Part I: Has Anything Changed?
This is the first installment of a two-part article entitled ‘Has Anything Changed’ based upon an article published in 2007 in the NAMI Advocate, written by Perry D. Hoffman, Ph.D., President of the National Education Alliance for Borderline Personality Disorder (NEA.BPD) with an introduction by Joyce Burland, Ph.D., Director, NAMI Education.
We ask has anything changed, as we describe how this illness has been, the most maligned, misdiagnosed, and misunderstood.
Has progress been made? Have practitioners become more educated and able to treat BPD? Are families more aware of how to support their family members and do they feel more supported?
PART I: Has anything changed?
EXCERPT From: NAMI Advocate, Winter 2007
Introduction by Joyce Burland, Ph.D., Director, NAMI Education, Training and Peer Support Center
“There is perhaps no serious mental illness more maligned and misconstrued than borderline personality disorder. Years ago, when I started my clinical career, I was warned to “stay away from ‘Borderlines’.” Being of a suspicious nature, I began to search out information about this dread diagnosis, which was primarily attached to women, and carried with it such a blatantly stigmatizing reputation.
As I began working with people with this disorder, I became aware of the enormous strength and resiliency they brought to the daily struggle of coping with the disruptive symptoms of the condition, and of the patience and loyalty shown by the families who loved and supported them.
Bringing this diagnosis out of the darkness is long overdue. Individuals and families living with the illness deserve current and correct information, and we must all advocate to dispel the myths which have made borderline personality disorder a “leprosy” of psychiatric diagnoses.
As part of the formal inclusion of borderline personality disorder in its list of priority populations in NAMI’s public policy platform, NAMI has invited Perry D. Hoffman, Ph.D., to write the article that follows. She is a pioneer in educating families about this disorder, and a prime mover in forming a collaborative effort with NAMI to increase visibility and understanding of this treatable mental illness.”
Borderline personality disorder (BPD) is a complex and challenging illness.
A disorder that is often prompted by and occurs in the context of relationships, BPD can wreak havoc not only on those with the disorder but on their loved ones as well. The symptoms of the disorder are: 1. fears of abandonment; 2. intense mood shifts; 3. impulsivity; 4. problems with anger; 5. recurrent suicidal behaviors or self-injurious behaviors; and 6. patterns of unstable and intense relationships.
The symptomatology is pervasive, encompassing five areas of dysregulation: emotion dysregulation, behavioral dysregulation, cognitive dysregulation, interpersonal dysregulation and self dysregulation. Those afflicted with borderline symptoms very often experience sudden shifts in emotion that frequently leave both the individual with BPD and those close to them in their environment in a state of intense disruption. To meet official DSM- IV criteria for the disorder, a person must have at least five of the nine symptoms. Needless to say, experiencing even a few of the behaviors can create a life of pain and suffering.
The prevalence of BPD in the general population continues to be debated. While estimates variously range from 0.7 percent to 2 percent, there is agreement that 11 percent of people that come for out patient psychiatric treatment and 20 percent of psychiatric hospital admissions meet DSM-IV criteria for this disorder.
Update: More recent statistics document that more that 5% of the general population may meet the criteria for borderline personality disorder.