Symptoms include emotional instability, insecurity, impaired social relationships, and feelings of worthlessness.
Personality disorders are mental health problems in which personality and behaviour cause you or others distress. There are 10 specific different types and potential causes of personality disorders, and the signs and symptoms are diverse.
Personality disorders fall into 3 different clusters with similar symptoms:
- Cluster A: paranoid, schizoid and schizotypal
- Cluster B: antisocial, borderline, histrionic and narcissistic
- Cluster C: avoidant, dependent and obsessive-compulsive
Core symptoms of personality disorders usually begin by early adulthood and present in a variety of contexts. These are:
- A constant behavioural pattern that differs greatly from the norm, and which is apparent in their person’s thinking, the range and intensity of their emotions and their social skills, marked by an impulsive control.
- These patterns are persistent and have been noticeable in a broad range of situations for a long time.
- The patterns cause significant distress for the person, showing higher sensitivity to emotional triggers, difficulty controlling anger, a strong fear of abandonment, intense relationships, impulsivity with substance abuse, and frequent suicidal ideation and self-harm.
These symptoms usually begin by early adulthood and present in a variety of contexts. The borderline personality disorder is also simultaneously present with other mental illnesses such as depression, anxiety, bulimia, and even other personality disorders.
BPD is one of the most common personality disorders and is usually in Australia using the American Psychiatric Association Diagnostic and statistical manual of mental disorders 5th edition (DSM-5). The World Health Organization International statistical classification of diseases and related health problems 10th Revision also includes diagnostic criteria for unstable personality disorder, borderline type.
The DSM-5 diagnostic criteria for BPD is based on the following 9 behaviours:
- Frantic efforts to avoid abandonment
- A pattern of unstable and intense relationships often distinguished by oscillating between extremes of idealisation and devaluation
- A continuous unstable self-image or sense of self
- Impulsivity in at least two potentially self-damaging areas: money spending, sex, substance abuse, reckless driving, binge eating, etc
- Recurrent suicidal behaviour
- Unstable effectiveness marked by the reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
- Temporary stress-related paranoid ideation or other dissociative symptoms
However, when considering professional treatments, Dialectical Behaviour Therapy (DBT) is the most effective method of treating people with BPD.
It’s based on the idea that BPD is mostly contributed by particularly emotionally vulnerability and growing up in an environment where emotions were dismissed by those around you. DTB presents two concepts to break the cycles of unhealthy behavioural patterns: validation and dialectics. Through validation, people learn to accept their emotions as valid and real, fighting the misconceptions around the disorder, and dialectics helps people to be open to new ideas and opinions, straying away from a “black and white” approach.
When caring for a person with a personality disorder in a community or hospital, we recommend you take into consideration the following:
- Develop a trusting relationship with the person based on empathy and appropriate boundaries
- Remain alert to suicide risk
- Promote functional coping and problem-solving skills
- Ensure good collaboration and communication with other people treating the person to ensure consistency in treatment