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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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Borderline Personality Disorder can itbe triggered by stre

Resolved Question:

Borderline Personality Disorder can itbe triggered by stress
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help. BPD is caused by early abandonment or neglect and is often triggered when the person feels they are abandoned.

Elliott, LPCC, NCC :

Here are the criteria:

Elliott, LPCC, NCC :

For your enlightenment and information here are the official criteria for BPD from the psychiatric diagnostic "bible", the DSM-IV.


BPD – DSM-IV


1. Frantic efforts to avoid real or imagined abandonment.


2. A pattern of unstable and intense interpersonal relationships characterised by alternation between extremes of idealization and devaluation.


3. Identity disturbance - markedly and persistently unstable self-image or sense of self.


4. Impulsivity in at least two areas that are potentially self-damaging, e.g. spending, sex, substance abuse, reckless driving or binge-eating.


5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.


6. Affective instability due to a marked reactivity of mood, e.g. intense episodic dysphoria, irritability or anxiety, which usually lasts for between a few hours and several days.


7. Chronic feelings of emptiness


8. Inappropriate, intense anger, or difficulty controlling anger, e.g. frequent displays of temper, constant anger or recurrent physical fights.


9. Transient, stress-related paranoid ideation or severe dissociative symptoms.


Anyone with six or more of the above traits and symptoms may be diagnosed with Borderline Personality Disorder. However, the traits must be long-standing (pervasive), and there must be no better explanation for them, e.g. physical illness, a different mental illness or substance misuse.



 

Elliott, LPCC, NCC :

To answer in a sentence: Yes. being around people with BPD is like walking on eggshells.

Customer:

It can be related to PTSD or intwined as a diagnosis. What is the recomended treatment?

Elliott, LPCC, NCC :

Dialectical Behaviour Therapy is the best treatment of BPD.

Elliott, LPCC, NCC :

Often people who have suffered trauma often have both disorders.

Customer:

Sorry not familiar with that treatment.

Elliott, LPCC, NCC :

Let me offer a wonderful book that will actually start a self-help program. Give me a moment please.

Customer:

Will gladly purchase if available online, RN and needing answers.

Elliott, LPCC, NCC :

Is this a teenager?

Customer:

No an adult, not sure if true diagnoses as based on objective assessments no testing.

Elliott, LPCC, NCC :

Objective assessments based on the criteria I have listed above ARE the basis of this diagnosis.

Customer:

Psychiatrist view, work input, hearsay. Awkward for patient.

Customer:

Thank you, XXXXX XXXXX see if Chapters, Indigo or Amazon have it.

Elliott, LPCC, NCC :

That is an amazon.ca link.

Customer:

I appreciate that. Do they recommend medication?

Customer:

If patient is stable on citalopram, 50 mg

Elliott, LPCC, NCC :

Not for BPD, other than extreme depression. For PTSD it might require some antianxiety medication as well, but therapy is the best for trauma-based disorders. PTSD is an anxiety disorder and BPD is a personality disorder.

Customer:

could they be wrong, only seen by this doctor for short IME

Customer:

Patient not presenting with anxiety, unless under extreme stress

Elliott, LPCC, NCC :

I will give you PTSD criteria as well and you make the call. You are a professional and have intelligence.

Customer:

I appreciate this it is hard to offer support with out full facts.

Elliott, LPCC, NCC :

 


PTSD DSM-IV


309.81 DSM-IV Criteria for Posttraumatic Stress Disorder


A. The person has been exposed to a traumatic event in which both of the following have been present:


(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.


B. The traumatic event is persistently reexperienced in one (or more) of the following ways:


(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.


(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.


(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.


(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.


C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:


(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma


(2) efforts to avoid activities, places, or people that arouse recollections of the trauma


(3) inability to recall an important aspect of the trauma


(4) markedly diminished interest or participation in significant activities


(5) feeling of detachment or estrangement from others


(6) restricted range of affect (e.g., unable to have loving feelings)


(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)


D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:


(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response


E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.


F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.


Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more


Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor


 

Customer:

Overlay of PTSD is there not noted by doctor, i think a 2nd opinion is warranted by a different Independet Medical Examiner. Thank you for your help. I should be able to print this off, or save you info?

Elliott, LPCC, NCC :

Absolutely. You can print, copy and paste, or return later on to the chat to review it.

Elliott, LPCC, NCC :

I hope I have been helpful and shall keep you in my prayers.

Customer:

I appreciate this well worth the cost. J

Elliott, LPCC, NCC :

I am so happy to have been of service.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Expert:  Elliott, LPCC, NCC replied 1 year ago.
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