In the past Borderline Personality DIsorder was considered untreatable – someone once described it as “the leprosy of mental illness”.
Today, there is still a persistent question that arises when talking about Borderline Personality Disorder.
Over the past 30 years, several treatments- both therapy and medication- have helped people with BPD “turn the corner” so to speak by reducing the impact of the disorder to a meaningful degree. But where do they hope to find themselves? Cured? Recovered? In remission?. And just what do those terms mean? Unfortunately, there doesn’t seem to be a definitive answer.
The Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association lists 9 criteria for making a diagnosis of BPD. If a person meets 5 or more of these criteria, they are considered to have the disorder. The question might then be asked – if a person in treatment drops down to meeting only 4 of the criteria are they no longer considered to have BPD? And what do they have? Partial BPD? Is there a point where they are considered totally free of BPD because they only meet three, two, one, or even none of the criteria? Is this person considered cured? And if not, what is their status– are they in recovery or in remission?
There doesn’t yet seem to be a consensus answer to that critical question.
However, there is one research study that may provide a possible resolution. The McLean Study of Adult Development (MSAD), headed by Dr. Mary Zanarini, followed several hundred women who had received treatment for their BPD. The study found that while every participants had difficulty overcoming most of their BPD criteria, of those who did, more than 80% were able to sustain that over time, even after 24 years of follow-up. Comparing BPD to other severe mental illnesses such as bipolar and schizophrenia Dr. Zanarini began referring to BPD as “the good–prognosis diagnosis”.
Last May we posted a story about Dr. Zanarini and the MSAD research as part of our support of the May Is BPD Awareness Month initiative in the U.S., sponsored by the BPD advocacy group The National Education Alliance for Borderline Personality Disorder (NEABPD). Perry Hoffman, a long time BPD therapist and co-founder of NEABPD, also provides her point of view on the ability of people to meet the challenge of overcoming their BPD related problems and learn how to achieve a “life worth living”. You’ll also hear from Krissy, a young woman profiled in our video series A Guide to Borderline Personality Disorder, who was able to do just that
Photo via helpguide.org