Indians always have a set of procedures that they adopt for treating any similar type of event. For example, irrespective of what issue occurs in an individual’s cell phone, a simple restart would be enough to fix it. If this didn’t convince you, lets toss it with another yet very common example, the example of illness. A person suffering from fever is suggested to take a rest of few hours or more appropriately, sleep for few hours, irrespective of the cause of fever (that is… viral, infection, heatstroke, bacterial, or even of Covid-19). But, there is one segment of health related illness that has always been ignored by majority of us. The segment of personality disorders.
To initiate, we will discuss what ‘American Psychiatric Association’ describes personality as: ‘Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual’s personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics.’
A person’s personality is not his/her physical appearance and his way of walking and speaking, as doubted by the majority of Indians; rather, it is the characteristics of an individual which typically stays the same over time. A personality disorder therefore, is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time. This blog is going to be concerned with one such personality disorder:
The Borderline Personality Disorder :
Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a mental illness characterized by a long-term pattern of unstable relationships, distorted sense of self, and strong emotional reactions. BPD typically begins by early adulthood and occurs across a variety of situations. Substance abuse, depression, and eating disorders are commonly associated with BPD. Approximately 10% of people affected with the disorder die by suicide. The disorder is often stigmatized in both the media and the psychiatric field.
People with BPD may feel intense emotions and can sustain them for a longer duration of time. This leads them to overthink about general things and manifests as unusually intense emotional responses to environmental triggers, with a slower return to a baseline emotional state. They are often exceptionally enthusiastic, idealistic, joyful, and loving, but may generate exaggerated responses to negative stimuli. Rendering extreme grief for sadness, mild sorrow for an unpleasant experience, rage instead of annoyance, and panic instead of nervousness are few examples.
BPD is believed to be the one psychiatric disorder that produced the most intense psychological pain and distress in its patients. Studies have shown that borderline patients experience chronic and significant emotional suffering and mental agony. People with BPD often feel euphoria, although they are usually prone to dysphoria (a profound state of unease or dissatisfaction), depression, and/or feelings of mental and emotional distress.
Causes:
Identifying the causes of personality disorders can be very complicated, though they may be categorised into some broad explanations. For BPD patients, the causes may be: genetics or brain abnormalities.
- Genetic : The heritability of BPD is estimated to be between 30% to 70%. Even so, the researchers of one study concluded that personality disorders “seem to be more strongly influenced by genetic effects than almost any Axis I disorder [e.g., depression, eating disorders], and more than most broad personality dimensions”. The researchers concluded that “genetic factors play a major role in individual differences of borderline personality disorder features”. These same researchers had earlier concluded in a previous study that 42% of variation in BPD features was attributable to genetic influences and 58% was attributable to environmental influences. Genes under investigation as of 2012 include the 7-repeat polymorphism of the dopamine D4 receptor (DRD4) on chromosome 11, which has been linked to disorganized attachment, whilst the combined effect of the 7-repeat polymorphism and the 10/10 dopamine transporter (DAT) genotype has been linked to abnormalities in inhibitory control, both noted features of BPD. There is a possible connection to chromosome 5.
- Brain abnormalities : The hippocampus tends to be smaller in people with BPD, as it is in people with post-traumatic stress disorder (PTSD). However, in BPD, unlike PTSD, the amygdala also tends to be smaller. This unusually strong activity may explain the unusual strength and longevity of fear, sadness, anger, and shame experienced by people with BPD, as well as their heightened sensitivity to displays of these emotions in others. Given its role in regulating emotional arousal, the relative inactivity of the prefrontal cortex might explain the difficulties people with BPD experience in regulating their emotions and responses to stress.
Apart from the brain abnormalities and genetic causes, they may also be led due to other factors such as developmental factors which include childhood trauma. There is a strong correlation between child abuse, especially child sexual abuse, and development of BPD. Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically, or sexually abused by caregivers of either sex.
Treatment:
Ideally, medicines can never treat a personality disorder. Psychological counselling sessions and social support, however, can be effectively employed as treatments. European countries have already started considering their patients with utmost care and supervision.
India, unfortunately is yet not stepping on the ascend to consider personality disorders as an actual medical condition that needs diagnosis, treatment and precautions. We have almost negligible amount of research done on personality disorders. To worse the situation, the younger generation is not even concerned the least about it. India needs a serious acknowledgment in psychological disorders and starts treating its patients medically and psychologically.
The superior existence of humans amongst all other species is the proof that in the competition between mind and brain, mind dominates. Apparently, it’s important to administer the mind as it can’t be protected by the skull, unlike brain.