Do you feel you are still searching for your sense of who you are (self-identity)? By “sense of who you are,” I mean do you have a set of values (what is important to you) that stays constant over time? Do you have long-term feelings of sadness? Do you have long-term feelings of anger?
Borderline personality disorder (BPD) can make everything about a person feel unstable. Whether it’s variations in mood, behavior, relationships, or thoughts, it can cause people with this condition to be quickly triggered by things others may not notice or react to. But it can also be treated effectively, allowing people to live less tumultuous lives.
So how can we recognize the condition in ourselves and others? Are there ways to determine what and when treatments will work? And is it really possible to manage triggers?
Lois W. Choi-Kain, MD, MEd, discusses signs and symptoms of BPD, explains the differences between treatment options, and answers audience questions about borderline personality disorder.
Lois W. Choi-Kain, MEd, MD, is the director of the Gunderson Personality Disorders Institute. With her mentor, John Gunderson, Dr. Choi-Kain developed a training program for general psychiatric management (GPM), a generalist treatment for borderline personality disorder (BPD) that any mental health professional can be trained to provide. She has also led a number of projects to increase access to care worldwide through teaching, supervision, and consultation.
As an assistant professor of psychiatry at Harvard Medical School, Dr. Choi-Kain actively conducts research on BPD. Her research focuses on personality disorders, attachment, psychotherapy, and accessibility of care.
It’s important to think about ways to manage your mental health. McLean is committed to providing mental health and self-care resources for all who may need them. You and your family may find these strategies from McLean experts helpful to feel mentally balanced in your everyday lives.
Psychiatric Interview: BPD (Borderline Personality Disorder) | Part 1 | Dr. Karen Jacob
Subspecialty See also:
If assessing a child, adolescent, or older adult, the interview and assessment will be significantly different. See the pages above.
Ask the pertinent social history upfront: this allows you to frame the interview and understand your patients social situation.
- Anything further in the past should be considered as past psychiatric history
The Psychiatric Review of Systems
- “Tell me about your mood right now,” “Hows your mood right now?”
- On a scale of 0 to 10 (0 = worst youve ever felt, and 10 = best mood you ever had)
- When someone says they are “depressed,” it is important to clarify what they mean by that, dont just take it at face value
- If someone says theyve “always been depressed,” try to get them to describe what their earliest memory of being depressed was like
“Now Im going to ask you about some other symptoms people might feel when theyre depressed.”: See main article:
- Sleep is more than just good or bad, you need to ask specific questions about the nature of the sleep:
- “Tell me about your sleep”
- Ask about sleep hygiene (screen time)
- How long are you asleep?
- What time do you fall asleep?
- What time do you get up?
- Are there night time awakenings?
- Are you told you snore at night? (think about sleep apnea, which can cause depressive symptoms)
- Do you ever experience nightmares? (could be a sleep disorder or a trauma disorder)
- ADHD screen may be applicable here
- Now may be a good time to ask about eating disorders (always ask, because patients do not always volunteer eating disorder information!):
- How much weight loss?
- What is their ideal weight?
- What specifically makes this ideal?
- Are they pre-occupied with their weight
- Current weight and highest weight
- Compensatory behaviour: medications, purging, laxatives, diuretics
Borderline personality disorder (BPD) can make everything about a person feel unstable. Whether it’s variations in mood, behavior, relationships, or thoughts, it can cause people with this condition to be quickly triggered by things others may not notice or react to. But it can also be treated effectively, allowing people to live less tumultuous lives.
Lois W. Choi-Kain, MEd, MD, is the director of the Gunderson Personality Disorders Institute. With her mentor, John Gunderson, Dr. Choi-Kain developed a training program for general psychiatric management (GPM), a generalist treatment for borderline personality disorder (BPD) that any mental health professional can be trained to provide. She has also led a number of projects to increase access to care worldwide through teaching, supervision, and consultation.
As an assistant professor of psychiatry at Harvard Medical School, Dr. Choi-Kain actively conducts research on BPD. Her research focuses on personality disorders, attachment, psychotherapy, and accessibility of care.
It’s important to think about ways to manage your mental health. McLean is committed to providing mental health and self-care resources for all who may need them. You and your family may find these strategies from McLean experts helpful to feel mentally balanced in your everyday lives.
So how can we recognize the condition in ourselves and others? Are there ways to determine what and when treatments will work? And is it really possible to manage triggers?
Anxiety See main article:
Always ask about anxiety and depression at the same time since these symptoms often overlap and are “co-morbid.” Key questions to ask include:
FAQ
What questions are asked during a psychiatric evaluation?
Is borderline personality disorder the most difficult to treat?
How do you ask a delusion question?
What are the components of psychiatric interview?
- Sections Psychiatric Interview.
- Identification and Chief Symptom.
- History of Present Illness.
- Psychiatric Review of Symptoms.
- Psychiatric History.
- Suicide and Violence Risk Assessment.
- Medical History.
- Family History.
