We all have met people who see life in “black or white”, “all good or all bad”, tend to idealize. Others and then to devalue them with enraged criticism, are always alert to a sign of rejection, and show similar. Instability in their own attitudes toward themselves. They may suffer from a common and disturbing personality disorder called borderline personality disorder (BPD).  Abandonment, a pattern of unstable and intense interpersonal relationships with  alternation between extremes of idealization and devaluation, unstable self. Image, impulsivity, recurrent suicidal behaviors, self-mutilating behaviors (e.g., slashing of wrists and forearms), marked reactivity of mood, chronic feelings. Of emptiness, intense anger , transient, stress-related paranoid ideation or dissociative symptoms.


Borderline personality disorder has a lifetime prevalence of 2- 3 %. It is more common in females than in males, and people in their 20’s are at higher risk for the disorder than those older or younger.   The causes are not fully understoo. Factors that seem likely to play a role include genetics, environmental factors (many patients have a history of childhood abuse, neglect and separation from loved ones), and brain abnormalities. The course of borderline personality disorder is chronic, with a gradual diminution in intensity of symptoms by middle years.

Psychotherapy is the core treatment for borderline personality disorder and is at least partially effective for many patients.  Dialectical Behavior Therapy (DBT) which uses a skills-based approach and Transference-Focused Psychotherapy (TFP) that centers on the relationship between the patient and the therapist have been effective. The overall prognosis for borderline personality disorder has improved over time, allowing many affected people to live productive, relatively stable lives.

By Ana Posada Diaz, M.D.

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