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).

Despite the devastating nature of this disorder, it has not received the scientific and clinical attention that other health and psychiatric problems of equal, or even lesser, level of disability have received.

References:

Clarkin, J. F., Widiger, T., Frances, A., Hurt, S. W., & Gilmore, M. (1983). Prototypic typology and the borderline personality disorder. Journal of Abnormal Psychology, 92, 263-275.

Cowdry, R. W., Pickar, D., & Davies, R. (1985). Symptoms and EEG findings in the borderline syndrome. International Journal of Psychiatry and Medicine, 15, 201-211.

Hellman, I.D., Morrison, T. L., Abramowitz, S. I. (1986). The stresses of psychotherapeutic work: A replication and extension. Journal of Clinical Psychology, 42, 197.

Kass, F., Skodol, A. E., Charles, E., Spitzer, R. L., & Williams, J. B. W. (1985). Scaled ratings of DSM-III personality disorders. American Journal of Psychiatry, 142, 478-483.

McGlashan, T. H. (1986). The Chestnut Lodge follow-up study: III. Long-term outcome of borderline personalities. Archives of General Psychiatry, 43, 20-30.

Stone, M. H. (1983). Long-term outcome in personality disorders. British Journal of Psychiatry, 162, 299-313.