, the name “Borderline” came about because it was thought to be on the border of neurosis and psychosis. Because of this common relation, Borderline became known as a “wastebasket” diagnosis, reserved for individuals who did not fall clearly into any solid diagnostic category. While this incorrect view has been largely diminished, it is still dishearteningly common.

Another reason for the controversial nature of Borderline is its difficulty to diagnosis. Those suffering with Borderline almost always have another condition, because people with Borderline are more likely to have another related problem than non-Borderline people. Disorders that often exist alongside Borderline include mood disorders, eating disorders, substance abuse disorders, anxiety disorders, post-traumatic stress disorder, ADHD, and OCD, as well as other personality disorders such as Histrionic and Narcissistic. This is where the wrench is thrown into the mix. The diagnosis of any of the coexisting disorders is usually correct, but the diagnosis of the actual Borderline Personality Disorder is often missed entirely, making treatment very difficult and extensive, as the patient would require not only treatment for Borderline, but also any other condition that they may have in addition to the Borderline. It also depends heavily on the psychiatrist to detect these disorders accurately and quickly so that appropriate treatment can be administered as promptly and efficiently as possible. However, this is usually not the case, as most Borderline sufferers unknowingly deal with undiagnosed disorders in addition to their Borderline.

Yet another cause of Borderline’s controversy is the number of myths that surround it. Borderline has long been believed to have been an invalid diagnosis that should be used only in non-concrete cases. This leads to many misdiagnoses and common misconceptions that slow what could be an otherwise effective path to treatment.

Also, because Borderline occurs in mostly women – 75% of Borderline sufferers are female – there is a hesitance to diagnose males with Borderline, and also decreases the willingness of men to accept this diagnosis.

Another myth is that teenagers shouldn’t be given this diagnosis because most of the symptoms of Borderline are common teenage traits. While diagnosing any personality disorder in a child is difficult, an improper diagnosis can cause severe damage to and stigmatize the individual, reducing hope for any successful future treatment.

The myth that Borderline Personality Disorder doesn’t respond well to treatment is also damaging. This comes from the fact that when Borderline was first made a legitimate clinical diagnosis, most forms of treatment were ineffective and actually made things worse. However, recent studies show that patients with Borderline usually improve with a combination of psychotherapy and medication.

Borderline Personality Disorder has a very wide range of symptoms, most of which can be difficult to isolate due to their prevalence among other diagnoses. The most common symptom is moderate to severe emotional instability, and the inability to control these emotions. People with Borderline commonly experience random bouts of inappropriate, yet extremely intense anger, often violently. These bouts of rage are usually followed by just as severe, episodic bouts of emotional self-pity, anguish, anxiety, and depression. This often leads to self-harm, and in some cases, suicide. Chronic feelings of worthlessness and emptiness are extremely common, and most people with Borderline have very little to no self esteem. Emotional responses are usually either over-reactive or under-reactive, and chronic boredom is also common.

Borderline usually causes the sufferer to act impulsively and without regard for any consequences of their actions. Such actions include frequent threats of suicide and self-harm, inappropriate sexual behaviors, irresponsible spending, binge eating, and reckless driving, among other things. Borderline individuals are typically blind to the pain that they bring upon themselves and others due to their thoughtless impulsivity.

Interpersonal relationships are especially hard to manage for someone with Borderline. Someone with Borderline is usually very clingy and possessive with virtually everyone, and may go to the most irrational extremes just to avoid real or imagined abandonment, the worst fear of someone with Borderline. Also, Borderline people usually have a very “black or white” way of thinking when it comes to people. They either worship someone or totally despise them, usually for almost no reason at all, and these relationships are commonly intense, tumultuous, and unstable.

The causes of Borderline remain unclear. Borderline may be genetic, as personality disorders can be inherited. Environmental factors also contribute largely to the presence and severity of Borderline, as most people with Borderline have experienced childhood abuse, neglect, or separation from loved ones, which explains the common comorbidity of this disorder.

Treating Borderline is often difficult, mainly because of the individual’s extreme emotional responses to pretty much everything. Effective treatment requires great patience and stability on the part of the therapist, so as not to encourage the standard irrationality that is so commonplace among those with Borderline.

Psychotherapy is generally the best way to treat Borderline. This is because the person with Borderline needs to learn coping skills, emotional regulation, and important lifestyle changes, things that cannot be gained from taking medication. Medication is generally used for controlling depressive/anxiety related symptoms, but that’s about it. An important aspect of psychotherapy for someone with Borderline is monitoring their suicidal tendencies. Frequently, threats of suicide with Borderline are just that – threats. However, in severe cases where the person is legitimately self-harming and exhibits signs that they may attempt suicide, hospitalization is necessary.

Borderline is not as uncommon as one may think, however. Angelina Jolie, a famous and well-known celebrity, suffers from Borderline. She exhibits all of the tell-tale signs – self-harm manifested in the form of substance abuse, volatile personal relationships, confused sexuality, poor self-image, and impulsiveness.

All in all, Borderline Personality Disorder is a very serious condition that people struggle with every day of their lives, usually misdiagnosed or not even diagnosed at all. It is imperative that the medical community, and the public as a whole, learns more about this mysterious and controversial diagnosis so that it can be better treated and more well-managed. With better coping strategies and ever-evolving treatments, people with Borderline can learn to not keep hurting themselves and their loved ones.