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Borderline Personality

Borderline Personality Disorder is a common, treatable condition with a variety of symptoms, most notably non-suicidal self-injury or recurrent threats of, or attempts at, suicide. Borderline personality can be a confusing name (borderline of what?) for a condition which can cause a lot of distress for those who have it and their friends and families. The condition is sometimes misdiagnosed as a mood disorder like depression or bipolar disorder, but has its own course and effective treatments.

Borderline personality usually develops in late adolescence or early adulthood, just when college is starting. Individuals with borderline personality are usually most symptomatic when they are young, sometimes with problems with functioning or even repeated hospitalizations, but studies show the majority of individuals with this disorder get better over time and can benefit from specific treatments.

While medications can help with certain symptoms of borderline personality disorder, unlike with mood or anxiety disorders, the medications are usually a minor part of the treatment, with the focus on psychotherapy. A number of different psychotherapies are known to help limit suicidal behavior and hospitalizations, with the promise of helping individuals develop the school, work and social life they desire.

Signs and Symptoms

Borderline Personality Disorder is a common psychiatric condition which causes significant distress to individuals with the disorder, and often distress to their friends and families. Patients with borderline personality disorder are disproportionately represented in almost all psychiatric and psychological treatment settings including outpatient and inpatient programs.

The symptoms of borderline personality disorder include:
• Inappropriate, intense anger
• Stress-related paranoid thinking or dissociative symptoms
• Chronic feelings of emptiness or boredom
• Recurring suicidal behaviors, threats or self-harming behavior, such as cutting or head-banging
• Impulsivity or dangerous behaviors including substance abuse, driving fast, unsafe sex, or binge eating
• Intense relationships often alternating between periods of idealization (feelings of closeness, safety) and devaluation (hatred, anger, suspiciousness)
• Marked instability in mood, usually over hours to days
• Extreme reactions to feelings of abandonment, either real or imagined
• Marked identity diffusion often manifested by unstable self-image
• As there is significant overlap between the symptoms of borderline personality disorder and bipolar disorder, it is not uncommon for them to be confused

Getting Help

Borderline personality disorder is not as widely known or well understood to the public as other psychiatric disorders such as depression or bipolar disorder. Many individuals with symptoms of the disorder will go years before a clinician shares the diagnosis with them or they themselves conclude that their symptoms suggest a borderline personality disorder diagnosis.
One common scenario is the individual who has been given a diagnosis of a mood or anxiety disorder who doesn’t respond positively to the treatments offered, who continues to be symptomatic with repeated hospitalization or a decline in functioning.

How can someone with borderline personality disorder get the help he or she needs?

• Start with the college or university counseling services. Ask the counselors for guidance, find out what kinds of counseling services are offered and if the clinicians have experience treating borderline personality disorder
• If you can’t access services through your college or university, ask you family doctor for guidance about how to access services in the community
• You can inquire about specialized services through community mental health centers, hospital psychiatry department’s outpatient clinics, family service agencies, or state hospital outpatient clinics
• Seek out peer support groups including “virtual” options on-line
• If you are already seeing a psychiatrist, psychologist, social worker, or counselor, talk about the diagnosis and about the treatment options available, particularly if you’re not responding well the treatments you’ve been offered
• Continue to educate yourself about the disorder – read the books available on the subject or visit the websites with up-to-date information
• Expect symptoms to improve gradually; for the most part borderline personality disorder is treated with “talk” therapy, with medications as an adjunct. Don’t expect a rapid recovery as is sometimes seen with certain medications in other disorder
• Spend time with other people you trust, confide in friends, family or teachers if you feel comfortable doing so
• Set reasonable goals; you may want to focus first on school or work before pursuing romantic relationship, particularly if romance has been destabilizing for you in the past

Please be sure to select your school above so we can provide you with information about resources and help on or near your campus.