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Post by Admin on Mar 22, 2017 17:47:10 GMT -4
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Post by Matt Kellner on Mar 22, 2017 19:05:15 GMT -4
The findings of DBT to helping borderline personality behavior was actually a life changing event for someone close to me. I have a 42 year old sister who throughout her twenties was diagnosed with bipolar , anxiety and depression. She was treated with the regular medications for many years, although she wouldn't take them as prescribed. The exact behaviors that are described in this article are exactly describing her personality. At about 32 years old she went off the deep end. I won't get into details about her charges, but she got put in prison on a ten year sentence and mandated to go to DBT(some DR for the state determined she had borderline PD). She served about 60% of her sentence and today she is thriving. She went back to college, received two degrees and is set to actually graduate in two months. I always asked what could a convicted felon do with their life as far as a job. She has a criminal justice degree plus a degree in addiction counseling and the state of SC actually paid for it. So being enlightened in the article about borderline personality disorder, having a personal experience makes it really hit home and helps me understand more what was going on.
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Post by sbonnerup on Mar 22, 2017 20:36:41 GMT -4
The part of the article that I found most intriguing is the part that mentioned pairing Borderline patients with healthy persons in an online game. It is interesting to see that the Borderline individual was so unpredictable that the non-Borderline individual would stop collaborating, despite it being in the mutual best interest. I surmise that it helps ingrain the notion that humans are creatures of habit that we (collectively speaking) will even go against our own self-interest (albeit virtual) to have a predictable scenario. This in turn creates a sort of paradox for the healthcare provider; how to treat the unpredictable. As the article alluded to, the success of pharmacologics is disappointing at best in the treatment of Borderline and that there are many metaphoric hurdles to the use of DBT including cost and treatment availability.
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Post by SKher on Mar 22, 2017 21:39:51 GMT -4
This article was really interesting to me and shed a lot of light on what exactly Borderline Personality Disorder is. It definitely helps see the condition in a better way and have a better understanding of what they go through and possibly experience in their daily lives without having any intention in doing so. When reading a textbook and doing questions, it seems pretty cut and dry as to what is BPD and what is bipolar disorder; I can see how getting the wrong diagnosis and giving the wrong treatment is plausible and it’s terrible how these patients have to suffer through trying new treatments, taking medications and paying for medications that they don’t even need, and possibly even experiencing the harmful side effects for no reason. I’m glad that DBT has been found to treat and potentially cure BPD, and hopefully in the future, DBT becomes more accessible for all patients with BPD.
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Post by Amaka E on Mar 23, 2017 11:42:25 GMT -4
Boderline Personality Disorder is one topic that people tend to brush aside or even joke about. Its one of the personality disorders that I for one have heard people make comments like "oh she's so dramatic its not that serious she must be borderline" while laughing. This article was nicely written and it captivates the reader with its reader while trying to educate on the example of how this disorder can affect millions of women and men without anyone paying particular interest and just branding them Drama Kings and Queens. Some people don't even get diagnosed correctly and they live with this disorder for years without any help. It is important to note that after diagnoses, treatment for Borderline personality using Dialectical Behavioral therapy although effective can be somewhat expensive, lengthy and not readily available. This can be very dangerous because there is no strong evidence connecting the use of phamacotherapy in the treatment of Borderline Personality disorder.
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Osvaldo Friger UMHS
Guest
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Post by Osvaldo Friger UMHS on Mar 23, 2017 13:53:31 GMT -4
Borderline personality disorder is emotional dysregulation and impulsivity that is often caused by any trigger. This type of personality disorder is viewed as taboo because it is misunderstood. The general population does not understand that it’s a disease that must be managed. What I found interesting is how scientists could correlate patients with borderline personality disorders with a highly reactive limbic system of the brain. It is the need to feel wanted that drives them into chaos and they are not able to manage their emotional outbursts. They have a lack of capacity for a realistic assessment. The article provided an important treatment option which is called dialectical behavioral therapy which aims to diminish suicidal behavior and to impart behavioral skills to manage emotional regulation and distress tolerance. Borderline personality disorder is a condition where psychotherapy is greater than medications and physicians must be able to get the correct diagnosis for appropriate therapy for patients.
