Borderline Personality Disorder (BPD) is a very disruptive condition and one of the most difficult to deal with in a medical setting.
Individuals with this condition typically have a long history of intense, unstable relationships and an extreme fear of being abandoned by people.
They almost always have a poor sense of identity that is highly influenced by surroundings and relationships.
Other key symptoms in BPD include inappropriate anger that is difficult to control as well as a history of impulsive, reckless behaviour in sex, spending, drug use, stealing or eating.
Chronic depression, anxiety, feelings of emptiness and rapidly changing moods are also hallmarks of this condition.
With the above symptoms, it is very common for those with this condition to have great difficulty in both relationships and employment.
Until quite recently, the prognosis for BPD patients was pretty poor. We had very little in terms of treatment options to offer and many physicians avoided dealing with these difficult patients.
In the past few years there has been progress in treatment with good outcomes using dialectical behaviour therapy.
A recently published study followed patients with BPD over the course of 16 years to learn what their lives were like as they recovered.
The McLean Adult Development Study (MADS) found that adults who had recovered from BPD were more likely to marry and be parents than those who do not recover—they also tend to wait longer to do so and have lower rates of divorce.
The variables of stable relationship and parenting were chosen as they are some of the indicators of successful adult adaptation.
At the 16-year follow-up, 60 per cent of patients had achieved at least a two-year recovery.
Almost everyone (99 per cent) had experienced a remission of symptoms, but some remained unable to work full-time, which was another factorin the definition of recovery.
Almost 80 per cent of recovered patients were ever married or lived with a partner for more than five years, compared with just under 40 per cent of non-recovered patients.
Those who recovered also tended to get married older (average age 29 vs 25 in non-recovered individuals).
Divorce rates were significantly lower among recovered individuals (42 percent vs almost 75 percent of non-recovered patients).
Some of the factors associated with successful marriage and parenting included an absence of childhood sexual abuse and a higher IQ.
This is one of the first long term studies looking at the life outcome for individuals recovering from BPD.
The results are encouraging and offer hope to those experiencing this very difficult condition.
If you suspect that you or a loved one may be experiencing a personality disorder such as BPD, speak with your doctor.
Help is available and recovery is possible.
Paul Latimer is a psychiatrist and president of Okanagan Clinical Trials.
250-862-8141
