Borderline disorders are not of clear-cut nature and cause difficulties in their categorization, assuming an accurate diagnosis. They may be accompanied by chronic irritability, periodic excessive impulsiveness, disorder of personal identity, time gaps in the self-perception, over-dependence on other people, anti-social behavior that can escalate into a crime.
The disorder manifests itself mainly in middle age, between 17 and 25 years old. Some features of borderline personality disorder can occur during childhood. Since the psyche of children have not yet been formed, it is a disorder diagnosed in childhood, and adolescence.
Borderline personality disorder is difficult to diagnose because it can manifest itself in various forms, which are difficult to compare. Individuals with BPD may experience ambivalence when, on the one hand, the external standard of living is represented by the visibility of a stable structure of character, on the other hand, the inner experiences are those that their consequences are displayed through different manifestations – from emptiness and indifference to the external environment to sexual perversions and criminal behavior. These patients are unable to self-analysis, and cannot distinguish between fantasy and reality, but they can use other people to meet their instincts and desires, or, conversely, to voluntarily submit to their authority, thereby avoiding the possibility of making their own decisions and take personal responsibility for their actions.
Borderline patients have psychotic and dissociative episodes. It is typical for them, for example, to experience psychosis disorders of perception, such as auditory hallucinations or thought disorders, excessive suspiciousness. These symptoms are usually short, from a few hours to several days.
Multiple symptoms indicating impaired sense of reality are the sense of separation from the body, being outside it, feeling of unrealness of the body.
Because of impaired sense of reality, people with borderline personality disorder perceive the risk of being isolated from the society, so their trust in others decreases continuously.
When trying to solve interpersonal conflicts, patients with borderline personality disorder tend to resort to such protective mechanisms such as projection, introjection, and projective identification.
Manifested conflicts may relate to different levels of mental organization and psychosexual development, and symptoms of psychopathology have a different focus and a diverse palette of concrete manifestations.
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