General overview of the disease
History (who discovered it, well-known people who had it, where it started, medical advances in past treatment)
Borderline personality disorder has no clear discovery. But personality disorders in general were first offered in ancient Chinese and Greek philosophy (Crocq). It did not have a clear origin of where borderline personality disorder was first seen, but there are many famous people that are diagnosed with BPD, such as Princess Diana, who was diagnosed with BPD and showed symptoms like her impulsive behavior and self-mutilation (“Famous Celebrities”). There hasn’t been significant discoveries or treatments made in the field of borderline personality disorder, but “the most prominent view and studies today come from Marsha Linehan, who has developed a special therapy for BPD”, her theory stated that people diagnosed with BPD naturally has a more intense reaction to low stress situations and takes a longer time to recover than those without BPD (Al-Alem and Omar).
What part of the body does it affect
Like most other mental disorders, borderline personality disorder also affects the brain. Specifically, it affects an area of the brain called the insula, whose function is to help determine how intensely a person is experiencing a negative emotions. For people with BPD, the insula is hyperactive, while the frontal areas of the brain, that helps control our emotional reactions, is underactive (“Scans”). To be more specific, “BPD has [also] been linked to the amygdala and limbic system of the brains, the centres that control emotion, and particularly, rage, fear and impulsive automatic reactions”. Borderline personality disorder can lead to the decrease in the size of the amygdala and hippocampus, which causes neuroanatomical changes (Lis).
What is going on inside the body? (What is physically, chemically, or emotionally going on inside the body down to the molecular level. If you could see inside the body what would you see?)
For someone diagnosed with borderline personality disorder, their neurotransmitters in their brain, specifically serotonin, has been distorted. “Neurotransmitters are ‘messenger chemicals’ used by your brain to transmit signal between brain cells”. When the level of serotonin in the brain is altered, it causes depression, aggression, and destructive urges that are hard to maintain under control (“Borderline Personality Disorder”, NHS Choices).
Forms, types, phases, or stages of the disease (ie- Type 1, Type 2, and gestational diabetes)
There are mainly two types of borderline personality disorder. The first type is known as the borderline-type, people with the borderline-type of BPD has more difficulties with handling relationships, controlling themselves from self-harm and the feeling of emptiness. The second type of borderline personality disorder is the impulsive-type. People diagnosed with this type of BPD is like to have difficulties with their impulsive behaviour and angry feelings, as said in the name itself (“Borderline Personality Disorder”, Mental Health UK).
Causes
What causes the disease to develop? (Poor habits? Transmitted from person to person? Genetics?)
Doctors believe experiencing traumatic life events, such as abuse, abandonment, or adversity during childhood can result in BPD yet they are not positive (“Borderline Personality Disorder”, Mayo Clinic).
Incidence
How many people does this disease affect? (explained in a ratio or single number with a domain)
An estimate of 1.6% of the adults in the United States population is diagnosed with BPD, but including the undiagnosed population could raise the estimate to at most 5.9% (“Borderline Personality Disorder, NAMI).
Does it affect a certain age group? Why?
The age of a person does not have any direct effect with borderline personality disorder, but the symptoms of BPD can vary depending on age. An experiment concludes that people from age 30-40 is the least likely to have impulsive behavior and thoughts of committing suicide as a resulting symptom of BPD (Stepp). This is because people at this age are “burnt out” patients of BPD, burnout patients are another way of describing workaholics, or people with extremely busy lives. Since this age group is at the climax of their career, their drastic amount of work is able to partially drift their attention from suicidal thoughts (“Informed Health Online”).
Does it affect a certain ethnic group? Why?
Data from the Epidemiological Catchment Area study showed a trend toward higher rates of BPD in nonwhite individuals, but this was not statistically significant. BPD was more prevalent in Native American men and less prevalent in Hispanic men and women and Asian women, compared with other racial and ethnic groups. There was evidence that BPD was less prevalent in blacks compared with whites in five studies, but the opposite was true in another (large, population-based) study. But suicide rates of white women in the United States have historically exceeded those of African-American women by a ratio of 2:1 (De Genna).
Does it affect a certain sex or gender? Why?
research indicates that women and men are equally likely to have this disease but current statistics show that out of people diagnosed with BPD, 75% is women (“Borderline Personality Disorder, NAMI).
