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Borderline Personality Disorder (BPD)

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J. T

on 11 November 2014

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Transcript of Borderline Personality Disorder (BPD)

Who Is Mostly

The symptoms usually first appear in mid - late teens or in early adulthood. According to BetterHealth, about two in every 100 people will develop BPD. Women are three times more likely to develop BPD than men.

In community settings, BPD is estimated to affect about 3% of adolescents and in clinical settings, it ranges between 11% of adolescent outpatients - 49% of adolescent inpatients. And about 10% of people with this condition die of suicide.
Signs & Symptoms
Even professionals struggle with making a diagnosis because the symptoms vary dramatically from person to person. These are some of the symptoms of BPD:

- e.g. substance and sexual abuse, binge eating and reckless behaviour.
- e.g. threaten to or attempt suicide often, burn themselves, cut their body.
Roller coaster emotions
- e.g. extreme mood swings like feeling on top of the world and all of a sudden feel hopeless.
- times of anger and rage is a frequent occurrence and often ruin relationships.
So What Are The Causes?
The exact causes haven’t been figured out yet but there are some factors that can contribute.

Family history
Abuse & Neglect -
many people with BPD have a history of childhood abuse, neglect and separation (death or divorce) from loved ones.
Traumatic event/s

are more prone to developing BPD.
- Research suggests that 60% of the risk of developing BPD is conveyed by genetic abnormalities.
Brain abnormalities
- Some research has shown changes in certain areas of the brain that is involved with emotion regulation, impulsivity and aggression. The brain chemical, serotonin, that helps regulate mood may not function properly.
Dialectal Behaviour Therapy (DBT)
- Research conducted has shown it to be more effective than most of other psychotherapeutic/medical treatments. DBT involves teaching the client how to learn to better take control of their lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.

Systems Training for Emotional Predictability and Problem Solving (STEPPS)
- Teaches people with BPD structured cognitive-behavioural skills in a weekly skills group over a period of 20 weeks.

Interpersonal Psychotherapy (IPT)
- Aims to solve problems; is time-limited (lasting 12-16 weeks) rather than long-term and focuses on the present. It helps people to regain control of mood and functioning.
Effects On The Brain
The area of the brain called the insular cortex (which helps control how intensely we experience negative emotions) is hyperactive in people with BPD. Furthermore, areas in the frontal part of the brain (which are thought to help us control our emotional reactions) are underactive.

Harold W. Koenigsberg, MD, professor of psychiatry at Mount Sinai School of Medicine found that people with BPD can't activate neurological networks that help to control feelings. He also found that when BPD patients tried to control and reduce their reactions to disturbing emotional scenes, the anterior cingulate cortex and intraparietal sulcus parts of the brain (active in healthy people under the same condition), were inactive in the patients.

“This research shows that BPD patients are not able to use those parts of the brain that healthy people use to help regulate their emotions,” said Dr. Koenigsberg.*

“This may explain why their emotional reactions are so extreme. The biological underpinnings of the disordered emotional control systems are central to borderline pathology. Studying which areas of the brain function differently in patients with borderline personality disorder can lead to more targeted uses of psychotherapy and medications, and also provide a link to connect the genetic basis of the disorder.”*
What Is It?
Tell Me More!
What Else Is There
To Know?
Borderline Personality Disorder
Borderline Personality Disorder (BPD)
is classified under Cluster B (dramatic) in the group 'personality disorder'. It is a mental illness that causes significant emotional instability.

People with BPD have negative self-image and feelings of worthlessness, anger, impulsivity and frequent mood swings which pushes others away.

They don't realise that they have an issue because their behaviour seems normal to them, and that causes them to blame others for their struggles and challenges they face.

