Borderline Personality Disorder
Borderline personality disorder can vary in severity. Patients with borderline personality disorder often have emotional instability and poor impulse control. It is believed that the onset begins between puberty and young adulthood. Younger individuals with borderline personality often exhibit features such as identity disturbance, substance use, sexual behavior, and problems with psychosocial functioning (Chanen et al., 2020). Other clinical signs attributed to borderline personality disorder include “emotional dysregulation, impulsive aggression, repeated self‐injury, and chronic suicidal tendencies” (Stoffers-Winterling et al., 2018, para. 2). Borderline personality disorder often overlaps with other psychiatric disorders such as mood disorders, anxiety, eating disorders, and post-traumatic stress disorder (Barnicot & Crawford, 2018).
Recommended treatment for borderline personality disorder is psychotherapy (Stoffers-Winterling et al., 2018). There is no recommended medication for the treatment of borderline personality disorder (Hancock-Johnson et al., 2017). Pharmacological interventions are used as adjunctive treatment to treat comorbid disorders such as anxiety or depression. Psychotropic medications are used for crisis situations such as psychotic exacerbations, impulsivity‐associated outbreaks, and suicidality. Psychotropic medications are only recommended for short term to stabilize the patient in times of crisis (Stoffers-Winterling et al., 2018).
Histrionic personality disorder is another cluster B personality disorder where the person exhibits dramatic or attention seeking behavior. Treatment for Histrionic personality disorder is psychotherapy (Lewis & Mastico, 2017). There are no medications approved to treat histrionic personality disorder. Like borderline personality disorder, pharmacological interventions such as mood stabilizers, antipsychotics, and antidepressants are reserved to treat mood dysregulation (French & Shrestha, 2021).
Barnicot, K., & Crawford, M. (2018). Posttraumatic stress disorder in patients with borderline personality disorder: Treatment outcomes and mediators. Journal of Traumatic Stress, 31(6), 899–908. https://doi.org/10.1002/jts.22340
Chanen, A. M., Nicol, K., Betts, J. K., & Thompson, K. N. (2020). Diagnosis and treatment of borderline personality disorder in young people. Current Psychiatry Reports, 22(5). https://doi.org/10.1007/s11920-020-01144-5
French, J. H., & Shrestha, S. (2021). Histrionic Personality Disorder. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK542325/
Hancock-Johnson, E., Griffiths, C., & Picchioni, M. (2017). A focused systematic review of pharmacological treatment for borderline personality disorder. CNS Drugs, 31(5), 345–356. https://doi.org/10.1007/s40263-017-0425-0
Lewis, K. C., & Mastico, E. (2017). Histrionic personality disorder. In Encyclopedia of personality and individual differences (pp. 1–9). Springer International Publishing. https://doi.org/10.1007/978-3-319-28099-8_590-1
Stoffers-Winterling, J. M., Storebø, O., Völlm, B. A., Mattivi, J. T., Nielsen, S., Kielsholm, M., Faltinsen, E. G., Simonsen, E., & Lieb, K. (2018). Pharmacological interventions for people with borderline personality disorder. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd012956
Response to Module 8 Discussion Post
The borderline personality disorder is a grave mental health condition, manifesting as fluctuating anger, depression, and anxiety episodes. The initial post covers symptoms, treatment, and histrionic personality disorder. However, it fails to address the risk factors, which are essential to understanding the condition’s epidemiology. The three main contributors to borderline personality disorder are family history, brain changes, and the socio-cultural environment.
While scientists are yet to establish a direct hereditary component to the disorder, it is evident that it runs within families. Hence, an individual is five times more likely to develop the condition if a parent or sibling has it (Perugula et al., 2017). Next, borderline personality disorder is common among people whose brains undergo structural or functional changes (National Institute of Mental Health, 2017). However, perhaps the most important risk factor is socio-cultural influence. Many people with borderline personality disorders report encountering some trauma-initiating adverse events. These adversities include physical and sexual abuse and abandonment, which occur during childhood. Consequently, borderline personality disorder’s onset is before or during early adulthood (Luyten et al., 2020). Therefore, a clinician attending to a borderline personality disorder patient should consider which risk factor is most likely to have caused the condition and model the treatment approach accordingly. Consequently, they will have a chance to understand their patients better, resulting in improved outcomes.
Luyten, P., Campbell, C., & Fonagy, P. (2020). Borderline Personality Disorder, Complex Trauma, and Problems with Self And Identity: A Social-Communicative Approach. Journal of Personality, 88(1), 88–105. https://doi.org/10.1111/jopy.12483
National Institute of Mental Health. (2017, Dec.). Borderline Personality Disorder. https://www.nimh.nih.gov/health/topics/borderline-personality-disorder
Perugula, M. L., Narang, P. D., & Lippmann, S. B. (2017). The Biological Basis to Personality Disorders. Primary Care Companion, 19(2). https://doi.org/10.4088/PCC.16br02076