What is the Mortality Rate? (expressed in a ratio or percentage with a domain)
borderline personality disorder does not directly cause death, but it is more likely for someone diagnosed with borderline personality disorder to attempt suicide than those who don’t. In the world, 10% of people diagnosed with BPD die by suicide, and within all suicides, 9-33% are borderline personality disorder individuals (https://borderlinepersonalitydisorder.org//wp-content/uploads/2011/12/If-Only-We-Had-Known.pdf)
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Symptoms and Risk Factors
What are the symptoms of that disease?
Some symptoms commonly seen are an intense fear of abandonment, even going to extreme measures to avoid real or imagined separation or rejection. A pattern of unstable intense relationships, such as idealizing someone one moment and then suddenly believing the person doesn't care enough or is cruel. Rapid changes in self-identity and self-image that include shifting goals and values, and seeing yourself as bad or as if you don't exist at all. Periods of stress-related paranoia and loss of contact with reality, lasting from a few minutes to a few hours. Impulsive and risky behavior, such as gambling, reckless driving, unsafe sex, spending sprees, binge eating or drug abuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship. Suicidal threats or behavior or self-injury, often in response to fear of separation or rejection. Wide mood swings lasting from a few hours to a few days, which can include intense happiness, irritability, shame or anxiety. They commonly have ongoing feelings of emptiness, inappropriate, intense anger, such as frequently losing your temper, being sarcastic or bitter, or having physical fights (“Borderline Personality Disorder”, Mayo Clinic).
What are the decisions, lifestyle choices or genetic risk factors that could lead to this disease?
Similar to many common mental health issues, if a person's brain struggles to produce chemicals that help regulate mood, and the parts of the brain that affect impulsivity and aggression are damaged or not working at full capacity they are more likely to develop any from of a personality disorder, including Borderline Personality Disorder. Similarly you can also develop BPD because a member of your immediate family , that is genetically related to you, has a personality disorder. Environment can also play a large role in developing the disease especially if you were abused or even separated from a parent as a child, when you were most vulnerable and your brain is still developing (“Borderline Personality Disorder”, Mayo Clinic).
Diagnosis
What tests do the doctors run to determine whether a person has the disease? Briefly explain each test(s) process. (What does a doctor see to indicate the presence of the disease?)
To determine whether a person has borderline personality disorder, they need to have a detailed interview with a professional, that can be a doctor or a mental health provider. The interview can consists of filling out questionnaires and other forms of psychological evaluation. The professional will also evaluate the patient’s medical history and exams, and discuss symptoms and signs that could help diagnose or undiagnosed the disorder (“Borderline Personality Disorder”, Mayo Clinic).
Living with the Disease
What does the daily routine look like for someone living with this disease? (What do they have to do differently than healthy people?
Many people with Borderline Personality Disorder struggle with a daily routine for many reasons. Their symptoms such as having impulsive behavior commonly results in losing their jobs regularly, fighting and legal issues resulting in jail time. This causes them to rarely have a regular daily routine to live by. People with BPD occasionally have patterns of unstable relationships such as abusive relationships having unsafe sex, sexually transmitted diseases, and unplanned pregnancies. They are also often hospitalized for various self injury such as cutting, or burning and attempted suicides (“Borderline Personality Disorder”, Mayo Clinic).
Is there anything they use to manage through their day that doesn’t directly treat their symptoms? (ie- wheelchair, prick their finger, assistance?)
Some lifestyles choices such as eating healthy and exercising can help patients manage their condition while it doesn’t directly cure it (Smith 807-809).
Treatment
What are the treatment options? (How are the symptoms treated?)
