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Case 35 - “I Cannot Wait to Get out of This Miserable Place”

Borderline Personality Disorder

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Borderline personality disorder is a complex mental health condition. Those with the condition have unstable moods, a history of difficulty functioning in relationships, and a dysfunctional self-image. Patients have emotional dysregulation that can lead to impulsive behaviors, self-harm, and fear of abandonment and have significant challenges in life that can lead to poor psychosocial outcomes. Interpersonal relationships can often be intense and dysfunctional and demonstrate frequent conflicts. Emotional dysregulation can lead to rapid and intense mood swings. Impulsivity can lead to issues such as reckless spending, risky sexual behaviors, and substance abuse. The treatment of borderline personality disorder is largely through long-term psychological therapy and the gold standard therapy approach is dialectical behavior therapy. This therapy focuses on optimizing emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness skills.

Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
, pp. 178 - 182
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Skodol, A., Stein, M., & Hermann, R. (2019). Borderline Personality Disorder: Epidemiology, Pathogenesis, Clinical Features, Course, Assessment, and Diagnosis. (Waltham, MA: UpToDate.)Google Scholar
American Psychiatric Association, D. S. M. T. F., & American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM–5 (Vol. 5, No. 5). (Washington, DC: American Psychiatric Association.) p. 663.Google Scholar
Evans, L. J., Harris, V., Newman, L., & Beck, A. (2017). Rapid and frequent psychiatric readmissions: Associated factors. International Journal of Psychiatry in Clinical Practice, 21 (4), 271276.CrossRefGoogle ScholarPubMed
Broadbear, J. H., Dwyer, J., Bugeja, L., & Rao, S. (2020). Coroners’ investigations of suicide in Australia: The hidden toll of borderline personality disorder. Journal of Psychiatric Research, 129, 241249.CrossRefGoogle ScholarPubMed
Woodbridge, J., Townsend, M., Reis, S., Singh, S., & Grenyer, B. F. (2022). Non-response to psychotherapy for borderline personality disorder: A systematic review. The Australian and New Zealand Journal of Psychiatry, 56 (7), 771787. https://doi.org/10.1177/00048674211046893CrossRefGoogle ScholarPubMed
Gartlehner, G., Crotty, K., Kennedy, S., Edlund, M. J., Ali, R., Siddiqui, M., & Viswanathan, M. (2021). Pharmacological treatments for borderline personality disorder: A systematic review and meta-analysis. CNS drugs, 35 (10), 10531067.CrossRefGoogle ScholarPubMed
Niesten, I. J., Karan, E., Franjenburg, F. R., Fitzmaurice, G. M., & Zanarini, M. C. (2016). Description and prediction of the income status of borderline patients over 10 years of prospective follow-up. Personal Mental Health, 10 (4), 285292.CrossRefGoogle ScholarPubMed
Paris, J. (2019). Suicidality in borderline personality disorder. Medicina (Kaunas), 55 (6), 223.CrossRefGoogle ScholarPubMed

Further Reading

Bozzatello, P., Garbarini, C., Rocca, P., & Bellino, S. (2021). Borderline personality disorder: Risk factors and early detection. Diagnostics, 11 (11). https://doi.org/10.3390/diagnostics11112142CrossRefGoogle ScholarPubMed
Gunderson, J. G., Stout, R. L., McGlashan, T. H., Shea, M. T., Morey, L. C., Grilo, C. M., & Skodol, A. E. (2011). Ten-year course of borderline personality disorder: psychopathology and function from the collaborative longitudinal personality disorders study. Archives of General Psychiatry, 68 (8), 827837.CrossRefGoogle Scholar
Soloff, P. H., & Chiappetta, L. (2019). 10-year outcome of suicidal behavior in borderline personality disorder. Journal of Personality Disorders, 33 (1), 82100.CrossRefGoogle ScholarPubMed
Veenstra, M. S., Bouman, R., & Oude Voshaar, R. C. (2022). Impact of personality functioning and pathological traits on mental wellbeing of older patients with personality disorders. BMC Psychiatry, 22.CrossRefGoogle ScholarPubMed

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