Causes and types of emotional personality disorders

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Emotionally unstable personality disorder (ENPD) is a mental disorder in which a person is impulsive, has poor self-control, and is unbalanced in words and actions. The condition requires the appointment of long-term psychotherapy, in which a specialist determines the causes of the development of the pathology and corrects them.

The psychiatric department of Dr. Isaev’s clinic offers treatment for emotionally unstable personality disorder in Moscow. Here, a thorough diagnosis is practiced, based on the results of which an individual correction program is drawn up. The therapeutic course includes traditional methods of psychotherapy and innovative proprietary techniques. Pharmacology is used if necessary. The result is a stable state of remission, normalization of mental processes and the emotional sphere.

How does the disease manifest itself?

In ICD 10, emotionally unstable personality disorder is characterized as instability, inability to self-control and increased impulsivity.

The disease is observed in people of both young and older ages. A person’s self-esteem is impaired, he cannot form relationships with other people and very often is in a state of non-existence, or, in other words, affect.

With this disease, patients:

1. They feel constant loneliness and make frantic attempts to avoid it.
2. They are characterized by sudden changes in mood.
3. They experience a feeling of separation, loss, as a result of which their behavior, emotions, thinking and sensations inevitably change.
4. They experience great fear of changes in plans.
5. They become angry and unbalanced even after short periods of separation.
6. They believe that if they are left alone, it will cause them great harm. These feelings cause impulsive behavior, which can lead to self-harm by the patient.

A person can so fiercely perceive both effective reality and invent his own vision of our world.

Cognitive behavioral therapy: features in the treatment of personality disorder

Aimed at relieving manifestations of decompensation, correcting behavioral reactions, and inadequate defense mechanisms.

Long-term psychotherapy is aimed at changing maladaptive attitudes and learning to adequately interact with others. Focusing on the patient’s anxiety about the undeveloped “ego” and the accompanying feelings of loneliness and emptiness allows one to obtain satisfactory results, significantly smoothing out the manifestations of the disease.

Drug therapy for the disorder is represented by antidepressants (Fevarin, Paroxetine), neuroleptics (Chlorpromazine, Levomepromazine, Neuleptil), tranquilizers (Diazepam) and mood correctors (lithium salts, valproate). The high risk of suicide limits the use of drugs in outpatient practice.

Prevention includes monitoring the health of the mother during pregnancy and children from infancy.

Being the result of the fusion of two fundamental areas of psychotherapy and simultaneously influencing the patient’s thinking and behavior, cognitive behavioral therapy provides a comprehensive approach to the correction of personality disorders.

The cognitive component, during which dysfunctional thinking patterns are identified and transformed, is carried out in the form of individual sessions. Behavioral, designed to help the patient replace unwanted forms of behavior with new, more constructive ones, can be carried out both individually and in a group or family form.

Cognitive behavioral therapy (CBT) has the following features:

1. using only those methods whose effectiveness has been reliably proven experimentally;
2. therapy begins with the elaboration of specific, most relevant tasks for the patient - the “here and now” rule;
3. CBT implies a directive position of the psychotherapist and an active position of the patient, clearly following the doctor’s instructions. Work is carried out not only during sessions, the patient often receives “homework” in the form of specific exercises, keeping a “thought diary”, etc.
4. with the patient’s consent, the assistance of family members is actively used in therapy.

Due to its characteristics, cognitive behavioral psychotherapy has established itself as a therapeutic technique with proven high efficiency, and patients notice the first positive results after just a few sessions.

How are interpersonal relationships developed?

Relationships with other people are unstable. They are accompanied by conflict situations.

Patients idealize their guardians or lovers from the first days of their acquaintance. They want to constantly be with the object of desire and from the first days they demand entry into intimate aspects.

At the same time, the ideal also quickly depreciates in their eyes. They easily begin to think that the person who was so close to them has grown cold and is not paying enough attention.

Their empathy is based only on the expectation that other people will begin to sympathize and satisfy all the desires and needs of the patient. If their opinions differ, then emotionally unstable individuals dramatically change their views on others.

Afterword

Thus, to correct borderline disorder, you need to work on analyzing and analyzing the problem, assimilating the world and the personality traits themselves, accepting these characteristics, increasing self-control over emotions (especially impulsivity and outbursts of anger), reducing sensitivity to criticism and the opinions of others, learning social skills .

