Hypothesis: Individuals with Borderline Personality Disorder are not dangerous, but are in need of special help and psychiatric care and shouldn’t be stigmatized by the public and healthcare professionals.
Borderline Personality Disorder
Borderline Personality Disorder (BPD) is a disorder characterized by a pervasive pattern of instability in affect regulation, impulse control, interpersonal relationships, and self-image. The cause of this personality disorder is only somewhat known currently, but it seems to stem from physical, emotional, and sexual abuse as a child. About 1-2% of the general population is affected by this disorder, and about 10% of people with BPD commit suicide. This is a very high number of people considering how that number relates to the total number of individuals that have it. Individuals with BPD require significantly more mental health resources than those with other common mental health disorders, because BPD causes severe psychosocial impairment and makes it hard to live a normal, functioning life.
The Lifetime Course of Borderline Personality Disorder
When people with BPD are not seen in a formal mental health treatment setting, they are often seen when in times of crisis. This leads people to believe that those with BPD are constantly in crisis and are never recovering. The truth is that while those with BPD do suffer intensely a lot of the time, their condition is proven to improve over time with proper treatment. BPD can be effectively treated with Dialectical Behavior Therapy (DBT). Being that BPD stems from childhood trauma, it can be reliably and validly diagnosed in adolescence. Risk factors for developing BPD in adolescents include maternal-child discord, maternal BPD, and depression. In a 10 year study of 668 patients, researchers found that the patients had improved with their condition over the 10 year period while being treated.
Effectiveness of Partial Hospitalization in the Treatment of Borderline Personality Disorder: A Randomized Controlled Trial
Researchers took 38 patients that were diagnosed with BPD and placed them into two different groups. One group received partially hospitalized care, while the other group received standard psychiatric care. The measures that they were looking for included frequency of suicide attempts and self harm, inpatient visits and their duration, depressive symptoms, anxiety, interpersonal function, and social function. At the end of the study, they found that psychoanalytically focused partial hospitalized treatment was significantly more effective than standard psychiatric care. Patients in the partially hospitalized group showed significantly less frequent self harm, and much improved depressive symptoms.
The Stigma of Personality Disorders
Borderline Personality Disorder is shown to be the most stigmatized mental disorder, and also has the most research related to its stigma. Individuals with mental illness are viewed to be at fault for their mental illness, and it is portrayed that they somehow choose to exhibit these symptoms. Despite efforts to combat this stigma, research shows that the situation has not improved over time, and people still continue to stigmatize the mentally ill. Some of those with personality disorders are afraid to seek treatment for their mental illness in order to avoid being labelled as “crazy”. This creates a very hard life for those who are struggling, as they are afraid to even get help in the first place. Those with BPD are shown to “self-stigmatize” and view themselves as insane, or unhelpable. This causes them to have great shame in their disorder and for their lives in general. Research shows that some psychiatrists may avoid telling their patient that they have BPD, in order to help them avoid stigmatization from the system.
Why go to the emergency department? Perspectives from persons with borderline personality disorder
Those with BPD are treated differently by healthcare professionals due to their diagnosis. Sulzer (2015) found that healthcare providers describe patients with BPD as “difficult” and a “pain in the ass”. They will stigmatize patients for the very behaviors that they are trying to correct, such as manipulative, attention seeking, and suicidal tendencies. These things are outside of the patient’s control, and they wouldn’t be in the doctor’s office if they could help it on their own. Those with BPD have a very limited ability to cope with intense emotions, and this can make them hard to treat. When they are blamed for these behaviors, it perpetuates the stereotype that those with BPD are just attention seekers and choose to act the way that they do. BPD is characterized with feelings of intense loneliness and fear of abandonment, so when healthcare providers make this worse by giving sufferers less than adequate service, it just exacerbates these awful feelings.