What is borderline personality disorder?

Borderline personality disorder is characterized by instability, excessive sensitivity in relationships, instability of self-image, and extreme mood swings.

This article is expertly advised by Hoang Tien Trong Nghia, M.D., Head of the Department of Neurology, Military Hospital 175.

People with borderline personality disorder often have difficulty controlling anger.

Characteristic

- Patients with borderline personality disorder are less tolerant of loneliness.

- The patient tries intensely to avoid being abandoned and creates crises, such as committing suicide to encourage others to help and care.

- Co-occurring pathologies are common, patients often suffer from:

• Mood disorders.
• Physical symptom disorder.
• Gambling disorder.
• Substance use disorder.

Reason

• Childhood history.
• Genetic.
• Dysregulatory function of the brain and neuropeptide system.

Symptoms and signs

- Feeling abandoned or abandoned, feeling extremely scared or angry.

- Tends to change opinions about others instantly and suddenly. The transition from idealization to contempt reflects black and white thinking (division, polarization between good and bad).

- Can empathize and care for another person, but only when feeling that another person will always be there whenever needed.

- Difficulty controlling their anger and often become violently angry.

• Often directed towards a caregiver or loved one for neglecting or abandoning him or her.
• After the outburst, the person often feels ashamed and guilty, reinforcing feelings of evil.

- Sudden changes in self-image, demonstrated by sudden changes in goals, values, opinions, career, or friends.

- Mood changes usually last only a few hours and rarely last more than a few days; these changes may reflect extreme sensitivity to interpersonal tensions.

- Often destroys himself when he is about to achieve his goal.

- Impulses leading to self-injury are common.

• Suicidal and self-mutilation (eg, cutting, burning) behaviors, gestures, and threats are common.
• These self-destructive behaviors are often triggered by rejection, possibly abandonment by, or disappointment by, a caregiver or lover.

- Dissociative episodes, paranoid thoughts and sometimes psychotic-like symptoms can be triggered by excessive stress, often fear of abandonment, whether real or imagined.

• In most patients, dissociative symptoms subside over time and recurrence rates are low.
• However, functional status often does not improve as much as symptoms.

Diagnose

- To be diagnosed with borderline personality disorder, the patient must have a persistent pattern of unstable relationships, self-image, and emotions (emotional dysregulation) and marked impulsivity.

- This condition is shown when there are 5 or more of the following:

• Desperate efforts to avoid abandonment (real or imagined).
• Intense, unstable relationships vacillate between idealization and contempt for others.
• An unstable self-image or sense of self.
• Impulses from 2 situations that can harm you (eg unsafe sex, overeating, reckless driving).
• Repeated suicidal behavior and gestures, threats or self-mutilation.
• Rapid changes in mood, lasting usually only a few hours and rarely more than a few days.
• Persistent feeling of emptiness.
• Intense, inappropriate anger or problems controlling anger.
• Temporary paranoid ideation or severe dissociative symptoms caused by stress.

- Symptoms begin in early adulthood but can occur during adolescence.

Treatment

• Psychotherapy.
• Use medicine.

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