Test for mental personality disorders online. What test is used for borderline personality disorder and what are the symptoms of the disease? Treatment for Borderline Personality Disorder

Borderline personality disorder is a serious mental illness, less known than schizophrenia or bipolar disorder (manic depression), but no less common. Borderline personality disorder is a form of pathology on the border of psychosis and neurosis.

The disease is characterized by mood swings, an unstable connection with reality, high anxiety and a strong level of desocialization. As a result, borderline personality disorder can disrupt families, careers, and an individual's sense of self. As a disorder of emotional control, borderline personality disorder often leads to suicide attempts.

Individuals suffering from this illness have a very complex relationship with reality. It is difficult to help them, but it is possible - modern psychiatry is capable of doing this.

This test will help you preliminarily assess the possible presence or absence of symptoms of this disease. Answer “yes” or “no” depending on whether the symptoms described correspond to your condition.

1. My relationships with other people are very turbulent, unstable and fluctuate between idealizing and undervaluing people who play an important role in my life.

2. My emotions fluctuate rapidly, and I experience severe bouts of sadness, irritability, or anxiety and panic.

3. My level of anger is often inappropriate, too intense, and I have difficulty controlling it.

4. I have currently or in the past experienced suicidal behavior, gestures, threats or acts such as cutting, bruising or burning myself.

5. I have a pronounced and persistent feeling of the impermanence of my own personality. I don't know who I am or what I really believe.

6. I sometimes have bouts of suspicion and even paranoia (false beliefs that other people are planning to harm me), or in stressful situations I experience feelings of unreality of the world and people around me and my own

7. I have engaged in two or more behaviors that are harmful to me, such as excessive spending of money, unsafe and inappropriate sexual activity, alcohol and drug abuse, road hazards, and excessive eating.

Borderline personality disorder is characterized by emotional instability, impulsivity, a high degree of anxiety, an unstable connection with reality, and problems building relationships with other people.

An increased level of desocialization is accompanied by low self-control and sudden mood swings. A person can behave aggressively and recklessly, but at the same time, have an acute need for the support of loved ones and be afraid of loneliness. As a rule, borderline personality disorder manifests itself in childhood, has a stable course and accompanies a person throughout his life.

Borderline personality disorder - description of pathology

Psychiatrists qualify borderline personality disorder as a mental illness bordering on neurosis and psychosis, and classify it as a form of psychopathy. In fact, this definition is controversial, since personality disorder is a mixed condition that manifests itself by building psychological defenses against changes at the neurotic level.

This mental disorder is difficult to attribute to any specific disease, so it is separated into a separate category. Disputes regarding the classification of borderline disorders have been going on in the scientific community for a long time, and the similarity of symptoms with other mental illnesses leads to frequent errors in making the correct diagnosis.

According to statistics, people with borderline personality disorder make up up to 3% of the adult population, and in the vast majority of cases, this type of disorder is diagnosed in women. In reality, this percentage is even higher, since diagnostic errors by clinicians distort the data downward. But even such statistical percentages are a high indicator that requires the close attention of specialists.

Borderline personality disorder is accompanied by other mental disorders, a tendency to,. Failures in personal life, social and professional unfulfillment, fear of loneliness - all this leads to depression, causes suicidal tendencies and pushes a person to commit rash acts.

Causes of the disease

Experts still do not have a consensus on the causes of this pathology. Many are inclined to think that borderline disorder develops under the influence of a number of provoking factors, and put forward several main hypotheses that explain the origins of mental deviation:

Like most mental disorders, this disorder is more common in families where close relatives or previous generations had borderline mental disorders.

Biochemical factor

Followers of this theory believe that the deviation is caused by an imbalance in the balance of brain neurotransmitters. As you know, human emotional reactions are regulated by three main substances: serotonin, dopamine and endorphin. Deficiencies or excess production of one of them upsets the balance and leads to mental disorders.

Thus, depressive, depressed states develop with a deficiency of serotonin, a lack of endorphin leads to a decrease in resistance to stress and increased psycho-emotional stress, and insufficient production of endorphins deprives a person of the joy of life, turning it into a meaningless existence.

