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Borderline disorder.

By Jose Pujalte Jr.

"He was a man, which,as Plato saith, is a veryinconstant creature."

-- Plutarch(A.D. 46?-A.D. c. 120), On the Tranquillity of the Mind

Say "Borderline" to me and the first thing that comes to mind is the certified gold 1980s pop hit by Madonna. Curiously, Time magazine talks of "borderline" in a less aural context and instead refers to a personality disorder popular in this decade. It's called the "borderline personality disorder." Writing in Time, John Cloud asks, "is borderline the illness of our age?" referencing the facts that in the 1950s, the popular "crack-up" illness was anxiety, in the 1960s and 70s schizophrenia, and the 90s, it was depression.

Definition. In general, personality disorders "are psychiatric disorders characterized by chronic patterns of inner experience and behavior that are inflexible ... with marked impact on patients' interpersonal relationships, and social and occupational functioning (American Family Physician journal). Personality disorders are grouped into three based on description. Cluster A (odd or eccentric) includes the paranoid and schizoid, Cluster C (anxious and fearful) lists the avoidant, the dependent, and the obsessive-compulsive. Cluster B (dramatic, emotional or erratic) is where the borderline belongs, along with the antisocial, the histrionic, and narcissistic.

Are you Borderline? What are the symptoms of the borderline personality disorder? enumerates the following:

Unstable self-image - sense of self changes rapidly from extreme good to evil leading to frequent changes in jobs, friendships, values, or goals, even gender.

Have tumultuous relationships - idealizing someone then suddenly hating him/her - because of the inability to handle gray or ambivalent realities of life; life for a borderline is either black or white.

Impulsive or risky behavior - careless driving, unsafe sex, taking illicit drugs, gambling sprees.

Strong emotions that wax and wane quickly.

Difficulty controlling emotions or impulses.

Inappropriate anger leading to violence.

Fear of being alone.

Suicidal behavior.

Intense but short episodes of anxiety or depression.

Causes. With the economic meltdown spreading like a virus worldwide, many health experts are already predicting a spike in suicides. How many of these will be known borderlines?

In the US, a 2008 Journal of Clinical Psychiatry study found that 5.9% (of 35,000 adults) or about 18 million Americans have been given a diagnosis of borderline personality disorder. The usual blame is pointed to genetics (as suggested by borderline twins, and family members), environment (seen more in individuals with a history of child abuse, neglect, and separation from loved ones) and brain chemical abnormalities (serotonin, a neurotransmitter that regulates mood has been implicated).

See the Doctor. The borderline is fully aware of his/her destructive behavior but is nevertheless helpless. This is where loyal friends and loving relatives should intervene and bring that person to a mental health professional (psychologists, counselors, and psychiatrists). It is never too late! You must make the effort because borderline suicide rates can reach a high 15%.

Complications too are just around the corner - depression, substance abuse, anxiety disorders, eating disorders, bipolar disorders - all, in the recipe for a painful and miserable life.

Treatment. Psychotherapy in the form of DBT or Dialectical Behavior Therapy emphasizes learned skills to handle emotions, tolerate distress, and improve relationships. Medications include anti-anxiety pills, antidepressants, and antipsychotics. The doctor may recommend hospitalization to lessen the chances of self-injury.

There is hope for getting better. It starts with first recognizing that the borderline personality disorder is staring right into our face. In fact, a coping skill is not to be embarrassed by having it and becoming responsible in getting proper treatment. This "take charge" attitude starts the right path to recovery. And as Madonna would have sung "keep on pushing me baby; don't you know you drive me crazy;you just keep on pushing my love over the borderline."

Eerily appropriate.



Jose Pujalte Jr.
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Title Annotation:Opinions and Editorials
Publication:Manila Bulletin
Date:May 19, 2018
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