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Post by Cynthia Okoro on Mar 23, 2017 20:14:01 GMT -4
Little difference between Bipolar disorder and Borderline personality disorder:
People with Bipolar disorder tend to experience depression as feeling of doing something wrong and reminiscence of wrong done in the past while those with BPD tend to experience depression as a vague feeling in the presence of anger and frustration.
People with Bipolar disorder move between manic and depressive phases with phases of normalcy in between while BPD effect is more consistent.
Bipolar symptoms can exist independent of relationship with other people while BPD symptoms come about because of how one interacts with others.
While cognitive behaviour therapy helps patient recognise their thoughts and how they affect the way they feel and behave, Dialectical behaviour therapy helps the way the patient interacts with others, reason why it is way more effective in BPD patients, and is also been used in other disorders.
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Post by Ankit Bindra on Mar 23, 2017 21:02:19 GMT -4
The point which stood out to me the most in this article was the lack of evidence to prove that pharmacotherapy was effective in treating Borderline personality disorder. Most psychiatric conditions are treated with medications and it is a very complex and individualized process of making a plan for every patients unique symptoms and needs. People with Borderline personality disorder essentially suffer from a misconception of socially acceptable behaviour. They misinterpret normal interactions to make themselves feel as if they are alone just to be in a familiar state of life again, of being alone. The conditions these people feel comfortable in are conditions most regular people would be uncomfortable in. This has not only been proven by studies before but the video game one as well. It showed that the behaviour of these individuals was so different that others were willing to isolate them rather than working with them towards a mutual benefit. This is why I believe that psychotherapy can be so effective for these patients because it can help teach them the normal social behaviours and how to modify their own in order to better control their emotions and life in general.
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jruiz
New Member
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Post by jruiz on Mar 23, 2017 23:06:25 GMT -4
It is hard to imagine the feeling of the patient and his family. This article helps to get on their shoes and have more empathy and understand the struggle they are going through. What surprised me the most was the high number of misdiagnosis. 40% of Borderline personality patients are first diagnosed as Bipolar Disorder. That is a really high number for a disease that is treated completely different. The diagnosis is challenging for many reasons like the symptoms don’t appear early on the doctor-physician relationship, symptoms are vague and overlap with other diagnosis, and not compliant with medications, which make the physician think that is the cause of they continue behavior. But truly big part of the misdiagnosed is the PCP lack of information on this topic and the lack of time on interview, which is not enough to really get to know the patient and for them to clearly expose they symptoms.
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devyn
New Member
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Post by devyn on Mar 24, 2017 0:03:32 GMT -4
This was an interesting article. It provided a better understanding of how a patient diagnosed with Borderline Personality Disorder (BPD) behaves and tends to react to reality. It is interesting how in the article they try to explain how they seek chaos as a means of distraction from their overwhelming emotions. Another thing I found interesting is how Mentalization-based therapy is also used for the treatment of patients with BPD. Mentalization-based therapy is a psychodynamic therapy that incorporates some cognitive techniques where the patient is trained to observe their state of mind and generate alternative perspectives of his or hers subjective experience (Bateman & Fonagy, 2009).
Reference
Bateman, A., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for Borderline Personality Disorder. AM J Psychiatry; 166(12), 1355-1360.
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Post by A. Deza on Mar 24, 2017 15:13:04 GMT -4
The best treatment is DBT. But it is too expensive. There seems to be a genetic factor previously ignored, as high as 55 percent. Very interesting to find out that there is an actual difference in the brains reaction to situations and though child-rearing impacts the development it is not just based off of parenting but structural make-up as well. People suffering with borderline personality will have trouble maintaing jobs and interpersonal relationships, sad that medication rarely helps. With these pt's living in a state of constant fluctuating emotions that affect their entire life, also with the amount of people affected by it, I hope more research will be done to come up with a practical cure.
