Types of Borderline Personality Disorder and Treatment Options

Current estimates indicate that approximately 1.5% of the adult population in the United States is diagnosed with borderline personality disorder (BPD), with nearly 75% of these cases identified among women. The etiology of BPD is complex and not entirely elucidated, potentially involving genetic predisposition, environmental influences, and biological factors that may affect emotional regulation in the brain. Despite these uncertainties, the clinical presentation of BPD is well-characterized, and there is a range of therapeutic interventions available to manage and treat the disorder effectively. We will now examine the characteristics and treatment modalities of BPD in further detail.

What Is Borderline Personality Disorder?

Borderline Personality Disorder (BPD) is characterized by significant difficulty in emotion regulation. Individuals with BPD can experience profound emotional intensity, which can be challenging to stabilize. This condition not only affects the individual internally but also has external manifestations, including impulsive behavior, a fragile self-concept, intense emotional responses, and unstable relationships.

There are four distinct types of BPD, each defined by unique emotional coping mechanisms. It is possible for an individual to exhibit characteristics of more than one type, and the specific presentation may evolve over time. The following sections will delineate each BPD subtype and outline the general approaches to treatment.

Symptoms of Borderline Personality Disorder

Certain core symptoms are often present in those with borderline personality disorder, including a pervasive fear of abandonment and unstable interpersonal relationships. Individuals may also exhibit acute anxiety, irritability, dissociation, prolonged feelings of emptiness, episodic outbursts of anger, a compromised sense of self-identity, and engage in self-harming actions. It is imperative for anyone displaying these symptoms, or recognizing them in a loved one, to seek the guidance of a medical or mental health professional for assessment and support.

Impulsive Borderline Personality Disorder

Impulsivity refers to actions that are hastily executed without adequate consideration of potential consequences, typically characterized by a lack of foresight and a propensity for taking unnecessary risks or engaging in behaviors ill-suited to the situation at hand. Such impetuous decisions are frequently linked to negative outcomes. While impulsivity is observed within the broader population, it is notably prevalent among individuals with borderline personality disorder (BPD). Those with this condition can display a range of impulsive actions, which may include episodes of binge eating, aggressive conduct, or participation in dangerous and self-harmful activities.

Discouraged Borderline Personality Disorder

Often termed "quiet BPD," the discouraged subtype of borderline personality disorder primarily stems from a deep-seated fear of abandonment. Clinicians note its 'quiet' nature due to the internalization of its symptoms. Unlike other forms of BPD, individuals with this subtype are more prone to self-blame, exhibit suicidal tendencies, withdraw socially, and feel estranged even in communal settings. Despite these challenges, they frequently maintain a high level of functioning and achieve success, which can render their condition less visible and more challenging to identify than other BPD subtypes.

Self-Destructive Borderline Personality Disorder

Borderline Personality Disorder (BPD) with self-destructive tendencies can be challenging to identify as it often exhibits symptoms commonly associated with other mental health disorders, such as bipolar disorder. Signs to watch for include abrupt surges in energy, euphoric mood states, and reduced need for sleep.

Patients with self-destructive BPD may engage in substance misuse, participate in hazardous behaviors without due consideration for safety, and display tendencies toward self-injury. Additionally, profound experiences of self-contempt, depressive episodes, pervasive bitterness, erratic self-conception, and emotional instability are indicative of this particular manifestation of BPD.

Petulant Borderline Personality Disorder

Petulant borderline personality disorder is characterized by a constellation of behaviors typically associated with sulky or ill-tempered behavior, but manifested in adults. Individuals with this condition may exhibit irritability, impatience, stubbornness, as well as passive-aggressive tendencies and intense mood fluctuations. Such individuals often struggle with maintaining satisfying relationships and may resort to detrimental and manipulative actions.

Treatment: Psychotherapy

Psychotherapy stands as the cornerstone in the management of borderline personality disorder (BPD). The objectives of therapy remain consistent across different approaches: equipping individuals with strategies to regulate distressing emotions, minimize impulsive behaviours, and enhance interpersonal skills. Several therapeutic modalities, including Dialectical Behavior Therapy, Schema-Focused Therapy, Mentalization-Based Therapy, Systems Training for Emotional Predictability and Problem Solving (STEPPS), and Transference-Focused Psychotherapy, have demonstrated efficacy to varying degrees in the treatment of BPD.

