At the present, borderline personality disorder (BDP) is believed to be the most widespread personality disorder diagnosis, and is among one of the ten personality disorders that are presently listed in DSM-v. The DSM-v states that at least five symptoms must be identified for one to be considered to be suffering from a certain disorder. The DSM-v lists these traits as unpredictability in two areas that are self-destructive, intense interpersonal relationships, as well as the lack of self-control. The other traits include an acute fear of rejection, persistent feelings of boredom, paranoia and emotional instability. DSM-v also lists suicidal behaviors and identity disturbance as the other traits that might point to the presence of personality disorder (American Psychiatric Association, 2013).

Traditionally, Borderline Personality Disorder was used to refer to patients that were neither psychotic nor neurotic. Over the years, the initial diagnosis has undergone numerous alterations in the DSM. Ideally, the most pointed alteration was the endeavor to cut the psychotic bit from the category, and the bringing in of schizotypal personality disorder into the DSM-iii revision of 1980 (Kroll, 2003). However, these revisions have not been successful in diminishing the axis I and axis II disorders in the ones with BPD thus depicting the heterogeneous nature of the disorder. Axis I disorders are categorized as clinical disorders as they are inclusive of schizophrenia, depression, panic attacks among others. Research has repeatedly shown that there is evident co-morbidity between the axis I and axis II disorders (Scheel, 2000).

History of Borderline Personality Disorder

Borderline Personality Disorder has for long been confused with schizophrenia, as well as other non-schizophrenic ailments such as anxiety and panic attacks. Since it coincided with so many other psychiatric ailments, clinicians believed that there were accurate diagnosis and could, therefore, only be diagnosed among patients who did not fall into any of the other classes. In the past, majority of the health professionals believed that Borderline Personality Disorder had poor reaction to medication and this myth is still existent even today (Leichsenring, & Leibing, 2003)..

Research conducted in the recent past has shown that borderline disorder can actually be diagnosed validly and with integrity. These studies have also debunked the myth that this disorder coincides with schizophrenia. There is also sufficient proof that the disorder actually appears distinctly although in most cases it appears amongst other mental disorders. This has made it hard for the disorder to be diagnosed accurately and has also increased the chances for misdiagnosis. While borderline disorder was traditionally thought to be without medication, research has shown that accurately diagnosed borderline disorder can be treated effectively thus offering hope to those suffering from the disorder (Beck, & Freedman, 2010).

Ideally, borderline disorder is believed to develop during infancy and progresses well into adulthood. However, it is hard to diagnose the disorder among children since the symptoms often change into a different type of disorder as the child grows older. This leaves early adolescence stage, and early adulthood as the only ideal periods to diagnose the disease. According to experts, stress is considered to be a risk factor, as well as well as the presence of mental disorders in the family line (Friedel, 2014).

According to the American Psychiatric Association (2013), borderline disorder is among the leading causes of suicide and other injurious behaviors especially among children and adolescents. Sociologists point out that the symptoms of borderline disorder are explicit from an early age and this means that unlike other mental disorders that become manifest later on in life, the effects of this disorder are evident all through the stages of life. This fact alone makes the disorder a social problem that needs to be clinically addressed in the society (American Psychiatric Association, 2013).

Ideally, the diagnosis of borderline personality disorder is a complex issue that requires cooperation between the clinicians and the patient. In most cases, diagnosis is made through interviewing the patient and those close to him. However, this is not an efficient method of diagnosis since the borderline disorder symptoms are identical to those of other mental disorders, and this leaves room for misdiagnosis. During the assessment, care should also be taken to ensure that the cultural beliefs are taken into consideration. A clear example of this is the Africans, who believe that evil spirits are responsible for the mental disturbances that characterize borderline disorder. When assessing a patient with such a background, care should be taken to ensure that the family is first educated about the disease and also to ensure that they are not harboring any crucial information (Verheul, et al., 2003).

Intervention

The most used intervention for borderline personality disorder is getting emotions under control. In most cases, patients with BPD demonstrate two behavioral extremes that have to be managed effectively. A clear example of this is a scenario where a patient might open up to a counselor about his/her problems without any coercion, but then turn around and shut down at an even faster rate. Psychologists propose the use of weekly one-on-one sessions with a counselor, as well as group sessions where patients are taught how to tolerate distress, and emotion regulation. The main aim of these sessions is to train patients on how to observe their emotions without necessarily reacting to them (Montgomery, 2007).

In effecting this intervention program, it is critical for the practitioner to learn how to appreciate the reality of the client’s emotions since most of them lack such emotional acceptance as children. If the borderline personality disorder is treated effectively, the chances of full recovery are significant especially on the area of reducing harmful behaviors among patients. In most cases, patients with borderline personality disorder focus on getting instant relief for their emotions through self-harm, and the intervention program is meant to train patients on how to master their emotions. Ideally, this intervention program does not necessarily seek to treat the symptoms, but it instead focuses on training the patients on how to shift attention from self-gratification (Verheul, et al., 2003).

Critical Analysis       

Getting patient emotions under control is an effective way of managing borderline personality disorder. This intervention program is ideal since it helps in attracting people with these disorders who would rather not seek treatment under normal circumstances. This intervention approach is also ideal in that it creates support groups for the individuals with the disorder, their families as well as that of the psychotherapists. Another good thing about this intervention program is that people are not charged to join the support group and it is, therefore, an ideal way of helping one another. The biggest downfall with this kind of intervention is that considerable harm can be meted on individuals within the group if individuals within the group get angry or act in manipulative ways. If there is no good leader to handle the situation in an ideal manner, the individuals within the group may be bared to great trauma (Linehan, 2000).

References

American Psychiatric Association. (2013). DSM 5 (Diagnostic and statistical manual of mental disorders 5). Washington, D. C.

Beck, A., & Freedman, A. (2010). Cognitive therapy of personality disorders. New York: Guilford.

Friedel, R. (2014). Borderline Personality Disorder Demystified. Retrieved from http://www.bpddemystified.com/resources/dr-friedels-book

Leichsenring, F., & Leibing, E. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: A meta-analysis. American Journal of Psychiatry, 160(7), 1223-1232.

Linehan, M. (2000). The empirical basis of dialectical behavior therapy: Development of new treatments versus evaluation of existing treatments. Clinical Psychology: Science and Practice, (1), 113-119.

Kroll, J. (2003). PTSD A/borderline in Therapy: Finding the Balance. New York: Norton.

Montgomery, S.A. (2007). The psychopharmacology of borderline personality disorders. Acta Psychiatrica Belgique, 87, 260-266.

Scheel, K.R. (2000). The empirical basis of dialectical behavior therapy: Summary, critique, and implications.Clinical Psychology-Science & Practice, 7(1), 68-86.

Verheul, R., et, al. (2003). Dialectical behavior therapy for women with borderline personality disorder: 12-month, randomized clinical trial in The Netherlands. British Journal of Psychiatry, 182, 135-40.

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