Talk:Borderline personality disorder/Archive 3

GA pass & FA fail
Does anyone know the dates when this article was nominated to GA status and when it failed FA nomination? I was going to switch out those banners on GA & FA for a milestone banner... Chupper 20:12, 6 June 2007 (UTC)
 * UPDATE - I found its FA Fails, and found the revision ID for a supposed GA pass, but I cannot find who reviewed it and approved it for GA and where this happened. Can someone point in the right direction? Chupper 20:32, 6 June 2007 (UTC)
 * Doesn't matter. All this happened way before the article got a complete overhaul in late 2006. A better way to go would be to compare article structure to schizophrenia, a Featured Article, which just underwent a Features Article Review successfully. cheers, Casliber (talk · contribs) 19:24, 28 June 2007 (UTC)

DSM criteria
Someone messed with the DSM criteria, adding in their own suggestions of examples of the criteria. Those should not be there as that section is a direct copy from the DSM-IV-TR. —Preceding unsigned comment added by 24.63.6.49 (talk)

My concern is that sufferers from BPD and their loved ones may not understand the first paragraph because it is intensional and abstract rather than extensional and concrete. In balance, I also acknowledge that BDP itself is a term defined by DSM-IV-TR, that it should be quoted accurately, and that all language should remain professional.

I inserted an example. It also helps motivate the next paragraph which speaks of potentially negative consequences and self injury.

--Ryan94114 (talk) 05:16, 2 July 2010 (UTC)

GA Pass
This article has been reviewed as part of WikiProject Good articles/Project quality task force. I believe the article currently meets the criteria and should remain listed as a Good article. The article history has been updated to reflect this review. Regards,  Lara Love  04:22, 24 September 2007 (UTC)


 * Do you (or anyone) have any suggestions for what the article needs to take it up to Featured Article?


 * It seems like the intro needs to summarise the whole article, at the moment it doesn't mention several sections. EverSince (talk) 20:38, 24 January 2008 (UTC)


 * Should be straightforward then. cheers, Casliber (talk · contribs) 02:40, 25 January 2008 (UTC)


 * PS: I was planning to take this, as well as bipolar disorder. There is a major issue with how we present material from DSM IV on wikipedia which dampened my enthusiasm significantly....anyway, lead first. cheers, Casliber (talk · contribs) 02:42, 25 January 2008 (UTC)

One link PLEASE
So far the article is very nice and encyclopedic. But the real power of wikipedia used to be that, in comparison to "ordinary" encyclopedias it had a practical side. Unfortunately with all the current "quality" hype that's rapidly disappearing. (Back to: "Nothing exists until a white male has written about it in a book") To make this a truly "great" article there should be at least one (or two) links to free information for sufferers and dependents. The current link via the British Institute of Health leads to a maze of ads for buying all kinds of stuff. thanks. —Preceding unsigned comment added by 80.171.253.37 (talk) 04:58, 28 October 2007 (UTC)
 * There's a plethora of information available in the article and in the references. Google can help those looking for free information from other sites. I don't think expanding the external links section isn't going to improve the quality of the article.  Lara  ❤  Love  05:05, 28 October 2007 (UTC)

Info on treatment of BPDs' families?
BPDs' impact on their families can be very severe due to the "anger" symptom, which results in abuse. In addition, many BPDs are also addicted. Consequently, treatment of BPDs needs to include therapy for family members. Should appropriate studies/links be included in this article? The downside is that, unlike families of alcoholics, there's not a huge amount of peer-reviewed study on BPDs' families, even though it's a common situation that comes up in therapy.3Tigers 07:55, 2 December 2007 (UTC)

++ COMMENT++ —Preceding unsigned comment added by 66.25.59.192 (talk) 19:16, 30 January 2008 (UTC) This point shouldn't be overlooked as the majority of individuals researching this subject are those that are collaterally affected by the disease; parents of children with BPD, children of parents with BPD, and someone in a relationship with BPD. Because BP are hypersensitive to criticism, and emotionally volatile, individuals with BPD tend cope by deflecting their feelings on others to avoid facing their own disability. This leaves the family members to deal with real issues like, how to you introduce a person with mental illness to treatment, how do you respond to the deflection in a way to support the person with BPD and not be emotionally injured by it.

Common human reactions to borderline behavior are often counterproductive with a borderline individual - cause problems for the family and the borderline person.

++ COMMENT ++

I totally agree with the person who posted above. I was once involved with a BPD but knew nothing about the illness until after the relationship completely fell apart. No one prepared me for it, not even her own family. I wanted to help her, but she didn't want to be helped. That was nearly seven years ago. Interestingly, the next woman I became involved with after her was very mentally healthy, and I'm now married to her. I guess the one lesson I learned was that I should stop trying to "fix" people. But even so, it seems unfair that BPDs have a low probability of having healthy relationships without some kind of professional help. Is it a catch-22 situation, where one of the symptoms of the illness is to reject the treatment? If so, there's something really innately sad about that. R. 199.173.225.25 (talk) 14:07, 25 June 2010 (UTC)

I think that the idea of Dialectical behavior therapy, I am currently diagnossed with this and this class has helped a lot.~ Sheila

BPD is now a Featured in es.wiki
It's been a long job to achieve it, but now here it is. This article and also the German one have been the basis for the Spanish article. Some things have been changed (i.e. the order of sections it's more like our nosographical criteria). Also we had to split it into two more articles (history, personality analysis) and also a non-encyclopedic supportive section with a quick guide and also a recorded wikipedia, because of the very large size of the article. Maybe the originality is the big space devoted to neurobiological approaches and also an important analysis on anti-psychotic medication. Let's say that it has been a "trilateral" achievement (Germany, Spain and USA). Thanks you all. --Gustavocarra (talk) 21:10, 20 February 2008 (UTC)


 * Thanks for posting here about this, I went to have a look and here for anyone else is the link to the Spanish-language version. Google provided a very dodgy translation that seemed to give up before the end!
 * The Spanish version has about 60 more sources and some nice pics, that might be useful here.
 * And can I just add all the other English-speaking people of the world along with USA as contributors to this article :)
 * EverSince (talk) 22:18, 17 June 2008 (UTC)

why split
i dont get why List of further reading on Borderline personality disorder is separate.. it's only linked from list of psychology topics —Preceding unsigned comment added by 74.12.96.150 (talk) 21:06, 6 March 2008 (UTC)
 * This is a good point. Why does this have it's own article?  Lara  ❤  Love  04:36, 7 March 2008 (UTC)


 * Well, we can't ask Zeraeph, who seems to be the one who split it off, at least she started the article anyway...oh wait, looks like it was a temporary holding bay, judging from this diff.


