For tennis star Destanee Aiava, borderline personality disorder seemed like a “death sentence” and a relief. What is this?

Last week, Australian Open player Destane Aiava revealed what she was struggling with borderline personality disorder: borderline disorder.

The tennis player said the formal diagnosis after suicidal behavior and severe panic attacks “brought relief.” But “it was also like a death sentence for me, because I have to live with it my whole life.”

It is often associated with diagnosis therapeutic nihilism. This means that it is considered impossible to cure and can cause doctors and sufferers to despair.

In fact, people with this disorder can and do recover with the right support. Understanding that this is caused by trauma is crucial to effectively treating this convoluted and poorly understood mental illness.

A stigmatizing diagnosis

The name “borderline personality disorder” is misleading and greatly increases the stigma surrounding it.

Doctors used the term “borderline” for the first time to describe a state they believed was in between two others: neurosis and psychosis.

However, this means that the condition itself is not real and can invalidate the suffering and anxiety that the person and their loved ones experience.

“Personality disorder” is an evaluative term that describes a person’s very essence – their personality – as defective.

What is borderline personality disorder?

People with this disorder may exhibit a range of symptoms, but high levels of anxiety – including panic attacks – usually remain constant.

Clustered symptoms around four main areas:

• high impulsivity (leading to suicidal thoughts and behaviors, self-harm and other risky behaviors)

• unstable or destitute sense of self (including low self-esteem)

• mood disorders (including intense, inappropriate anger, episodic depression or mania)

• relationship problems.

People with this disorder they are very afraid of being abandoned and as a result, they often have disturbing difficulties in interpersonal relationships.

This creates a “push-pull” lively in relationships with loved ones, as people with borderline personality disorder seek closeness but push away those they love to test the strength of the relationship.

For example, they can escalate from a minor matter into a major disagreement to see if a loved one will “stand by her” and reinforce her love.

Conversely, if a loved one seems distant or fed up – for example, thinking about ending the relationship – a person with borderline personality disorder will go to great lengths to “push” that person away. This may appear as an avalanche of messages, expressions of despair, or even suicidal behavior.

Who does this affect?

The disorder affects one in 100 Australiansalthough this is likely a conservative estimate on which the diagnosis is based the most severe symptoms.

There are many women more likely to be diagnosed more often than men – but why this is the case remains a sedate debate, and political and sociological factors play a role in psychiatric diagnoses. Symptoms usually begin in mid to slow adolescence.

Although this is an initial reaction to receiving a diagnosis may be comforting to someit is commonly seen as a chronic and relapsing disease, meaning that symptoms may return after a period of improvement.

Borderline personality disorder can vary in severity and mimic other conditions such as major depression, bipolar disorder, anxiety disorders, and psychosis.

Estimates suggest 26% of emergency department presentations due to mental health problems are reported by people diagnosed with personality disorders, in particular borderline personality disorder.

What is the cause?

Borderline personality disorder appears to be the main cause trauma at the beginning of lifelater compounded by repeated trauma.

Early life trauma may lead to biological changes in the brain that cause behavioral, emotional or cognitive changes leading to social and relationship problems. This is the so-called complex post-traumatic stress disorder.

Aiava he admitted the disorder stems “primarily from childhood trauma,” although she did not provide details about her specific experiences.

People with borderline personality disorder usually suffer from convoluted post-traumatic stress disorder. However, convoluted PTSD does not always result in a diagnosis of borderline personality disorder.

Although these two disorders are not identical, they have many similaritiesparticularly since both are caused by convoluted and repetitive trauma.

However people with borderline personality disorder tend to experience more rage, emotional disturbances and have a greater fear of abandonment.

They are also fighting back greater stigmawhile the term “convoluted PTSD” does not carry the same negative connotations and focuses on the cause of the condition – trauma – rather than on “personality”, leading to better treatment options.

Recognizing the central role of trauma in borderline personality disorder is an essential step forward in the treatment of this disorder. However, due to the stigma associated with it, getting a diagnosis of convoluted post-traumatic stress disorder may be a better step in the future.

Can it be treated?

There are many effective psychological therapies and other treatments for people with borderline personality disorder or convoluted post-traumatic stress disorder.

For example, dialectical behavioral therapy is a type of cognitive therapy that helps people learn skills such as tolerating stress, managing relationships, regulating emotions, and practicing mindfulness.

Treating people with PTSD, including victims of war and rape, has taught us a lot about healing convoluted, hidden trauma. For example, in the case of trauma-focused psychological therapies.

Other recent treatments such as desensitization and reprogramming of eye movementsalso proved to be effective.

Many people with borderline personality disorder who are treated and have supportive relationships are able to “grow out” of the disorder. Others may need to continue to manage their symptoms while striving for a good quality of life.

Treating trauma, not personality

Rethinking borderline personality disorder as a trauma-driven disorder allows for a more effective and understanding approach to those suffering from it.

Understanding the effects of trauma on the brain means that newer, targeted medications can also be used.

For example, our research has shown how the brain works glutamate system – chemicals responsible for learning and making sense of the environment – ​​is overactive in people with convoluted post-traumatic stress disorder. Drugs that act on the glutamine system may therefore facilitate alleviate the symptoms of borderline personality disorder.

Educating partners and families about borderline personality disorder, providing them with support, and co-designing crisis strategies are also essential elements of comprehensive care. Preventing trauma early in life is also extremely essential.

If this article has raised concerns for you, or if you are worried about someone you know, please call Lifeline on 13 11 14.