An Article on BPD from Earth Times

Here’s an article from Earth Times about BPD (I put the important parts in bold):

Borderline personality disorder: A journey between emotional states
Posted on : 2010-07-12 | Author : Aliki Nassoufis
News Category : Health

Hamburg – Just a moment ago everything was fine and the atmosphere positive but seconds later a cloud of depression falls and the world suddenly seems like an unfriendly place.

You feel sad and a person who you regarded as a friend is now an annoyance. Strong mood swings like these are the symptoms of borderline personality disorder.

Borderline personality disorder involves rapid swings in mood from joy to depression. Anti-psychotic medication can provide short-term relief while in the long-term the best help is provided by behaviour therapy.

“Emotional instability is a common symptom,” says Andreas von Wallenberg Pachaly, a psychotherapist in Germany. “It’s a little bit like seeing things only in terms of black and white. There are no grey areas.”

However, borderline disorder is more than just that: in addition to mood swings that can be caused by small stress factors and interpersonal experiences, it can also make a person’s behaviour unstable.

“Borderliners often behave impulsively,” explains Sabine Herpertz, director of the Clinic for Psychiatry at the University of Heidelberg.

“It also includes a self-destructive component that can lead to self harm,” she says. Not all aggression is self-directed. “Male patients in particular direct their rage against others and can become physically aggressive.”

The term borderline developed over a number of years. In its early days it came to describe people who were on the border between neurotic and psychotic disorders.

Today, the term has come to encompass a lot more, according to Herpertz. It has now been shown that the disorder has nothing to do with psychotic illness and the alternative term of emotionally unstable personality disorder has come into being.

Patients who suffer from the disorder usually have problems with their identity, says Herpertz. What’s special about me? What are my goals? What’s important to me?

It is questions like these that a borderline personality cannot answer. “They often have the feeling of disassociation, of standing outside themselves and observing events remotely,” she says.

Borderline disorder often first appears in adolescence and has a range of causes. Herpertz says genes can also play a role. Many borderliners had traumatic experiences as children.

“They include experiences such as emotional neglect, a great loss, violence or sexual abuse,” says Frank-Michael Gann, co-founder of an online self-help forum. He has years of personal experience of the disorder through a familial relationship.

“Such experiences can cause a person to learn how to suppress their feelings rather than learn how to express their emotions,” says Gann.

Anyone who cannot describe what annoys them might end up containing that feeling inside and eventually exploding. “This impulse-control loss is a very big problem, not just for the borderliner, but friends and family as well.”

There are several ways to treat the disorder. “In acute cases anti-psychotic drugs can help to lessen certain feelings and reduce the risk of suicide,” says Wallenberg Pachaly. But in the long run the best help is provided by psychotherapy.

Dialectical behaviour therapy is one form of treatment that may help. “It is similar to behaviour therapy but was developed especially for borderline disorder,” says Herpertz.

“Patients learn how to deal with problems in a guided fashion.” That includes teaching the patient how to recognise that they are under stress in a certain situation and how to deal with the situation emotionally.

Another method is schema therapy. “Together with the therapist, patients play out certain dangerous situations on an imaginary level. These situations have led the patient in the past to develop basic assumptions about themselves. The therapy’s goal is to teach the patient to discard those assumptions,” explains Herpertz.

There are also a number of other therapies that have been developed over the last 20 years.

“There has been a lot of change in this area,” says Herpertz. “We now have a better understanding of the disorder and we have developed new therapies. We can now provide very good help to about 50 per cent of cases.” Even more patients find their symptoms have been eased to some extent.