What is borderline personality disorder?

If you know someone who has a very poor self-esteem, and suffer constant breaks in their relationships and repeated outbreaks of anger, this person may suffer a borderline personality disorder, also known as borderline. It is one of the personality disorders less known and causes great suffering to those who suffer and those who live with him; in addition, it can present differently in each person, which makes a clear diagnosis difficult and delays the application of the treatment.

People with borderline personality disorder suffer from emotional ups and downs, constant hesitation and anger, which makes it difficult for them to relate to others. Know your symptoms and how you can prevent it.

As the name implies, borderline personality disorder is framed within personality disorders, and is also called borderline personality disorder; this term can lead to some confusion, as it is also used to designate a certain degree of intelligence. The borderline intelligence corresponds to the intermediate score obtained in the intelligence tests, resulting lower than normal without reaching mental retardation.

In borderline personality disorder, intelligence is not affected, unlike other areas such as emotional or impulse control
It is important not to confuse it, since in borderline personality disorder, intelligence is not affected, unlike other areas such as emotional or impulse control. It occurs more frequently in the female population, in a proportion of three cases compared to one in men. The age of onset is early, usually before adolescence. Although it sometimes has a genetic origin, in most cases it responds to an unstructured family environment or abuse.

Its main characteristic is that those affected have a weak and changing personality, who doubts everything, even of themselves, with moments of calm that can be returned instantly and without warning in anger, anxiety or despair. In these people the emotions "are in the flower of the skin", and live the relationships very intensely, both in love, in which you come to idolize the other person, as in the ruptures, where feelings of contempt arise from being rejected .

Coexistence with a person with borderline personality disorder is very difficult; hence the constant breakdowns in relationships, where the other party "can not stand it any longer" the situation, which can become "suffocating." This will add problems in performance and labor relations, which can put at risk the economy of those who suffer from this disorder. In addition, it is often aggravated by the presence of addictions to substances, and even other disorders presented at a time.

One of the greatest difficulties that the professional finds when making an adequate diagnosis of borderline personality disorder is to have to determine the symptoms that correspond to this disorder, whose main characteristic is precisely the instability, frequently changing its symptomatology. Among the symptoms and manifestations of borderline personality disorder that may occur are:

Changing state of mind, living phases of tranquility and tranquility, and the next moment, and without any circumstance any, you experience sudden attacks of anger or anxiety.
Constant doubts about himself, his worth as a person or about his ability to face the future, which will reflect in continuous changes of hobbies and interests, and a less involvement in activities that require continued effort over a long term .
Chronic feelings of emptiness and uselessness, due to a devalued perception of their identity, in comparison with the others.
Intense interpersonal relations and continuous ruptures, due to the instability in his way of seeing others, which sometimes leads him to idealize someone, then devalue him with the same intensity.
Extreme behaviors that endanger one's life, motivated by its impulsiveness and the search for meaning, which can even lead to suicide attempts.
As mentioned previously, this is a representative list of the symptoms that can present to establish the diagnosis of borderline personality disorder, but they do not have to appear all, and these can also vary in time, complaints of the patient and his closest relatives, not understanding what happens, and not find a clear and rapid diagnosis in this respect from which to start working to overcome it.

Although the person with this disorder shows normal intelligence, his academic performance may be inferior to that of his peers, due precisely to his instability in his interests and an unstable ability to work, which aggravates his feelings of frustration and hopelessness, increasing their psychological suffering.

In the workplace will show difficulties in those professions that require a constant effort, which could cause the loss of the job.

The term borderline of borderline personality disorder does not have to do with that which refers to a certain level of intelligence. Once this clarification is made, it should be noted that there is an objective difficulty in establishing the diagnosis, due to the great variability of symptoms that each person can present and to the changes that are manifested over time.

Thus, at a given time, a person may come to consultation for a problem of access of anger, ie hypersensitivity that leads him to explode in the form of anger. On another occasion, this same person may demand help to overcome a romantic breakup, which has ended abruptly despite having made great efforts to maintain that relationship. Later on, these symptoms present themselves, accumulating a seemingly confused and disjointed clinical history.

This range of possible symptoms that can be shown by the patient makes it difficult to diagnose borderline personality disorder, since some of these can come from other pathologies, such as bipolar disorder - where there is an alternation of moods, although their symptoms are or attention-deficit hyperactivity disorder, in which there is hypersensitivity and impulsivity, and which also leads to poor academic performance, in this case due to a lack of attention rather than a continuous change of interest.

