Borderline Syndrome • Typical Symptoms & Therapy

Borderline syndrome is a personality disorder that medical professionals classify as a very serious psychiatric condition. Borderline people find it difficult to keep their often intense feelings under control. They suffer from violent emotional outbursts and mood swings, which have a significant impact on their everyday life, the lives of those around them and all interpersonal relationships. Borderline patients' feelings and thoughts can change from one minute to the next for the slightest cause. Typical for the borderline syndrome are emotional instability, impulsiveness, internal tension and a disorder of the self-image.

Psychotropic drugs from nature: gentle help for the soul

Doctors also refer to borderline as borderline personality disorder (BPD), borderline disorder, or borderline syndrome. The World Health Organization (WHO) assigns the mental illness to the emotionally unstable personality disorders. Usually there are other illnesses and health problems, for example anxiety disorders, depression, sleep disorders, eating disorders or drug use.

Who does borderline affect?

The term "borderline" comes from English and translates as "borderline". The name has its origin in the fact that people with borderline show symptoms of both a neurosis and a psychosis, i.e. are on the border or in the transition area between the two clinical pictures. Doctors estimate that borderline disorder affects about three percent of the population. The first signs often develop at a young age. Most of those affected fall ill between the ages of 15 and 45. Borderline disorder is believed to affect women and men equally. However, more women than men trust a doctor, so the borderline diagnosis is more often made in women.

Symptoms: recognizing borderline

Borderline people experience violent mood and emotional swings as well as internal tension. They are easily irritable and can barely contain their emotions. Self-image and self-perception are also disturbed. Most of those affected experience the emotional roller coaster rides as extremely uncomfortable. They see themselves as victims of their moods and feelings and feel a high level of suffering. Relatives and friends also feel the effects of the borderline disorder: the disease has a decisive impact on interpersonal relationships.

In order to alleviate the tension, the inner pressure and the felt inner emptiness, those affected often resort to drastic measures such as self-harm. They cut their skin ("gashes") with razor blades and knives or burn themselves. They also display self-endangering behaviors: They consume drugs, balance on bridge railings or dash over the motorway at excessive speed to relieve internal tension. Many borderline patients also run the risk of suicide. Around 60 percent of those affected have made at least one suicide attempt. Early therapy for borderlines by an experienced therapist is therefore all the more important.

A borderline syndrome manifests itself in a variety of symptoms that those affected experience differently from one another. Borderline is characterized by impulsiveness and emotional instability. Not only the sick themselves, but also relatives, friends and the entire social environment suffer from mood swings and emotional outbursts.

An overview of the signs of the personality disorder

The American Psychiatric Association (APA) describes nine typical symptoms of borderline personality disorder in their Diagnostic and Statistical Manual of Mental Disorders (DSM):

• Fear of being alone: Borderliners are desperately trying to avoid breakups and loneliness.

• intense but unstable relationships: Due to the fear of being abandoned, the relationship between a borderline patient and his partner is usually very intense at the beginning (idealization). The initial admiration can quickly turn into devaluation (devaluation). Later, the partnership is in danger because of the strong emotional fluctuations.

• Identity disruption: Borderliners question themselves and their bodies. Your self-awareness is disturbed. You are insecure and lose yourself in a process of self-discovery.

• Impulsiveness: Strong impulsiveness often goes hand in hand with recklessness. Borderline people are easily irritable and show an increased willingness to expose themselves to danger.

• Self-harm and threatened suicide: Self-harm is often the desperate attempt by people with personality disorders to reconnect with reality. The self-injurious behavior also serves to relieve the internal tension and pressure. Threats of suicide or attempts to commit suicide often occur after or when expected rejection.

• Mood swings: Borderline people experience both positive and negative emotions very intensely, with negative emotional states usually predominating and lasting longer.

• persistent feeling of emptiness: To borderliners, things often seem pointless and boring. An inner emptiness leads to the loss of identity and makes them despair.

• Anger: Borderline people often have a very low stimulus threshold. They have difficulty controlling tantrums and are even ready for physical arguments.

• Stress-related loss of reality: "I'm in another world." A borderline patient often classifies anything and everyone as "bad" and believes that they cannot trust anyone.

Doctors speak of borderline personality disorder when a person has at least five of these symptoms.

Causes and triggers of borderline disorder

There are different causes for the development of borderlines. Doctors now assume that several factors must come together for the disease to develop. It can be assumed that genes play an important role: Hereditary factors influence whether a person is emotionally unstable, has an increased sensitivity or the self-image and self-perception are disturbed. If unfavorable environmental influences are added, such as experiences of violence or trauma, such as sexual abuse, a borderline personality disorder can develop.