When working with borderline individuals, it is important not to become unstable yourself. You need to sincerely support the patient, but not cross the line: do not romanticize or bring relationships closer together, do not ignore the problem, do not allow concessions.

Borderline pathology goes into remission in 50% of cases in the first two years and in 85% of cases in the first 10 years. Relapses are unlikely. But socialization still remains problematic; only 20% of patients are able to establish lasting close relationships and find a permanent job (no earlier than 10 years later).

What is identification expressed in?

It is expressed in the instability of the representation of one’s personality. Variable assessment of one’s “I” is expressed in a constant change in life goals and professional skills. For example, a good-natured person asking for help for himself suddenly becomes angry and vindictive. At the same time, he always fights for the truth.

Although in most cases these individuals consider themselves evil and aggressive, and sometimes even think that they do not exist on this planet. This mainly manifests itself when a person does not feel his importance and support from the people around him.

Individuals susceptible to this disease are impulsive in circumstances involving risk. They can:

• get involved in gambling;
• not knowing how to account for money and spending it irresponsibly;
• eat a lot of food and not feel full;
• use psychotropic substances;
• change many sexual partners;
• take risks while driving a car.

Suicidal tendencies

People with emotionally unstable personality disorder are predisposed to behavior that could take their life. At the same time, suicide attempts are constantly repeated.

Despite the fact that patients like to demonstratively attempt suicide, only eight percent achieve complete death. The actions of the others are aimed at getting people around them to pay attention to them. They may cut themselves or deliberately create burns on their bodies. If attention is not paid and help is not provided, attempts to take one's own life continue.

They may be caused by impending separation from the object of love. At the same time, suicide attempts provide relief for a while, especially if the patient is heard and understood, and these actions also made the other person understand that he acted wrongly towards the patient.

Symptoms

In patients with emotionally unstable personality disorder, pronounced symptoms of this condition are determined. An emotional disorder in a person is expressed by severe excitability and irritability, which, as a rule, is combined with rancor, malice, and an explosive character. Such people are excitable, they have a viscosity of affective reactions. Their frequent mood swings are combined with pronounced outbursts of emotions. Affective fluctuations develop as a consequence of the influence of external causes, which are very often insignificant. People who develop emotionally unstable personality disorder almost always look for reasons for dissatisfaction; everything irritates them. As a rule, such patients cannot adequately assess the situation due to the fact that they lack judgment.

Emotional personality disorder encourages a person to perceive all the ordinary events that happen in life every day with a touch of tragedy. Consequently, most situations cause them serious emotional stress, and, as a result, serious outbursts of anger. The latter especially often manifests itself during family conflicts, which ultimately leads to violent manifestations of indignation and even physical violence.

Such patients are not inclined to respond adequately to objections; they cannot listen to someone else’s opinion for a long time and are extremely categorical in all disputes. The interests of other people practically do not bother them, since they are categorically confident in their own importance. But at the same time, such people are not able to realize that they are the originators of conflicts. On the contrary, they tend to believe that everyone around them does not value them and cannot understand them.

That is why proper treatment of emotional unstable personality disorder allows not only to improve the condition of the sick person, but also to eliminate the tension in the family that arises due to his illness.

Symptoms of emotionally unstable personality disorder

People belonging to this type are characterized as follows:

1. They are constantly under tension.
2. Their health is fluctuating.
3. A person may look depressed and depressed for several days.
4. Irritation and anxiety can last from several hours to several days.
5. Patients feel empty and therefore constantly try to do something.
6. Sometimes, in very ordinary situations, they violently express anger, sarcasm and verbal outbursts. At the same time, they immediately feel an acute sense of guilt for their actions and thereby seem even more vicious to themselves.
7. Patients are carefree, cheeky and at the same time secretive.

These people are capable of destroying everything when the goal is almost achieved. For example, quitting school before receiving a diploma or breaking off a relationship at a time when everything is well established.

Attacks of the condition, in which a person feels as if outside of reality, in a strangely changed world, or feels that his mind has been separated from his body, arise precisely during periods of abandonment and loneliness. But as soon as care is resumed, these symptoms disappear.

