Definition
Borderline personality disorder (DBP) is a complex psychiatric condition, which is observed mostly among young people, especially women. This personality disorder is characterized by the instability of self-image, mood, behavior and social relationships.
An important role in the development of this condition can be growth in a debilitating environment, in which the expression of emotions, thoughts and physical sensations is not only not recognized, but often trivialized with inappropriate reactions. This produces pathogenic effects on the subject, which presents difficulties in understanding, expressing and modulating one's emotional state. An affective deficiency, a very authoritarian family or a traumatic event that occurred early in childhood can act as predisposing factors. Furthermore, some temperamental characteristics, such as impulsiveness, seem to be more frequently associated with the disorder.
Most common symptoms and signs *
- Aggression
- alexithymia
- anhedonia
- anguish
- Impulsive behavior
- Suicidal behavior
- Delirium
- depersonalization
- Depression
- derealization
- dysphoria
- Mood disorders
- dromomania
- Avoidance
- Social isolation
- Nervousness
- Mood swings
- Cough
Further indications
Borderline personality disorder is characterized by a complex and varied pattern of symptoms. The patient manifests a profound instability regarding the management of emotions, identity, behaviors and relationships with other people.
Self-perception fluctuates between opposing and partial identities: the borderline subject shows great difficulty in expressing his own choices and / or preferences, taking on a different role depending on the context and the situation in which he finds himself.
Furthermore, the patient changes mood very easily and may even experience conflicting emotions at the same time; moments of dysphoria can alternate sadness or generalized anxiety. A frequent humoral state is the angry one, characterized by violent fits of anger without a real reason, which can sometimes lead to physical confrontation. Emotional lability can also manifest itself with the oscillation between idealization and devaluation, enthusiasm and disappointment.
The borderline subject fears a real or imaginary abandonment, manifests anguish and, in some moments, loses contact with reality (the thought appears almost psychotic). In response to the perception of abandonment, depressive symptoms may also appear.
Interpersonal relationships are characterized by moments of overvaluation of the other person, which often turn into the opposite extreme, reaching contempt.
Borderline personality disorder can lead to impulsive behavior (drug or alcohol abuse, tendency to overeat, reckless driving, promiscuous sexuality, aggression, kleptomania, etc.). Furthermore, self-injuring gestures and suicide attempts were observed.
Borderline personality disorder involves chronic feelings of emptiness and lack of purpose, pervasive ideas of being evil and isolation. In particularly intense stress situations, paranoia or temporary but serious dissociative symptoms may occur, during which the subject has the feeling of not being present to himself (depersonalization and derealization).
The patient is not aware of the effects it produces and the sense of omnipotence (ie feeling that he can dominate all events) is a defensive reaction to emotional fragility.
About 10% of patients with borderline personality die by suicide.
DBP is the personality disorder that most commonly comes to clinical observation. For the diagnosis, reference is mainly made to the criteria reported in the DSM (diagnostic and statistical manual of mental disorders).
Individuals with a personality disorder often have no awareness of their condition and present symptoms such as anxiety, depression, substance abuse or other problems that are not clearly associated with the illness they suffer from. However, a sense of discomfort (eg annoyance, anger or defense reactions) during the interaction between doctor and patient can be interpreted as an early indication of borderline personality.
The treatment involves a psychotherapeutic intervention (psychodynamic or cognitive-behavioral therapy), to complement the pharmacological one. The use of antipsychotic drugs, mood stabilizers and antidepressants is useful for the management of rabies and commonly associated symptoms (anxiety, depression and psychotic symptoms) to borderline personality disorder.
