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Borderline personality disorder (BPS) is characterized by an emotionally unstable personality. A 23-year-old from Eritrea is currently standing before the Landshut district court after several outbreaks of violence. He suffers from BPS and may be incapacitated.
Life between the extremes
People with this mental disorder have a disturbed self-perception and commute between idealizing and demonizing, love and hate in interpersonal relationships. Abrupt mood changes, self-injuring actions and uncontrolled anger are typical.
Borderline is characterized by: Anxious efforts to avoid being abandoned - also with manipulation, supplication or threats; unstable intensive relationships with other people, which fluctuate between glorification and devaluation; permanently disturbed identity and a fragile self-image that can break down at any time; spending harmful impulsiveness when spending money, sex, drug use or eating disorders; repeated suicidal acts, threats of suicide and self-harm.
Feelings of borderliners
Those affected suffer from extremely fluctuating moods and react strongly to states of mind. Uncontrolled emotional outbursts, periodic depression, extreme irritability and severe fear are just as typical as a chronic feeling of inner emptiness, tantrums out of proportion to the trigger, and physical arguments.
Paranoia and dissociations
Especially in the case of stress, whether through administrative procedures, exams or relationship crises, those affected develop paranoid delusions that can turn into psychoses. Dissociations are also typical, ie states in which those affected “stand next to each other” and can no longer remember what happened and what they did. The cause of these dissociations are traumatic experiences.
Changes in the almond kernel
Studies on borderliners showed changes in activity in the almond kernel, this is the area in the brain where we process stress, danger signals and fears. This brain structure was shown to be smaller and overexcitable in those affected. In short: the patients live in a permanent mode, which signals to them “fight or flight” without a real reason.
Causes of Borderline Syndrome
Scientists today assume that genetic predispositions play a significant role in whether a person develops a borderline personality disorder. However, traumatization is the essential fuel for the symptoms to develop. For example, 60 percent of those affected were subjected to physical violence, 65 percent sexual violence and 40 percent were neglected in childhood and / or adolescence.
Outbreaks of violence
The defendant drew attention to himself when he broke the furnishings in his room in an asylum seeker accommodation in the Freising district in November 2018 and acted aggressively towards the police officers; another time he jumped into the car of a stranger and attacked him; in another case, he hit a roommate with an iron bar on the head while he was sleeping.
Many refugees are traumatized by their experiences. The most common traumas are due to having seen violence on others (70%), being a victim of violence (55%) or being directly tortured (43%).
The most common consequence of a trauma is the post traumatic stress disorder. However, adjustment disorders, persistent personality changes, dissociative disorders, but especially the borderline personality disorder are also common. This in turn overlaps in traumatized people with addictions, eating disorders, anxiety disorders and depression.
Problems in the host country
The stress of everyday life in the host country can exacerbate the symptoms of a borderline disorder, as it increases the stress of those affected who are already living in permanent stress mode. These include the fear of being deported, language barriers, hurdles in the asylum procedure, problems with health care and the everyday bureaucratic effort.
Too little therapy
There are still far too few therapies for asylum seekers with mental illnesses. Hardly any of them receive appropriate treatment in a timely manner - with borderline, for example, behavior therapy. The responsible administrators and medical officers generally do not have the qualifications to assess the urgency of psychotherapy, let alone correctly diagnose borderline.
Mental illnesses for asylum seekers are often not considered to be acute, even though they are, or medication is prescribed, which is often not enough - especially in the case of a personality disorder that involves behavioral control, such as borderline.
An unknown disease?
Triggers of borderline personality disorder such as the experience of sexual and non-sexual violence, neglect and past traumas occur much more frequently in refugees than in the rest of the population. As a result, the number of unrecognized asylum seekers who suffer from this mental illness without being recognized is probably high. (Dr. Utz Anhalt)