A Borderline Personality Case Example - Jordan
Even when Jordan was a tiny infant, it seemed that there was something very different about her. She was an intense baby; she seemed to always be easily upset, she didn't adjust very easily to new circumstances, and she was hard to comfort. Her parents assumed that all babies are different, and that this was just a phase. In fact, they knew of plenty of other parents with kids who had started off like this, but that had ended up being easy-going adults.
However, as Jordan grew, she didn't seem to "just grow out of it." She continued to be easily upset and difficult to comfort, and she had very severe separation anxiety. If her mother left the room, Jordan would scream until she returned. Still, her parents were not too concerned. Separation anxiety is pretty typical for kids to go through. And Jordan had so many sweet qualities; at times she could be the most loving child. They often had really wonderful times together.
Borderline Personality Case - Adolescence
When Jordan hit her early teens things started to change. There were fewer and fewer good times. Jordan became increasingly sullen and angry. She started acting out more and more -- yelling at her parents and teachers and engaging in impulsive behaviors, like running away from home. She at times would have a close friend or two at school, but some conflict seemed to always arise and that friendship would end. Jordan talked about how alone and bored she felt, how no one understood her. Again, this seemed like it might just be typical adolescent behavior, so while her parents were starting to get concerned, they weren't yet ready to seek help.
Borderline Personality Case - Persistent Symptoms
By the time Jordan turned 17, things were starting to get really out of control. Jordan's experienced serious emotional instability, her mood changes were totally unpredictable, and could turn on a dime. She was having fights with her parents almost daily, and they would usually involve her yelling and throwing things. At times, she seemed terrified to be without her mother, at other times she would leave the house in a fit of intense rage and not return for a few days.
One day, Jordan's mom noticed scars on Jordan's arms. When her mother first confronted Jordan about them, Jordan told her the cat had scratched her. But when pressed she admitted that she was self-harming because she felt so lonely and bored and this was the only thing that made her feel better. This was the last straw; her parents decided it was time to find help.
Borderline Personality Case - Seeking Help
Jordan's parents were able to find a psychiatrist in their area who accepted their family health insurance, and they brought Jordan to see her. The psychiatrist spent time talking to Jordan, and asking Jordan and her parents about her symptoms. Based on this brief assessment, the psychiatrist diagnosed Jordan with bipolar disorder, and prescribed a mood stabilizing medication.
The new medication seemed to help, and Jordan and her parents were hopeful that things were getting better. In attempt to better understand her disorder, Jordan's parents tried to read more about bipolar disorder and how to help their daughter recover. The things they read, however, didn't quite fit with their daughter's symptoms. For example, Jordan's moods seemed to change multiple times a day -- this seemed different than the infrequent but intense mood changes typical of bipolar disorder.
Borderline Personality Case - Getting a Diagnosis
Then, one day, Jordan was on the internet and stumbled on a description of borderline personality disorder. As she read about the symptoms of BPD, she realized that for the first time, she felt that someone else understood what was going on inside her head. She called her mom up to read the page she had found. Finally, they felt that they had an answer.
Jordan's mother found internet resources that led her to a list of experts in BPD in their area. They made an appointment with a psychiatrist, who met with Jordan a few times. After their third meeting, the new psychiatrist confirmed that Jordan met diagnostic criteria for BPD. The psychiatrist talked about different treatment options available, including medications and psychotherapy.
Borderline Personality Case - Treatment and Recovery
At 23, Jordan still has many symptoms of borderline personality disorder. However, a combination of medication and dialectical behavior therapy have reduced her symptoms considerably. She no longer self-harms, and she is working part-time and has a few close friends. Jordan still has times when she feels overwhelmed, and has difficulties with anger and in relationships, but she is working on learning coping skills to manage these symptoms.
Borderline Personality Case - A Summary
Jordan's case is only one example of the experience of BPD. There is a huge range of differences between people with BPD. Some have supportive families, like Jordan's, others grow up in a traumatic environment (which has been linked to BPD symptoms). Some, like Jordan, start showing some signs of BPD in early adolescence, others do not have any symptoms until they are later in their teens. And, not everyone with BPD responds as well to treatment as Jordan. However, there are certainly other people who have experienced significantly reduced symptoms with treatment.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed, text revision. Washington, DC, Author, 2000.
Kraus, G, and Reynolds, DJ. "The A-B-C's of the Cluster B's: Identifying, Understanding, and Treating Cluster B Personality Disorders." Clinical Psychology Review 21: 345-373, 2001.