The hidden diagnosis: "though it is considered to be two to three times more common than bipolar disorder or schizophrenia, [borderline personality disorder] is far less understood and grossly under recognized.".

• Author: Gershon, Judy
• Position: Psychology - Disease/Disorder overview

BORDERLINE Personality Disorder is a mental health condition that affects roughly 10,000,000 Americans, or more than three percent of the general population. Though it is considered to be two to three times more common than bipolar disorder or schizophrenia, it is far less understood and grossly under recognized. This can be attributed, in large part, to the heavy and cruel stigma that so often misrepresents people suffering from BPD as being manipulative and untreatable. As a result, there is little education about BPD and many patients are not properly diagnosed. In fact, they usually go undiagnosed or are misdiagnosed (often as being bipolar), leading to inappropriate and ineffective treatment protocols. The tragedy is that 10% of those with BPD die by suicide, most 'likely due to lack of information and silence surrounding the disorder. There is effective treatment for BPD, but people need to be educated, informed, and unafraid to access the correct therapy.

According to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, BPD is characterized by a pervasive pattern of instability of interpersonal relationships and self-image, as well as a marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

* Frantic efforts to avoid real or imagined abandonment.

* A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation--something called "splitting."

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

* Impulsivity in at least two areas that potentially are self damaging--spending, sexual activity, substance abuse, reckless driving, and binge eating.

* Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

* Affective instability due to a marked reactivity of mood--intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days.

* Chronic feelings of emptiness.

* Inappropriate, intense anger or difficulty controlling anger--engaging in physical fights frequently.

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

While about 75% of those diagnosed with BPD are women, it is believed there are many more men with it who have not been diagnosed properly. The character portrait of an individual who meets the above criteria would be...