Melody T. McCloud M.D.

Black Women's Health and Happiness

Borderline Personality Disorder: Who's at Risk (Part 1)

Early family dynamics play an important role in children's mental health.

Posted Aug 08, 2011

Inconsistent parenting. Divided, insufficient parental time (as if momma's working many jobs, or there are too many kids in the house). Early parental loss from death or divorce, and 70-75% are victims of childhood sexual abuse. If this sounds like the environment in which your child is raised, he/she is at high risk of developing Borderline Personality Disorder.

What is Borderline Personality Disorder (BPD)? It is a mental illness that wreaks havoc and causes tremendous private pain in the lives of the one affected, and all the interpersonal relationships they want, and attempt to have. It is said to be more prevalent in women, but as written here, it does occur in men, and in fact, is likely just underdiagnosed in males. The condition needs updated data; it also needs a new name and a specific evaluation protocol [see below].

Even though BPD can occur in children of "normal" families, in short, the less than optimal family structure described above can affect some children in such a way that they feel abandoned. Their young minds actually process it that way, and that sense of abandonment (by the very people who should be in place to love them, with constancy) can start a cascade of destructive emotions and actions.

What do people with BPD do? The pre-adolescent, adolescent (and, later, the undiagnosed adult) often exhibits inappropriate anger and sudden mood swings. They are "black-or-white" in their thinking; there is no gradient of gray that most of us understand and allow for in others.

Dr. Alec Miller has a call-in lecture at the site; in it (dated January 22,2012), he strongly supports an earlier consideration and diagnosis of BPD if symptoms are persistent and pervasive, even if beginning around age ten. Watch for the signs and follow the child, minimally keeping the Dx of BPD in mind. Many other experts agree with this, and the DSM-IV addresses this--BPD in adolescnets--on/about page 631.

"Borderlines" [I hate that term] do not know to moderate, or allow others to do so. They have tendencies to rage at the most innocuous of comments. They act out; are impulsive. They may be considered (and dismissed as) a "rebellious" kid at home and in school (sometimes resulting in being moved from one school to another). They often get into trouble. They have "repeat chaotic interpersonal relationships," pushing friends, and later, romantic interests, away. They have major trust issues and repeatedly, falsely accuse their sweethearts of things that aren't being done. They react before they reason, and with that impulsivity, all hell can abruptly break loose: disrupting a class, a family gathering, a drive together to the store, or a romantic evening.

The public doesn't know much about the condition. We hear about ADHD, Bipolar Disorder and schizophrenia, but BPD is lesser known and is even overlooked by mental health specialists, some of whom fail to include it in their differential diagnosis when evaluating a patient. Even when kids are brought in for evaluation after having committed a crime, BPD is rarely considered...and it needs to be. (For one, there is no full evaluation and treatment protocol for the condition; I humbly submit that I have developed one, in full. I'm just trying to figure out where best to first introduce it, and with whom, being that I--though, yes, a physician--am not a psychiatrist or psychologist, even though my friends often use me as such...with good results.)

I became passionate about increasing awareness of this condition earlier this year after encountering a wonderful person who, I've determined, is an undiagnosed, and escalating, sufferer of BPD. Prior to the diagnosis, the question often arose, what the heck is wrong here!? Why would this person react like that, to nothing!? Recognizing that all the pieces actually fit the BPD puzzle provided the answer. There is an organic reason "why"; and it's not something they do intentionally. Unfortunately the family dysfunction and traumas they suffered as a child causes them to feel threatened with perceived abandonment, and hence they (over)react.

I am not one to grant excuses for bad behavior; but I can say, with certainty, that if someone is truly a borderline, it is not their fault. However, it is incumbent upon them to get help once the possibility of the disease is brought to them. The problem do you get someone to properly reason with the very thing that is affected? I do believe that borderlines often know that they "have issues"; it is up to them to seek treatment, and/or, minimally, cooperate with loved ones and family members who attempt an intervention.

When reviewing the causative factors of the condition, I realized that, especially in today's society, many Black children have these lifestyles during their early years. Others have it, too; but government statistics prove that the highest rate of births to unwed mothers is to Black women. Compared to other races, Black women have more babies out of wedlock and are left to raise their children without the benefit of a husband or ever-present male figure in the home. "Single, head-of household, with children" is more than just a biostatistical measure; it is potentially a contributor to psychological damage to the child or children involved, and that fact needs to be brought to the fore, hence this post.

Many single parents--male or (mostly) female--work one or more jobs, trying to make ends meet; this takes away time with the kids. An absentee parent (usually the father) is not in the child's life; or if so, only minimally and inconsistently. They are not fully present to give sound, consistent parental guidance. Some absentee fathers have no contact with their children at all. There may also be early parental loss from death or divorce.

If there are many kids in the house with a wide range of ages, the custodial parent may delegate some of the child-rearing of the younger children to the older children, again minimizing input from the actual parent (input a child so needs). And too often some kids are sexually abused--molested, violated--by caregivers or those in authority over them. [Note: In the Black community, the high rate of HIV in, yes, young males ages 10-14 is believed due to sexual abuse of the young lads, usually by males known to them. But heterosexual abuse (regardless of race) also occurs; i.e., a brother violating a younger sister, or, yes, vice versa--a sister violating a younger brother.]

This is Part One of this discussion; to read Part Two, click here. That section includes mention of Miami Dolphin Brandon Marshall's revelation that he suffers from BPD, also important family dynamics for everyone to consider.

To all...Be Healthy, Be Blessed... and make sure you are Living Well.

Copyright © 2011 Dr. Melody T. McCloud. All rights reserved.

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