NUR2488 Module 07 Borderline Personality Disorder Case Study
S.is a 48-year-old divorced woman with one adult daughter and three grandchildren. She is currently working as an LPN part-time in a nursing home and works at a convenience store one or two days per week. She has had many jobs over the last 22 years, usually changing every one or two years to a new job. S notes that she has been called less often to work in the convenience store and worries that they don’t like her anymore. She reports being written up several times for arguing with customers. She also reports that she liked her supervisor at; first; she says, “Now I hate her; she’s trying to get me fired.” S. reports that she has tried to get full-time jobs five times in the last four years was hired for three but only lasted one or two weeks at each one.
S. reports that she is currently not talking to her daughter because “she is mean to me and she needs to apologize, or I won’t talk to her again.” She is upset that she hasn’t seen her three small grandchildren in about a year. She sends them presents and cards frequently that say “I still love you! Grandma” but hasn’t called them since she stopped talking to her daughter. She is considering reporting to the county that her daughter is keeping her grandchildren from her.
S. is very unhappy that she isn’t in a relationship. She was abused by her ex-husband and had a pattern of meeting and dating men who eventually abused her. She states that her last relationship was very good; the man was not abusive, and “I loved him very much.” The relationship ended for reasons that S. doesn’t understand. However, she does report many arguments that ended in “scenes,” such as her throwing chairs, stomping out of the house, making crank phone calls to his family, and calling the police with false reports. But S. also reports that she “couldn’t have loved him more, and I showed it.” She gives examples of going to her boyfriend’s place of work with flowers, buying him expensive presents, surprising him with tickets to Mexico at the last minute – she was very upset that he wasn’t willing to drop everything and go with her. S. reports asking him why he didn’t love her and what she was doing wrong regularly. When the boyfriend asked to break up, S. reported sitting outside his house for weeks, crying; she called his mother, called his boss, and called and texted him until he filed a restraining order. This occurred about four months ago.
S. admitted herself to the mental health unit when she felt suicidal. She reports that she had stopped her psychotherapy three months ago and stopped going to DBT. She also stopped her anti-depressant at that time, as she felt it wasn’t working, and missed her last two psychiatrist appointments
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Symptoms
S. is exhibiting several symptoms of borderline personality disorder (BPD), including:
Intense and unstable relationships: S. has a history of unstable and intense relationships with her family, friends, and partners. She has been married once, and her ex-husband was abusive. She has also had a pattern of dating men who eventually abuse her.
Distorted self-image: S. has a distorted self-image, which is characterized by feelings of emptiness, worthlessness, and identity confusion. She often feels like she is a bad person, and she may have difficulty maintaining a sense of self-worth.
Impulsive and often dangerous behaviors: S. engages in impulsive and often dangerous behaviors, such as arguing with customers, getting into fights, and using drugs and alcohol. She has also threatened suicide and self-harmed in the past.
Emotional dysregulation: S. has difficulty regulating her emotions, which can lead to intense mood swings, irritability, and anger. She may also have difficulty controlling her impulses, which can lead to impulsive and dangerous behaviors.
Diagnosis
A diagnosis of BPD is made based on a thorough assessment of the individual’s symptoms, including their history, current functioning, and mental status exam. There is no single test that can diagnose BPD, so the diagnosis is made by a mental health professional who is familiar with the disorder.
Treatment
There is no cure for BPD, but there are effective treatments that can help individuals manage their symptoms and improve their quality of life. Treatment for BPD typically involves a combination of psychotherapy and medication.
Psychotherapy: Psychotherapy is the most effective treatment for BPD. There are several different types of psychotherapy that can be effective for BPD, including:
Dialectical behavior therapy (DBT): DBT is a type of cognitive-behavioral therapy that focuses on helping individuals regulate their emotions, improve their relationships, and cope with stress.
Mentalization-based therapy (MBT): MBT is a type of psychotherapy that focuses on helping individuals understand their own and others’ mental states.
Supportive psychotherapy: Supportive psychotherapy can provide individuals with a safe and supportive environment to discuss their feelings and experiences.
Medication: Medication can be helpful for managing some of the symptoms of BPD, such as depression, anxiety, and impulsivity. However, medication is not a cure for BPD, and it should not be used as a substitute for psychotherapy.
Prognosis
The prognosis for individuals with BPD is variable. Some individuals with BPD are able to make significant improvements with treatment, while others continue to struggle with symptoms throughout their lives. However, with appropriate treatment, most individuals with BPD can learn to manage their symptoms and live fulfilling lives.
Conclusion
S. is exhibiting several symptoms of BPD. A diagnosis of BPD can be made based on a thorough assessment of her symptoms, history, and current functioning. Treatment for BPD typically involves a combination of psychotherapy and medication. The prognosis for individuals with BPD is variable, but with appropriate treatment, most individuals with BPD can learn to manage their symptoms and live fulfilling lives.
