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Symptoms of Borderline Personality Disorder

Borderline Personality Disorder is a disorder that affects the behavior, thinking and emotions of the person. Personality disorders can be divided into six categories. In this essay, the discussion of Borderline Personality Disorder (BPD) will be done. BPD is a kind of mental disorder in which the person does not feel comfortable with the people around them. People experienced uncontrolled emotions and anger. BPD can be diagnosed by observing the symptoms seen in the person. It can cause self-harming thoughts along with harming other people and is a serious mental disorder and needs proper treatment. This essay will outline the aetiology of BPD and the criteria of diagnosing it. BPD has a negative impact on the mental health of the people and their family. The clinical guideline for BPD will be identified and analyzed.

Borderline Personality Disorder is a serious mental disorder that affects the views, feeling, thinking, and behavior of the person (Chapman, 2019). This disease is recently identified in a client at the clinic that has negatively impacted his life. The cause of BPD may be a genetic or environmental factor. People who have experienced trauma or abuse in their life are more susceptible to having BPD and may have been abused emotionally, physically, or mentally that have a bad effect on their mind. The people who are often neglected by society and mistreated are also at risk of acquiring the disorder. The main thing about this disorder is people even do not know that they are suffering from the disease. They do not realize it until they are diagnosed by a psychiatrist (Campbell, & et al., 2020). The psychiatrist can also diagnose this disorder after observing the symptoms. Heredity is one of the causes of BPD; if any member of the family has a history of BPD then there are more chances that other members of the family can have this disorder. In some people, the part of the brain which is responsible for controlling emotions and feelings is not able to communicate properly with the other parts of the body. As a result of this, people don't have control over their emotions; it is also the possible cause of this disorder. Borderline Personality disorder is found generally in the people who have faced abuse during their early childhood (Gunderson, & et al., 2018). The conflicts and separation between the parents, sexual assault by the relatives or family friends, and other trauma faced by the people during childhood may also be responsible for having BPD. The diagnosis of this disorder is done by communicating with the person and knowing their medical history, their views, relationships, and observing the symptoms. The psychiatrist may ask many questions to the client regarding their personal and professional life (Lind, & et al., 2019). The symptoms of this disorder may vary from person to person. One of the most common symptoms of BPD is sudden mood swings. The person suffering from this disorder may have a feeling of being abandoned by their family or their partner. People may feel insecure about their relationship. In these people, the feeling of anger, sadness, happiness, love and fear changes suddenly. They have uncontrolled emotions. They have a strong feeling of being rejected by other people. They feel that they will be left alone and this makes them more aggressive (Beck, & et al., 2020). Their relationship cannot go a long way as they find the problem in maintaining healthy relations. The people suffering from this order show dangerous behavior. People suffering from this disorder can harm themselves or others. They often think to commit suicide because they are not happy with themselves. They have a feeling of guilt and ashamed. Some people become depressed with a feeling of being disliked by all. They begin to start feeling that they are of no use and people don't like to be with them; all of these are the symptoms of BPD.

Diagnosing Borderline Personality Disorder

The client who has experienced the BPD has described how his life is affected by this mental disorder. BPD has impacted his personal and professional life negatively. He has to leave his job due to his uncontrolled emotions and anger (Ellison, & et al., 2018). The staff doesn’t feel comfortable working with the client. His wife also left him as his nature has become aggressive. He is all alone and unemployed. This disorder not just affects the mood of the people but their whole life is affected by this. They don’t understand the reason why things are becoming worst. A tendency of avoiding people is developed in the client because he is not able to trust the people (Luyten,  Campbell, & Fonagy, 2020). The people suffering from this disorder sometimes try to end up their life as they think that no other option can help them. Suicide is not the solution to any problem instead it may have negative impacts on the rest of the life. The client also admitted in the interview that he had tried to end up his life as he had left with no other option. His father had schizophrenia and his parents often fight over little things and he has grown up in a stressful environment. The client had a few friends but now he is not in contact with any of them. He feels sad and upset most of the time and his feeling of guilt is causing difficulties in living a happy and satisfying life. He visited the clinic after his GP suggested him. During his interview, many emotional changes were observed. The client has become aggressive and experienced sudden mood changes when he entered his teenage. He was easily irritated by his friends. He has developed a feeling of being neglected by the people surrounding him. This disorder has disturbed his social life, his relationship and financial status. It is possible to treat this disorder and the normal life can be maintained (Videler, & et al., 2019). BPD is named Borderline Personality Disorder because it does not come under the category of either psychosis mental illness or neuroses mental illness and is on the borderline of these two categories therefore the name is given. It is important to get treatment for this disorder as it not only affects the person who is suffering from this but also the people surrounding him. BPD can be treated by psychological therapies. This treatment, also known as psychotherapies involves talking openly to a psychiatrist.

