Therapist Unlimited Blog

Borderline Personality Disorder pertains to those persons who suffer labile interpersonal relationship characterized by instability.
Persons suffering from this type of medical disorder are viewed by many as "delusional" or those people who have a hard time distinguishing reality from their own misperceptions of the world and their surrounding environment.

This type of behaviour might be viewed as negative for many but experts explains it as  related to their emotions overwhelming regular  cognitive functioning, which is likely to create many conflicts with others.
Borderline Personality Disorder also pertains to persons having fears of being abandoned by others in relationships, which oftentimes lead these persons to engage in many extreme and confusing behaviours of over-possessiveness or being unavailable, which ultimately makes their partner leave them in the end.
 

Here are some common symptoms of Borderline Personality Disorder:

A.  Frantic efforts to avoid real or imagined abandonment.
B.  A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
C.  Identity disturbance: markedly and persistently unstable self-image or sense of self.
D. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
E. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.
F. 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).
G. Chronic feelings of emptiness.
H. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
 I.   Transient, stress-related paranoid ideation or severe dissociative symptoms.

Persons suffering from Borderline Personality Disorder need immediate treatment and understanding from their lover, family and friends.

Treatment

Psychotherapy is nearly always the treatment of choice for this disorder; medications may be used to help stabilize mood swings.
Controversy surrounds overmedicating people with this disorder.

Psychotherapy

Like with all personality disorders, psychotherapy is the treatment of choice in helping people overcome this problem.
 While medications can usually help some symptoms of the disorder, they cannot help the patient learn new coping skills, emotion regulation, or any of the other important changes in a person’s life.
An initially important aspect of psychotherapy is usually contracting with the person to ensure that they do not commit suicide.
Suicidality should be carefully assessed and monitored throughout the entire course of treatment. If suicidal feelings are severe, medication and hospitalization should be seriously considered.
The most successful and effective psychotherapeutic approach to date has been Marsha Linehan’s Dialectical Behaviour Therapy.
Research conducted on this treatment have shown it to be more effective than most other psychotherapeutic and medical approaches to helping a person to better cope with this disorder.
 It seeks to teach the client how to learn to better take control of their lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.
A comprehensive approach is most often conducted within a group setting. Because the skill set learned is new and complex, it is not an appropriate therapy for those who may have difficulty learning new concepts.
Like all personality disorders, borderline personality disorder is intrinsically difficult to treat. Personality disorders, by definition, are long-standing ways of coping with the world, social and personal relationships, handling stress and emotions, etc. that often do not work, especially when a person is under increased stress or performance demands in their lives.
Treatment, therefore, is also likely to be somewhat lengthy in duration, typically lasting at least a year for most.
Other psychological treatments, which have been used to lesser effectiveness, to treat this disorder include those that focus on social learning theory and conflict resolution.
These types of solution-focused therapies, though, often neglect the core problem of people who suffer from this disorder — difficulty in expressing appropriate emotions (and emotional attachments) to significant people in their lives due to faulty cognitions.
Providing a structured therapeutic setting is important no matter which therapy type is undertaken. Because people with this disorder often try and "test the limits" of the therapist or professional when in treatment, proper and well-defined boundaries of your relationship with the client need to be carefully explained at the onset of therapy.
 Clinicians need to be especially aware of their own feelings toward the patient, when the client may display behaviour that is deemed "inappropriate." Individuals with borderline personality disorder are often unfairly discriminated against within the broad range of mental health professionals because they are seen as "trouble-makers."

