Borderline Personality Disorder

Running head: BORDERLINE PERSONALITY DISORDER
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Borderline Personality Disorder
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Borderline Personality Disorder
Introduction
Borderline Personality Disorder is one of the most common disorders in almost all
clinical settings in the world. The disorder is also experienced across different cultural settings
and in both genders. In particular, the disorder is associated with high profile destructive
behaviors with suicidal attempts and cases the most notable effects. In addition, the disorder
causes a variety of dysfunctions in humans significantly disrupting learning processes in schools,
peaceful co-existence in families, and failure to comply with the occupational standards and
expectations. Despite the effects of Borderline Personality Disorder, there are no consistent
diagnostic procedures and guidelines on the control and management in most countries in the
world. As a result, the disorder has led to massive economic disruptions due to failure of the
patients to seek medication or lack of medical care services in some cases. This essay focuses on
the diagnosis, treatment, and impacts of Borderline Personality Disorder.
Clinical Definition and Diagnostic Criteria for Borderline Personality Disorder
Borderline Personality Disorder is a disorder that is characterized by impaired
interpersonal and self-functioning as well as pathological personality traits (American
Psychiatric Association, 2013). The diagnosis of this disorder is based on impairment in self-
functioning, impairment in interpersonal functioning, and pathological personality traits. To
begin with, the impaired self-function is shown by poor identity such as self-criticism, stress, and
chronic emptiness. In addition, loss of self-direction is a characteristic of Borderline Personality
Disorder especially, instability in the development of career goals and objectives. Impairment of
interpersonal functioning is evaluated on the basis of empathy and intimacy. Impaired empathy is

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characterized by hypersensitivity and biasness towards vulnerabilities. The last criterion for
diagnosis of Borderline Personality Disorder is symptoms of pathological personality traits. One
of such traits is emotional instability marked by instant changes in moods. Moreover, the patient
shows evidence of anxiousness for instance the patient may be tensed or nervous. Other
personality traits include separation insecurity such as fear of being rejected and abnormal
dependency and depression including suicidal thoughts and pessimism. Finally, the patient
shows signs of impulsiveness, anger, and involvement in dangerous activities.
Effective identification of early symptoms of Borderline Personality Disorder has
significant implications for youth labeling and timely interventions as articulated by Stepp and
Lazarus (2017). The onset of the disorder can be predicted by observing the pathological
aforementioned pathological traits and temperament of the child (Van Dijk, 2015). This period of
severe pathological symptoms and temperament is known as the prodrome phase. Another
predictor of the prodrome phase is impulsivity and intense emotions (Paris, 2015). The prodrome
phase is also characterized by inability to pay attention in school (Martel, 2016) as well as poor
self-control (Hallquist, 2015). The identification of the prodrome phase is vital to early diagnosis
and control of Borderline Personality Disorder before advancement to full-blown phase. In this
regard, it is important that parents and school administrators have knowledge about the disorder
so that interventions are put in place following the onset of symptoms. Failure to elucidate the
symptoms during the early stages of development has emotional and financial implications on
the families with personality patients.

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Demography of Borderline Personality Disorder in Australia
Borderline Personality Disorder is one of the most common disorders in Australia. The
disorder has a prevalence of between 2% to 5% in the general population (Australian Bureau of
Statistics, 2016). Additionally, the disorder is more prevalent among the females. Specifically,
the statistics indicate that the females are 3 times more prone to Borderline Personality Disorder
than their male counterparts. More importantly, the disorder is most prevalent among adolescents
especially between 18 and 24 years. In this category, the boys are more likely to commit suicide
if diagnosed with the disorder. According to the National Health and Medical Research Council
(2013), the 1.8% of the population diagnosed with Borderline Personality Disorder is aged 19-
55. Further, the report also indicates that the symptoms of Borderline Personality Disorder are
more likely to be realized from late adolescence to early adulthood. The disorder has no ethnic
inclinations with the prevalence noted to be the same among the ethnic diversities in Australia.
Finally, the prevalence of the disorder had no significant difference in the urban and rural areas.
The same observation was made in regards to the impact of culture on the prevalence of
Borderline Personality Disorder (National Health and Medical Research Council, 2013).
Impacts of Mental Illness and Treatment on the Development of Adolescent
Mental illness significantly affects the development of an adolescent. The impacts are
categorized as physical, mental, and psychological effects on development (John &Leon, 2014).
In the first place, mental illness affects the adolescent physically. In cases where the pathological
personality traits persist, the adolescent suffers from severe physical injuries. Such injuries are
caused by suicide attempts, risk taking, and anger. Psychologically, adolescents suffering from
mental illness display emotional instability. For instance, mental illness is characterized by

