When someone constantly gets stuck in education, work and relations, it could be that that person is suffering from a borderline personality syndrome, also called borderline syndrome. This unsuccessful life is usually the same: a very enthusiastic start with high expectations followed by disappointment and quitting. The behavior of patients with borderline has often an "Its all or nothing". The illness is strongly marked by changing moods and impulsive behavior. There can be many other effects, like fear, depressive feelings, confusion, hearing of voices, problems dealing with shocking events in the past and even wounding oneself on purpose. It can be that the illness is presented as an eating problem or a depression and only later it is diagnosed as borderline. Even if the diagnose has been made usually they find other symptoms, like depression, fear and post-traumatic stress. The diagnose is difficult and should be done by a professional!

There are more women than men suffering from this problem. It is usually clearly seen during the adolescence, between 17 and 25 years old. But is is possible to see some of the symptoms during childhood. After it becomes manifest, many have long periods of deep depressions and many helpers before the diagnose is definitely made and a program to help is started.

Borderline has many different, sometimes difficult to comprehend, symptoms. It is not only a difficult to understand connection of feelings and happenings for the patient, but also for the people close to that patient.

The most known symptoms are:

• Mood disorders.
  The mood can change very fast, sometimes within a few hours. It can easily change after an event that is not important for others. It can be said that in the eyes of others the patient is reacting very sensitive. Sometimes he is reacting with outbursts of anger
• Impulsive behavior.
  Often the patient is reacting in an impulse, without thinking first and making a decision. It can also reflect in eating problems, changing sexual relations, spending much money, alcohol and drugs abuse.
• Identity problems
  Patients have mostly little or no self-confidence and are very sensitive to being criticized. Many do not know what to do with their life. Many complain that they feel empty inside. They feel often lonely, left alone and have difficulties being left alone.
• Thinking in extremes
  Other people and situations are either fantastic or entirely wrong. It seems as if there exist only black and white: all gray tints are not there. Because of this may have problems at work and in relations.
• Stress and tensions
  Conflicts can raise so high that it can lead to wounding yourself on purpose, to feelings to commit suicide and sometimes to commit suicide. This symptoms should be taken seriously!!!! Its not just asking attention.
• Psychotic symptoms
  This could be confusion, distrusting persons, hearing voices. Usually these symptoms are only for a few hours.

Its not known yet what exactly causes borderline. Mostly its a combination of different factors, in which every factor can contribute to the developing of the illness.

• Tendency
  Impulsive behavior and mood disorders can be a personality mark
• Psychological factors
  In the life and history of many borderline patients we can see radical experiences, like an instable parental family life, emotional neglect, aggression or sexual abuse. Because of this many patient have great difficulties to have a close bond with others, but at the same time they like to have friends. They fear that those people will leave them or betray their trust.
• Social circumstances
  Some professionals think that our changed lifestyle, like family, neighborhood etc, is important. Many people are more lonely, or their own and feel less save.

Mostly the treatment can be give policlinic. Sometimes the stress is raising so high that a short rest period is needed, like a 'time-out', in a hospital. The goal is to reach a balance in the daily actions and thinking, especially improving the relations with other people close to the patient..
If the patient finds a good therapist, problems can be discussed and then they can try to find a way to deal with it in another way. Feelings, thoughts and behavior are connected to each other. So certain things or remarks from others can lead to negative feelings for the patient, like: "They do not take me seriously!" or even: They NEVER take me seriously!". These feelings lead to tensions and stress. This on its turn lead to unwanted behavior, like impulsivity, wounding yourself, outbursts of anger etc. Its important to take a look which things are leading to negative feelings and how often you feel them. By exercises and training you can learn to deal different with those thoughts and lower your tensions and stress.
The relation between the patient and the therapist is usually under stress. We should never forget that the patient has difficulties to trust others and is also thinking in two ways: one day the therapist is fantastic, another day he thinks he is misunderstood or neglected. Even for a therapist is not always easy to handle a patient, because the patient is very inconstant in behavior. So, if they want to have a good result, they both need to spend a lot of patience and time in the treatment.
It is also important to pay attention to the relations of the patient with others closely living together with him or her. Over a period of time these can have highly raised tensions. Often people start to accuse each other and there is a lot of misunderstanding. So, if the patient agrees, all people around him should be invited to talk about their feelings and problems. It is very useful to give information about the illness, so that there can come more understanding for the problems and difficulties each one is facing. Advice can be given to deal with each other in a better way. If the patient can stand it, problems in the past can be discussed. Its needed to talk about these and to feel again the - often hidden- deep emotions that were involved.

Especially in the start of the therapy medicines are important, because it can take some time before the therapy itself has any effect. Medicines can only soften the symptoms. There do not exist any medicines that can cure the illness.
Because there are many different symptoms, there are also a wide variety of medicines that can be used. The most used ones are the anti psychotica and the anti depressiva. Besides the good effects all medicines have also side effects. Anti psychotica are used to help with psychotic symptoms, outbursts of anger, depressions, and fear. Anti depressiva are used during depressions, and can also have a good effect on fear and impulsive behavior. If the patient is complaining about 'an empty feeling inside' the medicine will not do much to solve this.
Sometimes medicines lowering the mood disorders can be used, as lithium or carbomazepine. I myself use natriumvalproate, sold as depakine or depakote. Be very careful with using tranquillizers or sleeping pils. You will need more and more to get a result. Mostly medicines can be limited after a couple of months.

• The patient having borderline should be taken serious. The illness is often affecting the whole life
• Professional help is mostly necessary. Family and other relatives can be a good support, but can usually not treat the patient.
• If you have a borderline patient in your family keep talking openly and frankly about all problems you experience. Try to respect each other always.
• Patience can be rewarded; many patients have reasonable till good prospects.
• A good ritm and regularity in the way of living is important. Try to keep your work for a longer period, have social contacts and stick to the treatment.