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Borderline personality disorder

The meaning of «borderline personality disorder»

Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD),[11] is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong emotional reactions.[6][7][12] Those affected often engage in self-harm and other dangerous behaviors, often due to their difficulty with returning their emotional level to a healthy or normal baseline.[13][14][15] They may also struggle with a feeling of emptiness, fear of abandonment, and detachment from reality.[6] Symptoms of BPD may be triggered by events considered normal to others.[6] BPD typically begins by early adulthood and occurs across a variety of situations.[7] Substance use disorders, depression, and eating disorders are commonly associated with BPD.[6] Approximately 10% of people affected with the disorder die by suicide.[6][7] The disorder is often stigmatized in both the media and the psychiatric field and as a result is often underdiagnosed.[16]

The causes of BPD are unclear but seem to involve genetic, neurological, environmental, and social factors.[6][8] It occurs about five times more often in a person who has an affected close relative.[6] Adverse life events appear to also play a role.[9] The underlying mechanism appears to involve the frontolimbic network of neurons.[9] BPD is recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a personality disorder, along with nine other such disorders.[7] The condition must be differentiated from an identity problem or substance use disorders, among other possibilities.[7]

BPD is typically treated with psychotherapy, such as cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT).[6] DBT may reduce the risk of suicide in the disorder.[6] Therapy for BPD can occur one-on-one or in a group.[6] While medications cannot cure BPD, they may be used to help with the associated symptoms.[6] Despite no evidence of their effectiveness, SSRI antidepressants and quetiapine remain widely prescribed for the condition.[17] Severe cases of the disorder may require hospital care.[6]

About 1.6% of people have BPD in a given year, with some estimates as high as 6%.[6][7][18] Women are diagnosed about three times as often as men.[7] The disorder appears to become less common among older people.[7] Up to half of those with BPD improve over a ten-year period.[7] Those affected typically use a high amount of healthcare resources.[7] There is an ongoing debate about the naming of the disorder, especially the suitability of the word borderline.[6]

BPD is characterized by nine signs and symptoms. To be diagnosed, a person must meet at least five of the following:[19]

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