Social factor

Researchers have noticed that this type of mental disorder is more common among those who grew up in disadvantaged social environments. Parents who abuse alcohol or drugs, demonstrate antisocial behavior, practically do not care for the child, who copies their behavior on a subconscious level and subsequently cannot adapt to normal life.

Against the backdrop of such unfavorable conditions, personality deformation occurs, self-esteem decreases, generally accepted norms of behavior are distorted, and a person has difficulty fitting into society.

Defects in education

A full-fledged personality is formed only with proper upbringing, which maintains a balance between rigor, love and respect for the little person. If a healthy, friendly microclimate is maintained in the family, then the child receives plenty of love and support.

In cases where a child is faced with the oppressive dictates of his family, an anxious personality may eventually develop. And, on the contrary, against the background of permissiveness and the absence of restrictive frameworks, a demonstrative personality grows up, who does not take into account the people around him and puts his own interests above all else.

Many experts believe that a traumatic situation experienced in childhood plays an important role in the development of the disease. This could be the departure of one parent from the family, the loss of loved ones, physical, emotional or sexual abuse.

Representatives of the fairer sex suffer from borderline disorders much more often than men. Experts explain this pattern by a more subtle mental organization, low resistance to stress, increased anxiety and low self-esteem.

Symptoms

Borderline personality disorder has no specific symptoms and can manifest itself in different ways, which makes diagnosing the disease much more difficult. Psychiatrists identify the following signs that may indicate the presence of a mental disorder:

• decreased self-esteem;
• fear of change;
• impulsiveness, loss of control and lack of “brakes” in behavior;
• manifestations of paranoia bordering on psychosis;
• life according to the principle “I want here and now”;
• instability of mood, problems with building interpersonal relationships;
• categoricalness in judgments and assessments;
• fear of loneliness, depressive or suicidal feelings.

Self-destructiveness is an important trait characteristic of individuals with borderline personality disorder. Against the background of emotional instability, a person is prone to unjustified risks, alcohol or drug abuse. This type of personality can commit any actions associated with the destruction of health or posing a threat to life. For example, racing a car, participating in risky activities that could end fatally.

People with borderline personality disorder experience a fear of loneliness that dates back to early childhood. Hence impulsive behavior, low self-esteem, and instability in relationships. Fearing being rejected, a person is often the first to interrupt communication or, on the contrary, strives to be close at all costs, falling into psychological dependence. In this case, a person with pathological deviations either idealizes the partner and places unrealistic hopes on him, or becomes deeply disappointed and completely stops communication.

With borderline disorders, a person cannot cope with his emotions, often conflicts, gets irritated and angry, and then feels remorse and emptiness. He can start a quarrel out of the blue and even provoke a fight, and when exposed to strong stress factors, he can cling to paranoid ideas.

Characteristic statements with a borderline state

What typical statements does a borderline person use to describe their feelings? Here are the basic settings:

1. No one needs me and I will forever remain lonely. No one will protect or take care of me.
2. I am unattractive, no one wants to know about my inner world and become close to me.
3. I cannot cope with difficulties on my own, I need a person who will solve my problems.
4. I don’t trust anyone, people can set me up and betray me at any moment, even those closest to me.
5. I have lost my individuality and have to conform to other people's desires to avoid being rejected.
6. I am afraid of losing control over my emotions; I cannot fully discipline myself.
7. I feel guilty for doing something bad and deserve to be punished.

Such attitudes are formed in early childhood and consolidated in adulthood, first as stable patterns of thinking, which then turn into patterns of behavior. The world around them is seen as hostile and dangerous, therefore, people with borderline disorders experience fear and powerlessness in front of it.

Diagnostic methods

Diagnosis of borderline personality disorder is complicated by unstable and varied symptoms. An experienced psychiatrist makes a preliminary diagnosis after a conversation with the patient, based on his complaints and test results.