 * In any case, I have not used further reading bits in articles I have read, I guess hoping the person reading the article would look at the references and go from there. The BPD article is a hefty 73 kb and could get up to 100 by the time it gets to FAC...which I am planning to do one day...when I am feeling fully charged with loads of time. Casliber (talk · contribs) 07:06, 8 March 2008 (UTC)

Missing Information
Therapy Anew type of therapy developed by gregory, et al. (2008) known as dynamic deconstructive psychotherapy (DDP) has been developed specifically for BPD with good empirical support and needs adding to this page, as it is a competing treatment od DPT (Linehan) —Preceding unsigned comment added by 143.210.122.132 (talk) 11:31, 15 May 2008 (UTC)

Two main points are missing from this article. The first being an important part of the diagnostic criteria for BPD - "every person on this earth experiences some or all of the above at some time in their life but it is the frequency and intensity that distinguishes BPD." (www.mjtacc.com http://www.mjtacc.com/frameset.html?mintroduction.html~mainFrame)

And secondly is the four divisions of BPD, which are extremely important when an individual is classified as having the BPD -

Four Divisions of BPD A first-level distinction along the Borderline continuum

There are four generally accepted divisions within Borderline. It is theorized that the next version of the Diagnostic and Statistical Manual of mental disorders will distinguish the four major categories, similar to how other disorders such as Bi-Polar have been categorized.

Quadrant A) Low-Functioning, Out-Acting: generally unable to hold a job, pay bills, live unassisted; generally acts inappropriately to others, screams, yells, makes groundless accusations, engages in extreme projection.

Quadrant B) Low-Functioning, In-Acting: generally unable to hold a job, pay bills, live unassisted; generally directs frustrations inward in the form of self-mutilation, extreme negative self-talk.

Quadrant C) High-Functioning, Out-Acting: generally able to hold a job, keep things together; generally will "keep their cool" in a public forum like the workplace but will lash out at loved ones or those who "should be able to take it."

Quadrant D) High-Functioning, In-Acting: generally able to hold a job, keep things together; generally will "keep their cool" in a public forum like the workplace but will lash out him or herself in private over their anger and frustrations unspoken.

This is taken, in part, from http://www.bpdrecovery.com/modules.php?name=Content&pa=showpage&pid=9 and is discussed at length in the DSM-IV-tr, as well as http://www.mjtacc.com/index.html —Preceding unsigned comment added by 58.165.174.17 (talk) 02:06, 29 March 2008 (UTC)


 * It's a very complex and poorly understood condition. As with any mental illness, there are varying degrees of functioning and morbidity. I wish I had more time to help, but I don't.KGBarnett (talk) 02:25, 15 May 2008 (UTC)

Rough summary: - I note you say you are not prepared to discuss further - I wish to say and ask a few things - I would be pleased for a reply - But only if you wish to - No rush – think about it - reply if you wish - when you not in a hurry:

1: I did not pick bpd randomly as place to put that passage. Any one with an overview of what is going on [the debate in the mental health arena] will know why I chose bpd: i) It is, and has long been, the most controversial label [schizophrenia is catching up now though]:	ii) It is within established texts that bpd teaches us something about mental illness definitions and personality disorders: iii) It is paradoxical in that the more extreme the case the less visible it is – unique and curious and of great difficulty to explain within the field of psychiatry: iv) Other reasons too technical for me to bother you with:

2: Can you tell me how many people are going to be logging in to discuss on bpd page. I WILL POST THIS THERE THOUGH ASWELL AS ELSEWHERE I GUESS:

3: I feel inclined to expose the emails I sent you – compelled actually. Openness in a dispute that someone has become sulky in is important I feel - It helps heal ALL of tribe: I emailed you out of consideration – but I prefer no secrets!!!:

4: Can we put article in with references – it does imply it is or may be a minority view. If not can I put disclaimer for wiki of any mental illness caused by reading a narrow received opinion?:

5: We could put it at bottom of article – I could add more – but NOTE AT HEADER TO SEE BOTTOM OF ARTICLE FOR ROUNDED VIEW WOULD BE ESSENTIAL? I could put the passage in anti psychiatry (which I did not know existed) BUT WOULD INSIST ON A LINK FROM ALL PSYCHIATRIC LABELS we can manage: This paragraph or a link must come near top (I did not put it at very top – I put it where it would be seen and where the following text ran seamlessly onward from it) AND BE CLEAR – see next point:

6: Wiki is not considered a reliable source for the technical – [despite a recent brilliant piece on bbc radio 4 ‘thinking allowed’ where a member of public compared wiki with Britannica on a varied selection of topics of which they were well versed – conclusion “the cathedral is dead - long live anarchy” TO PARAPHASE] – despite this rousing recommendation your reputation falls foul in others’ eyes of what you similarly wield then at others you see as beneath you - it would appear – THUS THE MAJORITY OF READERS WILL NOT EVEN KNOW OF BALANCING VIEW – MANY WILL BE SUFFERERS I SUSPECT – THIS IS DANGEROUS FOR BPD SUFFERERS AND CARERS – AS A POSSIBLE FIRST PORT OF CALL:

7: I AGREE WITH ALL THAT YOU HAVE SAID (see below point 8) - EXCEPT THE INSULT THING - YOU DEFINITELY STARTED IT - I BELIVE HUMOUR IS THE (one of) BEST MEDICINE - ADMITTEDLY THERE ARE at least TWO SIDES TO THIS ARGUMENT AND JOKES CAN HIDE AWFUL ABUSIVE MEMES – I THINK YOU WILL FIND YOU ARE PROJECTING AT ME FROM YOUR HIPPOCAMPUS AND HYPOTHYLAMUS etc STUFF THAT YOU HAVE PATTERNED FROM STARING AT SO MUCH VANDALISM OVER THE COURSE OF YOUR TIRELESS WORK - NO DOUBT - HUMOUR ASKS US TO SEE THINGS DIFFERENTLY - AT BEST IN A VERY CONSTRUCTIVE WAY - IF WE ARE too aloof & ARROGANT TO LOOK IT, CAN FEEL LIKE AN INSULT or we miss the point:

8: I have been very patient with you. You have ended up playing the ‘card’ you should surely have played first (and I would have expected first) last: i.e. That the article should be placed elsewhere or is not a majority view and so deservers little billing:

Of course this would mean that years ago gay would be a vicious attack on people as an entry: That ‘blacks’ should be whipped into slavery would be standard unquestioned stance in your wiki:

So I hope you see that in some articles wiki should be ahead of the game for reasons of GOOD WILL TO ALL (WO)MEN and children etc. MORAL compass etc:

