Borderline and Multiple Personality Disorders

Borderline Personality Disorder (also known as BPD): an instable pattern of self-perception, personal relationships, behavior, and impulsiveness. BPD affects between one and two percent of the population. It is a mental disorder characterized by thinking in extremes (i.e. "good or bad," no in-between, or "black and white," no gray), instability in relationships, self-identity, and behaviors, and reckless impulsiveness. Studies have shown strong relationships between childhood abuse and later cases of BPD. Other major traumas early in life may lead to the development of the disorder as well as chemical imbalances of neurotransmitters in the brain such as seratonin and norepinephrine (chemicals involved with emotions and moods).

Classified as an Axis II disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), BPD is a persistent personality disorder. BPD diagnosis requires any five of nine listed criteria in the DSM to be present. Symptoms include: irrational fear of abandonment, unstable self-image, chaotic relationships, relationships fluctuating between extremes of emotions (love to hate and back again), severe impulsiveness in at least two self-damaging areas (such as eating disorders and promiscuity), suicidal behavior, mood instability, recurring feelings of emptiness, stress-related paranoia, and inappropriate temper flares.

Several forms of psychotherapy have been employed to treat BPD over the years, such as group or individual therapy. Other forms of therapy, such as cognitive behavioral therapy, have also been used to attempt to teach self-awareness to sufferers of the disorder and to teach how to cope with external consequences of BPD (relationship damage, etc.). Medications such as antidepressants and antipsychotics have also been used to treat BPD, working to correct chemical imbalances in the brain and restore a normal pattern of thinking and mood.

Multiple Personality Disorder, Dissociative Identity Disorder

Dissociative Identity Disorder, also known as Multiple Personality Disorder, is described by the DSM as a condition in which the affected individual experiences the existence of two or more distinct personalities in one body, each with its own thought and behavioral patterns. At least two of the personalities routinely take control of the person's behavior and personality. The temporarily dormant personality or personalities may experience a loss of time and memory while another personality is active. Dissociation is defined as a complex mental process that provides a coping mechanism for painful and traumatic situations.

Although experts have questioned the actual existence of the disorder, several factors have been said to contribute to its development. Extreme stress and insufficient childhood nurturing in response to hurtful experiences are such proposed factors. Childhood abuse and experience of other traumas can lead to the formation of multiple personalities in one individual as a way to cope with the stress and trauma. Between ninety-seven and ninety-eight percent of adults with the disorder have reported being victims of childhood abuse.

Symptoms of Dissociative Identity Disorder can often resemble those of other psychological disorders. Symptoms include: depression, irrational and unexplainable fears, physical pain (headaches, etc.), eating disorders, self-mutilation, suicidal tendencies, substance abuse, anxiety, panic attacks, and feeling unreal.

The disorder can be diagnosed with the above symptoms only if there are two or more distinct personalities present in the individual. A full physical examination must be completed in order to rule out medications, other drugs, or medical conditions as the cause of the symptoms. If no physical condition is found, the person will undergo a psychological evaluation to determine level of dissociation.

Treatment of the disorder aims mainly to relieve symptoms and bring all present identities together to reconnect as one. Psychotherapy can be used to give a patient insight into their disorder and how to cope with it. Therapy can be used to teach the affected new coping skills and how to healthily process difficult memories and experiences and express themselves and their emotions. Medication cannot treat dissociation, but can treat symptoms such as anxiety and depression in an affected individual. Behavior therapy can be employed to integrate all present personalities together into one.