Borderline personality disorder

What is borderline personality disorder (BPD)?

BPD is a personality disorder characterized by emotional, relational and behavioral instability.

People with this disorder show excessive reactions to abandonment, invalidation and injustice. They have low self-esteem, fluctuating moods, a destabilizing inner rage and a sense of emptiness that nothing can fill. They frequently adopt self-destructive behaviors that lead them to require several health services.

There is no single cause of these problems. However, it seems that a combination of biological, psychological and social factors play a role in the development of symptoms.

Knowledge of borderline personality disorder (BPD) has developped significantly over the last 30 years.

Indeed, since the 1990s, we have witnessed the development and experimentation of useful and effective treatment models for people with BPD. Dialectical Behaviour Therapy, followed by Mentalization-Based Treatment, were developed on different theoretical bases, but both proved effective according to rigorous research criteria. Both approaches have helped to shake negative conceptions of borderline personality disorder and raise hopes of recovery.

On a more positive note, it has been well documented that many people show a significant reduction in symptomatology over time, and that some may lose their diagnosis – that is, show a reduction in the number of diagnostic criteria for BPD (according to the DSM5).

According to the Canadian Public Health Association, the social determinants of health (SDH) have a direct and significant effect on overall well-being. Good social health translates into the ability to establish and maintain meaningful connections, relationships, interactions and networks with other individuals, groups or communities. When these bridges are broken, a person’s overall health – and mental health in particular – is affected.

Recent studies show that these people live nearly ten years less than the general population. In addition to persistent suicidal risk, substance abuse and poor lifestyle habits are often present. These people are usually in poor metabolic health (obesity, sedentary lifestyle, overeating or food deprivation, sleep deprivation, poverty, drug abuse, violence, anxiety). This clientele is over-represented in emergency departments and general practitioners’ offices.

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