9: you do not mention that some administrators (I have found one straight away) may agree about progressively fostering genuine sub cultural anthropology etc (please don’t suggest I stick it in anthropology section) – it is probably, world wide across time, a majority view – can site examples if you wish and that wiki encourages opposing views for balance:

10: The issue of verifiability here is going to be important for the reasons of the ethics of the victor writes the rules. I cite modern historical study as moving toward accepting this paradox and trying to allow for it:

11: I have my own model of the universe as does everyone including you:

12: I note your use of the word OUR wiki in a sentence that excluded me:

13: I have not reviewed your biographies as yet but I URGE you to stop and thinkfeel - In this article, I want, (if you say I do sir), though I don’t feel I ask for it, an exception - Not for me as YOU INSULTINGLY put it more than once. But for the people the very entry is defining:

Who are you to dictate wiki policy in a conflict of rules and interest situation? Stop playing games and god? What is knowledge for? Let form follow function IN THIS ARTICLE?:

14: I would prefer to leave the body of the article untouched and add this paragraph (you exclude point blank with a litany of bias within wiki world of rules) to article but I could go and justifiably with citation spend (waste) hours hacking it to pieces if you prefer. The omissions and lack of emotional balance in society are everything in the bpd world my friend! All humans share the bpd traits - let not wiki - if only in this article! Think of bpd and other negative labels as actually people carrying the load under sensitivity that you don’t feel:

15: We have proved you don’t like labels. I rarely label a child or any for this reason. I say not you are an idiot. I say is that not an idiot thing to do or idea? QED. This entry MATTERS. If you don’t like it - why should a fascist’s entry not have proportionate balance in terms of effect - not your personal view of wiki hierarchy?:

16: Example: Should one place a ‘proven’ negative about someone everyone says is good ‘ GOD ’ like - at the very top of article - say a judge or the bloke the Catholics recently dug up and put in a glass box for all to (file/’phile’ past) bow to and made a saint – yet he seems to have been an abuser and had a personality disorder:

Similarly should a positive view of someone everybody wants to negatively label be put forward when individually they may have done only ‘ GOD’s ‘ work.

Tricky entries my friend - Need love? - Children are reading wiki as source - The study of the cult of psychiatry (psychology is clearer but needs to be seen in a wider context) has in my experience driven sensitive searching people over the edge as it is not an answer to the human condition as commonly thought and is presented but is a system of management or at least view which does not ‘add up’? All systems are imperfect so it is (can only be) perfect within its framework? THIS IS IMPORTANT:

17: For the record - Social anthropology devours psychiatry and psychology as foundations - I do not like or dislike them - I am impartial - BUT I AM partial to love - I am a shrink - A psychologist - Child psychologist - And more and less:

18: I give thanks: .-) (22catch (talk) 02:15, 24 May 2008 (UTC))


 * Dear 22catch. Some points you make are valid, but it is important to (a) write in a neutral manner and (b) avoid speculation. Talk of future classifications is just that. Another school of thought questions the vailidity of all personality disorders and noting the overlap between them. In this way ASPD, NPD, HPD and BPD have much in common. more later. Cheers, Casliber (talk · contribs) 02:29, 24 May 2008 (UTC)

Mnemonics in Wikipedia?
I find it strange to see mnemonic devices in an encyclopedic context. Though many contributors are likely students or professionals in psychology or medicine, and find these useful, it seems out of place in a matter-of-fact article. The mnemonic adds no new information to the article, it just repeats the diagnostic criteria. In addition (and this is why I've moved this here without discussing first) I find this particular mnemonic somewhat insensitive considering patients and their loved ones probably come here for help in understanding the diagnosis. --shingra (talk) 12:52, 27 May 2008 (UTC)

Mnemonic
A commonly used mnemonic to remember all features of borderline personality disorder is AM SUICIDE :
 * A - Abandonment
 * M - Mood instability (marked reactivity of mood)


 * S - Suicidal (or self-mutilating) behavior
 * U - Unstable and intense relationships
 * I - Impulsivity (in two potentially self-damaging areas)
 * C - (lack of) Control of anger
 * I - Identity disturbance
 * D - Dissociative (or paranoid) symptoms that are transient and stress-related
 * E - Emptiness (chronic feelings of)


 * I actually agree with this and would rather this was off the page than on it...Cheers, Casliber (talk · contribs) 13:34, 27 May 2008 (UTC)
 * I was surprised to see the mnemonic in the article to begin with and agree with removing it to the talk page.  – Mattisse  (Talk) 13:55, 27 May 2008 (UTC)
 * I agree as well. Not only is it out of place, but if someone who has been diagnosed with BPD, or the family of such a person, comes here to get information, AM SUICIDE is not really appropriate. It can give the inaccurate impression that everyone who lives with BPD has suicidal tendencies, which is not the case.  Lara  ❤  Love  15:08, 27 May 2008 (UTC)

New sections: (1) controversies (2) history
This is an excellent article but I would like to suggest two additions: Comments? --Anonymaus (talk) 12:30, 3 June 2008 (UTC)
 * 1) Contentious issues / controversies in relation to BPD, such as feminist peerpectives on gender and diagnosis; the stigma of BPD diagnosis and use of the BPD diagnosis to dimsmiss and deny care to 'difficult' patients who evoke powerful countertransference reactions. This would expand some of the points in the "terminology" section.
 * 2) The history of PBD, tracing the development of the concept from moral insanity to hysteria and on to borderline schizophrenia, pseudoneurotic schizophrenia etc, to borderline personality organisation and Gunderson's formalisation of ther concept - touching on Deutsch, Klein amd Winnicott on the way
 * 3) Under treatment, a section on Mentalization based treatment would be good


 * Strongly agree. I will be deveoping this article further at some stage this year on a march toward FAC. Hold me to this if I haven't done so already. Feel free to add material with references. if you ue a book I'd be really grateful got pages :) Cheers, Casliber (talk · contribs) 13:13, 3 June 2008 (UTC)


 * Ok, good. I'm happy to write one of the above but I dont want to duplicate what other are doing. A short paragraph on MBT will be easy, and I could do a 'Controversies' section by, say, end of June. The 'History of BPD' is much harder as it will require a lot of reading.  --Anonymaus (talk) 00:35, 4 June 2008 (UTC)::
 * I think a history section as well as a section deliniating controversies is a good idea as many people come to this article with various distorted views. Perhaps a history and controveries section can put it all in perspective. People can see from where their view stems. – Mattisse (Talk) 01:44, 4 June 2008 (UTC)


 * Fantastic. I am just confirming I ma not doing anything proactive with this article currently (apart from the film stuffI just added, and modelling the bottom section similarly to those in schizophrenia and major depressive disorder. Go for it and we'll keep an eye out and offer plenty ot 2c worth :) Cheers, Casliber (talk · contribs) 02:35, 4 June 2008 (UTC)