Childhood experiences as a trigger for borderline

The roots of the disorder can be in childhood. The first signs of borderline can often be seen in adolescence. Possible factors that contribute to the development of mental illness include:

• disordered, difficult family relationships
• sexual abuse
• physical and mental neglect
• Experiences of violence
• psychological stress

However, borderline disorder can also develop in people who grow up in intact family relationships. A lack of self-esteem also has a meaning. People who had traumatic experiences in their childhood often have little self-confidence as adults. They are generally more prone to mental illness.

Diagnosis: This is how the doctor recognizes borderline

A psychiatrist, psychotherapist, or doctor can identify a borderline disorder through conversations, targeted questions, and observing behaviors and typical personality traits. The mental problems from which the person suffers are always important for the expert. The doctor first tries to develop a more precise understanding of the needs, fears and emotions.

There is no fixed procedure for the discussions between doctor or therapist and patient. The latter simply tells about his problems, worries and complaints. It is important to tell the doctor or psychotherapist honestly and in detail about yourself and your own life. This requires a relationship of trust between the patient and the doctor.

Criteria for the borderline diagnosis

For example, a psychiatrist or psychotherapist asks the following questions:

• Are you afraid of being alone or of being abandoned?

• Do you idealize or devalue people close to you and loved ones?

• How do you perceive yourself?

• How impulsive are you? Important clues are, for example, your buying behavior, reckless driving style or excessive sexuality.

• Are you hurting yourself or having thoughts of suicide?

• Do you often feel an inner emptiness?

• Do you have more tantrums?

• Do you suffer from paranoid ideas in stressful situations?

Discussions often help

If the doctor or therapist has made the diagnosis borderline based on the symptoms and medical history (anamnesis), he will decide on an individual therapy together with the patient. In order for the treatment to be successful, it must be specifically tailored to the specific problems and personality structure of the person concerned. One possibility is to talk to a doctor or psychotherapist. The therapy can also involve family and friends.

Psychotherapy important in treating borderlines

People with a borderline diagnosis usually benefit from psychotherapy. How this looks exactly varies from person to person. Among other things, it depends on the suspected cause of the disorder, such as whether there is trauma in childhood that needs to be dealt with.

Family and friends are also important pillars in treatment. They also help to cope with daily problems and banish dangers that lurk in self-harming behavior.

The doctor or psychotherapist is an important fixed point who can provide support and stability. It is important that the therapy is carried out regularly and not suddenly stopped. Due to the emotional instability and the strong mood swings, there is an increased risk here, which those affected and those around them should keep an eye on.

Borderline drugs

Whether and which drug therapy makes sense for borderline personality disorder depends, among other things, on the symptoms. Doctors use antidepressants, for example, for severe anxiety or aggression – especially against themselves – as well as for depression. These brighten the mood, soothe and relieve anxiety.

Course at borderline

How a borderline disorder will develop cannot be predicted in individual cases. Since the syndrome often has its roots in childhood, the first signs of this personality disorder may show up at this age. They often increase in the course of personal development up to adulthood and then decrease again. It is still unclear whether other symptoms develop instead, for example alcohol or pill abuse.

Psychotherapy and a stable social environment, in which family and friends support you, have a positive effect on the progression of the borderline personality disorder. In many cases, symptoms improve or go away completely. However, the suicide rate is higher among borderline people. It is all the more important to diagnose and treat the clinical picture.

Can you prevent borderline syndrome?

Borderline personality disorder cannot be prevented directly. Seek help at an early stage if you experience emotional problems or severe mood or mood swings. If you grew up in difficult family circumstances or had traumatic experiences in your childhood, such as violence or sexual abuse, you should seek medical or psychotherapeutic support. It's also best to talk to your family, partner, and friends about any mental health problems or symptoms that could indicate a mental disorder.

Avoid stress

Make sure you are having positive experiences that will boost your self-esteem and self-esteem. Take time out and make sure that you don't have too much stress in your work and everyday life. It is best to learn a relaxation technique such as autogenic training or progressive muscle relaxation. Those who can relax well react more calmly even in difficult situations and keep a cool head.

Get treatment for existing illnesses, for example ADHD. Because some diseases can promote a personality disorder like borderline.

Advice and help for people with borderlines

The first step with borderline is to confide in relatives or loved ones. Conversely, family members or friends should also take the initiative themselves and speak to the person concerned if they find their behavior conspicuous. Because especially with a mental disorder, the ability to recognize problems in oneself and to help oneself is limited.

Many clinics and psychotherapists offer help with borderline disorders. Doctors look for the right therapy for each patient and are at the side of both them and their relatives.

You can also find tips on (self-) help with borderline on the Internet:

• Portal on the topic of borderline for Germany, Austria, Switzerland

• The Borderline-Netzwerk e.V. is the first Europe-wide self-help association on the topic of borderlines

Overview of relaxation techniques