This takes into account the feelings that the patient characterizes as emptiness, resistance to change, and expectation of a special approach. A tendency to self-destructive behavior, feelings of guilt, and inappropriate reactions (anger, unreasonable anxiety) are revealed.

Good to know

The final diagnosis is made based on the results of a psychological test for borderline personality disorder, which takes into account 9 main signs of the disease:

1. fear of loneliness;
2. a tendency to enter into unstable, tense relationships, accompanied by sharp changes from devaluation to idealization;
3. instability of one’s own self and one’s image;
4. impulsiveness aimed at causing harm to oneself (bulimia, alcoholism, drug addiction, sexual promiscuity, dangerous antics associated with risk to life);
5. suicidal thoughts, threats or hints of suicide;
6. sudden mood swings;
7. feeling of emptiness, lack of joy in life;
8. Difficulties with self-control, frequent outbursts of anger;
9. paranoid ideas in stressful situations.

If 5 or more of the listed symptoms are observed and persist for a long time, the patient will be diagnosed with borderline personality disorder.

The patient's condition with this disease can be complicated by additional disorders, which are expressed by panic attacks, depressive states, attention deficit disorder, eating disorders (overeating, anorexia). Sometimes such patients experience excessive emotional reactions, antisocial behavior or anxiety disorders, which force them to avoid contact with other people.

Treatment for Borderline Personality Disorder

Treatment for this condition is carried out on an individual basis and is symptomatic. That is, medications are selected taking into account the manifestations of the disease in order to stabilize the patient’s condition. The dosage of medications, the choice of a specific drug, the optimal regimen and duration of treatment should be dealt with by a psychiatrist.

For concomitant depression, suicidal tendencies or eating disorders, therapy is longer and can take several years. But even after a positive result has been consolidated, relapses of the disease often occur. First of all, the patient needs the help of a psychotherapist and psychological support from loved ones.

Psychological help

Conversations with a psychotherapist or psychologist are aimed at understanding and rethinking existing problems, as well as developing skills to control behavior and emotions. The main task of the doctor and the patient is social adaptation, establishing interpersonal relationships, forming defense mechanisms that help overcome panic fears, anxiety and develop resistance to daily stress.

Cognitive-behavioral or dialectical therapy methods are the best way to change your way of thinking and develop optimal patterns of behavior in society. They are aimed at developing the ability to adapt to any unpleasant and uncomfortable situations. Family and psychodynamic therapy aimed at overcoming internal conflict and increasing self-esteem gives good results. The psychologist suggests that many patients attend classes in support groups. Basic psychotherapeutic techniques:

1. Dialectical behavior therapy. This direction is most effective in the presence of self-destructive symptoms in behavior. Helps to get rid of bad habits, rethink behavior, and avoid unjustified risks in actions. The therapeutic effect is achieved by replacing negative attitudes with positive thinking patterns.
2. Cognitive-analytical method. It consists of creating a certain model of behavior that excludes manifestations of borderline disorder (anxiety, irritability, anger). During the treatment process, methods are developed to stop attacks of aggression and other antisocial habits. A person is taught to think critically about what is happening, control his behavior and independently deal with the symptoms of the disease.
3. Family therapy. This method is more often used in the rehabilitation process, after completing a course of treatment. The process involves the sick person’s relatives and friends, who take part in psychotherapy and jointly solve the accumulated problems.

Drug therapy

The following groups of medications are used in the treatment of borderline personality disorder:

• Neuroleptics. Antipsychotics are prescribed in combination with psychotherapy methods to control excessive impulsiveness and prevent attacks of anger and aggression. First-generation antipsychotics are now rarely used because they do not provide the required effectiveness. Of the latest generation drugs, Risperidone or Olanzapine are most often prescribed.
• Antidepressants. The action of medications is aimed at stabilizing the emotional background, relieving a depressed state, and improving mood. Of the broad group of antidepressants, selective serotonin reuptake inhibitors are best suited to eliminate the symptoms of borderline disorders. The main representatives of this category are the drugs Sertraline, Paroxetine, Fluoxetine.

