Borderline

When I think of the word borderline, I remember the first hit of Madonna. She was young then and I think she was the real epitome of a pop star before the emergence of Britney Spears. She had a style all her own. It was slutty but nevertheless cute."Borderline" has simple lyrics and melody but during the start of the MTV era, her video was one of the breakthrough videos. Adolescents would idolize her and copy her fashion.

But another definition of Borderline has something to do with personality disorders in Psychiatry.

We study this in school.In psychiatry, It says that:

DSM-IV defines ten categories of personality disorder. Of these, Borderline Personality Disorder (BPD) is the most frequent in clinical practice. BPD is also one of the most difficult and troubling problems in all of psychiatry.
But I have to admit I never understood it before until I was able to see a prime example in real life. Believe me, I think it's really difficult to deal with someone with this kind of disorder, especially if a love one or someone close to you is afflicted with it. To give you an idea of some of the characteristics of this disorder. Here are some characteristics:

They have consistent patterns of instability in their relationships.

They commonly complain of depression and boredom.

They have very little control over their impulses.

They have a fragile and unstable self-image and affect.

They exert a lot of energy avoiding abandonment, whether real or imaginary.

Their relationships tend to be intense and short-lived.

They alternately idealize and devalue others, particularly their mates.

They make excessive emotional demands in close relationships.

They have difficulty tolerating ambivalence.

They always seem to be in a state of crisis.

Their behavior is highly unpredictable.

They place people in polar extremes, either all good or all bad.


Treatment

It is no secret that this particular client group can be something of a nightmare when it comes to finding effective therapeutic interventions. The treatment of BPD is fraught with difficulty, particularly in an in-patient setting where many borderline behaviors result in discord among the staff or where the demands made upon an individual nurse can become extremely unrealistic.

Treatment of BPD falls into two main categories - pharmacology, incorporating a range of medication options and psychotherapeutic techniques ranging from supportive counseling to psychoanalysis. Although many of the treatments available fall firmly outside the remit of the RMN it does no harm for nurses to understand the options available.

Pharmacological treatments include:

SSRIs to combat the deficiencies in serotonin absorption.

Neuroleptics to treat psychotic symptoms as well as dysphoria .

Carbamazepine has been used in the treatment of behavioral and affective problems.

Psychotherapeutic approaches to Borderline Personality Disorder are dogged with the same problems of compliance as pharmacological approaches are. This is in no small measure due to the difficulty Borderline patients have in forming the stable relationships generally seen as a pre-requisite for therapy.

Anyway, this blog is by no means trying to stigmatize personality disorders. It is caused by a lot of factors and anybody could be afflicted with it. Here is a diagram to help us understand the causes of psychological disorders.


But I believe that people afflicted with it should be compliant in their treatment, in order to manage their illness. A strong support group also helps.