Borderline Disorder
Information for affected and their Familiy
Diagnosis of borderline
It is difficult to diagnose the borderline personality disorder due to its various symptoms. Therefore criteria have been defined in order to alleviate the diagnosis and a form of therapy that changes the disorder-based persistent burden. There are several forums dealing with borderline in the internet that provide information about life with borderline personality disorder.
The difficulty in diagnosing the borderline personality disorder is the fact, that all typical symptoms can also occur with healthy individuals. A borderline disorder cannot be defined by a small number of signs that match every patient’s individual case but rather by very different criteria that do not necessarily occur. The severity of the disorder varies, but all individuals suffer from a persisting mental burden that has a strong impact onto the life of the borderliner.
A final diagnosis can only be confirmed by a medical professional or therapist. The criteria of the DSM – the diagnostic and statistic manual for mental disorders – are always being used. One criterion is fear of solitude: persons concerned feel a strong need to prevent themselves from real or assumed losses. The urge for security is ironically often combined with the anxiety to be “swallowed up” by another person. Interpersonal relations often follow an established pattern by being impermanent and highly intensive at the same time. The attachment figures of the patient are being alternately idealized if they fulfil the expectations or devalued if they reject or disappoint the borderliner who clings to a “black-and-white-pattern”.
Another criterion is a persisting identity disorder in terms of self-perception, sexual orientation, choice of profession, judgement of values and the partner’s personality. Borderliners do not accept their characteristics like intelligence or attractiveness as stable but as properties that have to be consistently earned. For this reason the self-conscience of a borderliner does solely rest on current successes and setbacks as well as feedback from others.
Individuals diagnosed with borderline show a high sense of individuality in terms of self-harming behaviour. Typical patterns are lacks in sensible money handling, substance abuse, sexual promiscuity, gambling, kleptomania, risky driving behaviour and eating disorders, all possibly caused by a disturbed relationship, mood swings, anger or the attempt to benumb the feeling of solitude and detachment.
Repeated suicide threats and attempts as well as self-harm are typical borderline symptoms, also. The concerned persons thereby try to release an extreme inner tension and pressure. Not being able to find this release in everyday life, cuts or stab wounds are being inflicted and cigarettes are being stubbed out on the body of the borderliner. Eating disorders as refusal of food or regurgitation and drug or alcohol abuse occur alternately. Self-harm often begins as an impulsive form of self-punishment but becomes more and more a ritual behaviour that can be interpreted as a cry for help, a punishment method, a form of distraction and decompression of pent-up fear, grief or anger.
Finally, a chronic feeling of emptiness and boredom can be the reason for a pessimistic mood that can be suddenly replaced by an extreme anger that can be barely controlled. These outbreaks often appear highly disproportionate to the causing situation. Further characteristics of a borderline personality disorder are temporary delusions, psychotic episodes or hypnosis-like mental states.
Barbara Kliem
