Borderline disorder, also known as borderline syndrome, is a personality disorder . Severe mental illness is
characterized by the fact that those affected are emotionally
unstable . In people with borderline disorder, this instability
manifests itself in their relationships with others. They also have very
different feelings towards themselves. Borderline sufferers are usually
very impulsive and sometimes self-harming.
There is no precise definition of borderline. However, there
are clear diagnostic criteria that are based on the
borderline symptoms and that doctors can use to determine whether someone
suffers from the disease.
In the diagnosis classification system of the World Health Organization
(WHO), the ICD-10, the disease is called "emotionally unstable personality
disorder". There are two sub-categories: a so-called
impulsive type and a borderline type .
In the DSM-5, the diagnostic classification system of the American
Psychiatric Society APA, borderline is officially called "borderline
personality disorder".
Women are three times more likely to develop borderline disorder than
men.
Borderline: symptoms
The central sign of borderline is a severely disturbed emotion
regulation . Anyone who has borderline problems reacts very
quickly and extremely. Even small things can cause those affected to feel
fear, despair, anger, self-hatred or feelings of guilt. Mood swings are part of everyday life at Borderline.
Borderline sufferers quickly get into extreme emotional states that they
themselves often cannot name or describe correctly. Often they only speak
of an “ emotional chaos ” that is so strong that it displaces
any rationality.
Borderline sufferers are very afraid of being abandoned or
rejected by other people . If that happens once - sometimes
the idea of it is enough - it creates a strong inner tension in
borderliners. Anger, fear and despair or the often experienced "inner
emptiness" lead to strong negative feelings towards themselves in
borderliners.
The inner tension and negative feelings towards oneself often lead
to self-harming behavior in borderline
sufferers . Some of them cut their arms or legs, which is why the
behavior is often called "cracks". Over time, the injuries get
worse or it can even lead to suicidality.
The
main symptoms by which you can recognize a borderline disorder at a glance:
- Unstable
interpersonal relationships
- Unstable
self-image
- Extremely
changeable waves of emotions (affects)
- impulsiveness
In the ICD-10, the WHO diagnostic system, two different types are
distinguished under the “emotionally unstable personality disorder” - an
impulsive type and a borderline type. Both types are based on the same
criteria for diagnosis - they are just weighted slightly differently. In principle, all of the borderline symptoms mentioned above can
occur , but they do not have to be. Often those affected only
have a few of them and also differ in how severe the symptoms are.
Borderline:
relationship
It is difficult for people with borderline illnesses to cultivate and
maintain interpersonal relationships with family members, friends or
partners. On the one hand, borderline sufferers want close relationships,
love and closeness. On the other hand, they often find it difficult to
bear the closeness and feel fear, guilt or shame.
If the negative feelings get too big, borderline sufferers sometimes
cause an argument to get out of the uncomfortable closeness situation. In
extreme cases, there is also a separation.
The instability is often not only directed to the relationship, but also
to how the person affected perceives the other. Sometimes a borderline sick
person idealizes the partner or a family member to the extreme . The
next moment he or she finds him or her repulsive. This is often difficult
to understand for relatives.
Borderline: therapy
Borderline is a serious psychological personality disorder. The
right therapy helps those affected a lot. Whether the treatment leads to
borderline being completely curable also depends on the personal circumstances
and the severity of the disease. In principle, there are various
psychotherapeutic methods for treating borderlines. In addition,
some psychiatrists also give medication to help those
affected against the symptoms. Three forms of psychotherapy that
have been shown to be particularly effective for treating
borderlines are:
- Dialectical
Behavioral Therapy (DBT)
- Schema-focused
cognitive therapy / schema therapy (SFT)
- Transfer
Focused Therapy (TFP)
During the treatment, therapists first try to clarify which symptoms the
patient has. If he is suicidal (colloquially tired of life)
or self-harming, this has the highest priority . Thereafter,
the therapist devotes himself to behaviors that damage the relationship with
the therapist or the therapy itself. Once that is done, he ill deal with
the issues that bother borderline sufferers the most in life. The focus is
on helping the patient to better regulate their emotions.
In dialectical behavioral therapy (DBT) , the
psychotherapist combines approaches from behavior therapy ,
cognitive therapy, gestalt and hypnotherapy and from the Zen
philosophy. On the one hand, patients learn what borderline actually
is. At the same time, the therapist teaches them skills to help them
recognize and prevent undesirable behavior. The DBT takes place in
individual and group sessions. According to the current study situation,
the effectiveness for DBT has been best documented.
The Schema Therapy (SFT) is based on the assumption that
experiences have caused during childhood certain schemes that are now the
reason for the borderline disorder. They are initially not aware of the
sick person and are difficult to access. The therapist tries to change
these schemes in SFT.
The transmission-focused therapy (TFP) is working to
improve the differentiation of subject and object to those affected. The
cause of borderline illness, according to the assumption of this form of
therapy, lies in the reactions of the object (the person suffering from
borderline illness) to the subject (the partner, the girlfriend,
family). The patient should transfer this disturbed relationship to the
therapist, then both work on it.
Medicines only
play a subordinate role in the treatment of borderlines . They
cannot help those affected on their own. However, some psychiatrists use
them as support, for example to stabilize the mood. Or they use it to
treat mental illnesses that exist alongside the borderline disorder, such as
anxiety disorders or depression.