Taking such medications helps eliminate neurotransmitter imbalances and helps correct mood swings. Treatment with such drugs is long-term, the therapeutic effect develops gradually, the dose of drugs must be adjusted taking into account many factors, starting with the minimum. Such drugs have an extensive list of contraindications and can cause serious adverse reactions, so treatment is carried out under the supervision of a physician.

Normotimics- a group of drugs whose action is aimed at stabilizing mood in mental disorders. These include several groups of medications - based on lithium salts and carbamazepine derivatives. New generation drugs - valproate, Cyclodol, Lamotrigine are easier to tolerate by patients, cause fewer side effects and can be used for a long time without causing addiction. For borderline personality disorders, doctors recommend taking such medications from the first days of the disease.

Borderline personality disorder is a fairly common but rarely diagnosed pathology. The disease significantly complicates the patient’s life, creates difficulties with social adaptation and problems in personal relationships. Therefore, it is necessary to make a correct diagnosis as early as possible and promptly begin comprehensive and effective treatment.

Mental illness is not something that people usually talk about, so much less is known about borderline personality disorder - its symptoms, treatment regimens, medical prognosis - than about schizophrenia or depression. However, a large number of people face the manifestations of this diagnosis, which requires increasing public awareness. Why does this problem occur and what to do about it?

What are borderline states in psychiatry?

If a patient is diagnosed with a weak level of mental disorders - when the patient manages to control reality and the disease is far from the nature of the pathology - in medicine this is noted as a borderline state. Such disorders are represented by a number of disorders and even symptom complexes:

• psychosomatic;
• neurosis-like;
• neurotic;
• affective;
• neuroendocrine;
• neurovegetovisceral.

This term was introduced into official medicine in the mid-20th century and today is strongly associated with the diagnosis of “borderline personality disorder”, which has code F60.31 in ICD-10. For a long time, psychiatrists classified any mental disorders as borderline states, which created “diagnostic chaos” and the inability to identify clear signs for making an accurate diagnosis.

Causes of the disease

According to statistics, about 3% of the world's population live with borderline personality disorder (BPD), but this disease is “overshadowed” by more complex ones, so some cases are not taken into account. Manifestations of such mental disorders develop mainly in people aged 17-25 years, but they can appear in children, but are not diagnosed due to the physiological instability of the child’s psyche. The causes leading to this disease are divided into 4 groups:

• Biochemical – explained by an imbalance of neurotransmitters: chemical substances responsible for regulating the expression of emotions. A deficiency of serotonin causes depression; with a lack of endorphin, the nervous system cannot withstand stress, and a decrease in dopamine levels leads to a lack of satisfaction.
• Hereditary predisposition - experts do not exclude the possibility that an unstable psyche may be embedded in the DNA, so BPD often affects people whose close relatives also had disorders of psycho-emotional behavior.
• Lack of attention or violence in childhood - if the child did not feel parental love or faced the death/care of loved ones at an early age, frequent physical or emotional abuse was observed in the parents (especially with regard to high demands placed on the child), this may be the reason psychological trauma.
• Raising in a family - for the harmonious development of personality, a child must feel parental love, but know the boundaries and the concept of discipline. When the microclimate in the family is disturbed with a preponderance of a dictatorial position or excessive encouragement, this becomes the cause of difficulties in subsequent social adaptation.

Borderline mental disorders - symptoms

Borderline syndrome (short for the English name of the disease “borderline personality disorder”) can have a long list of manifestations that will not necessarily be fully present even in a seriously ill person. According to official data, patients diagnosed with BPD often experience:

• increased anxiety;
• depressive states (in severe cases - mental anesthesia);
• impulsiveness;
• loss of control over emotions;
• intense dysphoria followed by euphoria;
• problems with social adaptation;
• violations of self-identification;
• demonstration of antisocial behavior (before drug addiction, alcohol abuse, criminal acts).