Hospitalization

Hospitalization is often a concern with people who suffer from borderline personality disorder because they so often visit hospital emergency rooms and are sometimes seen on inpatient units because of severe depression.
People with this disorder often present in crisis at their local community mental health center, to their therapist, or at the hospital emergency room.
While an emergency room is an immediate source of crisis intervention for the patient, it is a costly treatment and regular visits to the E.R. should be discouraged.
Instead, patients should be encouraged to find additional social support within their community (including self-help support groups), contact a crisis hotline, or contact their therapist or treating physician directly.
Emergency room personnel should be careful not to treat the person with borderline personality disorder in blind conjunction with another set of therapists or doctors who are treating the patient for the same problem at another facility. Every attempt should be made to contact the client’s attending physician or primary therapist as soon as possible, even before the administration of medication that may be contraindicated by the primary treatment provider. Crisis management of the immediate problem is usually the key component to effective treatment of this disorder when it presents in a hospital emergency room, with discharge to the patient’s usual care provider.
Inpatient treatment often takes the form of medication in conjunction with psychotherapy sessions in groups or individually.
 This is an appropriate treatment option if the person is experiencing extreme difficulties in living and daily functioning.
 It is, however, relatively rare to be hospitalized in the U.S. for this disorder. Long-term care of the person suffering from borderline personality disorder within a hospital setting is nearly never appropriate. The typical inpatient stay for someone with borderline personality disorder in the U.S. is about 3 to 4 weeks, depending upon the person’s insurance.
Since this treatment is so expensive, it is getting more difficult to obtain. Results of such treatment are also mixed.
While it is an excellent way of helping stabilize the client, it is usually too short a time to attain significant changes within the individual’s personality makeup.
Good inpatient care facilities for this disorder should be highly structured environments, which seek to expand the individual’s independence.
Partial hospitalization or a day treatment program is often all that is needed for people who suffer from borderline personality disorder.
 This allows the individual to gain support and structure from a safe environment for a short time, or during the day, and returning home in the evening. In times of increased stress or difficulty coping with specific situations, this type of treatment is more appropriate and healthier for most people than full inpatient hospitalization.

Medications

As with all, the Personality Disorders there are no medications specifically prescribed to treat Borderline personality disorder.
However, some medications may be helpful to alleviate some of the associated disorders of anxiety, depression, and/or sometimes-psychotic symptoms.
It is, however, clear that low doses of high potency neuroleptics (e.g., haloperidol) may be helpful for disorganized thinking and some psychotic symptoms.
Depression in some cases is amenable to neuroleptics. Neuroleptics are particularly recommended for the psychotic symptoms mentioned above, and for patients who show anger, which must be controlled. Dosages should generally be low and the medication should never be given without adequate psychosocial intervention."
Antidepressant and anti-anxiety agents may be appropriate during particular times in the patient’s treatment, as appropriate.
For example, if a client presents with severe suicidal ideation and intent, the clinician may want to seriously consider the prescription of an appropriate antidepressant medication to help combat the ideation. Medication of this type should be avoided for long-term use, though, since most anxiety and depression is directly related to short-term, situational factors that will quickly come and go in the individual’s life.

Self-Help

The medical profession often overlooks self-help methods for the treatment of this disorder because very few professionals are involved in them.
 Encouraging the individual with borderline personality disorder to gain additional social support, however, is an important aspect of treatment.
 Many support groups exist within communities throughout the world that are devoted to helping individuals with this disorder share their commons experiences and feelings.
Patients can be encouraged to try out new coping skills and emotion regulation with people they meet within support groups.
They can be an important part of expanding the individual’s skill set and develop new, healthier social relationships.
Patients should also be encouraged to learn stress and anxiety reducing techniques as well as increased coping skills.
By learning how to utilize some of these tools on their own, they may be able to cope more effectively on their own possibly preventing situational crises from developing.
Even incorporating a consistent exercise regimen may help someone with this personality disorder regulate his/her emotional mood swings or release anger, thereby helping to produce more stability in the person’s life.

Source: http://www.mentalhelp.net

Based on internet research this type of personality disorder is characterized by a long-standing pattern of a disregard for other people’s rights, often crossing the line and violating those rights.
This pattern of behaviour has occurred since age 15 (although only adults 18 years or older can be diagnosed with this disorder). To better understand this type of character flaw here are some of its common symptoms:
Failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are grounds for arrest,  deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure,  impulsivity or failure to plan ahead,  irritability and aggressiveness, as indicated by repeated physical fights or assaults,  reckless disregard for safety of self or others, consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honor financial obligations and  lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
If you notice any of these signs, it would be best that you immediately consult a medical practitioner to deal with this condition.

Anti-Social Personality Disorder is a problem shared by many people in this planet.
 

