Researchers have revealed that individuals diagnosed with a personality disorder alongside another mental health condition face a heightened risk of enduring psychopathological issues over time. Moreover, the presence of concurrent disorders can significantly deteriorate the life quality of individuals battling mental health challenges.
One of the most impactful personality disorders, Borderline Personality Disorder (BPD), is distinguished by difficulties in maintaining interpersonal relationships, a distorted self-perception, and fluctuating moods, impulses, and emotions. According to recent studies published in the Journal of Clinical Psychiatry, the prevalence of BPD in the broader population is approximately 5.9%.
Notably, BPD often exists alongside issues related to substance abuse and various mood, anxiety, and other personality disorders. Research indicates a substantial overlap between BPD and depression, with findings suggesting that up to 83% of individuals with BPD have experienced major depressive episodes. This overlap may be attributed to common biological factors, making those with BPD more susceptible to depressive episodes.
Individuals with BPD may exhibit symptoms characteristic of a major depressive episode, such as a persistently low mood or diminished interest in once-enjoyed activities. Changes in appetite or weight, sleep disturbances, increased fatigue, reduced physical activity, and feelings of worthlessness or guilt, along with suicidal ideation, may also be present.
However, depressive symptoms in BPD can differ from those in major depressive episodes, particularly in their triggers and duration. Feelings of sadness or loneliness in BPD might be triggered by stress or fear of abandonment and typically improve as the triggering situation resolves. In contrast, the depressive symptoms in a major depressive episode tend to be more pervasive and less directly linked to specific situational stresses.
The role of affect, or emotional response, is critical in both BPD and major depressive disorder, with negative affect being associated with various psychological issues. The intensity of the effect, particularly its role in exacerbating depressive symptoms, underscores the connection between BPD and depression. Emotional regulation deficits, prevalent in both conditions, can amplify the impact of adverse effects.
Treatment for individuals facing depression compounded by BPD often involves a comprehensive approach by healthcare professionals. This may include the prescription of antidepressants coupled with behavioural interventions. While depression can be particularly stubborn in those with personality disorders, electroconvulsive therapy (ECT) has been considered for treatment-resistant cases. However, research in the American Journal of Psychiatry suggests that responses to ECT among those with BPD might be less favourable compared to individuals with depression alone or with other comorbid personality disorders.