According to the NICE guidelines for the treatment and management of BPD, evidence-based recommendations can be provided by health care professionals to treat this disorder (Yen, & et al., 2021). These guidelines help in effective communication between the patients, their families, and healthcare professionals. NICE, the National Institute for Health and Clinical Excellence is focused to enhance the quality of the care given to the people and giving patient-centered care. The goals of these guidelines are:

  • To assess the effectiveness of certain psychosocial therapies in the treatment of borderline personality disorder.
  • Assess the effectiveness of specific therapeutic treatments for BPD
  • Promote the adoption of excellent clinical practice through the creation of guidelines.

These guidelines recommend the treatment for BPD, generally focused on the psychological interventions but if short-term drug therapies will be given for the treatment then they should not be prescribed for more than a week. The drug which is prescribed should have very less side effects and addictiveness. A minimum effective dose should be used and prescribed in less quantity to avoid overdosage. If the symptoms do not improve the medication should be stopped. The patient should agree to the adherence to the medication. Awareness of BPD is very important in primary care. It is tough to assess persons with a borderline personality disorder because it's hard to comprehend the substantial changes in the mental state that many other individuals have but that also identifies the illness (Chanen, & et al., 2020). As a result, multiple meetings are usually required. Extra details from relatives or substantial others can aid in the development of a fuller insight into the personal conflicts that people with this disease face. People with this condition have feelings of extreme disturbance, including mood and anxiety disorders, as well as mood swings (Videler, & et al., 2019). The shifting character of an individual's psychological suffering can assist in distinguishing this disorder from some other psychological disorders. Individuals with this disorder have a high risk of additional mental health issues, such as binge eating and addictions, and a thorough evaluation is necessary to determine the best course of therapy.

Impact of Borderline Personality Disorder on Mental Health

Referring a person with this disorder to a therapist and developing a therapy strategy that fits the patient's approach may be useful if they appear to have numerous comorbidities. To avoid providing inconsistent or improper treatment, caution is essential. It is critical to ask specific questions about self-harming and suicidal behavior when identifying and assessing. Although posing a risk to others is rare, impulse hostility and aggression do occur on occasion (Chanen, & et al., 2022). It is equally important to think about the well-being of youngsters who are reliant on them. Individuals with this disorder may seek medical services in times of stress, and their adaptation mechanisms may be at their highest susceptible. Inquiring about comparable experiences and having trouble figuring out how the person got through them could be beneficial. If the person lives with a close relative, companion, or another person, seeking their permission to address the matter with them and enlisting their assistance may help to avoid a problem and lower long-term threats (Oud, & et al., 2018). When the people with this order are diagnosed in the primary care first they should be assessed for the risk for others and to themselves. People should be asked for the previous treatment they have taken for this disorder. The majority of patients with BPD can be treated in general practice; isolated emergencies do not necessitate referral to outpatient clinics. Some persons with borderline personality disorder interact with numerous programs, and it's important to assess the support they're already receiving before referring them to another. If there is a question regarding the diagnosis, a recommendation to outpatient clinics should be explored.

Repeated self-harming, a proclivity for taking risks, and a high level of emotional turbulence are all signs (Trull, & et al., 2018). A significant risk of damage to oneself or everyone else should prompt a recommendation to additional care providers. When a patient is diagnosed and is intended to improve, straight recommendations to psychological therapy facilities should be considered. A person can be recommended to the community mental service if he has an increased level of risk to others and himself and if they need additional help to manage their disorder.  All the strategies for coping with their anxiety and stress have been failed then he can be sent to mental health services. When diagnosing this disorder in outpatient clinics, it's critical to get a complete history that may include a check for concomitant mental problems including substance abuse or binge eating. A thorough examination of personal characteristics, protective factors, capabilities, and weaknesses should be provided. Individuals with this disorder may find the assessment procedure upsetting. As a result, it is critical that queries regarding early childhood be treated with care, as they may expose memories of parental neglect, and that the individual is supported throughout the process (Barr, & et al., 2020). Similarly, while discussing a diagnosis, caution should be exercised. Conducting multiple interviews and achieving compensation information about a person who understands the customer well can increase the performance of an analysis. The observation should also consider the potential risks to oneself and the others, as well as the wellness of dependants. In partnership with the customer, team members with people with borderline personality disorder should design complete interprofessional care plans.