Treatment: Anti-Anxiety Medication

The administration of anti-anxiety medications in patients with borderline personality disorder (BPD) presents a nuanced therapeutic challenge. While these medications can mitigate symptoms of anxiety associated with BPD, it is important to recognize that their efficacy in treating the core aspects of the disorder remains unclear due to a lack of substantive evidence. Moreover, some studies have indicated that these medications may potentially exacerbate BPD symptoms. Consequently, the decision to use anti-anxiety medications should be made thoughtfully, in close consultation with your healthcare provider, to ensure a tailored approach to treatment is employed.

Treatment: Antidepressants

Developing an effective treatment plan for borderline personality disorder (BPD) requires careful consideration of various factors. The plan must be tailored to the individual’s symptomatic profile and the intensity of those symptoms, under the guidance of a medical professional. In some instances, the treatment strategy may incorporate medications, such as antidepressants, which can alleviate symptoms related to depression, anxiety, and emotional instability. However, it is important to note that these medications may not directly address issues of anger or impulsivity associated with BPD.

Treatment: Antipsychotics

A variety of antipsychotic medications are available to clinicians to support the management of borderline personality disorder (BPD). These medications have proven effective in alleviating symptoms such as anxiety, paranoid ideation, heightened anger, and impulsiveness. Importantly, this is beneficial even though BPD is not typically characterized by psychosis. Nevertheless, the prescription of these antipsychotics requires careful consideration due to potential side effects. Notably, long-term administration may pose a risk of tardive dyskinesia, a condition characterized by involuntary movements in various parts of the body. Therefore, it is paramount for healthcare providers to balance therapeutic benefits with potential adverse effects when considering antipsychotic therapy for patients with BPD.

Treatment: Mood Stabilizers

With an understanding of borderline personality disorder (BPD), it is evident that mood fluctuations are a core concern. Consequently, medications designed to stabilize mood are typically the treatment of choice. These pharmaceuticals directly address the emotional dysregulation characteristic of BPD and have proven efficacious, particularly when combined with psychotherapy.

Treatment: Hospitalization

Individuals with Borderline Personality Disorder (BPD) may require hospitalization when there is a substantial risk of self-harm or potential harm to others. In such situations, short-term inpatient care at a certified psychiatric facility is often recommended, as extended hospitalization has not proven to be especially beneficial for BPD treatment. The primary aim of inpatient stays is to ensure patient safety through personalized or group psychotherapy, along with appropriate medication management. Following stabilization, patients typically transition to a partial hospital program or outpatient care for ongoing treatment.

The Takeaway

Borderline personality disorder (BPD) is a complex and significant mental health condition that can have a profound impact on the lives of those affected and their support networks. Timely and professional intervention is critical to managing the disorder and mitigating potential risks. Contemporary medical approaches, including an array of psychotherapeutic strategies and pharmacological treatments, have been shown to be beneficial in alleviating symptoms and enhancing the well-being of individuals with BPD. Each case requires a tailored approach; it is essential to seek guidance from a mental health professional to determine the most appropriate course of action for oneself or someone else impacted by BPD.

Types of Manipulation Tactics

It is important to recognize that manipulation tactics may occur in various relationships, including romantic, familial, and professional settings. Identifying manipulation can be challenging, particularly when it is subtle and persistent, potentially leading individuals to doubt their own perceptions. To safeguard oneself effectively, awareness and understanding of the various forms of manipulative behaviors are essential. This discussion aims to elucidate the different tactics employed by manipulators to help individuals recognize and protect themselves from such strategies.

What Is Manipulation

Manipulation can be identified as a method of emotional abuse, aiming to exert power or influence over others. Practitioners of manipulation strategically dictate the emotional and mental states of their targets to fulfill personal agendas, potentially indicating underlying mental health conditions, including narcissistic personality disorder. Awareness and recognition of various manipulative strategies are crucial for identifying and addressing such behavior when encountered.

