BORDERLINE PERSONALITY DISORDER

Borderline personality disorder

Borderline personality disorder

Introduction

Borderline personality disorder is a common mental disorder associated with high rates of suicide, severe functional impairment, high rates of mental disorders, intensive use of treatment, and high costs to society (Gregory, 2006). People with BPD have problems with self-image and identity, and may show an attitude of "all or nothing. This disorder is characterized by common self-destructive behaviour. In addition, BPD is often associated with other psychiatric disorders, such as eating disorders, anxiety or depressive disorder attention deficit hyperactivity disorder (ADHD) residual and the adoption risk behaviors. This paper focuses on borderline personality disorder, what it is and is not, its most common iterations in disability claims, cases in which it may cause impairment, and signs of impairment on the basis of the diagnosis.

Personality Disorders

Personality disorders are generally not believed to cause impaired function those results in lost work time. This is because, by definition, personality disorders have an onset in adolescence or early adulthood and are "an enduring pattern of inner experience and behavior” (Hoffman, 2003). Personality disorders, Axis II disorders, differ from Axis I disorders in that Axis I disorders can, theoretically, be diagnosed at any point in an individual's life. They differ from major depressive disorder (MDD) in that MDD is not required, by definition, to be "enduring"--MDD can be treated and can remit. A personality disorder is a long-standing (e.g., potentially existing for decades) pattern of behavior (Netherton, 1999). Theoretically, if an individual with a personality disorder was able to work at age 20, he or she should also be able to work at age 30 or 40. However, this logic does not always hold true. Personality disorders, including borderline personality disorder, are covered under the Americans with Disabilities Act.

The 10 personality disorders are divided into three general clusters corresponding to their type or commonalities: Cluster A (paranoid, schizoid, and schizotypal), Cluster B (antisocial, borderline, narcissistic, and histrionic), and Cluster C (avoidant, dependent, and obsessive-compulsive) (Gregory, 2006). Everyone has some maladaptive personality traits that manifest in stressful situations but are not pathological. Also, at some point, almost everyone has exhibited traits of all of these disorders. However, not everyone has these diagnoses. For example, someone experiencing the end of a relationship may be emotionally labile, vacillating between feelings of love and feelings of hate for the other person. This individual does not have a personality disorder because this is not an enduring pattern of experience and behavior, but rather a normal response to a stressful situation. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), a personality disorder should be diagnosed only if functional impairment (per DSM-IV-TR standards, not necessarily functional impairment in work capacity) or subjective distress exist (Hoffman, 2003).

Borderline Personality Disorder

Of the Axis II diagnoses, borderline personality disorder is most commonly found in disability claims. It is difficult to treat, live with, and navigate in the workplace. Individuals with borderline personality disorder may sabotage relationships, engage in risky or ...