BPD and PTSD Flashcards
What is borderline personality disorder?
From NHS UK website:
* Emotional instability – the psychological term for this is ““affective dysregulation””
* Disturbed patterns of thinking or perception – ““cognitive distortions”” or ““perceptual distortions””
* Impulsive behaviour
* Intense but unstable relationships with others
* May feel overwhelmed with intense emotions
including rage and also despair – so self harm and self sabotaging behaviours.
How to you diagnose and treat BPD?
Diagnosis
* GP will refer to specialised services for diagnosis
* Clinical picture – practitioner may make use of questionnaires
Treatments
* Support from CMHT
* Talking therapy – 1 to 1 and group work -
* DBT (dialectical behaviour therapy) focussing on validation and challenging ‘black and white’ thinking
* MBT (mentalisation based therapy) – stepping back, thinking about thinking
* Medication – possibly anti-depressants but no medications are specifically licenced, (in fact actively against NICE guidelines although mood stabilisers and anti-psychotics recommended for co-morbidities
Goal of treatments
* Goal of CMHT is to provide day-to-day support and treatment, while ensuring as much independence as possible.
* Historically was considered to be a long and enduring metal illness picture
* Some drift of narratives towards re-framing, & ‘living with’ - NICE guidelines recently revised after in April 22 – but approaches from 10 to 30 years ago still used.
What is PTSD?
PTSD – Flashbacks, nightmares, anxiety associated with a traumatic event
* Complex PTSD when that trauma has been
ongoing, re-occurring or compounding. NHS
describe symptoms as all of the above plus:
* Feelings of worthlessness, shame and guilt
* Problems controlling your emotions
* Finding it hard to feel connected with other
people
* Relationship problems, like having trouble
keeping friends and partners
How do you diagnose and treat PTSD?
Diagnosis
May be via GP – may be referred to specialised
assessment – more likely to be psychological
services than psychiatric.
Treatments
* Acute – active monitoring advised
* Complex – will be a combination of talking therapy - CBT ( cognitive behavioural therapy) and EMDR ( eye movement desensitisation and re-processing)
* Medication - symptomatic
Goals of treatment
* Acute – expectation that it may resolve after
weeks. NICE guidelines ‘Reassure that is a treatable condition’
* Treatment aims – mention access to
services, countering shame, involving families
and networks