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worried and nervous adolescents who have poor interpersonal traits. Psychological instability
leads to low academic standards. In particular, mentally ill adolescents have conduct issues such
as damage of property, persistent changes in moods, volatile anger, and impulsivity. As a result,
they find difficulty in relating with their fellow students and the teaching staff. Adolescent stage
being the schooling age, impairment of personal and interpersonal trait development
fundamentally affects the academic standards of the adolescent. It is therefore that symptoms of
mental illness are identified preferably at onset so effective interventions are put in place to
ensure a psychologically stable adolescent.
Mental illness and treatment as well causes Attention Deficit Hyperactivity (ADH) (John
&Leon, 2014). The impacts ADH negatively influence the adolescent. Primarily, ADH causes
distraction, which implies lack of concentration on an assigned task. In schools, inadequate
concentration results in low academic standards. At work especially in early adulthood,
inadequate concentration results in termination of employment as a result of failure to
accomplish assigned tasks. Moreover, mentally ill adolescents suffer from inability to pay
attention and thus do not follow instructions promptly. Therefore, they fail either to finish tasks
or complete tasks, which were not instructed. Treatment of mental illness has impacts on the
adolescents as well. In some cultural setting, mental illness is viewed as a curse. Therefore,
mentally ill adolescents face rejection and discrimination as they seek medication. Additionally,
medical care services may not be available or may involve huge financial implications. The
labeling of adolescents as being mentally sick not only leads to emotional instability but also
causes psychological stress and depression.

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Best Practice Treatment of Borderline Personality Disorder
Effective treatment of Borderline Personality Disorder involves a combination of both
pharmacological and no-pharmacological treatment methods. According to American Psychiatric
Association (2013), psychotherapy treatment methods are aimed at attaining and maintaining a
long-term improvement in the interpersonal traits and functioning. On the other hand, the role of
pharmacotherapy is to diminish the associated symptoms of Borderline Personality Disorder. To
begin with, two approaches are available under psychotherapy method of treatment, which
includes dialectical behavior therapy and psychoanalytic therapy (Kernberg & Selzer, 2014).
Regardless of the approach selected, psychotherapy involves three elements, which are regular
meetings between the psychotherapist and the patient, group sessions, and consultative meetings
among the psychotherapists.
The interventions psychotherapy treatment includes relationship building between the
psychotherapist and the patient and management of feelings. In addition, the suicidal behaviors
of the patient are monitored to enable limitation of destructive behaviors. Another intervention
that can be employed during the psychotherapy treatment of Borderline Personality Disorder is
employing psycho educational approach in which the patient is educated to take responsibility of
any destructive behaviors committed. This approach ensures that destructive behaviors and
suicidal attempts are suppressed in the patient.
Pharmacotherapy entails three interventions as presented by American Psychiatric
Association (2013). The first intervention involves the treatment of symptoms of dysregulation
such as intense anger, depression, and mood liability. During this intervention, the personality
patient is put under mood stabilizers and antidepressants. Further, serotonin reuptake inhibitors

