Borderline Personality Disorder In Nursing

Mental health is a portion of healthcare that not too many people know about. Although it’s not as hands on as other nursing fields, it is equally as important. Mental health cases are just as prevalent, if not more, than other nursing cases. The side effects of mental health cases are rapidly growing too. Borderline personality disorder or BPD is the topic of this paper and its main focus is to instruct the reader about the entirety of the disorder as well as treatment plans and patient education.

Borderline Personality Disorder

During nursing school, we learn a lot about physical conditions that affect people. In clinicals, the majority of our time is spent in a hospital setting. It is important for student nurses to learn about all things

that could affect a patient, not just physical ailments. Holistic care is something that hospitals strive for.
In 2009, a book called “Borderline Personality Disorder: New Research” was written by Linda Westbrook, and Marian Jackson. It was written as an informative guide to BPD. It is full of information and will be referenced multiple times during this paper. What is borderline personality disorder? A severe personality disorder characterized by disturbances in emotional regulation, impulse control, interpersonal relationships, and identity” (American Psychiatric Association 2000). BPD affects about 2 percent of the population but that small number doesn’t mean it isn’t important to learn about.
Signs and Symptoms
Signs and symptoms for BPD are characterized by a pattern of unstable mood and conflicted interpersonal relationships. This makes it difficult for patients with BPD to form close relationships with other people. A person may be impulsive and have tendencies of suicidal thoughts. This makes a person with BPD dangerous to be alone for long periods of time. Their safety is jeopardized. Someone with BPD may have tendencies to be involved in risky behaviors such as sleeping with multiple partners. One might have a sort of identity crisis. People may have a hard time understanding the fact that a person is officially diagnosed with a disorder as opposed to just having a few symptoms.

Complications
Complications of BPD can be tricky to assess.

They can either affect your health, finances, or relations with other people. WebMD has an article stating various complications of BPD. The list is fairly long but it goes to show that this disorder could have consequences.

A huge complication associated with BPD would be with inconsistent work stability. People who suffer with BPD have inconsistent moods and can be fairly unpredictable. Being in a workplace calls for stability and employers don’t normally tolerate vast changes in mood and attitude. If someone is fired it could cause a snowball effect. Depression could manifest in their life. Suicidal thoughts could be present. These are just some of the things that could add up in any given situation for a person with BPD. Individuals may take up cutting or any other form of self-injury. Frequent hospitalizations may occur. If symptoms listed above occur frequently, it may be best to visit the doctor.

Diagnostic Tests

It is very difficult to differentiate a personality from a disorder in a clinic. The history of that patient will be looked at thoroughly to try and discern different markers for BPD. A mental health professional leads the interview and delves into the patient’s history. They are highly trained to recognize signs and symptoms of BPD and make a decision on the diagnosis of that patient. There isn’t a clear cut lab test for diagnosing BPD because it is a mental

condition.
Treatment
The Mayo Clinic references a key treatment of BPD. “Dialectical behavior therapy, DBT can include group or individual therapy designed specifically to treat borderline personality disorder” (2015). Therapy is extremely important in the treatment of BPD and is fairly effective. Treatment includes ways how to control your emotions which will help reduce severity of behaviors. Schema focused therapy can be used to identify needs that people have that may lead to negative events. Mentallization-based therapy or MBT helps you identify your key thoughts, needs and perspective on every given moment. The list goes on with all of the possible therapy options. The bottom line is that therapy of all kinds is undoubtedly one of the major reasons behaviors improve over time. The only bad part about therapy as treatment is the availability or lack thereof in each community.
Drug therapy can also be used with the treatment of BPD.

The Encyclopedic Dictionary of psychology states “It is accepted that psychological treatment may have to be long-term” (2006). There isn’t a drug specifically designed to treat BPD but there are multiple drugs that can help with the manifestations of BPD. Antidepressants can be used as well as antipsychotics. Medications are given but health care providers encourage patients to incorporate therapy as well with their treatment. In 2013, three authors came together to write a book titled “Borderline Personality Disorder: A Guide for the Newly Diagnosed”. This book is a must read for anyone diagnosed with BPD. In the book, it lists “There are several different types of antipsychotics, but the most common medications in the newer generation include aripiprazole (Abilify), clozapine (Clozaril), loxapine (Loxitane), olanzapine (Zyprexa), risperidone (Risperdal), and sertindole (Serlect)”(2013). Antipsychotics may sound bad because the word psychotic may make people think they are for lack of better terms, psychotic. The people who take these meds need to realize that this medication can help them

greatly.
Nursing Interventions
Nursing interventions for care of someone with a mental illness are not the same for a floor nurse. The care plan is highly specialized and needs to be followed one hundred percent during the patients stay. Restraints may be ordered for some patients, being well versed in the different types and applications of restraints is a top priority of care. When communicating with your client, be as clear as possible and remain calm throughout conversation. Remaining calm can be contagious (in a good way) to your patient, prompting them to stay in a calm state. If the patient is in a manic state, standard care can’t be given to them. It is also best to be frank with your patient. Being honest and straight to the point with them is crucial because they have a lot going on with them and we have the ability to keep things straight to the point and flowing smooth.
Patient Teaching
Patient teaching is also a very important aspect of care because of the lack of knowledge a lot of people have. The prognosis of BPD directly correlates with the support that you have and if you are engaging in any self-destructive behaviors. The prognosis is usually fair with therapy and medication use. A majority of individuals with BPD reduce their symptoms by half thus officially making them non-BPD and considered normal functioning. For what it’s worth, individuals who take effective action against their BPD see vast improvement over time. If the patient has any questions, the nurse is responsible for answering them or finding someone who can. We as nurses have the job of making sure each patient understands the treatment options and well as being each patients advocate. Nurses shouldn’t take their job lightly, they can make a huge difference in someone’s life,