 * So would you agree with a heading Controversies and Contentious issues, with subheadings
 * A feminist position discussing BPD as a gendered diagnosis, and the view that it is a form of oppression of female abuse victims by male psychiatrists (I'm simplifying here obviously)
 * Patients that services don't like discussing the stigma of BPD, pejorative use of the label, the idea of it being untreatable being used as a reason to deny people treatment, and the idea that the term says more about the therapist or the 'therapeutic dyad' than it does about the patient
 * Is Borderline the best word, maybe move some of the discussion of the term "borderline" from the Terminology section --Anonymaus (talk) 09:11, 4 June 2008 (UTC)

(outdent) - the themes are good - generally headings are more succinct but nothing jumps to mind. Maybe a broader Gender issues for the first one above, rather than feminism per se. Second one is wordy and I will think on it. Third can be just left in terminology I'd have thought, as the issues are part of that subsection. The great thing is things can change and evolve as material is added. Make a start and we can discuss as we go. I generally agree with the ideas overall. Cheers, Casliber (talk · contribs) 14:03, 4 June 2008 (UTC)
 * I would prefer that the headings be less contentiously worded and more aimed an educating those who come to the page that, as in any diagnostic criteria, there are additional considerations that may not have been included for various reasons. For example, I agree that Gender issues is preferable to a feminist label as it is less political and plays less into stereotyped notions from my point of view. Besides, there may be other gender issues than just feminine ones. My concern is that the approach lean toward the educational rather than argumentative, if that makes sense.  – Mattisse  (Talk) 14:19, 4 June 2008 (UTC)


 * Agree - I think maybe just placing the Is Borderline the best word material in terminology would be best with a subheading maybe controversies in terminology or..well, jsut add away and we can play it from there. I did think that Patients that services don't like maybe best labelled as negative connotations which is essentially what the term has been encumbered with, and detail the development and arguments within. Cheers, Casliber (talk · contribs) 14:22, 4 June 2008 (UTC)
 * I'm not sure why the term Borderline has been retained, since I don't think there is now any attempt to explain that it is on the borderline of any category. A discussion of what would be a good term might be interesting in the light of current conceptualizations. The issue of negative connotations is also interesting. Many diagnostic categories have negative connotations e.g. antisocial personality disorder but this ones seems to have a constituency of those so diagnosed whose voice is heard. – Mattisse  (Talk) 16:16, 4 June 2008 (UTC)


 * Thanks for all that, I wil start playing in my sandbox. BTW, can you give some feedback on my bold editing of Group psychotherapy?--Anonymaus (talk) 23:19, 4 June 2008 (UTC)


 * My general impression is that borderline has been used fairly egregiously (I always wanted to use that word in a sentence!) - I haven't looked into the published literature and am interested to see what has been published in peer-reviewed journals on the matter. Cheers, Casliber (talk · contribs) 23:31, 4 June 2008 (UTC)
 * My guess is that after they realized the condition was not "borderline" anything, the term continued to be used because in general everyone knew what was meant. So it was easier to keep the term than settle on a new one that all would agree to.  – Mattisse  (Talk) 00:26, 5 June 2008 (UTC)


 * Sorry I meant egregiously WRT its pejorative nature. The initial 'borderline' concept was one on the border between neurosis and psychosis. Not sure if it will be renamed or what will happen. ICD10 has a more descriptive name. Cheers, Casliber (talk · contribs) 03:01, 5 June 2008 (UTC)

Sounds good. Just to note that no.1 as you describe it would also be covering content already in the Services and Recovery section regarding staff attitudes, difficulties in therapy etc, as well as the content in the terminology section. Be good to have more history on how the concept came about. EverSince (talk) 12:20, 11 June 2008 (UTC)

I have just one minor quibble in the Gender sub-section. Kaplan M (1983) is a rather old source for the line expressing the concept of the DSM being male-biased. It refers to DSM III from the old days of "ego-dystonic homosexuality," rather than DSM IV TR. Call me an idealist, but I'd hoped that the number of female mental health professionals and their influence had increased significantly in the interval between those versions, and that such bias had been lessened or even eliminated (I have no way of making such a judgement, I'm just hoping). Is there a recent source that can support this claim? Or else, should it be removed? (Note: I've worked with males with BPD, so I'd not heard much about the gender issue.) Legitimus (talk) 13:28, 17 June 2008 (UTC)


 * There are other recent (and BPD-specific) sources in there that I added last year like Women at the Margins: A Critique of the Diagnosis of Borderline Personality Disorder (2005). I think it's a good point about the Kaplan source and anyway more general points about the DSM should probably go in the DSM article... FWIW this pop article describes some of the related controversies continuing even for the planned DSM-V... Though I don't think the problem is just the DSM manual but the whole context - Defining Normal: Constructions of Race and Gender in the DSM-IV Casebook -- Sex and Gender Bias in Self-Report Personality Disorder Inventories -- Gender acts as a context for interpreting diagnostic criteria. EverSince (talk) 14:54, 17 June 2008 (UTC)


 * Fair enough, I've taken the Kaplan sentence out. --Anonymaus (talk) 06:03, 18 June 2008 (UTC)

"Sexual abuse is equal among boys and girls?" I just put in a "citation needed" for that claim. It's not true. The article on child sexual abuse cites many studies that show the incidence is higher among girls than boys in the US and UK. The claim is false, but simply removing it or modifying it would alter the basis for the statement that follows it, which I'm not sure actually makes sense as it stands. Anyone wanna tackle that? Dcs002 (talk) 09:49, 2 October 2009 (UTC)

The following statement in the article is problematic: "Clinicians respond differentially to men and women presenting with the same symptoms; for example, women presenting with angry, promiscuous behaviour are likely to be diagnosed with BPD, whereas men presenting with identical symptoms will be diagnosed with Antisocial personality disorder." It is stated as a fact, not as anyone's opinion, with no citation. I think this is particularly problematic due to the emotionality of the issue. It gives fuel for resentment and blame. I have heard this claim made before, but I've not seen it substantiated by evidence. Again, citation needed. Dcs002 (talk) 09:59, 2 October 2009 (UTC)

Globalize
With respect to Eduardo1971, the addition of "Licensed Clinical Social Worker (LCSW),Psychiatrist (MD), Clinical Psychologist Ph.D)" under Diagnosis seems very USA-specific, because (a) it would not be common practice in the UK or Australia for social workers or indeed clinical psychologists to make DSM diagnoses, and (b) the term "MD" is enttirely specific to the USA; in UK and in Australia we would say MBBS and/or MRCPsych or FRANZCP. I suspect LCSW is also a USA-specific qualification. Request permission to take out MD, PhD and LCSW as superfluous to the substance of the paper, and add "(in the USA)" after Social Worker?--Anonymaus (talk) 08:34, 11 June 2008 (UTC)


