Other symptoms of BPD include impulsive behavior, intense and unstable interpersonal relationships, unstable self image, feelings of abandonment and an unstable sense of self. An unstable sense of self can lead to periods of dissociation.[2] People with BPD often engage in idealization and devaluation of others, alternating between high positive regard and heavy disappointment or dislike. Such behavior can reflect a black and white thinking style, as well as the intensity with which people with BPD feel emotions. Self harm and suicidal behavior are common and may require inpatient psychiatric care.[3]This disorder is only recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) in individuals over the age of 18. However, symptoms of BPD can also be found in children and http://www.wholesalejerseysusa.us.com/ adolescents. Without treatment, symptoms may worsen, potentially leading to suicide attempts.[n 2]There is an ongoing debate about the terminology of this disorder, especially the word "borderline."[4][5] The ICD 10 manual refers to this disorder as Emotionally unstable personality disorder and has similar diagnostic criteria. There is related concern that the diagnosis of BPD stigmatizes people with BPD and supports discriminatory practices.[6]People with BPD feel emotions more easily, more deeply, and for longer than others do.[7] For instance, while an emotion typically fires for 12 seconds, it can last up to 20 percent longer in people with BPD.[8] Moreover, emotions in people with BPD might repeatedly re fire, or reinitiate, prolonging their emotional reactions even further.[8] Consequently, it can take a long time for people with BPD to return to a stable emotional baseline following an intense emotional experience.[9]The sensitivity, intensity, and duration with which people with BPD feel emotions have both positive and negative effects.[9] People with BPD are often exceptionally idealistic, joyful, and loving.[10] However, they can feel overwhelmed by negative emotions, experiencing intense grief instead of sadness, shame and humiliation instead of mild embarrassment, rage instead of annoyance, and panic instead of nervousness.[10] People with BPD are especially sensitive to feelings of rejection, isolation, and perceived failure.[n 3] Before learning other coping mechanisms, their efforts to manage or escape from their intense negative emotions can lead to self injury or suicidal behavior.[11] They are often aware of the intensity of their negative emotional reactions and, since they cannot regulate them, shut them down entirely.[9] This can be harmful to people with BPD, as negative emotions alert people to the presence of a problematic situation and move them to address it.[9]While people with BPD also feel joy intensely, they are especially prone to dysphoria, or feelings of mental and emotional distress. Zanarini et al recognize four categories of dysphoria that are typical of this condition: extreme emotions; destructiveness or self destructiveness; feeling fragmented or lacking identity; and feelings of victimization.[12] Within these categories, a BPD diagnosis is strongly associated with a combination of three specific states: 1) feeling betrayed, 2) "feeling like hurting myself", and 3) feeling completely out of control.[12] Since there is great variety in the types of dysphoria experienced by people with BPD, the amplitude of the distress is a helpful indicator of borderline personality disorder.[12]In addition to intense emotions, people with BPD experience emotional lability, or changeability. This phenomenon, sometimes called splitting or black and white thinking, includes a shift from idealizing others (feeling great admiration and love) to devaluing them (feeling great anger or dislike).[17] Combined with mood disturbances, idealization and devaluation can undermine relationships with family, friends, and co workers.[18] Self image can also change rapidly from very positive to very negative.While strongly desiring intimacy, people with BPD tend toward insecure, avoidant or ambivalent, or fearfully preoccupied attachment patterns in relationships,[19] and they often view the world as generally dangerous and malevolent.[16] BPD is linked to increased levels of chronic stress and conflict in romantic relationships, decreased satisfaction of romantic partners, abuse and unwanted pregnancy. However, these factors appear to be linked to personality disorders in general.[20]Manipulation to obtain nurturance is considered to be a common feature of BPD by many who treat the disorder, as well as by the DSM IV.[21][22] However, some mental health professionals caution that an overemphasis on, and an overly broad definition of, "manipulation" can lead to misunderstanding and prejudicial treatment of people with BPD, particularly within the health care system.[23] See and under .Self harm and suicidal behaviorSelf harming or suicidal behavior is one of the core diagnostic criteria in the DSM IV TR. of and recovery from this behavior can be complex and challenging.[24] The suicide rate among patients with BPD is 8 to 10 percent.[25][26]Self injury is common, and can take place with or without suicidal intent.[27][28] The reported reasons for non suicidal self injury (NSSI) differ from the reasons for suicide attempts.[11] Reasons for NSSI include expressing anger, self punishment, generating normal feelings (often in response to dissociation), and distracting oneself from emotional pain or difficult circumstances.[11] In contrast, suicide attempts typically reflect a belief that others will be better off following the suicide.[11] Both suicidal and non suicidal self injury are a response to feeling negative emotions.[11]Sexual abuse can be a particular trigger for suicidal behavior in adolescents with BPD tendencies.[29] of borderline personality disorder is based on a clinical assessment by a qualified mental health professional. The assessment consists of the client's self reported experiences as well as the clinician's observations. With permission from the client, the assessment may include interviews with friends or family members.Diagnostic and Statistical ManualThe Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM IV TR) has criteria for borderline personality disorder in Axis II Cluster B[2] that Wholesale Jerseys can be found on behavenet. Five or more criteria must be present for diagnosis.[2]disturbances in and uncertainty about self image, aims, and internal preferences;liability to become involved in intense and unstable relationships, often leading to emotional crisis;