Personality disorders are a group of mental illnesses that have long-term effects on the patient's behavior and pattern of thought. Personality disorders cause patients' distress and problems that affect their normal functioning. Borderline personality disorder (BPD) is depicted by self-image issues, emotional instability, intense interpersonal relationships, and impulsive behavior. BPD can be treated using dialectical behavior therapy (DBT), which uses cognitive-behavioral principles. The use of psychotropic medication such as SSRIs, and mood stabilizers alongside DBT, has been seen to be effective. However, these medications must be conservatively used as they have a potential lethality. It is essential to share the patient diagnosis to help patients get the right information and treatment. Borderline personality disorder is a stigma laden condition that can be treated by DBT and psychotropic medication, where patients may be read for the criteria of the disease to find out if they identify with any of them before practitioners share the diagnosis.
Description of the BPD
Personality disorders are described as non-normative and pervasive patterns of thought and conduct that cause significant impairment over extended periods in both relationships and general functioning (Dixon-Gordon, 2011). Borderline personality disorder was first determined as a personality disorder in 1980 under the DSM-III, where it is seen as an offshoot or expression of an underlining mood disorder. BPD is depicted by emotional instability, impulsive behavior, self-image issues, and intense interpersonal relationships (May et al., 2016). Patients with BPD have an intense fear of instability and abandonment and have difficulty tolerating being alone. BPD may be genetically inherited or a result of brain abnormalities in regions that regulate emotion, aggression, and impulsivity (May et al., 2016). Some risk factors of BPD are an individual's hereditary predisposition to the disease or a similar personality disorder and having a stressful childhood where they are exposed to unstable family relationships, or were neglected during childhood.
Delegate your assignment to our experts and they will do the rest.
Therapeutic approach
Psychotherapy is a fundamental treatment approach for individuals with BPD. One effective therapeutic approach in treating BPD that is empirically supported is dialectical behavior therapy (Dixon-Gordon, 2011). DBT is an approach that comprises individual and group therapy to treat BPD. The approach is based on cognitive-behavioral principles, and it uses a skills-based approach in teaching clients to tolerate distress and manage their emotions so they can improve their relationships (May et al., 2016). DBT emphasizes on creating a balance between acceptance and validation of the client with behavioral change in numerous areas. Clients should receive weekly individual therapy that lasts 50 minutes (Dixon-Gordon, 2011). They should also attend weekly skills training group for two hours and have access to their therapist outside of appointments via telephone. Finally, there ought to be a therapist consultation team for each case (May et al., 2016).
Psychotropic medication is efficient in the treatment of BPD using DBT. Second-generation antipsychotics can be used in the treatment and management of aggression, while first-generation antipsychotics can reduce suicidal behavior and anger in patients (May et al., 2016). Mood stabilizers and anticonvulsants can improve aggression and impulsivity and moderately minimize depression. Selective serotonin reuptake inhibitors (SSRIs) also improve aggression in BPD patients. However, research shows that psychotropic medication should be conservatively used as they have a potential lethality except for SSRIs (May et al., 2016). Due to the effectiveness of the approach, patients presenting with BPD may report less disability and a higher quality of life.
How to share a diagnosis of BPD
Clinicians can share the diagnosis of BPD without damaging the therapeutic relationship they share with the client. BPD has been historically difficult to diagnose and disclose to patients because the disorder is stigma laden and may have a variety of responses from clients (Sulzer et al., 2016). I would share my diagnosis with the client by first discussing with them what BPD entails. I would discuss with them the Axis I comorbidities to ensure they are fully aware of what to expect with their diagnosis (Sulzer et al., 2016). I would then read out the criteria to see if they identify with any of them, then let them know how many they met; thus, diagnosing them for the disorder. I believe that informed consent is vital for patients, thus letting them know their diagnosis is essential to the therapeutic relationship. According to Sulzer et al. (2016), many patients expressed a feeling of belonging and relief once they were made aware of their diagnosis. They find the diagnosis to be a crucial step to getting the right information and treatment. After sharing the diagnosis with the patient, I will ensure that I offer them my time and help to make sense of their diagnosis to prevent them from falling into depression.
References
Dixon-Gordon, K. L., Turner, B. J., & Chapman, A. L. (2011). Psychotherapy for personality disorders. International Review of Psychiatry, 23(3), 282-302.
May, J. M., Richardi, T. M., & Barth, K. S. (2016). Dialectical behavior therapy as treatment for borderline personality disorder. Mental Health Clinician, 6(2), 62-67.
Sulzer, S. H., Muenchow, E., Potvin, A., Harris, J., & Gigot, G. (2016). Improving patient-centered communication of the borderline personality disorder diagnosis. Journal of Mental Health, 25(1), 5-9.
