The diagnosis of borderline personality disorder is on the rise. There are a variety of reasons why the diagnosis has become increasingly popular, like the availability of resources “to identify difficult disorders, like BPD”. The author of “The Mystery of Borderline Personality Disorder”, John Cloud, believes that BPD could be the mental disorder of the decade as anxiety was to the 50s and schizophrenia was to the 60s and 70s.

Borderline personality disorder was discovered in the 1930s by Adolph Stern. Patients were described as being “between Freud’s two big clusters: psychosis and neurosis” and exhibiting “psychic bleeding”. Later, another psychologist wrote about the “inner emptiness” which borderlines sought to cure through attachments with friends and family, or by joining to community organizations.

The cause of BPD is not completely attributable to genes or environment, but a combination of both. Some borderlines were abused as children, or either lived in families that did not provide guidance for emotional growth, or viewed conveying emotion as something punishable. These children do not learn how to appropriately handle their emotions in any situation. Instead, they “oscillate between emotional inhibition and extreme emotional lability”.

Marsha Linehan, a psychologist at the University of Washington, is possibly the most influential figure in the research and treatment of borderline personality disorder. She added to the definition by saying borderlines are “on the border between various dualities”. In order to remedy these dualities, she created dialectical behavior therapy. Linehan claims that people with BPD are analogous to burn victims by stating, “Borderlines . . . simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering”. People with BPD tend to have emotional reactions not proportional to the provoking situation; they “have no internal governor”.

Psychologists viewed the diagnosis of BPD as a “death sentence” until Linehan innovated dialectical behavior therapy. It “significantly reduced borderlines’ tendency to hurt themselves as well as the number of days they spent as inpatients”. Dictionary.com defines dialectic as “the art or practice of logical discussion as employed in investigating the truth of a theory or opinion”. Both the patient and therapist must “find synthesis in various contradictions”, rather then thinking in black and white. Because borderlines never learned to gage their emotions in a situation, they resort to extremes of right or wrong, bad or good; there are no shades of gray. Another focus of Linehan’s treatment strategy is “don’t make the situation worse”. Linehan treats her patients simultaneously with “compassion and irreverence . . . validation and tough love”. The goal of dialectical behavior therapy is not to “cure” the patient, but to help the patient find happiness and be in control of their disease.

http://www.time.com/time/magazine/article/0,9171,1870491,00.html


Drug Treatments

17Feb10

Paul Markovitz, M.D., Ph. D., wrote an article detailing four new drug treatments for Borderline Personality Disorder. He says that currently there isn’t much to report, but “a host of new agents are under investigation by various companies through the Food and Drug Aministration, and some of these show promise based on their neurochemistry”. Dr. Markovitz is also glad to announce the recent decision of the NIMH to “recognize BPD as an illness that needs aggressive treatment”.

The first new type of drug treatment is atypical antipsychotics, many of which are FDA-certified treatments for schizophrenia. Zyprexa in particular seems promising. It has proven to decrease mood swings, depression, anxiety, and self-injury. However, this drug has been known to cause significant weight gain and thus increasing the risk of type II diabetes. Geodon and Abilify also fall into this category, and do not warrant the same weight gain. Possible side-effects for any of these drugs include “mental slowing, tremor, lethargy, and feeling a lack of motivation or joy”. It is important to remember that these drugs are not all the same; if one doesn’t work, try another.

Anticonvulsants such as Lamitral, Topamax, and Depakote have been proven useful for reducing mood swings in borderlines and bipolars alike. But, when depression sets in, these drugs are not the answer. Typical side-effects of anticonvulsants are mental dulling and weight fluctuation.

The purpose of Naltrexone is “to unbind heroin or other opiates from your brain if you overdose”. This drug hasn’t been researched much for the treatment of BPD, but it has helped some borderlines cope with the urge to cause self-harm. This drug is rather pricey and should not be used along with pain control opiates.

Unlike the previous three prescription treatments, the fourth is an over-the-counter drug. There are many known health benefits to taking Omega-3 fatty acids including heart health. It has also been proven to reduce depression and aggression in some people. While this should not replace prescriptions, there is no harm in adding it to a BPD’s regimen.


So it is past time for my first research blog entry. I found an article detailing the findings of a genetic study at the University of Missouri thanks to Charles Xu.

Borderline Personality Disorder affects more people than schizophrenia or bipolar disorder. People suffering from it are known for “pervasive instability in moods, interpersonal relationships, self-image and behavior”. Theses tendencies can lead to self-destructive behaviors.

This study took place in the Netherlands with over seven hundred pairs of siblings and almost six hundred parents. The goal was to locate specific genetic traits that lead to BPD. Using genetic linkage analysis, chromosome nine was found to have the strongest influence on this personality disorder. This evidence will have important clinical implications in treatment.

In another study comparing twins, it was found that “42 percent of variation in BPD features was attributable to genetic influences and 58 percent was attributable to environmental influences”. They also discovered that the prevalence of BPD in men and women was roughly equal. While gender is not a factor, age seems to be; “young adults displayed more BPD features than older adults”. The fact that these results were consistent across three countries is significant in proving genetic differences in BPD in Western cultures.


I created this blog for my senior exit project for AP Literature.  Hopefully, it will be a way to get feedback from and share my research with my classmates, instructor, and  anyone doing a related Google search.

By some unknown means of the universe, I came into possession of a book titled Understanding the Borderline Mother: Helping Her Children Transcend the Intense, Unpredictable, and Volatile Relationship. What a mouthful of a title, and an intense one at that.  Intrigued, I began to read.  The book was interesting to say the least.  I learned that Marry Todd Lincoln, wife of one of America’s most celebrated presidents, was suspected to be “one of these mothers”.  The book describes the lives of other nameless mothers who have Borderline Personality Disorder (BPD), and their unhealthy relationships with their children.  Each parent-child relationship was unique, and true to the book’s title in being unpredictable.  I began to wonder, how can this go on?  With the advances in psychiatric treatment, how can these children still be helplessly subject to live with these mothers?

For the next four-ish months, I intend to research how parents with personality disorders affect their children.  There are ten recognized personality disorders which are characterized by a common inability to cope with daily life or to maintain functional relationships with family, friends, and co-workers.  When faced with minor problems, these people all react differently, but none in a rational or purposeful way.  It has not yet been determined whether personality disorders are learned from parents by children, or genetically inherited.  One thing is certain, these children struggle to lead normal lives.


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12Jan10

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