What is BPD? The symptoms and diagnosis A serious mental health concern, BPD is a “personality disorder,” which is a pattern of thoughts, feelings and actions that tends to persist over time and leads to distress and problems in functioning (e.g., in relationships, jobs). BPD involves instability in several areas of life, including relationships, emotions, identity, thinking patterns and mental state (i.e., suspicious thoughts about others, dissociation), and behaviour. People with BPD often engage in self-destructive behaviours such as suicide attempts (up to 75% have attempted at least once), self-injury (up to 80% have self-injured) and death by suicide (approximately 9%).1 Many people with BPD struggle with intense self-hate, shame and feelings of inadequacy/failure. They have difficulty navigating relationships both at work and with loved ones, and difficulty understanding and managing their emotions. In order to get a diagnosis of BPD, a person has to have five out of nine total criteria, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). These criteria include the following: problems with relationships (fears of abandonment; unstable relationships) unstable emotions (frequent emotional ups and downs; high emotional sensitivity) unstable identity (unclear sense of self; chronic feelings of emptiness) impulsive and self-damaging behaviours (impulsive behaviour; self-injury or suicidal behaviour) unstable thinking/cognition (suspiciousness; tendency to dissociate when under stress)2 Although it may seem easy to “self-diagnose,” it is important to know that a valid diagnosis of BPD involves a fairly extensive assessment. This should be done by a professional trained to make valid psychiatric diagnoses, such as a psychologist or a psychiatrist. All too often, I have seen people receive a diagnosis of BPD (sometimes in error) based on a clinician’s impressions after a very brief meeting. Diagnosing BPD takes time and effort and must be done using methods with scientific support, such as structured diagnostic interviews, during which the clinician asks the patient a set of standardized questions about symptoms and experiences in order to arrive at an accurate diagnosis. Examples of these include the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II), or the Diagnostic Interview for Personality Disorders (DIPD). It is important for patients to know that the gold standard way to diagnose BPD includes these structured interviews and that they are much more reliable than the clinician simply asking questions that occur to him/her or using informal impressions to make a diagnosis.
Posted on: Sun, 27 Oct 2013 12:41:19 +0000
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