BPD Essay: Causes, Prevalence, and Impact on Patients & Families

This essay delves into Borderline Personality Disorder (BPD), examining its causes, including genetic, environmental, and neurological factors, and its estimated prevalence, affecting a significant portion of the population, particularly women. The essay outlines the disorder's impact on patients, describing symptoms such as emotional dysregulation, impulsivity, and self-harm, as well as the psychosocial effects like low self-esteem and unstable relationships. It also explores the profound effects on families, including emotional, physical, and financial burdens, and the strain on relationships. The role of healthcare providers, particularly nurses, is emphasized, highlighting their importance in providing care, support, and education to both patients and their families. The essay discusses evidence-based strategies, such as family therapy and effective communication techniques, to help manage symptoms and improve outcomes. It underscores the need for nurses to advocate for patients and families, connecting them with available resources and promoting collaborative approaches to treatment. The essay concludes by emphasizing the importance of a holistic approach that considers the well-being of both patients and their support systems.

Borderline personality disorder
Essay
student
8/6/2019

Borderline personality disorder
A borderline personality disorder is the health condition characterized by the problems in
regulating the emotions (Leichsenring, Leibing, Kruse, New & Leweke, 2011). This indicates
that the patient who experiences this health issue feel emotions extremely and for the long period
of time, and it is difficult for them to come back to the stable baseline afterwards the emotionally
simulating condition (Fonagy, Luyten & Strathearn, 2011). This difficulty later can result in
impulsivity, reduced self-image, stormy relationship and extreme emotional reactions to the
stressors. The patient's struggling with the self-regulation might also lead to the dangerous
behaviours for example self-harm. This particular health issue affects the way the patients think
and feel about themselves and other people, causing issues associated with everyday life (O'Neill
& Frodl, 2012). With the borderline personality disorder, the patients have an extreme fear of
rejection or instability, and they have problems tolerating being unaccompanied. Yet the
inappropriate anger, hastiness and recurrent mood swings might push other people away
(Gunderson, Weinberg & Choi-Kain, 2013). This health condition commonly occurs in early
childhood and appears to be worse in the young maturity and can gradually get better with the
time. Coping with this health issue is very difficult, but with the proper support from family
members and healthy collaboration with the healthcare providers like nurses can increase the
chances of resolve the symptoms associated with borderline personality disorder (Leichsenring et
al., 2011). In this particular essay, the causes, prevalence and its impacts on patients and their
family will be discussed. Role of the health and social care system, nurses will also be mentioned
in the essay including the evidence-based strategy to address the issues.

The causes of this particular health issue include heredities, environmental aspects, and
brain function (Kaess, Brunner & Chanen, 2014). It has been identified that the disorder is
inherited or strongly linked with the other mental health issues among the family members
(Gunderson, Weinberg & Choi-Kain, 2013). The disorder is 5 times more common among the
individuals who have a 1st degree relative with BPD. Individuals who experienced traumatic
happenings like physical or sexual mistreatment in childhood or abandonment and split-up from
their parents are at increased risk of developing this disorder (Bateman & Fonagy, 2010). The
emotional regulation system of the brain can be dissimilar in individuals with this health issue,
indicating that there is a neurological basis of certain of the sign and symptoms. The prevalence
of borderline personality disorder was originally estimated to be 1 to 2 per cent of the general
population and to happen 3 times more common among women compared to men (Sansone &
Sansone, 2011). Particularly in Australia, it affects nearly 1 to 4 per cent of individuals once in a
lifetime (Lawn & McMahon, 2015). In the US, recent investigations have identified that 1.6 per
cent of the total population has this health condition, and nearly 75 per cent of the individuals
diagnosed with this health condition are females (Pagura et al., 2010).
Borderline personality disorder can affect the patients and their family physically,
emotionally and financially (Laporte et al., 2011). Some of the symptoms associated with this
health issue include extreme eating behaviour, alterations and fluctuation in the sleep patterns,
evidence of self-injury, for example, cuts or burn marks and changes in the weights and
appearance. BPD can also cause poor decision-making ability, delusions or incorrect beliefs,
depersonalization or sensation out of the body (Laporte et al., 2011). De-realization or sense of
detached for the actual world. Some of the psychosocial symptoms associated with this health
issue include low self-esteem, sudden or drastic type of mood swings, suicidal thoughts, constant

