Borderline Personality Disorder Explained (Emotionally Unstable Personality Disorder)

Summary

Borderline Personality Disorder (BPD) is a complex mental health condition characterized by intense emotional responses, unstable relationships, and a distorted self-image. It is classified as a Cluster B personality disorder and is marked by nine core symptoms, including fear of abandonment, impulsivity, and mood swings. BPD is diagnosed based on the presence of five of these symptoms and is influenced by genetic, environmental, and social factors. It is associated with a history of abuse and can co-occur with other mental health disorders. Treatment primarily involves psychotherapy, with dialectical behavior therapy and mentalizing-based therapy being particularly effective.

Takeaways

• 🌟 Personality disorders are characterized by significant deviations from societal expectations, affecting normal functioning.
• 🔍 Borderline Personality Disorder (BPD) is classified as a Cluster B disorder in the DSM-5 and is also known as Emotionally Unstable Personality Disorder in the ICD.
• 🔑 The disorder is marked by intense emotional responses, unstable relationships, and a distorted self-image.
• 🔑🔑 There are nine core symptoms of BPD, including fear of abandonment, unstable relationships, identity disturbance, impulsivity, suicidal ideation, mood reactivity, feelings of emptiness, anger, and dissociation.
• 📈 To be diagnosed with BPD, an individual must exhibit five or more of these nine symptoms across different contexts.
• 👨‍⚕️ BPD is typically diagnosed in early adulthood, but it can also be diagnosed in adolescents.
• 🧬 A combination of genetic, environmental, and social factors is believed to contribute to the development of BPD.
• 🌐 The prevalence of BPD is estimated to be between one to two percent in the general population and up to twenty percent among inpatient psychiatry populations.
• 👥 Studies have shown a strong correlation between child abuse and an unstable family environment with the development of BPD.
• 💊 While no specific medication is approved for BPD, certain classes like anti-convulsants, antidepressants, anxiolytics, and antipsychotics may be prescribed.
• 💬 Psychotherapy is the main treatment approach for BPD, with three prominent therapies being Mentalizing-Based Therapy, Dialectical Behavior Therapy, and Transference-Focused Psychotherapy.

Q & A

What is a personality disorder according to the script?

A personality disorder is a condition where an individual's personality deviates strongly from societal expectations and can cause trouble in functioning normally.

What is borderline personality disorder and how is it classified?

Borderline personality disorder is a cluster B disorder in the DSM-5 and is also known as emotionally unstable personality disorder in the ICD classification.

What are the nine core signs and symptoms of borderline personality disorder?

The nine core signs and symptoms include fear of abandonment, unstable relationships, disturbed sense of identity, impulsivity or reckless behavior, recurrent suicidal ideation or self-harm, emotional dysregulation, mood reactivity, feelings of emptiness, uncontrollable anger, and severe dissociation or stress-related paranoia.

How many of the nine features need to be present for a diagnosis of borderline personality disorder?

Five of the nine features need to be present across a variety of contexts for a diagnosis of borderline personality disorder.

At what age is borderline personality disorder usually diagnosed?

Borderline personality disorder is usually diagnosed in early adulthood, but it can also be diagnosed in individuals under 18.

What factors are thought to contribute to the development of borderline personality disorder?

A combination of genetic, environmental, and social factors are thought to contribute to the development of borderline personality disorder.

What is the estimated prevalence of borderline personality disorder in the general population?

It is estimated that one to two percent of the general population are affected by borderline personality disorder.

What is the heritability of borderline personality disorder?

There is up to a 69% heritability of borderline personality disorder, which is the extent to which genes make up a trait.

What is the correlation between child abuse and the development of borderline personality disorder?

There is a strong correlation between child abuse, including emotional, physical, and sexual abuse, and an unstable family environment with the development of borderline personality disorder.

How does borderline personality disorder affect an individual's daily life?

Having borderline personality disorder can make completing school and keeping a job difficult, and individuals may partake in risky behaviors, which can predispose them to harm.

What are the common co-occurring disorders with borderline personality disorder?

Common co-occurring disorders include mood disorders, anxiety disorders, substance abuse, eating disorders, attention deficit hyperactivity disorder, and bipolar disorder.

What are the main types of psychotherapy used to treat borderline personality disorder?

The main types of psychotherapy used to treat borderline personality disorder are mentalizing based therapy, dialectical behavior therapy, and transference focused psychotherapy.

