BPD co-occurs with a variety of mood, anxiety, substance abuse, and eating disorders (Carson, Butcher, and Mineka 1998). Co-morbidity with depression is especially high, "with about 50 percent [of borderlines] qualifying for a mood disorder diagnosis at some time" (Carson, Butcher, and Mineka 1998). Despite the significant presence of BPD, relatively little is known about it, and it is hardly ever mentioned in either clinical or popular circles.
Why the silence surrounding BPD It could be because BPD is a relatively new and controversial diagnosis. The American Psychiatric Association did not even list BPD as a diagnosable disorder in its "Diagnostical and Statistical Manual" until 1980 (Mason and Kreger 1998). Mason and Kreger (1998) note that "many mental health professionals miss signs of BPD in their patients simply because they're not educated enough about the disorder." Other reasons BPD is ignored within the clinical community include disbelief that BPD even exists (this could be due to the fact that BPD is co-morbid with so many other disorders, as mentioned before), unwillingness to label patients because of the
There could be another societal reason for the general ignorance concerning BPD. Perhaps it is because there is no easy way to diagnose, or to treat, BPD. People living in today's fast-paced society want easy answers and quick explanations. As Roth and Friedman so colorfully put it, "it's difficult to explain BPD in snappy headlines and sound bites to a restless audience wont to channel surf" (2003). Sometimes it is easier to believe that something doesn't exist at all, rather than having to try to explain it. Is BPD just some imaginary psychological problem created to make a certain group of people feel better about themselves Is it just an opportunity for weak-minded individuals to throw the blame for their own interpersonal problems onto someone else Or is it an actual mental disorder with real, quantifiable properties Whatever one's current belief about the reality of BPD, one cannot ignore that the symptoms of BPD are all too real.
On her web site, Deb Martinson (2002) lists some of these constructs, and notes the difficulty in even trying to identify which constructs to measure when assessing Borderline Personality Disorder. According to Martinson (2002), there are two camps of thought when it comes to BPD assessment. The more generalized view belongs to Kernberg and his Borderline Personality Organization theory. The other, more scientific, view belongs to Gunderson (Martinson 2002). Unique to Kernberg's perspective is the belief that in order for a diagnosis of BPD to be made, there must be some evidence of "primitive defenses" (Martinson 2002). These include splitting1, magical thinking2, feelings of being all powerful, projection of one's own characteristics and beliefs on others, and emotional amnesia3.
Gunderson's conceptions of BPD are very similar to what the DSM-IV used for constructing its criteria for classifying BPD. These are explained in the ground-breaking 1998 book by Mason and Kreger. They list the DSM-IV criteria for classifying BPD as: "frantic efforts to avoid real of imagined abandonment a pattern of unstable and intense