Treatment

A. Psychotherapy

As with most personality disorders, individuals with this disorder rarely seek treatment on their own, without being mandated to therapy by a court or significant other.
Court referrals for assessment and treatment for this disorder are likely the most common referral source.
A careful and thorough assessment will ensure that the person has antisocial personality disorder.
This can often be confused with simple criminal activity (all criminals do not have this disorder), adult antisocial behaviour, and other activities that do not justify the personality disorder diagnosis.
As with a thorough assessment of any suspected personality disorder, formal psychological testing should be considered invaluable.
Because many people who suffer from this disorder will be mandated to therapy, sometimes in a forensic or jail setting, motivation on the patient’s part may be difficult to find.
In a confined setting, it may be nearly impossible and therapy should then focus on alternative life issues, such as goals for when they are released from custody, improvement in social or family relationships, learning new coping skills, etc.
 In an outpatient setting, the focus of therapy can also be on these types of issues, but a part of the therapy should be devoted to discussing the antisocial behaviour and feelings (or lack thereof).
Common in the population who suffer from antisocial personality disorder is the lack of connections between feelings and behaviours.
 Helping the client draw, those lines between the two may be beneficial.
Threats are never an appropriate motivating factor in any sort of treatment, and least of all with this disorder. If the only way to motivate the patient is to threaten to report their noncompliance with therapy to the courts or warden, it is highly unlikely the clinician will make any type of gains within therapy anyway.
 It is appropriate, however, to try to help the individual with this disorder find good reasons that they may want to work on this problem further. For instance, ensuring that they not meet the court system again, be incarcerated, have to submit themselves to additional psychological examinations, etc.
Effective psychotherapy treatment for this disorder is limited. It is likely, though, that intensive, psychoanalytic approaches are inappropriate for this population. Approaches that reinforce appropriate behaviours and attempting to make connections between the person’s actions and their feelings are more beneficial. Helping the patient to gain greater accessibility to his/her emotions and to identify them are usually key aspects of treatment of this disorder. In addition, since these patients often have had little or no significant emotionally rewarding relationships in their lives, the therapeutic relationship can be one of the first ones. This can be very scary for the client, initially, and it may become intolerable. A close therapeutic relationship can only occur when a good and solid rapport has been established with the client and he or she can trust the therapist implicitly.

B. Hospitalization

Rarely is inpatient care appropriate or necessary for this personality disorder. Like most personality disorders, most people will go through their lives with little realization of the difficulty they have.
In this case, though, the person is more likely to be seen as a criminal and have a history of difficulties with the law. Loss of freedom may be more of a motivating factor than in other personality disorders, so some specialized treatment facilities have started to treat people with this disorder.
One such program we have read about is the Patuxent Institute, located in Jessup, Maryland in the U.S. This hospital utilizes a strict behavioural approach of placing patients on a token economy based upon their treatment progress.
This is a relatively new and radical approach to this sort of disorder and little research has been conducted to confirm its long-term effectiveness.
As with any treatment, the focus on feelings and connecting antisocial behaviour to appropriate feeling states is appropriate.
Since inpatient, programs tend to be more intensive and expensive they are rarely sought out by the patient themselves. Community follow-up and support, either by the hospital or professionals, or with the use of self-help support groups, is imperative to maintaining treatment gains.

C. Medications

Medical doctors will typically use psychiatric medications to treat mood and disordered behaviour symptoms (e.g., depression, poor sleep), and disorganized thought processes (looseness of thought) that are associated with the Personality Disorders.