Interpersonal relationships

Problems with existing in society in various forms are characteristic of people with borderline personality disorder. Often there is an inability to reach a consensus and a categorical defense of one’s opinion, which constantly leads to confrontation with others. A patient with BPD does not see himself as the guilty party, but believes that no one realizes that he is right and worthwhile. Problems of interpersonal relationships are not excluded even in the family, and they can even be accompanied by sexual violence, since they are associated with uncontrollable emotions.

Fear of loneliness

For most forms of borderline personality disorder, the main common symptom is the fear of being alone, even when there are no prerequisites for this. A person may completely reject the feeling of love, which leads to a break in the relationship before the opposite party does so. This provokes difficulties in relationships with a person with borderline personality disorder. Most people (especially young women) who experience this type of anxiety have childhood psychological trauma associated with their parents.

Categorical opinions and judgments

With borderline personality disorder, a person sees the world exclusively in black and white, which becomes the cause of either pure, insane delight at what is happening, or a devastating depression from the situation. Life for such people is either amazing or terrible: there are no half-tones. Even the smallest failures cause serious manifestations of irritability. Due to this perception, the appearance of suicidal thoughts is characteristic of 80% of people with borderline personality disorder.

Tendency to self-destruction

Against the background of frequent depressive states that accompany internal tension, a person suffering from borderline mental disorder experiences suicidal tendencies or attempts at self-punishment. Only 10% of patients commit suicide - for the rest, everything ends in self-harm, which is a way to relieve tension or attract attention, an expression of auto-aggression, a method of non-verbal communication and suppression of hyperexcitability. This can manifest itself in any actions leading to deterioration of health and damage to one’s body.

Impaired self-perception

Low self-esteem against the background of idealization of others is a relatively weak sign of BPD, but the most common and comes from childhood. If the mental disorder is in a more severe form, a person may be faced with a constant change in the assessment of his character and capabilities, and the “switches” themselves will not have clear prerequisites. In some cases, patients even note a feeling of loss of their own personality and the inability to feel the fact of existence.

Lack of behavior control

The presence of various kinds of mania is a clear symptom of borderline personality disorder, in which one can observe impulsive behavior in any situation. A person with BPD is characterized by uncontrollable emotions, so he may experience painful cravings for anything, eating disorders, experience paranoid thoughts, sexual promiscuity, alcohol and drug addiction. Conditions of sudden changes in thoughts and actions are not excluded - a good mood is followed by a dysthymic phase or spontaneous outbursts of anger.

Diagnostics

Due to the modern view of comorbidity in psychiatry, it is difficult to separate BPD from a number of other diseases associated with personality disorder. Patients who receive this diagnosis have a tendency to use psychoactive substances, symptoms of bipolar disorders, social phobias, obsessive-compulsive disorders, and depressive states. Diagnosis is made using:

• physical examination;
• studying medical history;
• analysis of clinical manifestations to identify key signs (at least 5);
• testing.

Differential diagnosis

In its manifestations, borderline personality disorder is similar to a large number of mental illnesses, but requires a special approach to treatment, therefore it is necessary to make a clear differentiation between BPD and schizophrenia, psychosis, bipolar disorders, phobias, and affective states. This is especially true for the early stages of all of these diseases, where the symptoms are almost identical.

Evaluation criteria

When identifying borderline personality disorder, specialists focus on impaired perception of one’s own “I”, constant changes in thinking, hobbies, judgments, and the ease of falling under the influence of others. The International Classifications of Diseases 9 and 10 revisions specify that in addition to the general signs of a personality disorder, the patient must have:

• a pronounced tendency to impulsive actions that cause harm to oneself;
• behavioral outbursts against the background of their condemnation by society;
• making efforts to prevent the fate of abandonment;
• identity disorder;
• relapses of suicide attempts;
• dissociative symptoms;
• paranoid ideas;
• feeling of emptiness;
• frequent bouts of irritability, inability to control anger.

