Borderline


SAY "Borderline" to me and the first thing that comes to mind is the certified gold 1980s pop hit by Madonna. Curiously, Time magazine talks of "borderline" in a less aural context and instead refers to a personality disorder popular in this decade. It's called the "borderline personality disorder." Writing in Time, John Cloud asks, "Is borderline the illness of our age?" referencing the facts that in the 1950s, the popular "crack-up" illness was anxiety, in the 1960s and 70s, schizophrenia, and the 90s, it was depression.

Definition. In general, personality disorders "are psychiatric disorders characterized by chronic patterns of inner experience and behavior that are inflexible ... with marked impact on patients' interpersonal relationships, and social and occupational functioning (American Family Physician journal). Personality disorders are grouped into three based on description. Cluster A (odd or eccentric) includes the paranoid and schizoid, Cluster C (anxious and fearful) lists the avoidant, the dependent, and the obsessive-compulsive. Cluster B (dramatic, emotional, or erratic) is where the borderline belongs, along with the antisocial, the histrionic, and narcissistic.

Are you borderline? What are the symptoms of the borderline personality disorder?

MayoClinic.com enumerates the following:

* Unstable self-image - Sense of self changes rapidly from extreme good to evil leading to frequent changes in jobs, friendships, values or goals, even gender.

* Have tumultuous relationships - Idealizing someone, then suddenly hating him/her, because of the inability to handle gray or ambivalent realities of life; life for a borderline is either black or white.

* Impulsive or risky behavior - Careless driving, unsafe sex, taking illicit drugs, gambling sprees.

* Strong emotions that wax and wane quickly.

* Difficulty controlling emotions or impulses.

* Inappropriate anger leading to violence.

* Fear of being alone.

* Suicidal behavior.

* Intense but short episodes of anxiety or depression.

Causes. With the economic meltdown spreading like a virus worldwide, many health experts are already predicting a spike in suicides. How many of these will be known borderlines?

In the US, a 2008 Journal of Clinical Psychiatry study found that 5.9 percent (of 35,000 adults) or about 18 million Americans have been given a diagnosis of borderline personality disorder. The usual blame is pointed to genetics (as suggested by borderline twins, and family members), environment (seen more in individuals with a history of child abuse, neglect, and separation from loved ones), and brain chemical abnormalities (serotonin, a neurotransmitter that regulates mood has been implicated).

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