D. Self-Help

The medical profession often overlooks self-help methods for the treatment of this disorder because very few professionals are involved in them.
 Groups can be especially helpful for people with this disorder, if they are tailored specifically for antisocial personality disorder. Individuals with this disorder typically feel more at ease in discussing their feelings and behaviours in front of their peers in this type of supportive modality.
 Leaders of such self-help support groups, though, must be wary of individuals who come to group just to brag about their exploits and who may seek to use the group inappropriately.
 Usually a group can be very helpful and beneficial to most people with this disorder, once they overcome their initial fears and hesitation to join such a group.
 Many support groups exist within communities throughout the world, which are devoted to helping individuals with this disorder share their common experiences and feelings.
Trust brings up the issue of confidentiality since often the patient with antisocial personality disorder is mandated to therapy.
 This means that the clinician may have to occasionally report on the patient’s progress in therapy. While this can usually be done in a very general way, which reveals no significant details of the content of therapy, it is still an important issue for the client.
 He or she may be suspicious and distrustful of the clinician at first, since it will be unclear as to who has the highest priority — the patient or the court. This fear can only be alleviated with an honest disclosure as to what the therapist will reveal to the courts, and with time, as the client learns that what he says in the therapy session does not become common knowledge. The limitations of therapy should be discussed with the patient up-front, in a clear and matter-of-fact manner, so there are no misunderstandings later.
The content of therapy should focus on the patient’s emotions (or lack thereof). As the individual learns to experience various emotional states, one of the first may be depression. The client will likely be unfamiliar with the feelings associated with depression, and so it is beneficial for the clinician to be supportive and empathetic to the individual during this time. Reinforcing any emotions, outside of anger or frustration, is usually beneficial. Experiencing intense affect is usually a sign of progress in therapy.
Staying on "safe issues," and discussing more real-life concerns, while one way of treating this disorder, is not likely to be as effective in long term behavioural change as an approach emphasizing the discovery and labelling of appropriate emotional states.
People who have antisocial personality disorder often have trouble with authority figures.
The therapist should usually take a neutral stance in this matter, since it is a firmly held belief by the client. The clinician should avoid arguments and taking sides on authority issues and those who hold authority over the client. Their moral and ethical makeup may leave a lot to be desired as well. While this may be an appropriate topic for discussion in therapy, it will also likely be one of little progress.

Source: http://www.mentalhelp.net

After writing my blog about further cultivation of my knowledge that surrounds depression, it occurs to me that clinical depression and the one I previously wrote about, Depressive Personality Disorder, has some similarities. In fact, they share similarities so big that it’s difficult to separate them.

As this question tickles my curiosity more, I get more extensive to satisfy my curiosity and interest. And getting deeper, there are some differences that should be cleared, before anyone gets confused as to how they can be distinguished.

1. Depression has a wider scope of psychological effects. Depression gives the patient strong negativity in all aspects of his life – physical, social, mental, spiritual, and moral. He/She has a derogatory feeling over everything about his/her life.

2. Depressive Personality Disorder doesn’t have cause of negative feeling. Unlike depression that has causes like low amount of serotonin in the body or unsolved issues in life, Depressive Personality Disorder doesn’t have its known cause, but rather, it comes from one’s self without any solid explanations. It is only an individual’s normal reaction and common way of coping with things that make him/her qualified with such disorder.

Important matters as these should be taken into consideration to fully understand their nature. While Depression has a larger influence on one’s well-being, Depressive Personality Disorder shouldn’t be taken for granted, for it can sacrifice one’s happiness when this is not changed.

As the concept of depression becomes the object of my interest, I get further with other ideas revolving around this psychological matter with more researches and questions. And one of those things that trigger my attention is this personality disorder related with clinical depression…..

Depressive Personality Disorder, just what its name implies, is a disorder that suggests certain characteristics to be depressive or that it implies a personality with a strong negative sense of self. In order to understand what it’s about, here are some things that you should know about this matter:

1. Cheerlessness and unhappiness. Mood is being affected by this disorder. The sense of negativity is reflected from the inside, showing manifestations like an expression of sadness in the face and vacant expressions.

2. Aloofness. A person with this disorder has a low self-esteem. Because of this, it stops him/her from socializing with people with the fear of rejection or wrong judgments.

3. Paranoia. Ironically, a patient is very quick in making judgment or having suspicions with people around him. He/She becomes defensive and sometimes too argumentative even to small things.

There are more things to discover about depressive personality disorder. On the other hand, the things mentioned above are some of the most important, showing its manifestations that you might have.

Some things you should know about hysteria…..

Euphoria, according to Wikipedia, is “a medically recognized emotional state related to happiness.” It is an excessive happiness which can be triggered by outside factors like drugs or can be caused by psychological input like personality disorder. Take note that hysteria is not the usual happiness that we feel. It’s not excitement or joy from having something that motivates us. It’s an excessive happiness which means that it is no longer normal.

As mentioned earlier, there are two things that manifest euphoria:

1. Drug-induce hysteria. There are certain types of drugs that stimulate the mental state of a person, causing them to be extremely happy. Such drugs are amphetamine hydrochloride, LSD, Ecstasy, etc. When these are taken by a person, the effect is wild expression of happiness, something that you can no longer control

2. Disease-induced disorder. A personality disorder called Bipolar disorder triggers euphoria among those who have this. It causes them to act extremely depressed for some time, then be extremely happy after. The changes of their mood are extreme.