Mental Health Basics

Borderline Personality Disorder is a severe, chronic, disabling, and
potentially lethal psychiatric condition. People who suffer with this
disorder have extreme and long standing instability in their emotional
lives, as well as in their behavior and their self-image.

This is a common disorder affecting 2% of the general population. The
best evidence indicates that about 11% of psychiatric outpatients and
19% of inpatients meet diagnostic criteria for BPD (Kass, Skodol,
Charles, Spitzer, & Williams, 1985).

These instabilities of emotion, behavior, and self-image have
devastating and sometimes deadly consequences. People with BPD have
repeated and frequent difficulties in their relationships and work lives
and they feel alternating extremes of anger, depression, and emptiness.

All too frequently, 69% to 75% of individuals with BPD resort to
self-destructive behaviors such as self-mutilation, alcohol and drug
abuse, serious over or under eating, and suicide attempts to attempt to
escape from their emotional turmoil (Clarkin, Widiger, Frances, Hurt, &
Gilmore, 1983; Cowdry, Pickar, & Davies, 1985). The completed suicide
rate for BPD individuals is 3% to 9.5% (McGlashan, 1986; Stone,1983),
which is comparable to the other serious psychiatric disorders such as
depression, alcohol dependence, and schizophrenia.

Compounding the seriousness of Borderline Personality Disorder is that
it is difficult to treat. The very characteristics of the disorder, such
as unstable relationships and intense anger, interfere with establishing
the therapeutic relationship that is necessary to any treatment, whether
psychotherapy or medication.

Further, mental health professionals often are reluctant to treat these
individuals because they exhibit two characteristics likely to lead to
clinician " burnout " : the BPD person's hostility towards the clinical
professional and their persistent suicidal thoughts and feelings
(Hellman, Morrison, & Abramowitz, 1986).