 * Yep. sounds good to me. Cheers, Casliber (talk · contribs) 08:55, 11 June 2008 (UTC)

Diagnosis
I'm unhappy with the Diagnosis section. I was following up the [citation needed] for EEG and CT scan, and there is nothing on lab investigations in the assessment of BPD in the New Oxford Texbook of Psychiatry (a very big book), and this made me think that, no, all this talk of calcium, thyroid, epilepsy and brain lesions is really irrelevant to BPD (admittedly it does form part of a standard in-patient assessment protocol, but not for BPD specifically) -- and there is NO WAY any clinician is going to confuse BPD with (say) epilepsy. So I suggest we delete the lab investigation / EEG / CT paragraph, as adding nothing to this article, and potentially confusing to readers with a BPD diagnosis, and instead add a paragraph on structured psychological assessments such as the SCID, MCMI and SNAP. --Anonymaus (talk) 07:12, 12 June 2008 (UTC)


 * Erm...in general, everyone gets a one-off organic screen whichever way they come into psychiatry. It thus depends on how inclusive or exclusive the article is supposed to be. I put this material in the first place, with the idea of making sure it was clear it was a part of general psych. protocol and generally negative. I usually diagnose on clinical grounds and very rarely call for any structured interview/psychological assessments, however they are good for research and epidemiology. Cheers, Casliber (talk · contribs) 07:27, 12 June 2008 (UTC)


 * Fair enough and no offence intended to your contributions or your practice. I guess my points would be -- does the special investigations bit actually tell the reader anything about BPD? And is it actually standard practice to do Calcium and EEGs and CTs in the assessment of BPD? Maybe it is, but we need some supporting evidence. You're right about the structured assessments not being used clinically much, but for completeness they should perhaps be somewhere in the article? --Anonymaus (talk) 10:38, 12 June 2008 (UTC)


 * Absolutely. Go for your life on a para or the assessments. I guess my idea was education to a layperson, so there will generally be some baseline physical tests. Just like mentioning that most treatment these days is outpatient-based etc. etc. Cheers, Casliber (talk · contribs) 11:13, 12 June 2008 (UTC)


 * I thought the same thing and agree it should include something on the psych assessments used. Though I think it's right to mention that medical screening tests may be done. Routine practice varies by service and country...it is the case, and there are studies showing, that especially in the typical underfunded generalist service "diagnosis" is often just an intuitive judgement made after some informal interview and observation, albeit with reference to official criteria. EverSince (talk) 12:26, 12 June 2008 (UTC)


 * I am wondering about the mental health professions listed under diagnosis. Perhaps, just mental health professions should be mentioned and that would be enough. If Licensed Clinical Social Worker (LCSW) is mentioned, then why not Licensed Mental Health Councilor (LMHC) and the various nurse practitioners that also can make the diagnosis? And, of course, everyone must be licensed. – Mattisse  (Talk) 23:11, 26 June 2008 (UTC)


 * Yep I'd say so, the distinctions being covered in mental health professional. EverSince (talk) 14:41, 28 June 2008 (UTC)


 * Regarding Casliber's comment, I think a description of the type of medical screening procedures that would theoretically be done before any diagnosis should be minimized because if this were done for every diagnosis it would be redundant. Maybe there should be a general article on making a mental health diagnosis that would cover all these possibilities Second, most people receiving the diagnosis have not received a panoply of medical procedures (at least in the United States)  so anyone reading the article might wonder why he or she did not. It would set up expectations that would not, for the most part, be fulfilled. – Mattisse  (Talk) 15:02, 28 June 2008 (UTC)


 * It is usual practice here for anyone presenting with psych symptoms the first time to get a screen as outlined above. As far as I know, the screen doesn't have a name and varies depending on risk factors and diagnosis. So I am not sure what one would put them under as a separate article --> organic screen? I guess, but I have not seen it reified as such. (?) And again, we still do tehm alot more than structured interviews. Cheers, Casliber (talk · contribs) 22:31, 28 June 2008 (UTC)

(outdent) I agree with Matisse - the same assessment would apply to any psychiatric diagnosis and isn't specific to BPD, so I've greated a psychiatric assessment stub and moved the paragraph there. Within (literally) about 30 seconds it got an AFD tag because it was just a "definition" - so if anyone wants to help get the page going, that would be great.--Anonymaus (talk) 22:39, 28 June 2008 (UTC)
 * I tried to find an easy reference but "psychiatric assessment" does not seem to bring up much of relevance on the internet. Psychological assessment brings up psychological testing for the most part. I should look in my books. – Mattisse  (Talk) 23:03, 28 June 2008 (UTC)
 * I added a temporary reference to save it temporarily. But if the psychiatric assessment stub is to remain, it needs help!  – Mattisse  (Talk) 23:16, 28 June 2008 (UTC)


 * About the bit further above- I've never heard of anyone getting any physical tests if they end up somewhere for psychiatric assessment or suspected BPD. Maybe they'd get a routine blood test like you would when you arrive at hospital for most reasons, to rule out any other problems?  The only physical test I know of people with mental health problems being given prior to diagnosis is rarely, people with schizophrenia will be given a CT scan to either confirm the diagnosis, or rule out it being anything else. Sticky Parkin 00:52, 2 July 2008 (UTC)

Terminology
The terminology stection seems way too long and detailed to me, coming at the end of the article as it does. Besides, it repeats the key issue of who first coined "borderline" which is already mentioned above. Does a discussion this detailed about where the term came from belong in this article? &mdash; Mattisse (Talk) 21:20, 30 June 2008 (UTC)

I remove mark "to technical" from section terminology, because I'm not specialist in medicine but that section helped me to understand hole topic, though big yellow mark just distract me from.