Borderline Personality Disorder is a recognisable and real illness that deserves attention, care and treatment. Many people with this BPD get better with treatment.
Refer To:
Agencies For Help & Support
Campaign For BPD
Signs & Symptoms
Unstable self-concept
- a failure to find a stable and clear sense of identity. They often have little or no idea of what they want in life and frequently change jobs, religion or sexual identity.
- many people with BPD feel painfully empty on the inside. They crave for something more, but don't know what that something is.
- e.g. dissociate or be out of touch with reality. Sometimes, they hear voices telling them what to do.
Unstable relationships
- people with BPD often fall in love quickly and intensely. Also, emotional whiplash causes difficulty in maintaining relationships.
Worries of abandonment
- obsession over the fear that a loved one will leave them. It may cause them to become clingy, dependent and jealous.
Better Health Channel
- http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Borderline_personality_disorder
- http://www.sane.org/information/factsheets-podcasts/160-borderline-personality-disorder
- http://au.reachout.com/borderline-personality-disorde
Lifeline Australia
- 13 11 14
Kids Helpline
- 1800 55 1800
- 1800 18 7263
The Geelong Clinic
- 98 Townsend Road, St Albans Park, VIC 3219
Chris Mackey & Associates Psychology Services
- 42 & 28 Villamanta St, Geelong West, VIC 3218
Growth Psychology Practice
- 127 McKillop St, Geelong, VIC 3220
Barwon Health
- Bellerine Street (main entrance), Geelong, VIC 3220
TVC World Health Organization BPD Campaign 2014
Services Provided By
The Government
Online Websites
- online help on mental illnesses and also very easily accessible.
- to help raise awareness on mental illness and give a light of hope and that they are not alone for those who have a mental illness.
- free, private and confidential telephone counseling service.
School Counsellor
- best place to go to if he/she is schooling. They help students with academic achievement, personal/social development and much more.
- They can be found in youth services, private practices, community health centres, schools and universities. They talk with you about problems you may be experiencing and help you for possible solutions.
Services Provided By
The Government

health professionals who provide psychological therapies.

doctors who have undergone further training to specialise in mental health. They can make medical and psychiatric assessments, conduct medical tests, provide therapy and prescribe medication.
General Practitioner
- the best starting point for someone seeking professional help. A GP can: e.g. make a diagnosis, prescribe medication or discuss available treatments.
The most common prescribed medication are anti-depressants. These drugs increase the availability of certain chemicals that help nerve cells communicate in the brain.
Selective Serotonin Reuptake Inhibitors

are frequently prescribed for people with BPD. Studies have linked SSRIs to an increased likelihood of suicidal thoughts and attempts in children, adolescents and young adults.

Citalopram (Celexa) -
has fewer side effects and is well tolerated by elderly people.
Escitalopram (Lexapro)
- prescribed for anxiety and depression; may work faster than Citalopram.
Fluvoxamine (Luvox)
- prescribed for obsessive-compulsive disorder and is more sedating than other SSRIs.
Paroxetine (Paxil)
- associated with weight gain, sedation and significant withdrawal symptoms.
Fluoxetine (Prozac)
- more stimulating and can sometimes cause insomnia. Is FDA approved for the treatment of OCD, depression and anxiety.
Sertraline (Zoloft)
- the safest medication for people with cardiac problems and isn't overly stimulating or sedating.
Medications are almost always prescribed by a doctor but it is a complex and difficult area, both for the person with BPD and for the one prescribing.

Medication might help with depression but not other BPD symptoms.
It may help a lot, a little or not at all depending on the person.
There is no pill that 'cures' BPD.
It can reduce and make some symptoms easier to manage for some.
All medications have potential side-effects - e.g. weight gain, dizziness, insomnia, weight loss, sweating and headaches.
Medications are unsafe when not taken as prescribed.
Medication helps immediately but then stops helping - this could be a pharmacological effect or also a psychological effect.
Better Health Channel (2014), "Borderline Personality Disorder", available at:
(accessed 18 October 2014).
BeyondBlue (Unknown), "Who Can Assist", available at:
(accessed 25 October 2014).
Borderline Personality Disorder Demystified (2012), "Causes", available at:
(accessed 24 October 2014).
DepressioNet (Unknown), "Interpersonal Therapy", available at:
(accessed 25 October 2014)
Elliot, C. and Smith, L. (2009), Borderline Personality Disorder For Dummies, Wiley Publishing, Inc., Hoboken, NJ.
Futurity (2013), "Scans Show What Makes A Brain 'Borderline'", available at:
(accessed 24 October 2014).
Krawitz, R. and Jackson, W. (2008), Borderline Personality Disorder, Oxford University Press Inc., New York.
Mayo Clinic (2012), "Causes", available at:
(accessed 24 October 2014).
Mayo Clinic (2012), "Definition", available at:
(accessed 18 October 2014).
New Harbinger Publications (2013), "Brain Biology, BPD & Mindfulness", available at:
(accessed 25 October 2014).
Psych Central (2009), "Brain Scans Clarify Borderline Personality Disorder", available at:
(accessed 24 October 2014).
ReachOut (2014), "Borderline Personality Disorder", available at:
(accessed 18 October 2014).
SANE Australia (2014), "Borderline Personality Disorder", available at:
(accessed 18 October 2014).
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