Test

A simple diagnostic method that you can use even on your own is a 10-question test. Some experts shorten it for convenience, since suspicions of BPD can be raised after only 3-4 affirmative answers. The list of questions (with yes/no answers) is as follows:

1. If you have a feeling of manipulation of your consciousness?
2. Do you notice a quick change from outbursts of anger to a calm attitude towards the situation?
3. Do you feel like everyone is lying to you?
4. Do you receive unwarranted criticism in your relationship?
5. Are you afraid of being asked to do something for you because the response will make you appear selfish?
6. Are you being charged with something you didn't do/said?
7. Are you forced to hide your own desires and thoughts from your loved ones?

Psychotherapeutic treatment

The main way to influence a borderline mental state is psychotherapy sessions, during which the patient must develop strong trust in the specialist. Therapy can be group or individual; dialectical behavioral techniques are predominantly used. Doctors do not recommend classical psychoanalysis for the treatment of borderline disorder, since this contributes to the growth of the patient’s already elevated level of anxiety.

Dialectical behavior therapy

The most effective method of influencing borderline personality disorder is considered to be an attempt to show the patient the possibility of looking at a seemingly hopeless situation from several sides - this is the essence of dialectical therapy. The specialist helps the patient develop skills to control emotions using the following modules:

• Individual sessions - discussion of the prerequisites for anxiety-provoking experiences, analysis of sequences of actions, behavioral manifestations that are life-threatening.
• Group sessions - doing exercises and homework, conducting role-playing games aimed at stabilizing the psyche in a post-traumatic stress state, increasing the effectiveness of interpersonal relationships, controlling emotions.
• Telephone contact to overcome a crisis, during which a specialist helps the patient use the skills acquired during the sessions.

Cognitive-analytical methods

The essence of such therapy lies in the formation of a model of psychological behavior and the analysis of the patient’s thinking errors in order to identify problems that need to be eliminated in order to eliminate the personality disorder. The emphasis is on the patient’s internal experience, feelings, desires and fantasies in order to form a critical attitude towards the symptoms of the disease and develop skills to deal with them independently.

Family therapy

A mandatory element in the treatment plan for a person with borderline personality disorder is the work of a psychotherapist with his loved ones. The specialist should give recommendations on optimal interaction with the patient and ways to help in critical situations. The psychotherapist’s tasks include creating a friendly environment in the patient’s family in order to reduce the degree of anxiety and bilateral tension.

How to treat borderline neuropsychiatric disorders with medication

Taking medications for this diagnosis is mainly prescribed only in the case of severe depressive states, against the background of which suicide attempts are made, or in the presence of a biochemical prerequisite for BPD. It is possible to introduce medications into the therapeutic course for patients prone to panic attacks or exhibiting obvious antisocial behavior.

Lithium and anticonvulsants

According to medical statistics, borderline personality disorder is predominantly treated with psychotropic drugs based on lithium salts (Micalit, Contemnol), which help with manic phases, severe depression, and suicidal tendencies through their effect on neurotransmitters. Additionally, anticonvulsant mood stabilizers may be prescribed: Carbamazepine, Gabapentin.

Antidepressants

Doctors consider it advisable to prescribe selective serotonin reuptake inhibitors for BPD, accompanied by mood lability, emotional breakdowns, dysphoria, and outbursts of rage. Mostly doctors recommend Fluoxetine or Sertraline, the effect of which will appear in 2-5 weeks. The dosage of both drugs is determined individually, the initial dose is 20 mg/day in the morning for Fluoxetine and 50 mg/day for Sertraline.

Second generation antipsychotics

The use of atypical antipsychotics does not provoke motor neurological disorders and an increase in prolactin, and these drugs have a better effect on the general symptoms of personality disorders and cognitive impairment than first-generation antipsychotics. Mostly for patients with high excitability, doctors prescribe:

• Olanzapine - has pronounced anticholinergic activity, affects affective disorders, but can provoke diabetes mellitus.
• Aripiprazole is a partial antagonist of dopamine and serotonin receptors and is extremely safe.
• Risperidone is the most powerful D2 receptor antagonist, suppresses psychotic agitation, but is not recommended for depression.