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are also administered during this intervention. The next intervention is the treatment of
impulsivity especially behaviors which are self-damaging such as substance abuse. In this regard,
the patient is treated with neurpleptics. Finally, pharmacotherapy could involve treatment of
cognitive symptoms such as hallucinations and suspicion through administration of neuroleptics
in low dosages.
Family and Care Issues when Supporting a Young Person with BPD
Supporting Personality patients presents a burden to the family and caregivers alike
(Bailey & Grenyer, 2013). The burden experienced include emotional, financial, physical, and
social burden. First, Borderline Personality Disorder lacks recognition among the mental health
services that are offered in Australia despite post-traumatic stress calling for a psychotherapist
(Britt, 2015). As a result, the families and the caregivers of the patients face the challenge of
accessing support care from the mental health care centers. In addition, the choice of support is
also limited since the support services are not within the reach of the locals. Further, the families
of personality patient have to incur additional financial costs in order to access support services.
Another issue with supporting personality patients is discrimination as a result of exclusion from
seeking medical health services (Lawn & McMahon, 2015). The impulsivity and intense anger of
the Personality patients leads blame of the caregiver and the family in case they cause
destruction. The family also experienced strained relationships with the personality patients
leading to traumatic stress (Chang & Harrocks, 2016).
Role of the Nurse in the Treatment of Borderline Personality Disorder
Treatment of Borderline Personality Disorder involves a multidisciplinary team with the
nurse proving a crucial member of the team (Bowen, 2013). In particular, the nurse is responsible

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for provision of vital psychiatric services. First, a nurse is the source of health information such
as the diagnosis. As highlighted, post-traumatic stress and anxiety are cases of personality
disorder, which require medical intervention, and the nurse provides this service. Additionally, a
nurse is responsible for provision of support in the management of personality disorder. The
support may include suggesting psychotherapy interventions needed in the management of
personality disorder. Further, the nurse is responsible for the provision of medical support
especially the pharmacotherapy intervention measures. The other crucial role played by a nurse
in the management of Borderline Personality disorder is health screening. Finally, nurses are
responsible for the provision of training and education for patients, families, and caregivers.
Conclusion
Borderline Personality Disorder has emotional, social, and financial impacts on families
with personality patients. More importantly, the disorder is responsible for the deaths and
physical injuries among the patients in Australia. It is therefore important the disorder is
diagnosed in its early stages and intervention measures put in place before the disorder advances
to fatal stages. The management of the disorder requires interdisciplinary approach including the
parents, schools, nurses, and the government. The parents and teachers play a vital role in the
identification of symptoms at the onset of the disorder. On the other hand, nurses provide
screening services, psychiatric and pharmacological treatment, and training on management of
the disorder. On the other hand, the government should ensure that the treatment of the disorder
is prioritized and medical services made accessible among its population. With effective
collaborating between the highlighted parties, the prevalence of the disorder can effectively be
reduced.

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References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental
Disorders (5th ed.). Washington, DC: American Psychiatric Press.
American Psychiatric Association. (2013). Practice guidelines for the treatment of BPD.
American Journal of Psychiatry, 11(8), 157.
Australian Bureau of Statistics. (2016). BPD – Prevalence by age and sex. Retrieved from
http:www.abs.gov.au/ausstats/abs@nsf/mf/3201.0
Bailey, R. & Grenyer, B. (2013). Burden and support needs of care givers of persons with BPD.
A systematic Review. Harvard Review of Psychiatry 21, 248-258.
Bowen, M. (2013). BPD: Clinician’s accounts of good practice. Journal of Psychiatric and
Mental Health Nursing 20 (1), 551-553.
Britt, H. (2015). General practice activity in Australia. General practice series No. 27 Cat No.
GEP 27.AIHW, Canberra.
Chang, K. & Harrocks, S. (2016). Lived experiences of family and care givers of mentally ill
relatives. Journal of Advanced Nursing, 53(1), 435-443.
Hallquist, M. (2015). Poor self control and harsh punishment in childhood prospectively predict
BPD symptoms in adolescents. Journal of Abnormal Psychology, 2(7), 37-41.
John, T. & Leon, L. (2014). Childhood and adolescent mental health: Understanding lifetime
impacts. London: Mental Health Foundation.

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Kernberg, O. & Selzer, M. (2014). Psychoanalytic Psychotherapy of Borderline Patients. New
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Lawn, S. & McMahon, J. (2015). Experiences of family care of people diagnosed with BPD.
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Stepp, D. & Lazarus, S. (2017). Identifying BPD prodrome: implication for community
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Van Dijk, F. (2015). Symptomatic overlap between attention deficit and BDP: Role of
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