Good source of knowledge for borders.

Torbjörn Engström, a nurse/nurse assistant in psychiatric care, and Louise Chesta, a senior physician in psychiatry, have written an excellent book on borderline personality that seeks, with increased knowledge and openness, to reduce prejudice. The book is a good source of knowledge for those who want to understand someone with borderline personality disorder and covers diagnostic criteria, everyday situations, crises, treatment, and forms of therapy.

Lead author Torbjörn Engström writes that the diagnosis of borderline personality disorder or emotionally unstable personality disorder is stigmatizing and can be challenged. The text is based on his own opinions, reflections, and in some cases, speculation. According to the definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an individual who undergoes a psychological evaluation and meets five of nine criteria can be diagnosed with emotionally unstable personality disorder. The criteria detailed in the book are separation anxiety, emotional instability, feelings of emptiness, suicidal behavior, paranoid thoughts during stress, identity confusion, intensely unstable relationships, impulsive behavior, and difficulty controlling strong anger. The author writes that “the core problems of a borderline person are difficulties in relating to others and unstable emotions.”

It is relatively common for individuals with anxiety, depressive disorders, and borderline symptoms to refrain from seeking help. Borderline can appear in adolescence, and the book emphasizes the importance of early detection and diagnosis in planning appropriate interventions and treatment. Several pages are devoted to prejudice, misdiagnosis, differences, and similarities between borderline and autism spectrum disorders, ADHD, bipolar disorder, and PTSD. The author's conclusion is that the patient should be screened before a diagnosis is made.

The book provides concrete examples of how a borderline person can manage their daily life. Accepting the diagnosis may be the first step. When a borderline person is stressed, their perception of the world can be affected. A borderline person is sensitive to stress and tension, which can be managed with a daily routine of regular eating habits, exercise, sleep, and occupation (work/school). Lifestyle changes are recommended. Torbjörn Engström notes that emotional distress can be managed with mindfulness, exercise, self-help cards, and more. A borderline person may try to become aware of their feelings and practice not acting out or reacting. Socializing with others combats isolation.

Furthermore, he stresses the importance of psychiatric and physical care workers treating the borderline person with respect, calm, trust, a positive attitude, and active listening, without accusations, reprimands, or reproaches.

Self-destructive behavior, common in borderline patients, is described in detail. Medical professionals encounter borderline patients who attempt to kill themselves, and many do not survive. “Treatment of borderline patients should alleviate anxiety, addiction, and self-injurious behavior,” the author writes.

At the end of the book, Louise Chesta reviews some treatment methods. Voluntary or forced care for the borderline patient is discussed. It can be added that the first choice for treating anxiety and depression are psychological therapies such as dialectical behavior therapy (DBT), mindset-based therapy (MBT), structured clinical therapy (SKB) or “good psychological management” (GPM). The book conveys hope: people with borderline can get rid of the diagnosis after successful treatment.

I would recommend reading the book. The author hopes to give “some celebrities” a borderline face, which I can understand.

Lakartidningen.se 2024-09-24