PanAeon (talk) 21:20, 30 June 2008 (UTC)


 * Most of the terms in the explanation are archaic, technical terms and are not understood fully by younger people in the profession, never mind a non expert. How did it help you understand Borderline personality disorder? I am curious to know. &mdash; Mattisse  (Talk) 21:25, 30 June 2008 (UTC)


 * I think it is relevant because
 * It helps answer the recurring question "why is it called borderline?"
 * It conveys to non-specialists that diagnoses are socially constructed concepts that evolve over time and do not exist in objective reality in the same way theat tulips and geraniums exist in objective reality
 * It is of encyclopedic interest, and takes people to other ideas.
 * --Anonymaus (talk) 22:44, 30 June 2008 (UTC)


 * Perhaps we should decided what this article is about. Is it about the APA DSM classification in the diagnostic manual or is it about a general concept of borderline. If is is about the former, then it seems to me the history of the DSM classification and the reasoning that went into that concept should be emphasized rather than popular press concepts. If is is the later, then anything goes in the article. &mdash; Mattisse  (Talk) 13:40, 1 July 2008 (UTC)
 * I started a history section, as the terminology section is misleading. Hopefully the history section can show that the issue is not primarily one of terminology but of conceptualization of what the disorder encompasses. &mdash; Mattisse  (Talk) 16:47, 1 July 2008 (UTC)
 * Given that new section, it seems like the first half or so of the terminology subsection could be merged in to there, leaving the terminology subsection to start from "There is a debate as to whether BPD should be renamed..." since it's in the controversy section about the current issue. It could be linked to the history section, which should probably be moved further down the page to be consistent with other articles in this area. EverSince (talk) 09:58, 2 July 2008 (UTC)

Treatment Line
Is this line actually controversial?

"The mainstay of treatment are various forms of psychotherapy. In general, medication and talk therapy are methods of treating borderline personality disorder.[citation needed]"

It seems to me that it would be obvious that in an article about a psychiatric illness, that "medication and talk therapy" are the routine forms of treatment for the problem, or am I missing something? The statement seems to be a foregone conclusion and uncontroversial and does not require a citation. Thoughts? SiberioS (talk) 03:28, 8 September 2008 (UTC)


 * I can see your point, however there are diagnoses where medication is of little help, and some where psychotherapy's role is limited. Cheers, Casliber (talk · contribs) 04:49, 8 September 2008 (UTC)

From my experiences, borderline is treated with medications much less than mood disorders (like depression) because of the great emotional instability. Anti-depressants don't have nearly as much of an affect on people with borderline personality disorder, and I think this point should be explored more here; sometimes people with this disorder are put on mood stabiliizers, but I think in general borderline can't be treated as effectively with medication. Solstici (talk) 03:54, 30 September 2008 (UTC)


 * Do you have a source or is this merely conjecture? As I said below, the NIMH and the American Psychiatric Association both recognize medication as standard treatment options for BPD, and it is in fact included in the APA's Ptreatment guidelines for the disorder. Rapunzel676 (talk) 02:49, 23 February 2010 (UTC)

PLEASE, someone mention DBT. For me, nothing has had as positive impact on my BPD as DBT. I worship at the alter of Marsha Lineham daily. CBT helps but I never made any progress toward being able live with myself until she came into my life.

BPD is difficult to treat. I have factual and clinical references which support the role of DBT. But I also saw DBT mentioned in an earlier draft of this document, and remember some atypical antipsychotics mentioned as helpful medications. I know the science hasn't changed, why has the text? DBT is taken seriously by most CBT clinicians. I don't want to write up DBT unless I understand the forces removing prior mentions of DBT. (I know, no gaurantees, anyone deletes anything anytime, but hoping there's an undercurrent of consistency here as there is elsewhere).--Ryan94114 (talk) 05:38, 2 July 2010 (UTC)

Also, there is some new research on brain research on. The

A new way to describe Borderline Personality Disorder
A NORMAL person experiences their emotions between their belly-button and their nose. A person with Borderline Personality Disorder experiences THEIR EMOTIONS from the floor to the ceiling.

Please keep in mind, this is my opinion and observation from my own experiences as I am burdened with borderline personality disorder.

cayenne4605, Portland, OR


 * I definitely agree. One minute I can be laughing and joking and the next I'm escalating into a rage over what can very well be a small matter. I'm not sure if the article gets that point across clearly enough. 65.60.232.191 (talk) 03:42, 30 September 2008 (UTC)


 * We will try, this is called emotional dysregulation, or sometimes colloquially "mood swings" - problem is this gets confused with "mood swings" of bipolar disorder, which last weeks to months generally and are very different. Cheers, Casliber (talk · contribs) 03:51, 30 September 2008 (UTC)

to do box
I have left a 'to do' box above. Rather than having possibly useful bits buried in talkpage archives, I have created this place for moving material which may be useful but is not sourced properly, or may be with primary sources and could do with a review article or whatever. Feel free to add questionable content from the mainpage to there for reviewing if need be. Cheers, Casliber (talk · contribs) 13:02, 25 November 2008 (UTC)

Cultural references.
As a therapist I find this article in general full of vague conjecture. To say this article needs more citations is an understatement, it is full of opinion and and vague material that has obviously been cut and pasted from other articles without a full explanation of the nature of the original article. Unless the writers of these films have stated these characters have bordeline personality disorder who the hell is anyone else to say they do, "Strongly suggested" is not good enough, it is opinion and not fact and incredibly irresponsilbe and ignorant to sat the least! A "tongue in cheek" book is not a valid reference for an article on such a serious issue, it needs references from medical texts. The only noted cultural reference is the play blue/orange which is stated as being about BPD these other films have absolutely nothing to do with it, you might as well refer to BPD as 'bunny boiler syndrome'! —Preceding unsigned comment added by 92.239.136.234 (talk) 02:41, 8 January 2009 (UTC)


 * Several books written by a psychiatrist on psychiatric cinematic portrayals that would be. I am sure there are some peer reviewed texts as well.


 * PS: If you are asserting there have been copyvios, then providing the original text would help prove that allegation, and if true, the text will be changed or removed. Cheers, Casliber (talk · contribs) 05:37, 8 January 2009 (UTC)

Copyviolation? No not at all that was never mentioned. The characters in these films are not explicitly stated as having been written specifically with Borderline personality disorder in mind. What they are suggested as having however is Erotomania (or de Clerembault's Syndrome),(American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn, revised) (DSM-IV) Washington, DC: APA). As referenced in Orit Kamirs' Every Breath You Take: Stalking Narratives and the Law (University of Michigan Press, 2001), Glenn Close's character Alex is quite deliberatley made to be an erotomaniac. Gelder reports that Glenn Close, "consulted three seperate shrinks for an inner profile of her character, who is meant to be suffering from a form of obbsessive condition known as de Clerembault's syndrome (Gelder 1990, 93 - 94.) While it is possible people with BPD could develop erotomania this has never been stated as being a sympton of the condition and rather I believe an example of co-morbidity, perhaps it is just the case that this is under explained either in the book itself or in your statement, perhaps some detail as to why the author believes these characters to possess BPD or features of BPD would help rather than the statement as it is stands which I'm sure you agree could be mis-interpreted by some and give the impression that BPD directly leads to stalking. Blaa90 (talk • contribs) 00:49, 11 January 2009


