Causes of Borderline Personality Disorder
cont. from
- Impaired brain chemistry (treated with medications). The
neurotransmitters dopamine, serotonin, acetylcholine, and norepinephrine may
be involved.
- Early environmental influences (anything from long-term isolation for an
early infectious disease to severe physical or sexual abuse).
- Triggers that bring on symptoms (such as divorce or adolescent traumas).
Treatment of Borderline Personality Disorder
When a person with
BPD allows themselves to be treated (denial is often part
of the disorder), treatment generally consists of:
- Medications, which are often successfully used to reduce
depression, dampen emotional ups and downs, and put the brakes on excessive
impulsivity. Antidepressants can help with depression, while mood
stabilizers such as Depakote,
Tegretol, or
Lithium can help with mood
swings. Selective Serotonin Re-uptake Inhibitors (SSRIs) such as
Prozac,
Zoloft, and
Paxil may help control impulsivity, as may
Effexor, a related
antidepressant. Tegretol may be helpful for controlling excessive anger and
irritability.
- Therapy, especially cognitive-behavioral therapy. The major
problems are finding a qualified therapist and getting the Borderline
patient into therapy.
Researcher Marsha Linehan’s cognitive-behavioral method of treatment, called
Dialectical Behavior Therapy (DBT), has been shown in empirical research to
help BPD patients experience less anger, less self-mutilation, and fewer
inpatient psychiatric stays than patients who received other forms of
treatment.
Expectations (prognosis)
Borderline personality disorder has a poor outlook because noncompliance with
treatment is common.
Complications
- Drug abuse
- Suicide attempts
- Eating disorders
- Depression
Future Progress
Studies that translate basic findings about the neural basis of temperament,
mood regulation and cognition into clinically relevant insights—which bear
directly on BPD—represent a growing area of NIMH-supported research. Research is
also underway to test the efficacy of combining medications with behavioral
treatments like DBT, and gauging the effect of childhood abuse and other stress
in BPD on brain hormones. Data from the first prospective, longitudinal study of
BPD, which began in the early 1990s, is expected to reveal how treatment affects
the course of the illness. It will also pinpoint specific environmental factors
and personality traits that predict a more favorable outcome. The Institute is
also collaborating with a private foundation to help attract new researchers to
develop a better understanding and better treatment for BPD.
continue: More Detailed Information on
Psychotherapy for BPD
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Reviewed: 04/2006
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