Outlines

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🧠 Understanding Borderline Personality Disorder

Borderline Personality Disorder (BPD) is a mental health condition characterized by intense emotional responses, unstable relationships, and a distorted self-image. It is classified as a Cluster B personality disorder in the DSM-5 and as emotionally unstable personality disorder in the ICD. The disorder is marked by nine core symptoms, including fear of abandonment, unstable relationships, identity disturbance, impulsivity, suicidal ideation, emotional dysregulation, mood reactivity, feelings of emptiness, uncontrollable anger, and dissociation. For a diagnosis, an individual must exhibit five of these symptoms. BPD is typically diagnosed in early adulthood and can affect 1-2% of the general population and 20% of inpatient psychiatry populations. It is believed to result from a combination of genetic, environmental, and social factors, with a significant correlation between child abuse and unstable family environments. BPD can complicate education and employment, and individuals may engage in risky behaviors, leading to a 10% suicide rate among patients. Comorbidities are common, with mood, anxiety, substance abuse, eating disorders, ADHD, and bipolar disorders often co-occurring. Treatment primarily involves psychotherapy, with dialectical behavior therapy, mentalizing-based therapy, and transference-focused psychotherapy being particularly effective.

Keywords

💡Personality Disorder

A personality disorder refers to a long-term pattern of abnormal behavior, thought, and inner experience that deviates from societal expectations and causes distress or impairment in functioning. In the context of the video, it sets the stage for discussing borderline personality disorder, which is a specific type of personality disorder characterized by intense emotional instability and difficulty in maintaining relationships.

💡Borderline Personality Disorder (BPD)

BPD is a mental health condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a Cluster B personality disorder. It is marked by a pervasive pattern of instability in interpersonal relationships, self-image, and emotions. The video script elaborates on the nine core symptoms of BPD, emphasizing the impact of this disorder on an individual's life.

💡Emotional Instability

Emotional instability refers to the inability to maintain a stable emotional state, often experiencing intense mood swings. The video mentions emotional dysregulation and mood reactivity, which are key symptoms of BPD, where individuals can experience rapid shifts in emotions that can last from hours to days.

💡Fear of Abandonment

The fear of abandonment is a central feature of BPD, where individuals have an intense fear of being abandoned or rejected. The video script describes how this fear can lead to frantic efforts to avoid real or perceived abandonment, highlighting the profound impact on interpersonal relationships.

💡Interpersonal Relationships

Interpersonal relationships are the connections and interactions between individuals. The video discusses how individuals with BPD often have unstable relationships, with feelings towards others oscillating between idealization and devaluation, which is linked to the defense mechanism known as 'splitting.'

💡Impulsivity

Impulsivity is the tendency to act suddenly without thinking about the consequences. The script mentions that individuals with BPD may exhibit reckless behavior, such as unsafe sex or substance abuse, which is a direct result of their impulsivity.

💡Self-Harm

Self-harm refers to the act of deliberately causing harm to oneself without suicidal intent. The video script includes recurrent suicidal ideation or self-harm as one of the nine core symptoms of BPD, illustrating the severe emotional distress that individuals with this disorder may experience.

💡Dissociation

Dissociation is a psychological phenomenon where a person feels disconnected from their thoughts, feelings, memories, or sense of identity. The video mentions severe dissociation or stress-related paranoia as symptoms of BPD, indicating a disconnection from reality that can be distressing and impairing.

💡Genetic Factors

Genetic factors refer to the influence of one's genes on the development of certain traits or disorders. The video script discusses the heritability of BPD, suggesting that genes play a significant role in the development of this disorder, with estimates of up to a 69% heritability.

💡Child Abuse

Child abuse encompasses a range of abusive behaviors that can cause harm to a child's physical, emotional, or mental health. The video script correlates child abuse, including emotional, physical, and sexual abuse, with the development of BPD, noting that a significant percentage of patients with BPD have experienced abuse or neglect.

💡Psychotherapy

Psychotherapy, also known as talking therapy, is a treatment method that aims to help individuals with mental health issues through verbal communication. The video describes psychotherapy as the main treatment for BPD, with specific therapies like Dialectical Behavior Therapy (DBT), Mentalizing-Based Therapy, and Transference-Focused Psychotherapy being particularly effective in managing the symptoms of BPD.

Highlights

Personality disorders are characterized by a strong deviation from societal expectations.

Borderline personality disorder is classified as a cluster B disorder in the DSM-5.

It is also known as emotionally unstable personality disorder in the ICD classification.

The disorder is marked by strong emotional responses, unstable relationships, and a distorted sense of self.

There are nine core signs and symptoms of borderline personality disorder.

Fear of abandonment is a key feature, with frantic efforts to avoid it.