Lying and Blaming

Individuals who exhibit manipulative behaviors are frequently adept at deceit. They commonly distort the truth about events and their behavior as a means to exert influence or coerce others. This level of proficiency in deceit can lead to victims doubting their own perceptions and judgment. Furthermore, manipulators frequently employ blame-shifting strategies as a tool to evade accountability for their actions, thereby redirecting attention away from themselves and maintaining a semblance of control, as noted by Verywell Health.

Gaslighting

Gaslighting is a prevalent form of manipulation aimed at leading individuals to doubt their own perceptions and sense of reality. As outlined by Verywell Mind, the insidious nature of gaslighting can result in a person questioning their cognitive faculties to the extent that they may feel they are losing touch with sanity. Recognizing indicators of gaslighting is crucial due to its potential to evoke mental health issues, including anxiety and depression. Should you find yourself experiencing a persistent sense of uncertainty regarding your judgment, feelings, and personal reality, or feeling increasingly insecure, it is possible that you are being exposed to gaslighting and may benefit from seeking professional support.

Projection

Projection is a psychological phenomenon where an individual attributes their own emotional state to another person. This tactic is often employed by manipulators to deflect personal issues by asserting that someone else is experiencing the feelings they are trying to avoid. For instance, a manipulator feeling jealousy might suggest their target is the one harboring jealousy, thereby shifting attention away from their own behavior. Recognizing projection is crucial, as it can undermine an individual's confidence in their own perception of reality, explains Maggie Holland, a licensed counselor in Washington. Vigilance against such manipulative strategies is essential to maintain personal psychological integrity.

Guilt-Tripping

Guilt-tripping is a psychological tactic characterized by inducing feelings of guilt to manipulate an individual into feeling remorseful or to compel them into certain actions. According to Mind Body Green, it is a method employed to influence the behavior of others through the encouragement of guilty sensations. Recognizable indicators of guilt-tripping, as outlined by the source, comprise a variety of specific behaviors.

Triangulation

Triangulation is a manipulation strategy where an individual may draw a third party into a disagreement between two people to influence the outcome. According to Choosing Therapy, the manipulator might present information selectively to the third party to bias them toward a particular side. Such tactics can also serve to heighten the sense of isolation in the victim, potentially escalating their reliance on the manipulator.

Moving the Goal Post

The concept of 'moving the goalposts' refers to the devious tactic whereby an individual alters the criteria or conditions of a situation during its course, effectively making it impossible for another party to succeed, as outlined by Choosing Therapy. This often manifests when, despite providing sufficient evidence to substantiate one's point, or fulfilling the initial request posed by the manipulator, they respond by imposing further requirements or demanding additional evidence.

The primary aim of employing such a strategy is to leave the targeted individual in a perpetual pursuit of validation. It is crucial to remain vigilant for indications of this manipulative behavior and to actively steer clear of it. It is important to remember that your self-worth is not contingent upon the acceptance of others.

Name-Calling

Utilizing derogatory language, manipulators often employ name-calling as a strategy to diminish their victims' sense of self-worth and establish a power imbalance in the relationship. This approach may not exclusively involve explicit insults; it frequently encompasses assigning negative connotations to the victim's character traits or actions. Such tactics tend to escalate progressively; initiators may engage in this behavior sporadically at first, intensifying the frequency as the victim becomes desensitized to the abuse, fostering an increasingly toxic dynamic.

Flattery

Exercise caution with excessive flattery; while it can appear authentic, it is often a strategy employed by those with manipulative inclinations for personal gain. Psych Central distinguishes between authentic compliments—offered sincerely and without ulterior motives—and flattery, which is frequently wielded to obtain emotional dominance and elicit reciprocation. It is important to discern the intention behind the praise, as manipulators typically leverage flattery with the expectation of receiving something in return.

Love Bombing

Love bombing is a subtle form of manipulation that may not be immediately evident. It entails the excessive bestowal of attention through gifts, compliments, affection, and time, which can create a façade of intimacy designed to gain the victim's unwavering loyalty, according to Psych Central. Initially, this overwhelming attention may seem flattering, but adopters of this strategy often reduce engagement abruptly, potentially leading to feelings of isolation in the victim. To mitigate the risks of love bombing, it is advisable to maintain regular connections with friends and family and to pursue personal interests independent of the relationship.