 * OK, I get you, you do make a good point. I will pull out the books and show what they say here, as they talk about diagnoses and criteria etc. Gimme a sec...Cheers, Casliber (talk · contribs) 03:46, 11 January 2009 (UTC)


 * Play Misty for me - long time since I have seen it, has rapid changes in affect (idealisation/devaluation), and frantic attempts to avoid abandonment noted in source Reel Psychiatry. Single White Female is discussed with several criteria. The ref for Fatal Attraction does not discuss it much, but I am sure I have seen some stuff elsewhere. I will ask and post something in several hours. Cheers, Casliber (talk · contribs) 04:22, 11 January 2009 (UTC)


 * Finally, my take on diagnoses etc. is that many bizarre behaviours do not occur in isolation, and are often part of a larger pathology in character construct. Yes, many of the depictions of BPD are more externalising than are seen in practice (and that is noted). I get back to you. Contesting the diagnosis and offering a counterviewpint would be great on the Fatal Attraction article. Cheers, Casliber (talk · contribs) 04:22, 11 January 2009 (UTC)

Update
I did just find that this reference:


 * Wedding D, Boyd MA, Niemiec RM (2005). Movies and Mental Illness: Using Films to Understand Psychopathology. Cambridge,MA: Hogrefe.

notes that Close's character displays impulsivity, emotional lability, fear of abandonment, idlealisation/devaluation and self-mutilation. Cheers, Casliber (talk · contribs) 04:30, 11 January 2009 (UTC)


 * Cultural references should be split into a separate article. Any refs in this article must be accurately sourced.  For fictional characters that would mean a primary source from the book / movie (and those sources are't good enough for wiki, and certainly are not good enough for this article) or sources from the actual author saying "character X was written as having BPD".  Some random doctor writing a book with his personal noodlings trying to diagnose fictional characters can go on some other age.  PLEASE don't clutter and already big article with trivial fluff. 82.33.48.96 (talk) 18:42, 22 March 2009 (UTC)


 * No, they were from reputable scholarly books written by psychiatrist, and they are notable. It could have been a hell of a lot longer. This is an encyclopedia not a medical journal so some real life context, including depiction in the media is highly relevant. Casliber (talk · contribs) 20:05, 22 March 2009 (UTC)


 * But they're not about BPD, they are about one man's interpretation of fictional character's possible mental health problems. Leave in stuff that's directly connected to BPD.  Stuff that's not directly connected to MH should go to some other article.  82.33.48.96 (talk) 10:49, 23 March 2009 (UTC)


 * Some have been more widely discussed than others and display more than 'possible mental health problems' eg the Glenn Close character in Fatal Attraction has been widely discussed and exhibits an array of symptoms. Also, highlighting that the characters are rather more externalising - a person more aggressive to others than to herself - is important too to show the discrepancy between depiction and more common real-life presentation. Casliber (talk · contribs) 10:53, 23 March 2009 (UTC)


 * If there is strong evidence that Glenn Close's character was meant to portray erotomania, as was stated by people directly involved with the films, then why is this being ignored in favor of the conjecture of a single psychiatrist who is unrelated to the production and writing of the movie and the preparation of Close's performance?


 * Erotomania and erotomanic behavior is usually a part of one of two larger disorders, delusional disorder or schizophrenia, *not* BPD. While several MDs have listed this as a possible example of BPD, given the position of the actress and, presumably, the writers, and given the rate of incorrect diagnoses with delusional disorders, why is there any argument about removing this reference?


 * Female borderlines are much more likely to attempt or commit suicide, or self-harm, over physically attack, attempt to murder, or actually murder others. Why are there so many examples of extremely violent females in movies in this section? They all seem to stem from the same book. Unless this single source is clearly stating how each of these film characters meets six of the nine criteria necessary to make a definitive diagnosis, this source does not seem to be up to par for use in an encyclopedic article.


 * I am certainly not arguing *Girl, Interrupted*, and *Single White Female* is pretty consistently diagnosed as BPD (usually codiagnosed with another disorder, and I have seen it in reference to "As-If" Personality Disorder, which has little research but is essentially BPD with the need to imitate and copy others to appear normal). However, the other references could really use a source that more clearly outlines their conformation to the diagnosis. Viralhyena (talk) 08:18, 23 September 2009 (UTC)


 * The imitating and copying others clearly relates to indentity disturbance which is a core feature. Furthermore criterias 6, 8 and 9 are all more externalising behaivours (anger/affect dysregulation etc.). Focussing on erotomania in hte context of broader personality disturbance is like focussing on the broken skin over a compound fracture, if this analogy makes the situation any easier to understand. Casliber (talk · contribs) 19:57, 23 September 2009 (UTC)

Hi, the report of Anakin Skywalker/Darth Vader of Star Wars fame being diagnosed with BPD is unfortunate. Please see http://www.psychologytoday.com/blog/stop-walking-eggshells/201006/putting-darth-vader-the-couch72.82.47.72 (talk) 03:20, 1 December 2010 (UTC)


 * You're replying to a comment from more than 1 year ago, so it's unlikely for anyone to respond to this. If you wanted some change to the article, please clarify at the end of this talk page.  Second, I removed your blog, as there's no need to advertise it here.  Qwyrxian (talk) 08:37, 1 December 2010 (UTC)

Reply
I agree these things dont always occur in isolation so perhaps if the quote from above was included in the section it would help add to the understanding of the characters behaviour, though wouldn't want to go into detail here as relying on movies to explain psychiatric conditions is questionable,as its too complex, the problem with BPD is you only need 3 out of the 5 characterisics to be diagnosed. —Preceding unsigned comment added by Blaa90 (talk • contribs) 23:20, 12 January 2009 (UTC)


 * Agree, the article will be bolstered later (one of a load of things on a to-do list...). WP has policies on no original research too, the idea being only to use reliable sources. Cheers, Casliber (talk · contribs) 23:42, 12 January 2009 (UTC)

Medication and UK guidance
The UK's National Institute for Health and Clinical Excellence (NICE) has issued recent guidelines for the treatment of BPD. They say that medication for BPD is not appropriate, but that it is appropriate for comorbid illnesses. Here's a link. http://www.nice.org.uk/Guidance/CG78/NiceGuidance/pdf/English NICE are very much a reliable source - UK health care providers have to follow NICE guidelines or have very good reason not to. I don't want to edit the article to kludge this in, because. 82.33.48.96 (talk) 18:35, 22 March 2009 (UTC)


 * Thanks for the heads up - that is a very important stance to get in the article. Casliber (talk · contribs) 20:08, 22 March 2009 (UTC)


 * Anyone else amused that the official UK group NICE is using DSM IV-TR rather than ICD 10? Casliber (talk · contribs) 20:15, 22 March 2009 (UTC)

The NIMH and the American Psychiatric Association (among others) disagree with the notion that medication cannot help sufferers of BPD. I think these differing views should be included to ensure neutrality and balance. Rapunzel676 (talk) 03:33, 21 February 2010 (UTC)

Number of Symptom Combinations that meet Diagnosis Criterion
The article clearly states the diagnosis is at least 5 concurrent chosen from a total of 9 possible ones. This is the binomial coefficient C(9,5) which is equal to 126, not 256. Furthermore, this means it is impossible to find 136 combinations that meet this criteria. This section needs to be reexamined and changed. Chrismaster (talk) 17:03, 24 July 2009 (UTC)


 * I'm not the best at math so I had to ask a friend for help with this one, and then I used this online calculator to help out.


