Comorbidities and Borderline Personality Disorder

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If you have borderline personality disorder (BPD), you may find that standard treatment plans are difficult to find. Treatment plans for many people with BPD will be individualized because few of these individuals have only one illness. Most people affected by BPD have other disorders, known as comorbidities. Research has shown that physical and psychiatric comorbidities are more common in individuals with borderline personality disorder.

What Is a Comorbidity?

A comorbidity refers to the existence of two or more diseases or conditions in the same individual at the same time. Some of the most common comorbidities that occur alongside BPD are depression, anxiety, and post-traumatic stress disorder. A person who has both BPD and depression would be referred to as having 'comorbid depression and BPD.' 

While by definition comorbid disorders must exist at the same time, it may be the case that one of the conditions or disorders may have started before the other. For example, someone may develop PTSD in childhood, then later develop BPD as an adolescent. Or, both conditions may develop at the same time, but one may end while the other continues or worsens.

For as long as the symptoms of both disorders overlap in time, they are considered to be comorbid.

Why Comorbidities Can Be Problematic

Comorbidities can lead to problems, particularly if you have BPD. The other illnesses, like depression or anxiety, are more easily recognized and are more regularly treated. Many people are not appropriately diagnosed with BPD because the other illnesses "hide" the BPD symptoms. This means that the personality disorder symptoms go untreated and unchecked.

While depression and anxiety may be treated with medication, there are no medications currently approved by the Food and Drug Administration (FDA) to treat BPD. There are, however, several different medications that are often used "off-label" (without FDA approval) to treat BPD symptoms.

If BPD is not recognized, your disorder can go undiagnosed and untreated for months or even years, making you feel even worse and putting your health at risk.

Treatments

Regardless of the comorbidities that exist, BPD needs to be addressed as a distinct and unique disorder. While other illnesses can be treated and managed with medications, BPD usually requires a more intensive approach. Many forms of psychotherapy have shown significant positive results in clinical studies, especially dialectical behavior therapy.

Therapy is an essential part of managing BPD. Look for a therapist who understands comorbidities and who specializes in BPD to develop an effective treatment plan for you. In some cases of comorbidities, you may need multiple physicians and therapists to handle every aspect of BPD and the other disorders. In this case, it's important that all of your healthcare providers know what's going on with other aspects of your treatments. If there are any changes to your therapy plan or medication regimen, make sure everyone on your medical team is aware.

Clear communication between all your health care providers can prevent misunderstandings or mix-ups that could interrupt your recovery. Keeping communication open between parties will ensure your therapy moves forward appropriately.

While comorbidities can make BPD more difficult to diagnose and manage, understanding the other disorders and how they impact BPD is essential to developing an effective treatment plan.

If you are unsure if you have other disorders or think you are at risk of developing a comorbidity, talk with your doctor or therapist to be evaluated.

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Article Sources
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  1. Shen CC, Hu LY, Hu YH. Comorbidity study of borderline personality disorder: applying association rule mining to the Taiwan national health insurance research databaseBMC Med Inform Decis Mak. 2017;17(1):8. doi:10.1186/s12911-016-0405-1

  2. Slotema CW, Blom JD, Niemantsverdriet MBA, Deen M, Sommer IEC. Comorbid diagnosis of psychotic disorders in borderline personality disorder: prevalence and influence on outcome. Front Psychiatry. 2018;9:84. doi:10.3389/fpsyt.2018.00084

  3. May JM, Richardi TM, Barth KS. Dialectical behavior therapy as treatment for borderline personality disorderMent Health Clin. 2016;6(2):62–67. doi:10.9740/mhc.2016.03.62

Additional Reading
  • Biskin, R. "Comorbidities in Borderline Personality Disorder". Psychiatric Times, 2013.
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