loneliness, hopelessness, and unstable relationship. The borderline personality disorder is the
overwhelming psychological health issue that not only impacts the individual but also affects
everyone they are in a relationship with comprising friends, family, and life partners (Goodman
et al., 2011). Stress; seeing a loved one suffering from BPD and dealing with very problematic
relationship signs of BPD are extremely stressful for the family members. Patient's Family
members frequently feel abandoned while seeing their loved one with this health issue engage in
self-harm behaviours (Bateman & Fonagy, 2010). This might be specifically true for the parents
or care providers of teenagers with BPD, who might be uncontrolled. Along with the long-lasting
stress of concerned for a loved one having BPD, several members of the family can also
experience very serious psychological trauma due to some of the high-risk behaviours linked
with BPD (Staebler, Helbing, Rosenbach & Renneberg, 2011). Impacts on the relationship;
Parents of adolescents and grownups with BPD define the extreme stress caring for their kid can
result in tension in the married life and even results in separation or split-up (Leichsenring et al.,
2011). Siblings or kids of BPD affected parents may be grateful to become care providers,
whereas others might make the distance from the patient in order to safeguard themselves from
the emotional suffering being in close connections with BPD patients (Stepp et al., 2012).
Extended family counting grandparents, aunts, uncles and other relations of the borderline
personality disorder family provision network might feel the anxiety of caring for the individual
with BPD. The families of the patient may also experience the financial burden of the disease as
the treatment of this disease long term and they have to get the treatment multiple time.
Treatment-seeking individuals with personality disorders can pose a high financial burden on
their family. BPD is deliberated one of the highly expensive psychological disorders in terms of
the direct and indirect healthcare charge (Meuldijk et al., 2017). The two different types of costs;

direct cost is associated with the diagnosis and treatment of this health issues, second is the
indirect costs which are associated with the lost productivity linked with the borderline
personality disorder. It has been identified that the average yearly costs per BPD case ranged
from around €752 to €1880 for the direct cost and from € 1654 to € 3083 for the indirect costs
depending on the international differences (Soeteman et al., 2008).
Having a member with this particular health issue is quite challenging for the family as
they have to provide continuous care to the patient. Thus nursing role in this scenario can be vital
for them. Nurses are considered as the core member of any healthcare team assigned for the
patients (O'Connell & Dowling, 2013). They are equipped with different skills required for the
effective care of diseased patients. Caring for individuals with borderline personality disorder
needs patience, effective communication skills, secure limitations, and the readiness to gain more
information about this health issue. The Family members of the patient must be educated by the
healthcare providers like registered nurses about BPD, about the requirement of the treatment
process, and need to tolerantly help a loved one dedicated to getting healthier (Lawn &
McMahon, 2015). Family care providers commonly feel unprepared to provide care, have
insufficient knowledge to provide suitable care, and attain little support from the formal health
care providers; therefore registered nurses can play a key role here. Registered Nurses and family
care providers must agree about particular requirements or difficulties throughout hospital
admission or discharge of the patient, in part as registered nurses are frequently unaware of the
strong point and weaknesses of both the diseased person and caregiver (King, 2014). Because of
insufficient knowledge and skilfulness, family care-providers may be inexperienced with the sort
of care they should deliver or the amount of care required. Family care-providers may not
understand when they require public resources and then might not understand how to receive and

best utilize obtainable resources being provided by the government and non-government
organization. Consequently, family care providers often show a lack of care towards their own
health care requirements in order to help their family member suffering from BPD, causing
worsening in the care provider's healthiness and well-being. Frequently when a family member
has this health issues, other family members can become isolated, due to this the management of
these health issues can take more time and energy. Individuals commonly stay away from their
friends to hide the problem they sense as stigmatizing and disgraceful. This might deteriorate the
health condition of the patient as in loneliness they might feel rejected. Therefore nurses can help
the families to address this loneliness and asking them to build a therapeutic or healthy
relationship with the client (Koehne et al., 2013).
Considering the role of RN in supporting the family of the patient, it should be noted that
it is crucial for the nurse to make the family caregivers understand that it is important for them to
take care of themselves apart from the patient. As if they will not take care of him or her then
there will be no person left to take care of the patient. Considering the ethical and social
implication of this support, it should be noted that it is crucial for the RN to focus on the health
of their patients and not get attach to them. Such support attracts the family towards the RN and
makes them dependent on them to take decision that is ethically unfit. Further, it should also be
noted that this type of support can make the RN convey several messages to the family that they
should not convey or do not hold the competency to convey. Resulting in which social and
ethical breach of the responsibilities can occur that can give rise to several negative impacts in
the environment.
Family therapy is unlike than the traditional type of psychotherapy that the majority of
individuals are aware of. Instead of just one individual and their healthcare providers, family