Unstable relationships are characterized by rapidly changing feelings towards others.

Splitting is a defense mechanism where people are seen as entirely good or bad.

A disturbed sense of identity and impulsivity are common.

Recurrent suicidal ideation or self-harm is a symptom of the disorder.

Emotional dysregulation and mood reactivity can last from hours to days.

Feelings of emptiness, uncontrollable anger, and severe dissociation are also symptoms.

For a DSM-5 diagnosis, five of these nine features need to be present.

The disorder is usually diagnosed in early adulthood but can affect under 18s.

A combination of genetic, environmental, and social factors contribute to the disorder.

It affects an estimated 1-2% of the general population and 20% of the inpatient psychiatry population.

There is a strong correlation between child abuse and the development of the disorder.

Seventy percent of patients are thought to have experienced abuse or neglect.

The disorder can make completing school and keeping a job difficult.

Patients are at risk for engaging in risky behaviors and have a 10% chance of dying from suicide.

Comorbidities are common, including mood, anxiety, substance abuse, and eating disorders.

No medication is specifically approved for borderline personality disorder, but some are prescribed off-label.

Psychotherapy is the main treatment, with three main therapies identified as effective.

Mentalizing based therapy helps manage emotional dysregulation and improve understanding of others.

Dialectical behavior therapy uses interpersonal skills and mindfulness for emotional regulation.

Transference focused psychotherapy raises awareness of interpersonal issues and self-destructive behaviors.

Transcripts

foreign

[Music]

Ty is what makes us unique it's how we

think feel and behave a personality

disorder is when this deviates strongly

from societal expectations and can cause

trouble in functioning normally

borderline personality disorder is a

cluster B disorder in the diagnostic and

statistical manual fifth edition it is

also known as emotionally unstable

personality disorder in the ICD

classification it is characterized by

strong emotional responses unstable

interpersonal relationships and a

distorted sense of self

there are nine core signs and symptoms

which are a fear of Abandonment which

can be real or perceived abandonment and

people with this disorder will make

frantic efforts to avoid abandonment

unstable relationships with other people

part of this is because their feelings

towards others can change from being

close to extreme dislike very quickly

this is linked to splitting which is a

defense mechanism in which people are

seen as either entirely good or entirely

bad next there is a disturbed sense of

identity or feeling uncertain about

themselves impulsivity or Reckless

Behavior like unsafe sex or substance

abuse recurrent suicidal ideation or

self-harm emotional dysregulation and

mood reactivity which can last from

hours to days then there are feelings of

emptiness uncontrollable anger and

severe dissociation or stress-related

paranoia

to meet the DSM-5 criteria five of these

nine features need to be present across

a variety of contexts

it is usually diagnosed in early

adulthood but can be diagnosed in under

18s

it is thought that a combination of

genetic environmental and social factors

result in borderline personality

disorder is estimated that one to two

percent of the general population and

twenty percent of the inpatient

Psychiatry population are affected

Studies have previously noted a higher

female to male ratio in clinical

settings however when applied to the

general population it seems roughly

equal

there is up to a 69 heritability which

is the extent to which genes make up a

trait and a correlation in twin studies

but it may be that these results are

skewed because twins tend to have

similar environments there is a strong

correlation between child abuse

including emotional physical and sexual

abuse an unstable family environment and

the development of borderline

personality disorder seventy percent of

patients are thought to have experienced

abuse or neglect in their past

having borderline personality disorder

can make completing school and keeping a

job difficult there's also the partaking

in Risky behaviors like unsafe sex and

reckless driving which can predispose to

harm overall 10 of patients will die

from suicide patients are also likely to

have another disorder such as mood

disorders seen in 80 to 96 percent of

cases anxiety disorders in 88 substance

abuse and 64 percent eating disorders in

53 percent attention deficit

hyperactivity disorder between 10 and 30

percent and bipolar disorder in 15

percent

no medication is currently approved

specifically for borderline personality

disorder although some classes like

anti-convulsants antidepressants

anxiolytics or antipsychotics are

prescribed sometimes

Psychotherapy or talking therapy is the

Mainstay and three main therapies have

been identified in particular

mentalizing based therapy is used to

help manage the emotional dysregulation

and help in feeling understood

ultimately this allows patients to make

fewer assumptions about the intentions

of surrounding people it is sometimes

referred to as thinking about thinking

dialectical behavior therapy involves

using interpersonal skills and

mindfulness to achieve emotional

regulation and help to reduce conflict

in relationships transference focused

Psychotherapy helps raise the patient's

awareness to the interpersonal issues

and self-destructive behaviors