Borderline personality disorder (
BPD) is a
personality disorder described as a prolonged
disturbance of personality function characterized by depth and variability of moods.
[1] The disorder typically involves unusual levels of instability in
mood; "black and white" thinking, or
splitting; chaotic and unstable
interpersonal relationships,
self-image,
identity, and
behavior; as well as a disturbance in the individual's
sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of
dissociation.
[2] These disturbances can have a pervasive negative impact on many or all of the psychosocial facets of life. This includes difficulties maintaining relationships in work, home and social settings. Attempted suicide and completed suicide are possible outcomes, especially without proper care and effective therapy.
[3]Because the term no longer reflects current thinking, there is an ongoing debate concerning whether this disorder should be renamed.[4] There is related concern that the diagnosis stigmatizes people, usually women, and supports pejorative and discriminatory practices.[5]
People suffering from borderline personality disorder and their families often feel the hardships are compounded by a lack of clear diagnoses, effective treatments, and accurate information. At their request, the U.S. House of Representatives unanimously declared the month of May as Borderline Personality Disorder Awareness Month (H. Res. 1005, 4/1/08), citing BPD's "prevalence, enormous public health costs, and ... devastating toll on individuals, families, and communities."
Since the earliest record of medical history, the coexistence of intense, divergent moods within an individual has been recognized by such writers as Homer, Hippocrates and Aretaeus, the last describing the vacillating presence of impulsive anger, melancholia and mania within a single person. After medieval suppression of the concept, it was revived by Bonet in 1684, who, using the term folie maniaco-mélancolique, noted the erratic and unstable moods with periodic highs and lows that rarely followed a regular course. His observations were followed by those of other writers who noted the same pattern, including writers such as the American psychiatrist C. Hughes in 1884 and J.C. Rosse in 1890, who described "borderline insanity." Kraepelin, in 1921, identified an "excitable personality" that closely parallels the borderline features outlined in the current concept of borderline.[1]