therapy includes the entire household functioning together with nurses. This form of
management typically includes the parents or siblings however can also comprise lengthy groups
when suitable. Family therapy might be a choice for families if the individual with BPD is
unfavourably impacting the family's everyday life or if they think the activities of the household
might be deteriorating BPD symptoms. Occasionally these two difficulties interrelate; the BPD
indications damage family working and poor family working makes the BPD indications worse,
making a painful series that sorts' things more problematic for everybody involved, therefore
family therapy can be effective for BPD families to manage the symptoms of their loved ones
(Dickens, Hallett & Lamont, 2016).
Registered nurses can help family members to set and reinforce healthy boundaries to
avoid deteriorating symptoms. Registered nurses are equipped with effective communication
skills that can be used by the family members to maintain the better relationship with the patient
as it is essential to recognize when it is safe to initiate a conversation with the patient. For
example, if the patient is raging, vocally abusive, or creating physical threats, this is not the
perfect time to talk (Stroud & Parsons, 2013). Registered nurses skilled in Effective
communication can teach the family members to learn strategies of effective communications
like listen actively, being empathetic, concentrate on emotions, try to make the individual with
BPD feel heard, talking about thing instead of the disorder, and seek to distract the patient when
emotion rises. Having a family member suffering from a borderline personality disorder can pose
a financial burden on the family and they might feel helpless to receive effective treatment for
their loved ones. Here registered nurses can play a role in advocating the family to the services
being provided by the government free of cost or by other organization at a low cost. There are a
number of services being provided for the patient with BPD, for example, Australia BPD

Foundation, SANE Australia, reimagine, spectrum, mental health compass etc. (Lawn &
McMahon, 2015).
I think implementing any strategy or intervention for the family and patient with BPD
needs a collaborative approach in which all the family members and registered nurses are
involved. There are different interventions available for the patient and their families such as
Dialectical behaviour therapy (DBT) which is the form of CBT (cognitive behavioural therapy)
(Kliem, Kröger & Kosfelder, 2010). This particular therapy includes an emphasis on the
cognition, which denotes to the opinions and beliefs and the behaviour, or activities in the
treatment of the patient with BPD. This therapy includes certain changes to the customary
cognitive-behavioural components of the therapy. There are 4 different types of skills enclosed in
DBT therapy; mindfulness, meditation abilities, effective interpersonal skills, distress tolerance
abilities, and emotion control skills (O'connell & Dowling, 2014). In my opinion, most of the
registered nurses are experienced to teach these skills to the patient and their families.
mindfulness meditation abilities focused on learning to perceive, define and participate in every
experience, in addition to thoughts feelings, emotions, and other things taking place in the
environment, deprived of arbitrating these experiences as good or bed. I think these skills can
help the families to assess the unusual behaviour of the patient and address them effectively.
Interpersonal effective skills can help both the patient and families to build a healthy relationship
and avoid conflicts between them (Kliem, Kröger & Kosfelder, 2010). In my opinion, the
distress tolerance skills can promote the ways of learning to admit and tolerate distress deprived
of doing something that can worsen the situation such as self-harm. I think this can help the
family to tolerate the unusual behaviour of the patient. I have studied about the intervention and
came to a point that DBT is centred on the concept that the central issue in BPD is dysregulation

of emotion, which occurs from mixing the biology, counting hereditary and additional biological
risk aspects, and an expressively unstable environment, for example where care-providers
punish, underestimate or respond unpredictably to the patient's expression of sensation, together.
I think the emphasis of DBT is actually on assisting the client to learn and implement skills that
will reduce the dysregulation of emotion and unhealthy efforts to cope with strong feelings.
There are four different steps to implement the intervention that are establishing and managing
the collaborative association, maintaining the consisting disease management process, building
and managing the validating the treatment method, and the establishment and maintaining the
inspiration for the change. I think other therapies like metallization based therapy and
transference focused psychotherapy can also be effective for the patients. These therapies are
recognised as the talk therapy help in identifying the thoughts and feeling, and interpersonal
difficulties by developing a healthy relationship between family and nurses (Kliem, Kröger &
Kosfelder, 2010).
In conclusion, borderline personality disorder or BPD is the health issue which is
characterized by the difficulty in regulating personal emotions. These problems can lead to
impulsivity, decreased self-image, problematic relationship, over-emotional reaction to the
stress. Causes of this health issue include hereditary, environmental factors, and functioning of
the brain. The prevalence of this health issue estimated to be one to two per cent of common
people. In Australia, it impacts one to four per cent of people once in their lifespan. BPD can
impact both the client and their family physically, emotionally, and financially. It can cause
sudden mood swings, suicidal ideation, low self-esteem, weight changes, and changes in sleep
patterns. A family member of the BPD patient can be impacted financially and emotionally. The
treatment process of this health issue requires money to spend for a long period of time which

can affect the socioeconomic status of the family. Providing care to the patient can be difficult
for their family, therefore they should take assistance from nurses, who can educate them about
the communication skills require to converse with the client, about the disorder and its symptoms
etc. there is some intervention that can be used as an effective strategy includes family therapy,
dialectical behaviours therapy, talk therapy etc. these strategies can be implemented with the
effective collaboration among family members, client, and the registered nurses.

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