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Borderline personality disorder (BPD) remains an underdiagnosed psychiatric illness in the US due to a variety of reasons. According to Zimmerman, Chelminski, Dalrymple, and Martin (2018), the first issue with this condition is that it has symptoms similar to those of a bipolar disorder, which makes it difficult to distinguish this illness. For instance, mood changes and impulsivity can be observed in both cases.
Moreover, people with BPD can also have bipolar, thus, making it more difficult to recognize the issues affecting a person’s behavior and developing an appropriate treatment plan. However, Zimmerman et al. (2018) argue that most medical professionals identify the described symptoms as signs of bipolar and not a BPD. One of the reasons is that pharmacological companies advocate for the recognition of bipolar, which leads to issues with overdiagnosing (Zimmerman et al., 2018). This provides implications for the improvement of the criteria and tools used to evaluate a patient’s state.
The approaches to the treatment of patients that are admitted to a facility and those receiving outpatient care differ. This makes it challenging to treat BPD because such patients often choose to leave therapy after a particular time due to the nature of the condition (Brthoud et al., 2017). The case described in the presentation indicates some serious risks connected to possible self-harm that may complicate the process.
Fassbinder et al. (2018) conducted a study in which they examined the effect of outpatient treatment interventions for individuals diagnosed with BPD. The authors conclude that dialectical behavior therapy can be used as a method for outpatient treatment of BPD. Thus, one should take a chance at using this model without admitting a patient into a medical establishment.
References
Berthoud, L., Pascual-Leone, A., Caspar, F., Tissot, H., Keller, S., Rohde, K. B., … Kramer, U. (2017). Leaving distress behind: A randomized controlled study on change in emotional processing in borderline personality disorder. Psychiatry, 80(2), 139–154. Web.
Fassbinder, E., Assmann, N., Schaich, A., Heinecke, K., Wagner, T., Sipos, V., … Schweiger, U. (2018). PRO*BPD: Effectiveness of outpatient treatment programs for borderline personality disorder: A comparison of Schema therapy and dialectical behavior therapy: Study protocol for a randomized trial. BMC Psychiatry, 18(1). Web.
Zimmerman, M., Chelminski, I., Dalrymple, K., & Martin, J. (2018). Screening for bipolar disorder and finding borderline personality disorder: A replication and extension. Journal of Personality Disorders, 1–11. Web.
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