A personality disorder is defined as an “inner experience” (that is, our personal interpretation and understanding of things that happen, as well as our own thoughts and feelings) that deviates significantly from expectations of our culture (DSM-5). There are a number of types of personality disorders, showing different patterns of that inner experience. One such type is Borderline Personality Disorder (BPD). BPD may be diagnosed when a person shows instability in four key areas:
Receiving a diagnosis of BPD can be a source of anxiety in itself as there is not as much awareness of the condition as other psychological diagnoses such as anxiety or depression. On one hand, there may be some relief in knowing that the intense symptoms someone is feeling has a name, but it also elicits questions about treatment and whether they will ever feel “normal”.
Medication VS. Therapy
While there is no medication to specifically address BPD, prescriptions may be made for specific symptoms such as mood reactivity or anxiety. Therapy is considered particularly important for individuals with BPD. One specific type of therapy that has garnered significant attention for its effective treatment of BPD is known as Dialectical Behavior Therapy (DBT). Generally, BPD symptom severity and risk of suicide are greatest in young adulthood, and then often diminish with age, particularly with therapeutic intervention.
Dialectical Behavior Therapy (DBT)
The word “dialectic” means looking at opposing ideas in order to find the truth. In the case of DBT, this type of therapy aims at broadening our perspectives and developing skills to both accept and regulate our emotions. DBT also places value on developing skills for having healthy relationships.
DBT is practiced in both individual therapy and in group sessions. Group sessions follow a particular structure of training skills from four different modules:
If DBT is started in a structured setting, clients often then continue with individual therapy afterward to continue the skill development and receive effective support.
By Kristi MacDonald
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Linehan, M. M., & Wilks, C. R. (2015). The Course and Evolution of Dialectical Behavior Therapy. American Journal of Psychotherapy, 69(2), 97-110.
Palmer, R. L. (2002). Dialectical behaviour therapy for borderline personality disorder. Advances in Psychiatric Treatment, 8(1), 10-16. doi:10.1192/apt.8.1.10
On the surface, social media may seem to have a positive impact in our lives. After all, they are platforms where we can reconnect with friends and relatives who are geographically separated from us or whom we haven’t spoken to for years. However, many can get caught up into the virtual world of social media that it becomes about far more than reconnecting.
Social Media and Depression
A very recent study on this topic has looked into the direct relationship between the psychological health of teenagers ages 11-17 and the time they spent on social media platforms. The study, which was presented in September 2015 at the British Psychological Society conference in Manchester and yet to be published, showed that night-time specific usage of social media may cause poorer sleep quality, lower self esteem and higher risk of anxiety and depression among teenagers.
While the researchers consider this as another piece of evidence into the theory that social media use can affect well-being, they admitted that the real causes why this is so are yet to be established.
Use of Facebook
A number of studies have shown that social networking is linked with depression among adolescents. Steers, M., Wickham, R. & Acitelli, L. (2014) found in the first part of their study that Facebook can be linked to depressive symptoms through the already well-established psychological phenomenon known as “social comparison.” This is when you compare the mundane parts of your life to the “highlight reels” your Facebook friends posted on their walls.
In the second part of the study, they tried to tap the differences between the three types of social comparisons, namely: upward, downward and nondirectional. Upward social comparisons happen when you look at someone better than yourself in different aspects, such as external appearances and material ownership. Downward social comparison, on the other hand, is when you look down on people and think you are more superior. In nondirectional social comparisons, you simply compare yourself with others with no particular “direction.” It turned out that the subjects in the study showed depressive symptoms across the three types of comparisons.
The research concluded that Facebook interaction may negatively affect the psychological health of those who use the platform. Moreover, the more one spends time on the networking site, the higher is the chance for them to spontaneously engage in social comparisons. As a result, they may suffer from depressive symptoms.
Adolescence is the stage of increased vulnerability for anxiety and depression. This is when teenagers navigate through the maze of finding what they want, who they truly are and where they can fit in.
Although teen years can be really tough, many can get through the angst through good friendships, loving family, success in school, outdoor and extracurricular activities, and an overall positive outlook in life. Teenagers do experience the occasional blues, but when it comes to depression, it’s a different thing altogether.
