2. What is Borderline Personality Disorder (BPD)? Presentation is often in early adulthood BPD is a cluster B personality trait BPD affects how the individual feels, relates to others and how they behave BPD causes impulsiveness and instability of emotions, relationships and self-image BPD causes idealization and devaluation of others BPD patients are often viewed as manipulative due to their efforts to obtain nurturing BPD has a 8-10% suicide rate

3. What Causes BPD? Causes are not fully understood Research shows there is a combination of factors to include environmental, genetics and brain abnormalities

4. Causes Continued Environmental- childhood abuse, neglect and separation Genetics- BPD may be inherited Brain abnormalities- changes in the areas of emotion regulation, impulsivity, and aggression; chemical imbalances may be present

5. Who is at risk for BPD? Individuals with a family history of BPD Individuals with a history of childhood abuse, physical of sexual Individuals with a history of childhood neglect that suffered abandonment or deprivation

6. What do individuals with BPD act like? They have: Intense fear of abandonment (fear of being alone) Pattern of unstable relationships Unstable self-image or sense of identity Impulsive and self-destructive behaviors (risky driving, drug use, sexual promiscuity, and unsafe sex practices) Suicidal behavior or self-injury Wide mood swings (difficulty controlling emotions) Chronic feelings of emptiness Anger-related problems, such as physical violence (inappropriate anger) Periods of paranoia and loss of contact with reality

7. How do you diagnose BPD? An interview with a psychiatrist is completed A psychological evaluation is completed A complete clinical history is obtained Five of the nine symptoms listed on slide six must be present for a clinical diagnosis of BPD to be made.

8. There is no specific pharmacologic treatment for BPD; treatment with medication is based on treating the symptoms of the disease Antidepressants and anti-anxiety medications are not widely used but can be used to help in co morbid conditions

9. Pharmacotherapy continued 2 nd generation antipsychotics are sometimes used Zyprexa Geodon Thought to affect brain chemicals decreasing symptoms of BPD Adverse effects seen especially with Zyprexa to include weight gain, sedation, and increased self harming behavior Can only manage symptoms of BPD; unable to manage illness of BPD

10. Pharmacotherapy Continued Anti-seizure medications are used as mood stabilizers Tegretol Lamictal Topamax Dietary supplement Omega 3 fatty acid is also used as a mood stabilizer

11. Pharmacotherapy Continued Side Effects : Tegretol – dizziness nausea/vomiting dry mouth Lamictal – blurred vision tremors/dizziness loss of coordination insomnia skin rash Topamax – dizziness loss of appetite weight loss

12. What are other treatments for BPD? Psychotherapy Peer support Family education Medication for symptom control Skills training/ Dialectical behavioral therapy All treatment modalities of BPD must work together to help the individual feel as if life is worth living

13. What is it like to live with BPD? http://www.youtube.com/watch?v=yA80UiR CQ7U

14. References Duckworth, K. (2009). National Alliance on Mental Illness The Cochrane Collaboration. PubMed Health. (2010). Hoboken, NJ. John Wiley and Sons, LTD. Borderline Personality Disorder. MayoClinic.com. Retrieved July 2013.

15. Thank you for your attention For additional information or help with someone that is suffering with BPD, call the National Alliance on Mental Illness 1-800-950-6264

16. SCORE 99/100 Comments Grader Feedback CREATIVE AND GOOD GRAPHICS. VERY INFORMATIVE. YOUTUBE VIDEO IS NOT HYPERLINKED WITHIN THE SLIDE SHOW AND HAD TO EXIT TO VIEW.