Borderline Personality Disorder is characterized by an ongoing pattern of varying moods, self-image, and behavior. The symptoms of BPD often result in impulsive actions and problems in relationships (NIMH, 2018). Individuals may also struggle with a feeling of emptiness and a fear of abandonment (NIMH, 2016). BPD normally starts in early adulthood and occurs across a multitude of situations. Substance abuse, depression, and eating disorders are commonly associated with BPD, and about 10% of people affected die from suicide. And according to the DSM (Diagnostic and Statistical Manual of Mental Disorders)-V, BPD is recognized as a personality disorder (DSM-5, 2013).
Causes
According to scientists, there is no agreed upon cause of BPD. It has been found that Post Traumatic Stress Disorder may correlate and there is a strong correlation between childhood trauma and the development of BPD. Many affected by BPD have reported a history of abuse and neglect as young children (Ball, J.S. Links, P.S. 2009). Individuals also report having caregivers denying the validity of their thoughts and feelings. Neuroimaging studies have shown that individuals with BPD have reductions in the region of their brains that regulate stress and emotions. Women who are affected by BPD can predict their symptoms by changes in their estrogen levels during their menstrual cycles.
Symptoms
One of the main symptoms that individuals have with BPD is the displaying of uncertainty about how they see themselves and their role in the world. They may also experience mood swings and tend to view things in extremes, either all good or all bad. The opinions of people can change quickly, resulting in unstable relationships. They can have impulsive and dangerous behaviors, such as, spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating (NIHM). Actions can also affect people with BPD are self-harming behavior, chronic feelings of emptiness, feelings of dissociation. These symptoms can be triggered by seemingly ordinary events.
Diagnosis
The main way to diagnosis someone with BPD are psychiatrists, psychologists, or clinical social workers with experience in diagnosing mental disorders. BPD is difficult to diagnosis as it can occur with other disorders. Some of the other disorders that it occurs with is depression, bipolar disorder, anxiety disorders, substance abuse disorders, and eating disorders. These co-occurring can make diagnosing and treating BPD difficult. Along with the possibility of symptoms of other illnesses can also overlap with the symptoms of BPD adding to the difficulty of diagnosing BPD.
Management/Treatment
A considered cornerstone for treating BPD is psychotherapy, it aims to address the emotional dysregulation that is associated with the illness. Other coping strategies are Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Mentalization Based Therapy (MBT). DBT focuses on teaching coping skills to combat urges, regulate emotions, and improve relationships (2017, National Alliance on Mental Illness, par. 4). CBT focuses more on the processing and coping of negative thoughts that come with BPD. MBT focuses on how to develop empathy and create explanations for unpleasant interactions with others. Another form of treatment is medication. Although there is no singular medication to specifically treat BPD, it can be useful to treat other symptoms like depression and anxiety.
Prognosis
If BPD is treated, individuals can find relief from symptoms and achieve remission. The patients personality can have an effect in the treatment process, leading to worse or better outcomes. The individuals who participate in DBT often experience better outcomes clinically. Patients who also have strong bond with their therapist were found to have better outcomes in treatment.
Epidemiology
When BPD was originally estimated, it was found that only 1-2% of the population was affected and more commonly found in men. It is now to be 5.9% of the population and more common in women. BPD is estimated to contribute to 20% of psychiatric hospitalizations, and in the US, the prison population is estimated to be affected by BPD at about 17%. This statistic may be in correlation with the increased about of substance abuse amongst people with BPD.
Hypothetical Application
I believe that BPD could affect the acts of criminal behavior in different ways. Since individuals with BPD can have impulsive actions, like substance abuse, spending sprees, and reckless driving, which can put the individual with BPD and people around them in danger or leave them with consequences. Mood swings are also very common with BPD patients which could cause someone with this illness to possibly commit murder. Patients with BPD also view things in extreme good or bads, which could mean that they could view a normal person as an enemy and could cause complications with that individual.