Borderline Personality Disorder

In the past few decades, treatment for Borderline Personality Disorder has changed radically, and, in turn, the prognosis for improvement and/or recovery has significantly improved. Unfortunately, treatment programs, outpatient programs, and transitional living for BPD are not yet widely available. As for transitional living facilities or outpatient services, after a client leaves treatment, there are close to none. Malibu Recovery Center is different and is offering day treatment and/or Outpatient Services for those in need.

Malibu Recovery Center staff understands the need to be alert to signs of BPD which include withholding, dishonesty, or antisocial tendencies, since these have an adverse effect on prognosis. One of the preliminary questions confronting families/friends is how and when to place confidence in those responsible for post-treatment for the patient. Generally speaking, the more experience the the staff has had working with borderline patients, the better. Most often, a good “fit” with the new treatment options is the “key” to success.
The symptoms of the disorder can be as difficult for treatment and post-treatment facilities to experience as those experienced by family members. Most facilities are apprehensive about working with individuals with this diagnosis.

What is Borderline Personality Disorder?
Borderline Personality Disorder (BPD) is a most misunderstood, serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. It is a disorder of emotion dysregulation. This instability often disrupts family and work, long-term planning, and the individual’s sense of self-identity.

The disorder, characterized by intense emotions, self-destructive acts, and stormy interpersonal relationships, was officially recognized in 1980. The complex symptoms of the disorder often make it difficult for those seeking stability therefore evoking feelings of anger and frustration in finding suitable treatment, with the result that many facilities are unwilling to house and/or treat persons with these symptoms.

What are the Symptoms of Borderline Personality Disorder?
A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

• Frantic efforts to avoid real or imagined abandonment.
• A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
• Identity disturbance: markedly and persistently unstable self-image or sense of self.
• Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
• Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
• Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
• Chronic feelings of emptiness.
• Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
• Transient, stress-related paranoid ideation or severe dissociative symptoms.

Considerations about Borderline Personality Disorder
1. BPD rarely stands alone. There is high co-occurrence with other disorders.
2. 75% are women. This number may, in part, reflect that women more often seek treatment, that anger is seen as more acceptable in men, and that men with similar symptoms often enter the penal system receiving a diagnosis of antisocial personality disorder.
3. 75% of patients self-injure.
4. Although a chronic disorder that is resistant to change, we now know that BPD has a good prognosis when treated properly. Such treatment usually consists of medications, psychotherapy and educational and support groups.
5. In many patients with BPD, medications have been shown to be very helpful in reducing the severity of symptoms and enabling effective psychotherapy to occur. Medications are also often essential in the proper treatment of disorders that commonly co-occur with BPD.
6. There are a growing number of psychotherapeutic approaches specifically developed for people with BPD. Some of these have been in use, tested in research trials, and appear to be very effective; the newer ones are very promising. Malibu Recovery Center provides treatment that is effective and offers hope.
7. These and other treatments have been shown to be effective in the treatment of BPD, and MANY PATIENTS DO GET BETTER!
Many facilities continue to deny meaningful input from family members of a client with BPD. This situation is especially frustrating for family members, who often provide the sole financial support for everyday living expenses, and much of the moral support, but who receive little or no response from treatment and/or aftercare. Families are especially distressed when the treatment plan is not supported by aftercare, and especially when the patient becomes isolated from their therapists. Given the importance of the family in establishing functional relationships in the lives of people with borderline disorder, families should actively seek “family friendly” treatment.