Normotimics

Mood stabilizers help soften or influence the duration of relapses of affective states, smooth out the manifestations of sudden mood swings, irascibility, and dysphoria. Some mood stabilizers have antidepressant properties - this mainly concerns Lamotrigine, or anti-anxiety (valproate group). Nifedipine and Topiramate are often prescribed for the treatment of BPD.

Video

For many, PPD is a diagnosis vaguely familiar from the wonderful film “Girl, Interrupted” starring Winona Ryder and Angelina Jolie. Unfortunately, this diagnosis is increasingly found not in movies, but in life.

Researchers estimate that borderline personality disorder (BPD) affects 2–3% of the world's population. At the same time, many psychologists and psychiatrists note that PLR is not given enough attention. For example, in the International Classification of Diseases ICD-10, used by Russian doctors, there is no clear definition at all; it is considered as a type of emotionally unstable disorder.

The American Diagnostic and Statistical Manual of Mental Disorders DSM-5 contains a definition of PPD, however, American experts believe that this disease has been neglected. They believe that PPD exists “in the shadow” of the somewhat similar bipolar personality disorder. In the latter case, research is much more generously funded, and progress in this area is already obvious.

Bipolar disorder is included in the list of disorders whose negative impact on society is being studied as part of the international program Global Burden of Disease, but borderline personality disorder is not on this list. Meanwhile, in its severity and ability to provoke suicide, borderline personality disorder is not inferior to bipolar disorder.

Diagnosis of PLR also faces serious difficulties; a single and generally accepted description does not yet exist. However, at least 6 signs can be identified, the severity and frequency of which suggests that a person suffers from borderline personality disorder.

1. Instability of personal relationships

Those who suffer from PPD can be called “skinned people.” They are incredibly sensitive to the slightest emotional influences. A word or look that most of us would simply ignore becomes the cause of serious trauma and painful experiences for them.

They perceive themselves as either the most beautiful people in the world, or the most insignificant creatures

It is easy to understand that maintaining the stability of relationships in such a situation is almost impossible. And the perception of people with borderline disorder even of their loved ones can change from “I love you” to “I hate you” in just a few seconds.

2. Black and white thinking

Eternal tossing between love and hate is a particular manifestation of a more general problem. Such people hardly distinguish between halftones at all. And everything in the world looks either very good or monstrously bad to them.

They extend this same attitude to themselves. They either perceive themselves as the most beautiful people in the world, or as the most insignificant creatures who are not worthy of living. This is one of the sad reasons that up to 80% of patients with this diagnosis sometimes think about suicide. And 5–9%, alas, ultimately realize this intention.

3. Fear of abandonment

This fear often makes borderliners appear as shameless manipulators, tyrants, or simply selfish. However, everything is much more complicated. They cling to relationships again and again, strive to spend all their time in the company of those they love, and may even physically try to prevent them from leaving just to the store or to work for the reason that separation is unbearable for them.

Fear of separation (real or imagined) from loved ones can provoke attacks of panic, depression or anger in those suffering from PPD - typical symptoms are listed in a certificate from the US National Institute of Mental Health.

4. Impulsive, self-destructive behavior

We all do something rash from time to time. But it’s one thing to spontaneously buy an unnecessary thing or suddenly refuse to go to a party where we are expected, and quite another to have habits that threaten health and life.

Such habits include addiction to alcohol and drugs, deliberately risky driving, unprotected sex, bulimia and many other not very pleasant things. It is interesting that Russian researcher Tatyana Lasovskaya attributes the tendency to get tattoos to similar self-destructive behavior patterns. She estimates that PLR can occur in up to 80% of people who get tattoos. At the same time, those suffering from the disorder most often remain dissatisfied with the result and in 60% of cases return to apply a new drawing. And in the tattoos themselves, the theme of death often prevails.

5. Distorted self-perception

Another typical feature of patients with PPD is a distorted perception of themselves. Their strange and unpredictable behavior is often determined by how good or bad they think they look at the moment. Of course, an assessment can be infinitely far from reality - and change suddenly and also without any apparent reason.

People with borderline personality disorder have great difficulty controlling their thoughts, emotions, and the way they express them.

