Borderline personality disorder (BPD) a Flashcards
Borderline
personality
disorder (BPD)
is a mental illness that can make it difficult for people to feel safe in their relationships with other people, to have healthy thoughts and beliefs about themselves, and to control their emotions and impulses.
People with BPD may
experience distress
their
work, family and social
life, and may harm
themselves.
Having BPD is not the
person’s own fault –
it is a
condition of the brain and
mind
Research has not yet
discovered exactly how a
person develops BPD, but it
probably involve
combination of biological factors (such as genetics) and experiences that happen to a person while growing up (such as trauma early in life
For most people with BPD,
symptoms begin during
adolescence or as a young adult, but tend to improve during adult life. Research has not yet shown how health systems can best help prevent people developing BPD.
Signs that someone has BPD may includ
Making frantic efforts to avoid being abandoned by other people
Repeatedly having intense and unstable relationships with other
people
Being very unsure of who they are and what to think about themselves
Acting impulsively in ways that could be very risky
Repeatedly harming themselves or threatening to commit suicide
Experiencing intense emotional ‘lows’
Irritability or anxiety for a few hours or days at a time
Constantly feeling ‘empty’
Experiencing unusually intense anger and being unable to control it
Sometimes feeling paranoid or experiencing strange feelings of being
detached from their own emotional or physical situation
Health professionals working with people who have BPD
should be respectful, caring, compassionate, consistent
and reliable.
They should listen and pay attention when the person is
talking about their experiences, take the person’s feelings
seriously, and communicate clearly.
Consider assessment (either by GP or through Emergency Department) for BPD for people with any of the following:
ü frequent suicidal or self-harming behaviour
ü marked emotional instability
ü multiple co-occurring psychiatric conditions
ü non-response to established treatments for current symptoms
ü a high level of functional impairment
For friends, family and carers, it’s important to remember that
providing appropriate support for a person with BPD in crisis
usually requires the assistance of health professionals such as
doctors, case managers and psychiatrists. It may be appropriate
to request emergency assistance from Police and/or Ambulance
services, particularly where the person may be at risk of harm to
themselves or those around them.
Psychosocial treatments for BPD
Dialectical behaviour therapy
Mentalisation-based treatment
Schema-focused therapy
Cognitive behavioural therapy
Cognitive analytic therapy
Transference-focused therapy
Systems training for emotional predictability and problem solving
Dynamic deconstructive psychotherapy
Common characteristics OF TREATMENT OF BPD
Approaches to prototypic borderline personality disorder problems are structured (manual-directed)
Patients are encouraged to adopt self-control (i.e. sense of agency)
Therapists help patients to connect feelings to events and actions
Therapists are active, responsive and validating
pharmacology reasons BPD
Drugs should not be used as primary therapy for borderline personality disorder, because they have only modest and inconsistent effects, and do not change the nature and course of the disorder.
Caution should be used if prescribing drugs that may be lethal in overdose, because of high suicide risk with prescribed drugs in people with borderline personality disorder.
Caution should be used if prescribing medicines associated with substance dependence.
If drugs have been prescribed to manage a crisis, they should be withdrawn once the crisis is resolved.
