ITS GOOD FOR ESPECIALLY NURSING STUDENTS AND ALL

1. BORDERLINE PERSONALITY DISORDER (BPD)
BY:
MR.SUNIL KUMAR
FINAL YEAR M.SC
NURSING
B.V.D.U.C.O.N,PUNE
29TH OCTOBER 2015

2. INTRODUCTION
Before going on my topic I would like to ask you
one question “what do you mean by
personality?”

3. • Personality refers to individual
differences in characteristic patterns
of thinking, feeling and behaving.

4. • If there is any disturbance in maintaining
in your personality more than few weeks
than it leads to personality disorder.

5. PERSONALITY DISORDERS
• Personality disorders are conditions in
which an individual differs significantly
from an average person, in terms of how
they think, perceive, feel or relate to
others.

6. Changes in how a person feels and
distorted beliefs about other people can
lead to odd behaviour, which can be
distressing and may upset others.

7. INCIDENCE
• 5-15 % of adults have one or more
personality disorder

8. TYPES OF PERSONALITY
DISORDER

9. CLUSTER A PERSONALITY
DISORDERS
• Paranoid personality disorder
• Schizoid personality disorder
• Schizotypal personality disorder

10. Cluster B personality disorders
• Antisocial personality disorder
• Borderline personality disorder
• Histrionic personality disorder
• Narcissistic personality disorder

11. Cluster C personality disorders
• Avoidant personality disorder
• Dependent personality disorder
• Obsessive-compulsive personality disorder

12. DEFINITION
OF
BODERLINE PERSONALITY
DISORDER
(BPD)

13. Borderline personality disorder (BPD)
is a serious mental illness marked by
unstable moods, behaviour, and
relationships.

14. CAUSES OF BODERLINE PERSONALITY
DISRDERS:
• Genetic
• Traumatic childhood
• Vulnerable temperament
• Stressful maturational events in
adolescence and childhood
• Childhood abuse or trauma or neglect

15. CAUSES Contn:
• Abuse (emotional, sexual, physical) by
the care takers
• Chronic stress
• Unresolved life events
• Over involvement and under involvement
of parents
• Defective family environment

16. CAUSE contn…
• Alteration in level of neurotransmitters,
e.g. serotonin, acetylcholine, GABA and
norepinephrine
• Affective disorders
• Substance abuse disorder
• Post-traumatic stress disorder

17. SYMPTOMS
• You feel very worried about people
abandoning you, and would do anything
to stop that happening.

18. • You have very intense emotions that last
from a few hours to a few days and can
change quickly (for example, from
feeling very happy and confident in the
morning to feeling low and sad in the
afternoon).

19. • You don't have a strong sense of who
you are, and it can change depending on
who you're with.
• You find it very hard to make and keep
stable relationships.

20. • You act impulsively and do things that
could harm you (such as binge eating,
unsafe sex, using drugs or driving
dangerously).
• You have suicidal thoughts or self-
harming behaviour such as cutting.

21. • You feel empty and lonely
a lot of the time.
• You get very angry, and struggle to
control your anger.

22. • When very stressed, sometimes
you might:
–feel paranoid
–have psychotic experiences, such as
seeing or hearing things other people
don't
–Feel numb or 'checked out' and not
remember things properly after they've
happened.

23. DIAGNOSIS
• Self- reported experiences of the client
• A comprehensive personal and family history
• A physical examination
• Blood test to exclude HIV or Syphilis
• EEG, CT scan to exclude epilepsy and brain
lesions
• Mental state examination

24. To be diagnosed with BPD, a person
must experience at least five of the
following symptoms:

25. • Fear of abandonment
• Unstable or changing relationships
• Unstable self-image; struggles with
identity or sense of self
• Impulsive or self-damaging behaviours
(e.g., excessive spending, unsafe sex,
substance abuse, reckless driving, binge
eating).

26. • Suicidal behaviour or self-injury
• Varied or random mood swings
• Constant feelings of worthlessness or
sadness
• Problems with anger, including frequent
loss of temper or physical fights
• Stress-related paranoia or loss of contact
with reality

27. TREATMENT
1.Counselling and therapy
2.Medications

28. DIALECTICAL BEHAVIOUR
THERAPY (DBT)
• Dialectical behaviour therapy (DBT).
This type of therapy focuses on the
concept of mindfulness, or being
aware of and attentive to the current
situation.

29. • DBT teaches skills to control intense
emotions, reduces self-destructive
behaviours, and improves relationships.

30. This therapy differs from CBT in that it
seeks a balance between changing and
accepting beliefs and behaviours.

31. • Individual, Family and marital
counselling may be require according
to needs.

32. MEDICINE
• Typical antipsychotics :- Haloperidol
• Atypical antipsychotic:- Aripiprazole,
• Mood stabilizers:- valproate sodium,
• antidepressants:- Amitriptyline
• . Omega-3 fatty acid

33. HEALTHY HABITS
• Such as getting enough sleep, eating healthy
foods, getting regular exercise, and avoiding
alcohol and drugs. These habits can help
reduce stress and anxiety. And they can help
make your symptoms less severe and less
frequent.

34. NURSING MANAGEMENT
• Place the client near to the nurses’ station
• Have a keen insight into client’s
behaviour in all the means, e.g.
communication, performing activities

35. • If the client is developing destructive
behavioural tendency, observe
closely, never allow the client to keep
potentially dangerous objects like
knife, blade, etc.

36. • Based on client’s need one-to-one
relationship has to be maintained.
• Identify the stressors which promote
undesirable behaviour of the client, try to
avoid them

37. • Remove sharp and dangerous objects in
the client’s environment
• Encourage the client to interact and share
his past experiences, review the events,
explore the feelings related to these
episodes
• Allow the client to participate in small
group discussions, where he can
exchange his feelings.

38. • Set clear and realistic goals for client
activities.
• Set limitations for client’s inappropriate
behaviour like destructive behaviour .e.g
.mutilation behaviour, fears related
leaving alone or verbal or physical
threats.

39. • Rotate the staff for client’s care, so that
he will not develop any dependency.
• Motivate the client to establish and
maintain effective communication skills
and relationship with significant members

40. • Avoid labelling the client by his
activities.
• Never show sympathy or empathy to the
client’s humiliation attitude or activities.
• Give positive reinforcement for client’s
appropriate behaviour.

41. • Promote consistency.
• A written contract has to be established
for acceptable and appropriate behaviour.

42. • Encourage the client to participate
actively in assertiveness techniques,
problem solving techniques.
• Never do argument or criticism for
client’s activities

43. CONCLUSION
• So, today we have deal with bipolar
personality disorder. And it’s our
responsibility as a nurse to identify the
patients and give proper care,
counselling, and support to cope up with
the life situations

45. REFERENCES
• Neeraja KP.Essentials of Mental Health and Psychiatric
Nursing .New Delhi.Jaypee Brothers Medical
Publishers.2011.p.454
• http://www.nimh.nih.gov/health/topics/borderline-personality-
disorder/index.shtml#part_145390
• http://www.mind.org.uk/information-support/types-of-mental-
health-problems/borderline-personality-disorder-
bpd/#.Vio9bvkrLIU
• https://en.wikipedia.org/wiki/Borderline_personality_disorder
• http://www.borderlinepersonalitydisorder.com/what-is-
bpd/bpd-overview/
• http://www.webmd.com/mental-health/tc/borderline-
personality-disorder-topic-overview

46. THANK YOU