Here's how actress Lauren Ocean describes it in her story What It's Like To Live With Borderline Personality Disorder: “At times I feel nurturing and tender. And at times I become wild and reckless. And it also happens that I seem to lose all personality altogether and cease to exist. I sit and can think about everything in the world, but I don’t feel anything at all.” Ocean has suffered from PPD since she was 14 years old.

6. Inability to control emotions and actions

After all of the above, it is hardly surprising that people with borderline personality disorder find it very difficult (and often impossible) to control their thoughts, their emotions, and the ways they express them. The result is unprovoked aggression and outbursts of anger, although manifestations such as depression and paranoid obsessions are also possible.

Lauren Ocean notes, “One of the most frustrating things about PPD is how it affects my behavior towards other people. I can praise a person to the skies. But I can’t give him a damn - and it’s the same person!”

People with borderline personality disorder suffer just as much from their illness as those who have to endure their endless mood swings, angry outbursts and other severe manifestations of the disease. And although it may not be easy for them to decide on treatment, it is absolutely necessary.

Psychotherapy is considered the best way to combat PPD today. There is no cure for the disease, and drug treatment is recommended only for patients whose borderline disorder is complicated by underlying problems, such as chronic depression.

Schizotypal disorder refers to a group of schizophrenia-like diseases, including schizophrenia itself, schizotypal and other delusional disorders. Schizotypal disorder is somewhat similar in its manifestations to schizophrenia. Its symptoms include behavioral abnormalities, emotional inadequacy, and eccentricity. Obsessive ideas, avoidance of communication, and paranoid disorders are common. Delusional and hallucinatory episodes are possible. However, there are no obvious signs of schizophrenia.

The main difference between schizotypal disorder and schizophrenia is the predominance of positive symptoms. It is characterized by delusions, hallucinations, and obsessions without the development of a personality defect. There are no symptoms characteristic of schizophrenia, such as emotional flattening, decreased intelligence, and sociopathy.

Diagnosis of schizotypal disorder

To establish this diagnosis, a long-term (more than two years) presence of characteristic symptoms in the absence of personality deficit is necessary. The diagnosis of schizophrenia should also be excluded. Information about illnesses of close relatives can help in establishing a diagnosis - the presence of schizophrenia in them serves as confirmation of schizotypal disorder.

It is important to avoid both over- and under-diagnosis. An erroneous diagnosis of schizophrenia is especially dangerous. In this case, the patient will receive unreasonably intensive treatment, and, when information is disseminated among friends, social isolation, which contributes to the aggravation of symptoms.

There are a number of methods that help clarify the diagnosis of schizotypal personality disorder. The SPQ (Schizotypal Personality Questionnaire) test is one of the easiest ways to do this.

Test Description

The test for schizotypal personality disorder includes 74 questions that cover 9 main signs of this disease according to ICD-10. A score of more than 41 points is considered a sign of schizotypal disorder. More than half of respondents who exceeded the diagnostic level on the test were subsequently diagnosed with schizotypal disorder.

There are also separate tests for diagnosing the level of psychoticism authored by Eysenck, scales for assessing general and social anhedonia, possible disturbances of perception and a tendency to schizophrenia. However, only in the SPQ are all the signs of schizotypal disorder collected together and presented in an easy-to-use form.

The questions in the test for schizotypal traits are divided into the following scales:

• impact ideas,
• excessive social anxiety,
• strange ideas or magical thinking,
• experience of unusual perception,
• strange or eccentric behavior
• lack of close friends,
• unusual sayings,
• reduction in emotions
• suspicion.

This test demonstrated good reproducibility and reliability of results in different groups of subjects.

The SPQ test can be used both to confirm the diagnosis of schizotypal disorder and for screening healthy people at risk. This is a fairly reliable and psychologically comfortable way to identify the presence of a disorder at its first symptoms.

The test is also convenient for dynamic monitoring in order to identify worsening or alleviating symptoms. The test questions can be used by patients for self-control - patients do not always perceive their condition as pathological and make corresponding complaints, but with the help of the test they can be easily identified.