Borderline Personality Disorder (BPD)

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Chelsea Hargrove

Week 11 Forum

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The personality disorder that I decided to discuss is Borderline Personality Disorder (BPD). BPD is characterized as a pattern of instability in interpersonal relationships, self-image, affects, and impulsivity, often beginning in early adulthood (American Psychiatric Association, 2013). Additional signs and symptoms of BPD include: extreme efforts to avoid being real or imagined abandonment, unstable and intense relationships, impulsivity (unsafe sex practices, substance abuse, or spending), recurrent suicidal behavior, chronic feelings of emptiness, affective instability, difficulty controlling anger or intense anger, stress related paranoid ideation, or dissociative symptoms (American Psychiatric Association, 2013). When it comes to presenting this disorder to the client is it is essential that the provider is honest with the client and provides education regarding the disorder. In order to avoid damaging the therapeutic relationship between the provider and client, it has been found that the preferred method for disclosing this diagnosis with clients is use the actual label of BPD, discuss the presence of stigma, and discussion treatment strategies and treatment options (Sulzer et al., 2016).

There are five major therapeutic approaches that have shown to be effective in treating BPD, they include: dialectical behavioral therapy (DBT), mentalization-based treatment (MBT), schema-focused therapy (SFT), transference-focused psychotherapy (TFP), and systems training for emotional predictability and problem solving (STEPPS) (Choi-Kain et al., 2017). Of these therapeutic approaches I would utilize DBT for a client with this disorder. There is substantial research that demonstrates the efficacy of DBT in individuals with BPD. The goals of DBT in treating BPD is to regulate emotions, seek to understand interpersonal situations, surviving crises, improving motivation, reducing dysfunctional behavior, and providing a structured environment (Chapman, 2006). There are no US Food and Drug Administration (FDA) approved medications for BPD and there is minimal evidence that supports symptom reduction with single psychotropic medication use in individuals with BPD (Ripoll, 2013). Potential medications that could be beneficial in treating some symptoms of BPD include antidepressants, antipsychotics (olanzapine and aripiprazole), anticonvulsants (valproate or lamotrigine), and benzodiazepines (Ripoll, 2013). Often times BPD is commonly associated with other psychiatric disorders, in which psychotropic medications would be effective in treating the comorbid disorders (May, Richardi, & Barth, 2016).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author

Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont (Pa.:Township)), 3(9), 62–68.

Choi-Kain, L. W., Finch, E. F., Masland, S. R., Jenkins, J. A., & Unruh, B. T. (2017). What Works in the Treatment of Borderline Personality Disorder. Current behavioral neuroscience reports, 4(1), 21–30. https://doi.org/10.1007/s40473-017-0103-z

May, J. M., Richardi, T. M., & Barth, K. S. (2016). Dialectical behavior therapy as treatment for borderline personality disorder. Mental Health Clinician, 6(2), 62-67.

Ripoll L. H. (2013). Psychopharmacologic treatment of borderline personality disorder. Dialogues in clinical neuroscience, 15(2), 213–224.

Sulzer, S. H., Muenchow, E., Potvin, A., Harris, J., & Gigot, G. (2016). Improving patient-centered communication of the borderline personality disorder diagnosis. Journal of mental health (Abingdon, England), 25(1), 5–9. https://doi.org/10.3109/09638237.2015.1022253

 

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