The task of the specialist, in the first place, will be to determine if it is a borderline personality disorder, distinguishing the symptoms that are specific to it and, if other symptoms are observed, determine if there are also occurring other concomitant disorders . Among the most common that occur at the same time is major depression, narcissistic disorder and eating disorders, also complicated in many cases with addictions and substance abuse, which only make the clinical picture worse and complicate its recovery.

One of the first difficulties that the professional has to face when designing the therapeutic intervention for borderline personality disorder is to establish priorities, since this problem usually presents with other psychiatric disorders, especially accompanied by emotional disorders such as major depression. In addition, in the case that the person present drug addiction, it will have to be treated previously.

Unlike other cases, the borderline personality disorder causes great psychological suffering to those who suffer from it, as well as their relatives and close friends; that is why the demand for treatment is usually initiated at the request of the patient, although in some cases it is at the request of his partner or family. The changing symptomatology can "despair" the complainant and even the specialist, frustrated by not being able to reach a clear diagnosis.

It may be the case that a patient is going from an appointment to an appointment trying to know what is happening to him or her, and it may be months or even years before a proper diagnosis of his disorder is made, precisely because of its main characteristic of continuous symptomatology change; a situation of uncertainty that only aggravates personal suffering and those close to them, while consolidating negative consequences in their academic, professional and social life.

Once the diagnosis has been established, and it has been determined whether there are other concomitant disorders, it is necessary to establish the treatment priorities, so that we will start by working on those symptoms that cause the person to feel more discomfort, or even put at risk their life, as is the case of suicide attempts. It will be essential to carry out a previous detoxification treatment when the person is habitual consumer of illegal substances, since these will interfere in the expected progress.

Some of the objectives that are pursued in the treatment of borderline personality disorder are described below, with an indication of the techniques used in each case:

Emotional independence. You work with the person's emotional dependency problems so that he learns to be guided by his own values and opinions, and is taught that these are as valid as those of others, for which he is asked to be able to express and defend their opinion in different situations.
Improvement of communication, so that he can establish healthy relationships with other people, without idealizing them or demanding them beyond what corresponds to the relationship, using techniques of role-playing of couples therapies, where they are represented (really or in the imagination) different situations to see first how the patient behaves and then learn how to be more effective in those same situations.
Increased self-esteem and personal identity, a cognitive work that seeks to strengthen the identity that makes it unique and different from the rest, while learning to value itself with its virtues and its defects.
Control of stress and frustration: understanding your disorder and the consequences it causes are a first step to get rid of that psychological suffering that involves not knowing what happens to you and the frustration of not knowing if it can change. Observing progress in other areas, such as independence or interpersonal communication, will help you reduce your frustration and, along with relaxation techniques, control stress.
Control of impulsivity and anger, teaching him to detect when he is tense and, with it, the moment in which that outbreak of anger can arise. Once detected you should apply positive visualization techniques (where you imagine as vividly as possible in a quiet and calm place away from any problem) and relaxation (with three deep breaths, in which you breathe in through your nose and exhale through the mouth slowly the air while counting to ten), that give back the necessary tranquility to overcome this situation.
Combat suicidal ideation and attempts at self-harm, through established agreements between patient-therapist in which a greater understanding of himself and his disorder is sought, while progress is observed in other areas in which he works, in exchange for a reduction until their disappearance of behaviors of autoagresión and attempts of suicide.
Decrease in certain acute symptoms, for which specific psychoactive drugs will be used to help control them when they arise.

Although in some cases of borderline personality disorder there is a clear genetic component that determines neuronal alterations of information processing - mainly emotional type and impulse control -, in most cases this condition occurs due to to an environmental influence, especially of the family, either because it has unstructured characteristics or because there have been abuses that mark the person and cause it to mature inappropriately; this is why it is important to prevent the onset of borderline personality disorder:

Maintain, as far as possible, a healthy relationship, where children can grow up in an environment without problems, and without inappropriate examples of violence or substance abuse.
Avoid using children as a scapegoat or to blackmail the couple, when there are conjugal disagreements or in the case of dissolution of relationships, either by separation or divorce.
Be aware of the first cases of anger, self-injurious behavior or attempted suicide, as these behaviors are serious enough to ask for professional help without the need for other symptoms.
Teaching to value oneself and their opinions, highlighting the individual differences and the idiosyncrasy of each one, avoiding comparisons, nor idealizing others as "models" of life.
Allow your child to make mistakes, giving them the opportunity to learn from their mistakes, while comforting and listening to their feelings, as a way of expressing their frustration in a healthy way.
Observe the academic performance to see if it is below the average class, to put as soon as possible remedy, because if it can not negatively affect your self-image.

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