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Post by Mythri Samboju on Mar 25, 2017 0:08:29 GMT -4
This article points out a lot of interesting facts about Borderline personality disorder. To me personally, it puts into place how common it is and how it is affecting a lot of people. I feel that people do not recognize or get treatment on it soon enough and it's quite sad that they usually end up at such a low point that they HAVE to receive help. It is also interesting to me how BPD can be misdiagnosed with so many other illnesses like Bipolar, anxiety, depression. Also, it is striking similar as a codependent and most have the same risk factors, meaning they come from a broken home or there was no sense of self where they grew up that possibly contributed to this disease. The core issue I believe is the same which is "bone of rejection" that people are going to leave them and the only way to cope with is to have an overwhelming fluctuation in their moods, despite all of their mood swings they can never really solve the root core. I am quite excited to see that they have come up with Dialectical behavior therapy it is working well for people to have a healthy lifestyle and that addresses the root issues. One thing I would love to learn more about though is how to differentiate BPD from other disorders in order to get the correct treatment. I would also like to understand how the role of family and friends play a part in dealing/coping with a BPD and be a good social support for them.
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Post by Ali Choudhry on Mar 25, 2017 19:51:43 GMT -4
Discussion surrounding the misdiagnosis of borderline personality disorder is an important one to consider, and clearly emphasizes the need for thorough interviewing of patients over a period of time, rather than focusing on isolated incidents. As clinicians, the skill of interpreting patterns of behavior and identifying underlying themes is the ultimate goal, allowing for proper diagnosis and treatment. In my experience with patients, it is in fact a difficult task to tease apart bipolar disorder from borderline personality disorder, and this article highlighted some of the key characteristics of each. I was able to learn about the technique and overall premise of mentalization and dialectical behavior therapy and hope to see it in practice. As exemplified by the patient in the article, DBT when successful can be life-altering and liberating.
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Post by Amir Mullick on Mar 25, 2017 20:47:46 GMT -4
The paranoia Klara displayed and the general height of her reaction were the exact criteria for borderline. BPD in her arose like it does in most major cases. She felt the couple left because something was wrong about her and that is what brought out her storm of damage. I have always been curious if BPD patients, before even being diagnosed, know they have BPD and thats why they are quick to assume that it was THEM that was the problem. Regardless, Klara consumed the fear of rejection and sent out a blatant text and spread fire to the guests. Rejection sensitivity is common, but not all of those people have BPD. "Chaos and crises bring comfort to borderlines" and they feel "safer in chaotic environments and relationships." There are a large number of such people as well, but they do not have BPD either. Or do they? I have personally met so many women, either in my life or the lives of others, who prefer chaotic relationships and have extreme paranoia that they mask with the term "jealousy." DBT is the perfect treatment and it was good to see that it has helped so many. Society needs to be more educated about such people and more emphasis needs to be put in teaching parenting. Parenting does not come naturally to everyone, and it is one of the major contributing roots to BPD and many other psychological disorders.
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Post by Chelsea Hoenes on Mar 26, 2017 22:11:46 GMT -4
I've always found Borderline Personality Disorder to be a rather fascinating focus of study, if only for the patient's desire for validation and acceptance and the subsequent, classic refusal of such treatment. This would naturally make it an extremely challenging disorder to treat for physicians, requiring an inordinate amount of patience and resolve. Dialectical therapy is so effective as a first line treatment, where medication often seems to be lacking in efficacy. It is so interesting that medications do not adequately treat the disorder, given that at least 55% of it (according to the article) is genetic, suggesting a physiological etiology. It is also noteworthy that most patients are women, again suggesting a strong physiological component. These observations may then suggest that we just do not know enough about the pathophysiology of the disorder to treat it pharmacologically. It would follow that much more research should be done to pinpoint the disease mechanism, which would hopefully provide some insight into a more successful treatment guideline. This would be of benefit to patients, as dialectical therapy is so often expensive and of lengthy duration, making it inaccessible to many. Parenting, as the article notes, plays a large role in development of the disorder in children, but the evidence is just too strong in favour of a physiological component to not delve deeper into possible unique treatment regimens
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