 * While you're initially correct, you seem to have forgotten the "at least" part, you're only thinking in "just 5" terms, but the person can also fit 6 or 7 (etc) symptoms as well. 5 of the 9 have 126 possibilies. 6 of the 9 have 84, 7 of 9 have 36, 8 of 9 have 9 and 9 of 9 have 1.


 * Which adds up to 256. Avalik (talk) 10:40, 8 October 2009 (UTC)


 * Guys, I have never heard nor seen anyone in psychiatry calculate how many variations there could be - and have removed it. It is nonnotable +++ Casliber (talk · contribs) 10:46, 8 October 2009 (UTC)


 * Haha this is true, I've never seen that used before either, so this solution works as well. Avalik (talk) 21:45, 8 October 2009 (UTC)

Popular and colloquial in 1940s?
The History section says: "For the next decade the term was in popular and colloquial use, a loosely conceived designation mostly used by theorists of the psychoanalytic and biological schools of thought." Don't the two halves of that sentence contradict each other? To me, "popular and colloquial use" means widespread among non-professionals, while "mostly used by theorists" seems to me to imply that it wasn't in popular and colloquial use. Neither assertion is sourced (nor is anything else in that paragraph). I would attempt to clean it up, except that I know nothing about the issue. Could someone else clarify this bit? --Elysdir (talk) 17:58, 26 October 2009 (UTC)

Reducing length of intro
The intro is very long. Much of it duplicates text in other sections and some can be deleted. I will do some tidying up. --Penbat (talk) 10:17, 3 November 2009 (UTC)

Merging Emotionally unstable personality disorder
It should be quite simple to merge Emotionally unstable personality disorder into here by expanding the ICD-10 section. Anankastic personality disorder had already been merged into obsessive-compulsive personality disorder.--Penbat (talk) 12:34, 15 November 2009 (UTC)


 * I dont think this is controversial. Unless somebody screams i will do the merge in a few days time. --Penbat (talk) 17:30, 19 November 2009 (UTC)

Section on psychoanalyis
I was unable to guess the meaning of the two sentences in this section: Borderline_personality_disorder. Psychology is not my area of expertise, so I won't make an attempt to edit them. So...


 * "in the apparition of the DSM-IV" -- the appearance? first edition? issuing?


 * "psychiatric one behavioral and the other, included in a psychoanalytical psychopathology" -- what?


 * "According to this split, the diagnosis takes on, or a character objectivizing with ascendancy of symptoms to be eradicated or it indicates a particular type of patients of psychoanalysts to treat in modalities different from those typical cures" -- again, what? Punctuation gone awry?

It is possible that these sentences would be comprehensible with the right jargon translator, in which case clarification would be helpful. FelixSmiley (talk) 18:33, 3 December 2009 (UTC)
 * You could try putting sample phrases of the above in Google and try to find an alternative copy of the text (although beware copies taken from Wikipedia). At least you can check if the text has got mangled or if it is just verbose.--Penbat 18:41, 3 December 2009 (UTC)
 * (groan) another page on teh to-do list. Might haev a look at this meslef a bit later today. Casliber (talk · contribs) 22:52, 3 December 2009 (UTC)

BPD from a BPD
I am a "recovered" BPD. I am medium functioning at the moment. My recovery is due to my taking responsibility for my illness, looking at the criteria, and working on fixing the criteria. I have had 20 years of therapy. I have been BPD since I was born (I displayed symptoms as a baby....removed from the home because of incessant crying twice.....I could not be "comforted"...thought I was "bad" at age 3) My recovery resulted from intense prolonged CBT conducted mostly on my own, with input from a therapist (was I on the right track with the CBT). I believe that BPD is a combination of: genes, enlarged amaygdala and other emotional reasoning centres in the brain, and environmental influences. Although I had no qualms about my life....it was full of chaos, I can say that being "recovered" is much preferrable, and I highly recommend any BPD to "give it up" and allow the vulnerability. You can do it, and it is worth the anxiety experienced during the process. I not only "came out" I can talk about it freely with no anxiety. I have no more "secrets"...don't wear a mask...there's no need for it. —Preceding unsigned comment added by 70.49.147.17 (talk) 02:25, 2 January 2010 (UTC)

Management
I've removed the line 'The mainstay of treatment is various forms of psychotherapy with medications of little use.' at the top of 'Management'. It's pretty poor as a 'sum-up' line, especially seeing as medication does play a role. 'Of little use' is most certainly POV.

In my opinion the sentence is misleading and pointless. Treatment is widely seen as complicated and different for every sufferer - which is described anyway, so the sentence is redundant. Dvmedis (talk) 05:50, 25 February 2010 (UTC)
 * Compared with such conditions as schizophrenia and bipolar disorder, psychotherapy plays a much more important, and medication less important role. Depends what one compares it with really. Casliber (talk · contribs) 09:56, 25 February 2010 (UTC)


 * I wholeheartedly agree that psychotherapy is the 'main' treatment - but when I was in a psychiatric institute, *everyone* with BPD was on medication of some kind for the co-morbid symptoms which make up the illness such as depression, anxieties, and quasi-psychotic symptoms. I think therefore it could be misleading to outright say that medication is of 'little use' - despite not being formally recommended for direct treatment. Dvmedis (talk) 12:12, 25 February 2010 (UTC)
 * Funnily enough a collegue emailed me a cochrane summary recently, which I've been meaning to add. Casliber (talk · contribs) 22:20, 12 March 2010 (UTC)

is BPD AS TERRIFYING AND AS HOPELESS AS IT SOUNDS IM JUST STARTING TO RESEARCH IT AND IM SO SCARED AND LOST.HAVE I REALLY LOST MY CHILD OR CAN I STILL SAVE HIM 5/5/10 —Preceding unsigned comment added by Gtweety3888 (talk • contribs) 08:26, 5 May 2010 (UTC)