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Borderline personality disorder 

Borderline personality disorder. Now the borderline can be in either men or women, more likely to be women. What characterizes these people is the intense emotionality. They tend to often have emotional storms.

Their interpersonal relationships are often characterized by idealization followed by borderline personality disorder, border line personality disorder Theyíll meet a man and in one week they are wildly in love with him, infatuated, heís the best thing that ever came along.

Thereís this kind of pattern, but whatís really important for you as physicians, they do that with you too. You are the greatest doc they have ever seen and then you disappoint them and you discover that they are ragefull and may even sue you. So this is something to keep in mind. The borderline is also prone to drug abuse, to a variety of impulsive behaviors; shopping, promiscuity, reckless driving.

Other types of acting out are not at all uncommon, including cutting oneself or some type of mutilation. Now these people, in terms of their co-morbidity, almost always have some affective component. They also often have anxiety disorders and itís not at all unusual for them to have brief psychotic types of episodes. Thatís because some type of cognitive distortions are often common. They will hear something, they are not quite psychotic, but they will twist it around in some way so that it comes back and it sounds different. You will tell them something in your office and they will come back and tell you that they told you something different. You listen to the words and you understand that they heard the words but they got interpreted markedly different.

Now the narcissistic personality disorder is a relatively new concept. It has become very popular in psychiatry over the past 20 -30 years. What characterizes the narcissist is a grandiosity, often in behavior or in fantasy. These people have a pumped-up opinion about themselves. A need to be admired, feelings of special-ness and entitlement. Iíve had patients who, if Iím a little bit late in the office - and for me as a psychiatrist being a little late might be five to ten minutes - be rage-full because I was not paying enough attention to them to be right on time. After all, they got there on time. Thereís a lack of empathy for others. A lack of understanding what others may feel and that often leads to exploitiveness. Bosses may exploit employees, expect them to do extra things for the glorification of the