Borderline personality disorder is a mood disorder characterized by relatively frequent mood swings from hypo-manic to depressive states. This condition has a major effect on individual’s social and professional life which become fully dependent on person’s current emotional state. While the diagnosis criteria for borderline personality disorder have been established for a long time now, scholars still lack a complete understanding, and thus, continue research on causes, biological processes behind it, as well as the most efficient treatment for this condition.
Borderline personality disorder is diagnosed when a person demonstrates constant shifts in their emotional state and general spirits from manic to depressive states with spending no or little time in balanced, normal mood. Manic periods last anywhere between couple of weeks and six months and are characterized by elevated mood and energy levels, decreased need for sleep, increased desire and ability to socialize and attain professional goals, hypersexuality, and sometimes aggression. During these periods person is very energetic and inspired, handles all the tasks easily, remains productive for longer. However, such bright periods are followed by depressive episodes which last longer, from half a year to a year, and are characterized by lowered mood, feelings of sadness, reduced ability to enjoy activities that are usually pleasant, difficulties concentrating and working persistently, and in some cases suicidal throughts. Depressive episodes interrupt the normal life span and cause people suffering from Bipolar disorder to take a step back in attaining their personal and professional goals, as well as cause difficulties in maintaining and building their social relationships.
Having much effect on individual’s ability to function in social and professional spheres, bipolar personality disorder attracts much societal attention do its possible causes and prevalence. Although considered to be rare, bipolar disorder is actually a widely spread condition within the United States, with about 14 million Americans suffering from it and people with bipolar personality disorder diagnose making up 20% psychiatric inpatients (Aguirre, 2017). These number includes both older and younger people, as symptoms of bipolar personality disorder may be observed as early as teen age (Aguirre, 2017), however, research concerning the effectiveness of treatment for bipolar personality disorder is mostly done on subjects who are at least eighteen years old (Clarkin et al., 2007), thus leaving the effect generally recognized treatments might have on teens suffering from bipolar personality disorder under researched.
It is also commonly believed that women are affected by borderline personality disorder at a larger scale than men. However, some researches suggest that actual distribution may be about equal and previously reported differences may be attributed to the fact that women more often seek psychological help(Aguirre, 2017). As the statistics is derived from numbers reported by psychiatric centers, the fact that women seek for professional help more often may create an impression that it is a feminine disorder, which is also supported by long-lived stereotypes about women having regular changes of mood.
While psychologists have worked out a sufficient understanding of what symptoms are associated with bipolar personality disorder, the biology of this condition is still being researched. As with many other psychological diseases, mood swings are explained by changes in levels of key neurotransmitters like dopamine, serotonin and others, which may trigger better of worse reaction of certain brain areas responsible for feeling of pleasure, sadness, etc. While this causal relationship is understood pretty well, scholars still do not know what causes the change of neurotransmitter levels during bipolar personality disorder. Some researches also attribute the observed emotional dysregualtion to abnormalities in function of certain brain regions. Namely, researchers observed that during the processing of negative emotions, patients with this condition have demonstrated more intense activation of left amygdala which makes up the emotional “motor”, and less intensive than normal responses from dorsolateral prefrontal cortex which serves as emotional “brakes” (Emotion dysregulation, 2013). In other words, while urge to experience the negative emotions is heightened, brain’s ability to properly process them without them dramatically affecting the overall mood is reduced.
Bipolar personality disorder is subject to treatment both with the means of pharmacology and psychotherapy. Combination of both approaches is usually recommended as it yields better results. Apart from generally prescribed medicines aimed at regulating the levels of neurotransmitters and thus normalizing person’s ability to function normally, there is a need to select an appropriate therapy to go with it. While classical psychoanalysis does not prove to be effective for this particular condition, many other psychological approaches have developed inventories and techniques for treating bipolar personality disorder. A study conducted by Clarkin et al. reports that transference-focused therapy, dialectical behavioral therapy, and supportive treatment are all effective approaches for bringing about positive change to bipolar personality disorder symptoms (2007). Particularly, transference-focused therapy and dialectical behavioral therapy reduce the level of suicidality, transference-focused therapy and supportive treatment are effective at handling anger issues. All three approaches yield positive results for depression, anxiety, global functioning, and social adjustment (Clarkin et al., 2007).
Drawing conclusions, bipolar personality disorders is relatively widely spread psychological condition which affects people regardless of age and gender. It is characterized by regular mood shifts from hyper-active manic episodes, to reluctant depressive states which negatively impact person’s life in professional and social spheres. Neurological explanations of bipolar personality disorder focus on abnormal levels of certain neurotransmitters in the brain as well as dysfunction of brain structures responsible for emotional regulation, namely the amygdala and dorsolateral prefrontal cortex. Treatment for this condition usually involves taking medicine combined with psychotherapy. Among various approaches to psychotherapy, transference-focused therapy, dialectical behavioral therapy, and supportive treatment were proved to positively effect bipolar personality disorder symptoms, thus offering people with this condition a chance to lead happy and productive life.