Most common personality disorders

The most common and widespread emotionally unstable personality disorders include:

1. Manifestation of bulimia (after eating a person gets rid of it by artificially inducing vomiting).
2. Stress disorders after injury.
3. Sudden change of mood.
4. At a young age there is a lack of impulse control.
5. Suicidal attacks. Most often appear at a young age. The older a person gets, the less he is haunted by attempts to take his own life.
6. Tense relationships with people and impulsive disorders haunt a person throughout his life.

These manifestations are especially pronounced in individuals who abuse psychotropic active substances.

Those who seek help from specialized medical institutions are susceptible to recovery. Improvements occur already in the first year of therapy.

What types of personality disorder are there?

There are two types of this disease:

• borderline type;
• impulsive type.

In a borderline state, in addition to emotional instability, difficulties arise with awareness of one’s own image. A person does not feel his intentions and preferences, thereby seeking to harm himself.

The self-esteem of the individual is very high, which is not properly perceived by others. The patient is too arrogant and impatient.

In the second type, the personality is prone to impulsive manifestations and acts hastily in any situation, without thinking about the consequences. In response to condemnation from surrounding people, the patient shows rigidity and aggression.

How does a personality disorder manifest?

An emotionally unstable person can easily be distinguished from all others. Such people are characterized by increased excitability, irritability, unreasonable outbursts of anger and aggression even in minor situations; these people are more vindictive and vindictive. Any little thing can make such a person angry; he does not have enough patience, anger and dissatisfaction constantly manifests itself.

People suffering from mental imbalance often experience mood changes: an angry and dissatisfied mood can quickly be replaced by bright manifestations of goodwill and fun.

It is very difficult to please such people, they are constantly dissatisfied with something and look for the slightest reasons to splash out their negative energy and express complaints. All events are perceived inadequately, with the manifestation of aggression and anger. Even from the most insignificant troubles in life, such people are ready to create a whole tragedy with all the ensuing consequences.

In the family, people with symptoms of a personality disorder are most often completely unbearable and are real despots. Frequent family scandals are always accompanied by emotional outbursts with the destruction of dishes and furniture, misunderstanding and refusal to accept the position of the interlocutor, seeing only one’s own “correct” opinion and unwillingness to take into account the interests of other people. There are often cases when such scandals can be accompanied by the use of violence.

All this once again indicates the need for treatment of patients with emotional disorders.

Depending on the characteristics of the mental disorder, a person may experience different manifestations of behavior.

Diagnosis of impulsive type

This type is characterized by the following manifestations:

1. Tendency to act suddenly. Don't consider the consequences of your actions.
2. Relationships with people around you are built on constant conflict.
3. Anger and violence appear.
4. Patients require immediate reward for their actions, otherwise they do not complete the task.
5. Unstable mood, accompanied by constant whims.

Being surrounded by this type is difficult and unpleasant.

Diagnosis of borderline type

For a borderline state, the following characteristics are distinguished:

1. The person does not understand himself. He does not feel his own “I” and therefore cannot decide what he really wants.
2. The patient enters into promiscuous relationships and constantly changes partners.
3. Directs all his energy to avoid loneliness.
4. The patient is prone to suicidal behavior.
5. He constantly feels a feeling of uselessness and emptiness.

If you seek treatment at a psychiatric clinic at a young age, then by the age of 40, both relationships with other people and professional relationships will improve.

Borderline treatment

It can be very difficult to determine a borderline state, sometimes even over several years. The doctor conducts a large number of studies and prescribes therapeutic treatment only after the clinical picture becomes clear.

The treatment process necessarily includes psychotherapy procedures.

Doctors' actions are aimed at:

1. Returning a person to the real environment.
2. The patient's ability to withstand stressful situations.
3. Improving the patient's relationships with other people.
4. Fighting emotional imbalance.

During the entire treatment, the patient should be surrounded by the care and love of people close to him.

Diagnostics

The diagnosis is carried out by a psychiatrist. In the process of establishing a diagnosis, it is important to differentiate this type of disorder from an organic personality disorder, in which similar symptoms are observed, but in addition to them, dysmnestic and cognitive disorders, and drive disorders are also present.

The basis for establishing such a diagnosis is the doctor’s observations of the patient’s behavior, in particular, the detection of disturbances in emotional response, thinking, perception and other inappropriate manifestations.