Treatment Options for Borderline Personality Disorder

The plan of care should: Set out the duties of all healthcare practitioners engaged; outline achievable brief therapeutic goals and specify activities that the individual and others can do to accomplish them. Specify long-term objectives that the individual would like to attain, particularly those related to job and profession, that must support the entire freaking treatment plan; these objectives should be achievable and related to the short processing aims (Perrotta, 2020). Create an emergency plan that addresses the issue that exists and the possible causes, clarifies consciousness techniques that are practical and effective, and sets up what to do to offer healthcare when consciousness techniques are insufficient.  The care plan should be shared with the health professional and the customer (Shah, & Zanarini, 2018). Young people who seek help have social and cognitive patterns that are compatible with a description of this disorder. Excluding the research, there seems to be little compelling evidence of therapies for young individuals with BPD which is not unsurprising due to the comparatively tiny evidential basis in adults. Because many younger people with borderline personality disorder need a multi-professional approach, knowing each institution's roles helps with care delivery. To deliver quality healthcare, organizations must work together. Various entry standards for resources can jeopardize this goal; for instance, level 3 experts may be concerned about younger perceived personality care if it does not fulfill social welfare involvement criteria (Temes, & et al., 2019). Healthcare providers may recommend admitting patients with a borderline personality disorder to inpatient care in a variety of situations, including controlling an immediate emergency, managing chronic hazards, managing the borderline personality disorder specifically, or treating a comorbid condition. Acceptances for emergency risk assessment should be clearly connected to an immediate aggravation of risk, be a moment, and also have clear aims. When such risk is significant and the client's willingness to participate in therapy is minimal, hospitalization may be required.

Due to the limited evidential basis, there seems to be no explanation why the guidelines formed for adult people must not be applied to the care and diagnosis of youths with borderline personality disorder, with extra suggestions addressing issues unique to young people, such as work procedure and the involvement of family members or other caregivers (Porter, & et al., 2020). Additional investigation into the management of young persons with a borderline personality disorder is essential.

Conclusion

It can be stated that the Borderline personality Disorder negatively impacted the mental health and the relationship status of the people.  The etiology, symptoms, causes, and the impacts of this disorder on the client's mental, social and physical health are discussed. This disorder had a negative effect on the person's social and financial life. If it is not diagnosed and treated on time then it can affect other people also. There is not any specific test that can diagnose the BPD but on the basis of the symptoms it can be identified and the treatment can be provided. Awareness about this disorder is very essential as most people don't even know that they are suffering from this disorder. The main reason for obtaining this disorder is the abuse and trauma people faced in their life, especially during their childhood. The symptoms of this disorder are generally seen at the beginning of teenage. The person loses control over his emotions and anger. The clinical guidelines of NICE have been identified and analyzed for this disorder. Evaluation of the treatment and the overall care of the client is done with regard to the clinical guidelines. It can be concluded from this essay that further research on the treatment of young people should be conducted.

References

Barr, K. R., Townsend, M. L., & Grenyer, B. F. (2020). Using peer workers with lived experience to support the treatment of borderline personality disorder: a qualitative study of consumer, carer and clinician perspectives. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 1-14. https://doi.org/10.1186/s40479-020-00135-5

Beck, E., Bo, S., Jørgensen, M. S., Gondan, M., Poulsen, S., Storebø, O. J., ... & Simonsen, E. (2020). Mentalization?based treatment in groups for adolescents with borderline personality disorder: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 61(5), 594-604. https://doi.org/10.1111/jcpp.13152

Campbell, K., Clarke, K. A., Massey, D., & Lakeman, R. (2020). Borderline Personality Disorder: To diagnose or not to diagnose? That is the question. International journal of mental health nursing, 29(5), 972-981. https://doi.org/10.1111/inm.12737

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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), 1-8. https://doi.org/10.1007/s11920-020-01144-5

Chapman, A. L. (2019). Borderline personality disorder and emotion dysregulation. Development and Psychopathology, 31(3), 1143-1156. DOI: https://doi.org/10.1017/S0954579419000658

Ellison, W. D., Rosenstein, L. K., Morgan, T. A., & Zimmerman, M. (2018). Community and clinical epidemiology of borderline personality disorder. Psychiatric Clinics, 41(4), 561-573. 2018DOI:https://doi.org/10.1016/j.psc.2018.07.008

Gunderson, J. G., Fruzzetti, A., Unruh, B., & Choi-Kain, L. (2018). Competing theories of borderline personality disorder. Journal of personality disorders, 32(2), 148-167. 2018https://doi.org/10.1521/pedi.2018.32.2.148

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