by Dave Piltz
Borderline Personality Disorder
Borderline personality disorder is characterized by a persistent and lasting over time emotional instability. This emotional instability manifests in unstable and tumultuous relationships, severe neediness, low tolerance for frustration, low self-control (impulsiveness) resulting in self harm or substance abuse, anger management issues and continuous feelings of emptiness. In addition anxiety and depression tend to be typical for the individual to experience (Preston, & Johnson, 2014).
Not ruling out a biological cause, typically it is proposed that the underlying cause stems from early childhood events that are significant and affects normal psychological development. For example severe neglect as a child would be an example (Preston, & Johnson, 2014).
There are no medications that treat the personality disorder itself but there are several that treat specific issues. For anger control and impulsivity selective serotonin reuptake inhibitors, atypical antipsychotics, and omega 3 are used. For schizotypal or peculiar thinking low doses of antipsychotics are used and for extreme feelings of being alone serotonergic antidepressants and atypical antipsychotics are used. Finally for the emotional instability lithium and atypical antipsychotics are used (Preston, & Johnson, 2014).
Approaches need to deal with assisting the individual to deal with their specific reality and create new behaviors that create more effective living. Treatment should focus on both regulating emotions and creating healthy habits in terms of interacting with others. From a systems perspective using therapies such as Structure or Strategic to recognize patterns of relationships and how to interact with others; or Satir’s Communications approach to deal with recognizing and communicating emotions in a healthy way; or Solution-Focused approach to create new behaviors that are healthy in regards to interacting with others. In addition, psychoeducation along with family sessions using all of these approaches is advisable (Gehart, & Tuttle, 2003). Non-system based therapies that are effective is cognitive behavior therapy and dialectical behavior therapy (Patterson, et al, 2010).
One should consider meditation, yoga, and or massage to help to relax and calm the person. Exercise and proper nutrition is also important in allowing the body to be well balanced so that the impulses can be controlled more effectively. Reading and/or attending workshops on effective relationships could also be helpful in creating new behaviors.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Gehart, D., & Tuttle, A., (2003) Theory-based treatment planning for marriage and family therapists. Belmont, CA: Cengage Learning.
Gehart, D., (2014). Mastering competencies in family therapy a practical approach to theories and clinical case documentation. Belmont, CA: Cengage Learning.
Patterson, J. E., & Albala, A.A., & McCahill, M.E., & Edwards, T.M. (2010). The therapist’s guide to psychopharmacology: Working with patients, families, and physicians to optimize care. New York: Guilford Press.
Preston, J., & Johnson, J. (2014). Clinical psychopharmacology made ridiculously simple. 8th Miami, FL: MedMaster.
Smith, P., (2008). A concise guide to better health and longevity what you must know about vitamins, minerals, herbs & more choosing the nutrients that are right for you. Garden City Park, NY: Square One Publishers.