Borderline personality disorder is mainly treated using psychotherapy, but medication may be added. There are many types of psychotherapy that have been found to be effective the most common types are listed below. One very common psychotherapy is known as dialectical behavior therapy or (DBT) for short. DBT includes group and individual therapy designed specifically to treat borderline personality disorder. DBT uses a skills-based approach to teach you how to manage your emotions, tolerate distress and improve relationships. Another type of therapy used by people suffering with BPD is Schema-focused therapy. Schema-focused therapy can be done individually or in a group. It can help you identify unmet needs that have led to negative life patterns, which at some time may have been helpful for survival, but as an adult are hurtful in many areas of your life. Therapy focuses on helping you get your needs met in a healthy manner to promote positive life patterns. Another common type of psychotherapy is known as Mentalization-based therapy or (MBT) for short. MBT is a type of talk therapy that helps you identify your own thoughts and feelings at any given moment and create an alternate perspective on the situation. MBT emphasizes thinking before reacting. Although no drugs have been approved by the Food and Drug Administration specifically for the treatment of borderline personality disorder, certain medications may help with symptoms or co-occurring problems such as depression, impulsiveness, aggression or anxiety. Medications may include antidepressants, antipsychotics or mood-stabilizing drugs. At times, people with BPD may need more-intense treatment in a psychiatric hospital or clinic. Hospitalization may also keep them safe from self-injury or address suicidal thoughts or behaviors (“Borderline Personality Disorder”, Mayo Clinic).
Is there a cure?
There is no know cure some treatment options can help such as therapy and some medications yet like many mental health illnesses it will never go away (Sherry 246).
Prevention
Are there any ways to prevent this disease?
Since borderline personality disorder usually develops from some sort of trauma there is no way to prevent it after someone has experienced a triggering event. (“Borderline Personality Disorder”, Cleveland Clinic)
Works Cited
Al-Alem, Linah and Omar, Hatim A., "Borderline Personality Disorder: An Overview of History, Diagnosis and Treatment in Adolescents" (2008). Pharmacology and Nutritional Sciences Faculty Publications. 20.
“Borderline Personality Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 June 2018, www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237.
“Borderline Personality Disorder.” Mental Health UK, Mental Health UK, www.mentalhealth-uk.org/mental-health-conditions/borderline-personality-disorder/what-are-the-different-types-of-bpd/.
“Borderline Personality Disorder.” NAMI: National Alliance on Mental Illness, www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder.
“Borderline Personality Disorder.” NHS Choices, Crown Copyright, www.nhs.uk/conditions/borderline-personality-disorder/causes/.
“Borderline Personality Disorder (BPD) Prevention.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/9762-borderline-personality-disorder-bpd/prevention.
Crocq, Marc-Antoine. “Milestones in the history of personality disorders” Dialogues in clinical neuroscience vol. 15,2 (2013): 147-53.
De Genna, Natacha M and Ulrike Feske. “Phenomenology of borderline personality disorder: the role of race and socioeconomic status” Journal of nervous and mental disease vol. 201,12 (2013): 1027-34.
“Famous Celebrities with Borderline Personality Disorder.” New Health Guide, 4 Nov. 2013, www.newhealthguide.org/Famous-People-With-Bord
Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: What is burnout? 2012 Dec 5 [Updated 2017 Jan 12].
Lis, Eric et al. “Neuroimaging and genetics of borderline personality disorder: a review” Journal of psychiatry & neuroscience : JPN vol. 32,3 (2007): 162-73.
“NAMI.” NAMI: National Alliance on Mental Illness, www.nami.org/Learn-More/Mental-Health-Conditions/Borderline-Personality-Disorder.
“Scans Show What Makes a Brain 'Borderline'.” Futurity, 18 Jan. 2013, www.futurity.org/scans-show-what-makes-a-brain-borderline/.
Sherry, Alissa. "Borderline Personality Disorder." The Corsini Encyclopedia of Psychology,
edited by Irving B. e and W. Edward Craighead, 4th ed., vol. 1, Wiley, 2010, pp. 246-248. Gale Virtual Reference Library, http://link.galegroup.com/apps/doc/CX1942000144/GVRL?u=merc94236&sid=GVRL&xid=6f878b78. Accessed 29 Nov. 2018.
Smith, Gregory T., et al. "Impulsivity." The Corsini Encyclopedia of Psychology, edited by Irving B. e and W. Edward Craighead, 4th ed., vol. 2, Wiley, 2010, pp. 807-809. Gale Virtual Reference Library, http://link.galegroup.com/apps/doc/CX1942000446/GVRL?u=merc94236&sid=GVRL&xid=2b78a3af. Accessed 3 Dec. 2018.
Stepp, Stephanie D and Paul A Pilkonis. “Age-related differences in individual DSM criteria for borderline personality disorder” Journal of personality disorders vol. 22,4 (2008): 427-32.