MHM Magazine

Issue 4 | 2021 | MENTALHEALTHMATTERS | 43 MHM for borderline personality disorder, was a specialised form of cognitive behaviour therapy specifically tailored to treat emotional dysregulation. “DBT assists individuals to learn to identify and accurately name their emotions, and to communicate how they’re feeling, accurately and frequently. It also incorporates techniques of mindfulness, meditation, relaxation therapy and grounding behaviours,” she added. “Therapy for all personality disorders is long-term. Because it’s a pervasive pattern of mood dysregulation and the fear of abandonment is chronic. One can’t realistically expect oneself or a loved one to change their behaviour after only a few sessions or months. “These behaviours have to be unlearnt, very slowly over time. The person has to learn new, healthy ways of behaving, thinking and relating to the world – and importantly, maintain the changes.” Patients are encouraged to lead healthier lifestyles, which aids in symptoms of depression and anxiety, and are taught skills to regulate their moods and set up daily schedules that include putting time aside for self-care. She said medication should ideally be prescribed by a specialist such as a psychiatrist and be specific to the individual, to treat symptoms such as impulsivity or anger, as well as comorbid disorders, aiming to help improve the quality of their life. Families or others living with a person diagnosed with BPD should become informed about the symptoms, acknowledging them and being supportive. “Acknowledging that the person has a real illness rather than appearing to judge them for being over-dramatic may also go a long way. The repetitive pattern of behaviour and heated interactions can wear family members down, and this is why having your own support networks is important, people you can reach out to for emotional support and advice. Depending on the severity of the case, family members may look to counselling for themselves as well.” Dr Moodley advised calmness – “as much as humanly possible” – in the face of angry outbursts or conflict, and to learn some of the basic skills of dialectical behaviour therapy to help. “Ask if they’re feeling suicidal and help them to reach out for help to a suicide hotline or an online or telephone counselling service. Contact their clinical psychologist or take them to an emergency room if it seems serious. “Help them do the exercises they’re learning in therapy or to take medication – when a person is in absolute crisis, bringing them back to the coping skills they’re learning is very helpful. In calmer times, encourage and support their health- seeking behaviours – this could mean driving them to doctors’ appointments or to fetch their medication. Check in with them after their therapy appointments and ask how the process is going for them.” “If the family members themselves are taught how to keep healthy boundaries, then that makes a healthier family environment for all concerned,” comments Dr Moodley. “Living with someone with any sort of psychological or psychiatric illness is difficult and complex. Make sure you have the support you need to help your loved one to cope, and to improve your relationships,” she said. References available upon request