Passive Aggressive Behavior

Passive aggressive behavior is characterized by the indirect expression of negative emotions rather than direct communication, as defined by the Mayo Clinic. Manifestations of such behavior include sarcasm, sullenness, and insincere praise. It is a manipulative strategy aimed at maintaining control over another individual by causing them to remain vigilant and responsive to the manipulator's emotional state. According to Choosing Therapy, this tactic serves to centralize control and influence with the manipulator, thereby inhibiting the other party's ability to assess their personal emotions within the relationship.

Criticizing or Judging

Individuals who engage in manipulation commonly employ detrimental remarks to assert dominance, aiming to diminish another's self-esteem, as highlighted by Verywell Health. Repeated criticisms or judgments about one's looks, character, or life conditions could signal manipulation. These manipulators may have a tendency to exacerbate personal insecurities.

Taking Control of Your Life

Individuals displaying manipulative behavior may seek to exert influence over both your emotions and personal decisions. As reported by Choosing Therapy, such manipulation can extend to directing your financial expenditures and obstructing educational pursuits. Manipulators might also restrict your social interactions, specifying whom you may associate with during your leisure time. Should you experience isolation from loved ones or a lack of autonomy in your life, it is essential to recognize that these may be indicators of manipulation. If you find yourself in this situation, it is important to seek assistance.

What to Do if You’re in a Manipulative Relationship

It is imperative that one promptly identifies and addresses manipulative behavior, as it can significantly impact mental well-being. Engaging in a candid discourse with the individual, utilizing concrete instances to illuminate the behavior's impact, can be an effective initial step. Further action could involve the guidance of a mental health professional, who can assist in establishing appropriate boundaries and, if needed, advise on disengaging from the situation. It is crucial to garner support from a trusted network, including friends and family, to mitigate the potential isolation associated with manipulation. Resources such as Verywell Mind underscore the value of timely intervention and the support of loved ones in these circumstances.

20 Signs of Pancreatitis

Pancreatitis is a medical condition characterized by the inflammation of the pancreas, as noted by Healthline. The pancreas, situated behind the stomach, plays a critical role in releasing digestive enzymes and regulating blood glucose levels. While some cases of pancreatitis may resolve spontaneously, others may persist as a chronic issue, accompanied by a range of distressing symptoms. Below, we outline 20 indicators that may signify the presence of pancreatitis.

Acute Pancreatitis

Pancreatitis presents in two distinct forms: acute and chronic. Acute pancreatitis is characterized by its sudden onset and typically resolves in a matter of days. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), approximately 210,000 American adults are diagnosed with acute pancreatitis annually, with gallstones being the predominant cause.

Chronic Pancreatitis

Chronic pancreatitis represents a persistent form of inflammation within the pancreas that can result in lasting damage to the organ. Commonly associated with prolonged alcohol abuse, chronic pancreatitis may also arise due to autoimmune disorders and genetic factors.

Upper Abdominal Pain

The primary manifestation of pancreatitis, encompassing both its acute and chronic forms, is upper abdominal pain, which may radiate contingent upon the disease's intensity. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) clarifies that the nature of abdominal pain experienced differs between acute and chronic pancreatitis.

Pain Spreads To Back

Acute pancreatitis typically presents with pain originating in the upper abdomen, which may radiate to the back. This pain can range from mild to severe and often persists for an extended period, according to the National Institutes of Health (NIH). In cases of chronic pancreatitis, while the pain also generally commences in the upper abdominal region, it is noteworthy that some individuals may experience no pain whatsoever.

Pain Worsens After Eating

Pain located in the upper abdomen, directly below the ribcage, is often associated with pancreatitis. Initially, the discomfort may be subtle, but it typically intensifies post-consumption of food and beverages, as reported by Everyday Health.

Pain Worsens When Lying Down

According to Everyday Health, the intensity of pain associated with pancreatitis typically escalates when an individual reclines on their back and may subside when leaning forward while seated. Additionally, the discomfort may radiate to the back, yet it remains unaffected by bodily movements. The underlying cause of the pancreatitis can also influence the nature and severity of the pain experienced.

Abdominal Tenderness

Individuals suffering from pancreatitis commonly exhibit symptoms such as abdominal tenderness, which renders the midsection particularly sensitive to physical contact. This tenderness frequently coincides with abdominal distension and discomfort.

