Ms. Laura Jane Hanna-Bergen, ARNP, MSN, CNM

Borderline personality disorder is diagnosed by a psychologist, psychiatrist, clinical social worker, or other mental health professional. The disorder is a type of "Cluster B" personality disorder, which are chronic conditions characterized by unstable and dysfunctional behaviors that affect one's relationships with others. People with BPD often have co-existing mental conditions, such as depression, anxiety, PTSD, or substance abuse.

Borderline personality disorder is known to develop and become present during adolescence, however, mental health providers rarely diagnose anyone under the age of 18 with BPD. Mental health providers analyze behaviors, family history, and discuss symptoms with their patients, which may lead to a diagnosis using the DSM-5 criteria for BPD.

Borderline personality disorder is treated with psychotherapy and oral medications. Forms of therapy like dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT) can help people with BPD identify self-destructive attitudes and harmful behaviors, which they may then be able to manage or change. Group therapy is another treatment option which may improve people with BPD's ability to share their emotions and to promote positivity. Psychiatrists may prescribe patients antidepressants and/or anxiety medications such as Prozac (fluoxetine), Wellbutrin (bupropion), and Zoloft (sertraline). Some patients may receive antipsychotic drugs which can help stabilize mood and reduce impulsivity.

With consistent treatment, people with BPD are able to recognize and prevent destructive behaviors and mood swings, typically by changing their patterns of thought. Many people with borderline personality disorder are able to live successful and healthy lives.

Some people with bulimia may have swollen parotid glands (salivary glands near the cheeks) that give their face a puffy "chipmunk" appearance. Their skin may look dehydrated and dull from repeated purging. Red scars and marks on the backs of the knuckles are prevalent in those with bulimia. Eating disorder experts may refer to these as "Russel's sign," named after a well-known psychologist.

However, others with bulimia may not show any outward signs of having an eating disorder. They may deliberately hide their eating habits or conceal their purging after a meal. It is important that family members and friends help loved ones with bulimia seek treatment. While many people with bulimia are still able to lead outwardly successful and active lifestyles, bulimia may have lasting and severe consequences to one's health. Electrolyte imbalance from bulimia is particularly dangerous and may lead to heart attack or stroke. Similarly, continued dehydration and disturbances in electrolyte levels can cause kidney damage and reduced kidney function.

Treatment for bulimia typically includes therapy and nutrition counseling. Eating disorder support groups, both online and in person, are often beneficial to recovery. Medical professionals may also look to treat the mental health problems that frequently accompany bulimia, which are body dysmorphia, post-traumatic stress disorder (PTSD), and depression. Dietary specialists can assist patients with reintegrating foods into their diet and increasing consumed calories. Some patients may attend inpatient rehabilitation or eating disorder clinics, which provide all of the above treatments in a residential facility.

Fortunately, many people recover from bulimia and are able to fully restore their health.

We don't yet know what causes depression, but it's thought that it is a combination of genetic, biological, environmental, and social influences. Because of this, the most effective treatments for depression combine medication with psychotherapy. Therapy, especially cognitive-behavioral therapy, can be extremely helpful in resolving the negative thoughts and feelings that come with depression. It gives patients new tools that they can use themselves to cope when their depression is making them feel down.

Some of the common medications used to treat depression include antidepressants such as SSRI's (Prozac, Paxil, Zoloft) or atypical antidepressants (Cymbalta, Wellbutrin). It's important to remember that these medications have different effects on everybody, and no one medication works right for everyone. Patients may have to try a couple before finding the one that works just right for them. If the first medication they try doesn't work, they should talk to their doctor about trying something else. In extreme cases where medication is not enough, electro-convulsive therapy and hospitalization may be the answer to keeping a severely depressed person safe.

Depression is a difficult illness to deal with, but it is more common than believed and there are many people who can help. With the right treatment, individuals with depression can get back to fully enjoying life again.