Friday, May 20, 2022

BORDERLINE PERSONALITY DISORDER

Borderline Personality Disorder (BPPD) is a mental health problem that affects about 2% of the world population and is currently one of the greatest therapeutic challenges for psychiatry and psychology, in terms of understanding, psychodiagnosis, treatment and intervention.

Psychodiagnosis is not easy, and in an emergency room case it may be confused with anxiety or depression disorders, attention deficit hyperactivity disorder and, more commonly, with bipolar disorder. Still quite misunderstood and underdiagnosed, BPP and sufferers are often stigmatized. BPP is characterized by a generalized pattern of persistent hypersensitivity and instability in interpersonal relationships and self-image, emotional inconstancy with extreme and constant mood fluctuations that can range from intense dysphoria, to irritability and anxiety that can last for hours.

BPP is a borderline or borderline personality disorder because it characterizes a way of being, being and feeling and relating to the world that is considerably pathological because of some of the defining features that shape a complex, unstable, and disorganized clinical picture.

It is mainly in relationships, through them and because of them, that symptoms manifest. There is a conflict between the intense need for the other and the fear of rejection, abandonment, and disapproval. Behind the fear of abandonment lies hidden aggressive behavior, which demands total availability from the other. If they feel they are being abandoned or neglected (even when this is not the case) they feel anger and intense fear, which gives rise to conflict and ultimately to suicide attempts, not in order to die, but to make others not leave them and take care of them.

They adopt abrupt and dramatic changes in their view of people, from idealization to devaluation, a cleavage thinking (division and polarization of good and evil). For example, at the beginning of a relationship they may idealize a potential caregiver and demand a lot of time and sharing, and then suddenly change their mind and become disillusioned.

These personality traits marked by melodrama, an overly intense way of feeling punctuated by emotional hyperactivity, sometimes with intense jealousy, fits of rage, and despair, generate serious love, family, and social problems and great suffering for those around them.

In terms of treatment, it is important to turn to specialists, Psychologists and Psychiatrists, Psychotherapy allied to Psychopharmacology helps to better control their impulses and understand their behavior. A systemic, conjugal and family look is ideal to understand the sources behind the maintenance of this disorder. Cognitive Behavioral Therapy helps to change dysfunctional beliefs and behaviors underlying inaccurate perceptions of self and others; reduction of mood and anxiety symptoms, impulsive and self-destructive behaviors; regulation in the face of disappointments and crises; correct identification and regulation of emotional reactions. Family therapy should also be considered in the treatment.

In this context, using appropriate techniques and psychotherapy and/or pharmacological therapies show unequivocal gains in the treatment of anxiety.

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