Fever

Acute pancreatitis typically presents with several symptoms, including fever, as recognized by renowned health authorities such as the Mayo Clinic and WebMD. Additionally, patients may experience a general feeling of weakness as the body combats the inflammation, and in more severe cases, there could be respiratory difficulties and a risk of shock.

Chills

Patients may experience fever accompanied by chills and symptoms reminiscent of influenza. These chills often stem from a blockage in the pancreatic bile ducts, leading to disturbances in the digestive process.

Elevated Heart Rate

Patients suffering from pancreatitis may present with tachycardia, where the heart rate accelerates to between 100 and 140 beats per minute. This cardiovascular manifestation may co-occur with systemic symptoms reminiscent of influenza, including fever, chills, and profuse sweating.

Weight Loss

Weight loss is a prevalent symptom in chronic pancreatitis. As reported by Very Well Health, individuals may experience weight reduction despite maintaining regular eating habits. While unintended weight loss might initially seem appealing, it typically signals a considerable health concern. This weight loss in chronic pancreatitis results from the pancreas's inability to function optimally. The organ fails to produce adequate pancreatic enzymes necessary for food breakdown, leading to suboptimal nutrient absorption. Consequently, essential nutrients such as fats, proteins, and sugars are excreted rather than utilized by the body, as noted by the aforementioned medical resource.

Nausea

Pancreatitis, a prevalent pancreatic disorder, frequently results in nausea and vomiting, particularly following the intake of fatty foods. The pancreas struggles to produce essential digestive enzymes, leading to discomfort when breaking down fats. High-fat foods such as hamburgers, avocados, nuts, and pizza are commonly reported to induce nausea, explains Dr. Andrew Hendifar, Co-director of Pancreas Oncology at Cedars-Sinai Medical Center. Patients with compromised pancreatic function may find these foods particularly challenging.

Vomiting

Nausea and vomiting are common symptoms of pancreatitis that require appropriate management. In instances where the patient is unable to manage vomiting, medical professionals may insert a nasogastric tube to alleviate the discomfort by draining fluid and air from the stomach. Very Well Health notes that, in cases of acute pancreatitis, conservative treatments may include a period of fasting for three or four days, during which the patient receives intravenous hydration and pain management to facilitate recovery.

Indigestion

Individuals suffering from pancreatitis frequently experience gastrointestinal discomfort, such as diarrhea, bloating, and dyspepsia, commonly resulting in upper abdominal pain or a burning sensation.

Bloating

Abdominal pain is the primary symptom of pancreatitis, but individuals may also suffer from bloating and abdominal distension, according to Healthline.

Oily, Smelly Stools

Healthline provides insight into an unusual symptom known as steatorrhea, characterized by fatty stools with an atypical odor. This condition indicates malabsorption, suggesting that essential nutrients are not being adequately absorbed due to insufficient production and secretion of digestive enzymes by the pancreas. Moreover, such stools may appear oily, resulting in an oil-like film on the toilet water, which Dr. Andrew Hendifar of Prevention attributes to undigested dietary fats that were not processed by the pancreas.

CHECK CALORIE

Diarrhea

Chronic pancreatitis can manifest through various symptoms, including abdominal pain, back pain, and diarrhea. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) emphasizes that symptoms may not be immediately apparent in individuals with chronic pancreatitis. In some cases, the initial indication of the condition could be the onset of complication-related symptoms.

At-Risk for Developing Diabetes

The pancreas plays a crucial role in regulating blood glucose by producing hormones essential for this process. Impaired pancreatic function can elevate the risk of developing diabetes. According to Dr. Axe, chronic pancreatitis often leads to physical scarring of the pancreas, which not only increases the likelihood of diabetes but also digestive disorders and pancreatic cancer.

Shortness of Breath

The U.S. Department of Health and Human Services identifies multiple symptoms indicative of severe pancreatitis, classified into acute and chronic forms. It is imperative to promptly seek medical assistance upon experiencing any of these symptoms, such as shortness of breath, to ensure immediate care and treatment.

Jaundice

Jaundice, characterized by the yellowing of the skin and eyes, is commonly recognized as a significant symptom associated with pancreatitis. It is essential to consult a medical professional if you observe such symptoms to ensure timely and appropriate care.