Numerous studies regarding the relationship between social media usage and depression among teens can pave the way to better understanding on how this vulnerable population can be helped.
Steps to Consider
Giving up social media once and for all may not be the solution. The attitude towards social media could be the better answer. For teenagers, here are some tips to balance your need to check your social media account and maintaining a positive mind.
By Dr. Syras Derksen
2015, September 11. Pressure t be available 24/7 on social media causes teen anxiety and depression. University News - University of Glasgow. Retrieved from http://www.gla.ac.uk/news/headline_419871_en.html
Steers, M., Wickham, R. & Acitelli, L., 2014. Seeing Everyone Else’s Highlight Reels: How Facebook Usage is Linked to Depressive Symptoms. Journal of Social and Clinical Psychology. 33(8): 701-731; doi: 10.1521/jscp.2014.33.8.701
Adolescence is a time of immense physical, emotional, and social change. The growth teenagers are experiencing prepares them for great opportunities, but also leaves room for great risk. They are preparing to take on the responsibilities of adults, but are experiencing a world of pressures and confusion.
One of the key features of adolescence is their increasing need for independence from their parents. Teenagers are developing their own identity, learning how they view themselves and their values, as well as worrying about what others think of them. This is natural and can be a healthy part of their life, but it can cause tension in even the closest parent-teen relationship. Talking with a therapist can be helpful for a teen to work through their struggles and enable them with skills to face new problems.
Just a Phase?
With all its ups and downs, adolescence shouldn’t be seen as something just to “get through” or outgrow. It’s an important time of maturation and can be a time for teens to thrive. The teenage brain is going through substantial and rapid changes which can enable them to succeed; however, the malleability of the brain at this stage also means that unhealthy experiences and patterns can result in further risk-taking and maladaptive behaviour.
Additionally, symptoms of most mental health disorders begin in adolescence, around age 14, but the majority of people do not seek help until about 10 or more years later, when their symptoms have become disabling to their work and relationships. Seeking early treatment in teen years is important to help develop coping skills and understanding of their emotions. Earlier treatment and assessment can reduce later severity of symptoms and prevent the development of addition, co-occurring disorders.
Extra support will help teens access the benefits of their developing brains and can help teens and their families enjoy this time instead of waiting for it to be over.
Is My Teen's Behaviour Normal?
It is normal to see a change in behaviour when your child reaches adolescence, but sudden, extreme, or long-lasting changes in mood and behaviour may be cause for concern. Additionally, if your teen is showing signs of depression or anxiety, it is important to seek appropriate assessment and treatment.
Stress is a typical part of teenage life, but for some teens, stress becomes anxiety, which is intense worry that is out of proportion to the actual event and its possible consequences. When that anxiety starts to impair daily functioning, it may be part of a disorder.
As teens take risks and try new things, they will inevitably experience disappointments, failure, and loss. They may demonstrate more extreme reactions to seemingly trivial things, so distinguishing normal periods of depression from a clinical diagnosis involves judging whether they are able to recover themselves, how long it takes to get back on track, and how quickly they fall back into a depressed state. After a failure or loss, if your teen doesn’t show much improvement even when other things are looking up, they may be showing signs of clinical depression.
Is Medication Enough?
Studies have repeatedly shown that when it comes to mental health, best outcomes are seen when medication is combined with therapy. Medication can help reduce anxiety or regulate emotions so that we are ready to engage in therapy in order to learn healthy ways of thinking and relating and put them into practice.
By Kristi MacDonald
Institute of Medicine (US) and National Research Council (US) Committee on the Science of Adolescence (2011). The science of adolescent risk-taking: Workshop report. Washington (DC): National Academies Press (US). Retrieved from: http://www.ncbi.nlm.nih.gov/books/NBK53420/
National Institute of Mental Health (June 2005). Mental Illness Exacts Heavy Toll, Beginning in Youth. Retrieved from: http://www.nimh.nih.gov/news/science-news/2005/mental-illness-exacts-heavy-toll-beginning-in-youth.shtml
White, A. M. & Swartzwelder, S. (2013). What are they thinking?!: The straight facts about the risk-taking, social-networking, still-developing teen brain. W.W. Norton & Company, Ltd: New York, NY.