“Clinicians must understand that this is a bona fide psychiatric condition. Patients with BPD are as psychiatrically ill, vulnerable, and in emotional pain as are patients with BD,” said Zimmerman.

Treating Patients with BPD: Tips for Psychiatrists

Self-monitor. Be aware of potential countertransference, Aviram recommended. Notice when patient characteristics and demands trigger defensive reactions or judgmentalism.


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Don’t hesitate to share the diagnosis with the patient. Patients usually welcome a diagnosis that puts their symptoms into perspective, but presenting it supportively and nonjudgmentally is key. “In my experience, for every patient who feels stigmatized, there are six or seven who feel relieved,” Paris reported.

Use respectful nomenclature. Using the descriptor “a patient with borderline personality disorder” is preferable to “a borderline” because it implies that the person has the disorder, not that the person is the disorder, noted Aviram.

Advocacy and Clinician Education

Patients with BPD experience morbidity, psychosocial impairment and mortality comparable to those with BD. But research into BPD has received considerably less funding from the National Institutes of Health than has BD, according to Zimmerman.13

Zimmerman urges researchers specializing in BPD to advocate for more research funding and for practicing clinicians to become conversant in delivering appropriate and compassionate care to this vulnerable population.

Batya Swift Yasgur MA, LMSW, is a psychotherapist and freelance writer who lives in Teaneck, N.J. She practices therapy in New York City.

References

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  3. Aviram RB, et al. Borderline personality disorder, stigma, and treatment implications. Harv Rev Psychiatry. 2006; 14(5):249-256.
  4. Katz I. Stigma: A Social Psychological Analysis. Hillsdale, NJ: Erlbaum, 1981.
  5. Paris J and Black DW. Borderline personality disorder and bipolar disorder: what is the difference and why does it matter? J Nerv Ment Dis. 2015; 203(1):3-7.
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  9. Stoffers JM and Lieb K. Pharmacotherapy for borderline personality disorder–current evidence and recent trends. Curr Psychiatry Rep. 2015; 17(1):534.
  10. Krause-Utz A, et al. The latest neuroimaging findings in borderline personality disorder. Curr Psychiatry Rep. 2014; 16(3):438.
  11. Rossi R, et al. Abnormalities in cortical gray matter density in borderline personality disorder. Eur Psychiatry. 2015; 30(2):221-227.
  12. Whalley HC, et al. White matter integrity and its association with affective and interpersonal symptoms in borderline personality disorder. Neuroimage Clin. 2015; 7:476-481.
  13. Zimmerman M. Borderline personality disorder: a disorder in search of advocacy. J Nerv Ment Dis. 2015; 203(1):8-12.