I Read an interesting observation about some of the difficulties in the diagnosis of borderline personality disorder (BPD), which significantly distorts the understanding of the epidemiology of this condition.
for Example, psychiatrists tend to put BPD women than men. The explanation is such that women suffer more from the consequences impulsivity, poor self-identity and feelings of abandonment, so often seek medical or psychological help. The same promiscuity, the inability to create lasting relationships, loneliness, clinging to anyone anyhow and the subsequent destruction of the relationship the woman can survive more difficult given the gender and social foundations. The man must have a high enough level of awareness to otrevizirovat and formulate things for women are a natural part of communication.
consequential one gender error in diagnosis is a risk to see the colorful descriptions of the experiences of the hysterical personality, not a border. The woman really brightly and defiantly will complain.
in addition, impulsive behavior for men is considered "typical". Such a patient probably will make the diagnosis of "antisocial personality disorder", ignoring the symptoms of BPD. However, the antisocial person does not feel guilt or remorse from their actions. Patients with BPD still has the ability to the minimum of empathy. I've noticed some thrust to confuse the two diagnoses for primary admission.
it is difficult to Diagnose BPD in a person over the age of 35-40, when the impulsivity and extremest objectively decrease due to changes in the condition of the nervous system. The person with BPD, losing the ability to peak life, fall into a deep depression or anxious feelings, and come to the experts. Not always depression or phobias could find primary psychopathology, on the basis of which arose secondary to depressive or phobic state. Patients with BPD tend to control the anxiety of emptiness and uncertainty, the obsessions, and why getting a primary diagnosis of OCD.
And another point that aging patients with BPD, testing the wild horror of the loss of "the power over life" through smertonosnoe behavior that just masked the emptiness, the feeling of fear and their own psychological weakness, tend to blame the environment for their problems of implementation, and thus become extremely emotionally dependent on supporting people. There is a risk to see constant nagging and dissatisfaction, searching for "truth", the accusations, the insults on the minor things traits paranoid, or dependent personality than a border.
the Unstable identity, which gives way for even one day, for example, from the soaring feelings "I am the most intelligent" to complete the feeling of stupidity when a minor error is diagnosed as a result of narcissistic personality disorder, is also associated with unstable self-esteem, depending on the reaction to an outsider.
mood Swings regardless of age is often confused with bipolar disorder, although patients with BPD may have episodes of mania as a separate condition that is not associated with manic-depressive psychosis. However, in contrast to the TIR mania in a patient with BPD occurs on the basis of objective social situations causing disruption of the stable state. Suspect schizophrenia can be a tendency to depersonalization and reactive psychosis, and weirdness and pretentiousness of such people can be confused with schizotypal disorder. Often in therapy several clients with BPD I have observed isolated psychosis (a few minutes) during the session, as short-term psychotic bouts and outside the meetings, which were recorded by people, in contrast to patients with schizophrenia or TIR.