Borderline Personality Disorder affects many

Posted 6/22/22

Borderline personality disorder (BPD), affects approximately 6% of the population. Major symptoms include provoked and unprovoked mood swings …

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Borderline Personality Disorder affects many

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Borderline personality disorder (BPD), affects approximately 6% of the population. Major symptoms include provoked and unprovoked mood swings, anger issues, self destructive behavior and relationship difficulties.  Multiple divorces are common.  Approximately 10% eventually die by suicide. 

46% of the cases were from untreated ADHD in childhood.  46% is caused by childhood sexual abuse.  The remainder are genetic, head trauma, and being bullied.

The official DSM 5 criteria are: (need to fit 5/9)

1) Extreme abandonment fears,

2) Relationship instability,

3) Self identity problems,

4) At least two impulsive, self-destructive or risky behaviors (such as spending, sex, substance abuse, reckless driving and binge eating),

5) Suicidal threats or attempts, self mutilation,

6) Mood swings,

7) Feeling empty inside,

8) Anger problems,

9) Paranoia, deja vu or sensations of unreality.

On a day to day basis individuals with BPD have unprovoked mood swings, where the individual goes into a bad mood for “no reason.”  They usually have persistent anger with rages.  They misinterpret and jump to the wrong conclusions a lot which causes relationship problems and usually multiple divorces.

BPD is commonly misdiagnosed as bipolar, which is very different from BPD.  Bipolar is an occasional event with self destructive behaviors from feeling too good.  Borderline symptoms are day by day.  Falling in love can make the symptoms go away for 6-15 months, but they will return.

The BPD is a neurological illness like Parkinson’s.  Its a chronic disease.  Fortunately there are treatments.  Prozac (fluoxetine) at the right dose will stop the unprovoked mood swings and persistent anger.  Sometimes the epilepsy medication Tegretol (carbamazepine) can help with the dysphoria (anxiety, rage, depression and despair).  It has been shown to reduce losing control of their behavior.  A “chill pill” - haloperidol will usually stop dysphoria (anxiety, rage, depression and despair) in 5-10 minutes if caught early.

Counseling is needed as well, although this can be done virtually.  DBT counseling has been shown to be of help.   Reading books is necessary to learn new ways of coping with the world.  I recommend “Your Erroneous Zones” by Wayne Dyer, “How to Win Friends and Influence People” by Dale Carnegie.  Affirmations can be helpful as well.  BPD coaching is also available.

Okeechobee Family Practice, Leland Heller

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