Symptoms and Treatment of Borderline Personality Disorder ( BPD ) Borderline Personality Disorder Borderline Personality Disorder (BPD) is a condition characterized by pervasive patterns of instability in emotions, behavior, self-image, and interpersonal relationships. Individuals with BPD often struggle with extreme emotional reactions, impulsive behavior, and intense fears of abandonment. Dr Shariq psychiatrist in jaipur, estimates that BPD affects about 2% of population, with a higher prevalence in women than in men. Core Symptoms of Borderline Personality Disorder - Emotional Instability One of the hallmark features of BPD is emotional dysregulation. Individuals experience intense mood swings, often shifting from extreme happiness to deep sadness, irritability, or anger within a short period. These rapid emotional changes make it difficult for them to manage emotions effectively, leading to impulsive actions. Emotional sensitivity is heightened, and the emotional responses are often disproportionate to the situation. - Fear of Abandonment A deep-seated fear of abandonment is a central symptom of BPD. Individuals with this disorder often have an overwhelming fear of being left alone or abandoned, whether real or perceived. This fear may lead to frantic efforts to avoid abandonment, such as clinging to others, becoming overly dependent, or even threatening self-harm if they sense rejection. The intensity of this fear can lead to erratic and impulsive behaviors in relationships. - Unstable Relationships Relationships for individuals with BPD are often chaotic and unstable. They tend to oscillate between extreme idealization and devaluation of others, a phenomenon known as "splitting." For instance, they may view someone as their best friend or love interest one moment and despise them the next. This instability in relationships stems from their emotional volatility and difficulty trusting others. - Identity Disturbance A pervasive identity disturbance is commonly seen in individuals with BPD. They experience chronic feelings of emptiness, often not knowing who they are or what they want in life. Their sense of self is unstable, leading to frequent changes in career goals, personal values, and even sexual identity. This lack of a stable self-image often contributes to their emotional instability and poor self-esteem. - Impulsivity BPD is associated with impulsive behaviors that are potentially self-damaging. These can include reckless driving, substance abuse, binge eating, unsafe sexual practices, and overspending. This impulsivity is often a response to emotional pain or a means of alleviating negative emotions, though it frequently results in further distress and guilt. - Self Harm and Suicidal Ideation or suicidal behavior Self-harm, such as cutting or burning, is a common coping mechanism for those with BPD. It serves as a way to regulate emotions or as a form of punishment for perceived self guilty thoughts. Suicidal thoughts and gestures are also common, with some individuals making repeated suicide attempts or engaging in suicidal behaviors in response to emotional distress or relationship difficulties. - Dissociation and Paranoia Individuals with BPD may experience transient, stress-related episodes of dissociation or paranoia. During these times, They may also become suspicious or paranoid about others' intentions. Treatment of Borderline Personality Disorder Mood Stabilizers - Sodium Valproate (Valparin, Encorate) : Prescribed for its effectiveness in controlling mood swings. It helps reduce irritability, aggressive outbursts and prevent extreme mood fluctuations. - Lamotrigine (Lamitor, Lametec) : Particularly effective in reducing depressive symptoms in individuals with BPD. - Lithium (Lithosun, Licab) : Prescribed to stabilize mood in BPD patients with significant mood swings and impulsivity. Antidepressants - Selective Serotonin Reuptake Inhibitors (SSRIs) : - Fluoxetine (Flunil, Prodep) : Known for its long-term effectiveness in treating depression, fluoxetine also helps in reducing impulsive behaviors. - Sertraline (Daxid, Serlift) : This SSRI helps manage depressive and anxiety symptoms. It is particularly beneficial for reducing emotional reactivity and anger outbursts. - Escitalopram (Nexito, Cipralex) : Escitalopram is frequently prescribed for BPD-related anxiety and depression. Antipsychotics - Quetiapine (Seroquel, Qutan) : Quetiapine is frequently used to manage symptoms such as irritability, anxiety, and mood instability. It has sedative properties and may help reduce insomnia and agitation. - Olanzapine (Olanex, Oliza) : Olanzapine is prescribed to reduce symptoms of anger, mood swings, and paranoia. It is effective in controlling psychotic-like symptoms. Dialectical Behavior Therapy (DBT) Dialectical Behavior Therapy (DBT) is psychotherapy for treating BPD. DBT teaches skills for emotional regulation, distress tolerance, and improve relationships.