Doctors hesitate to diagnose Borderline Personality Disorder (BPD) due to its symptom overlap with other conditions (like depression, bipolar), stigma, complex criteria (256 combinations!), and the perception that it's difficult or unrewarding to treat, leading to underdiagnosis despite the need for specific therapies like DBT.
The Myth that BPD Isn't Treatable
Today, unfortunately, many professionals continue to think that BPD is not treatable despite growing evidence that it is. This leads some professionals to avoid giving the diagnosis even when someone meets the criteria.
Diagnosing BPD presents several challenges due to the wide variety of possible symptom combinations—256 different patterns can meet the diagnostic criteria. This makes it difficult for clinicians to make an accurate diagnosis, especially with limited time to spend with patients.
Clinicians can be reluctant to make a diagnosis of borderline personality disorder (BPD). One reason is that BPD is a complex syndrome with symptoms that overlap many Axis I disorders. This paper will examine interfaces between BPD and depression, between BPD and bipolar disorder, and between BPD and psychoses.
Because the criteria for diagnosis are so overinclusive – including anxiety and depressive moods, identity disturbance and psychotic features – even if there is no personality pathology, a borderline diagnosis could be made. Making a borderline diagnosis obscures rather than illuminates pathology.
Several things can make BPD more common now:
Obsessive-Compulsive Disorder (OCD) Arguably, the most misunderstood mental illness out there is obsessive-compulsive disorder or OCD. And if it doesn't take the number one spot, it's certainly up there vying for the title.
To find out whether you have this diagnosis, you will need to have an assessment with a GP, a clinical psychologist, or a psychiatrist.
Why BPD Symptoms Peak in Early Adulthood. In the 20s, identity formation and independence conflict with emotional vulnerability. Research shows impulsivity and mood swings occur most frequently between the ages of 18-25.
A community study also found that young people with a BPD diagnosis were at a much higher risk than others of having the same diagnosis two years later. This means that diagnosing BPD early and offering effective treatment is one of the most effective ways to protect against adult BPD.
5 Disorders Similar to Borderline Personality Disorder
Personality disorders, including borderline personality disorder, are diagnosed based on a:
It is called 'borderline' because doctors previously thought that it was on the border between two different disorders: neurosis and psychosis. But these terms are no longer used to describe mental illness. It is sometimes called emotionally unstable personality disorder (EUPD).
Complications if Left Untreated
They may experience broken marriages and unplanned pregnancies and deal with dysfunctional interpersonal relationships. The social complexity and mental instability can sometimes lead to severe loneliness and depression when dealing with untreated symptoms associated with BPD.
The "3 C's of BPD" typically refer to advice for loved ones of someone with Borderline Personality Disorder, reminding them: "I didn't cause it, I can't cure it, I can't control it," to help set boundaries and avoid taking on undue responsibility for the person's actions or illness. Another set of "C's" describes core BPD traits for individuals: Clinginess (fear of abandonment), Conflict (intense relationships/moods), and Confusion (unstable self-image).
Cognitive triggers
Thoughts that seem to come out of nowhere can trigger intense distress and other BPD symptoms. This is particularly true for people who have BPD related to traumatic events like child abuse. A memory, location or image of a past experience of trauma or loss can bring about intense emotions.
Conclusions: Parental externalizing psychopathology and father's BPD traits contribute genetic risk for offspring BPD traits, but mothers' BPD traits and parents' poor parenting constitute environmental risks for the development of these offspring traits.
Feeling either “good” or “broken” — People with quiet BPD often turn splitting inward. This means they see themselves in extreme ways. You might switch between feeling confident and capable to feeling worthless and broken with little or no in between.
In general, the BPD group was faster to remit than the comparison group of patients with other PDs. Taken together, these results suggest that patients with BPD are able to achieve remission of symptoms, and that the longer the remission lasts, the lower the risk of relapse.
You can only be given medication after an initial 3-month period in either of the following situations: You consent to taking the medication. A SOAD confirms that you lack capacity. You haven't given consent, but a SOAD confirms that this treatment is appropriate to be given.
First, people with BPD are characterized by a biological vulnerability to experience intense emotions (i.e., affective instability), which includes (a) greater reactivity to internal and external stimuli, (b) stronger emotional intensity, and (c) slower return to a baseline level of emotional arousal.
Your GP can't diagnose BPD. Only a psychiatrist can make a formal diagnosis. A psychiatrist is a medical doctor who specialises in mental health. If your GP thinks you're living with BPD, they should receive to what are known as secondary mental health services in the NHS.
Neither BPD nor schizophrenia is “worse” in a universal sense, as both are serious mental health conditions that impact individuals differently. Each condition presents unique challenges. Schizophrenia often affects a person's perception of reality, while BPD affects emotional regulation and relationships.
Anorexia Nervosa – Highest Mortality Rate of Any Mental Disorder: Why? While all eating disorders are dangerous mental health conditions, anorexia nervosa (AN) has the unfortunate distinction of being the deadliest eating disorder—and, by some accounts, the deadliest psychiatric disorder.
Pseudologia fantastica (PF), also known as pathological lying or mythomania, is a mental disorder characterized by persistent, pervasive, and often compulsive lying. PF causes dysfunction in many realms of life.