Borderline syndrome is a personality disorder that experts place in the "borderline" between neurotic and psychotic abnormalities. Those affected suffer from severe mood swings and react extremely impulsively and unstably, especially in interpersonal relationships. Borderline syndrome is particularly common in adolescents, with about six percent of German adolescents affected.

Tricks to Reduce Pressure

Claudia Wiegmann always carries her emergency kit with her, which includes chili, a hard brush, and extra spicy mustard. In case of emergency, she puts a handful of pebbles in her shoes and ties rubber bands around her wrist. She recommends the emergency kit to all so-called borderliners: "When the pressure becomes overwhelming or you feel empty inside." These small things bring life back and reduce pressure. "To get out of an unbearable situation, you don't have to hurt yourself or take drugs."

The Symptoms are Diverse

According to the German Society for Psychiatry, Psychotherapy, and Nervous System Medicine (DGPPN), about six percent of adolescents in Germany are affected by borderline personality disorder. This is a serious mental disorder that begins in puberty and has long been neglected by medicine. Although knowledge about the danger of the disease and medical treatment has made great progress in recent years, only about one in a thousand affected individuals receives effective outpatient therapy. "They regularly inflict self-injury, torture themselves with suicidal thoughts, and take drugs to calm down," says Martin Bohus from the Central Institute of Mental Health in Mannheim.

Difficult Diagnosis

Few seek professional help. Adolescents who are "borderline" are often unrecognized, warns adolescent psychiatrists. Their behavior - especially because alcohol and drug abuse often come into play - is misinterpreted as a puberty crisis. "Out of shame, those affected often hide self-inflicted cut injuries or burns with razors," says Michael Schulte-Markwort, President of the German Society for Child and Adolescent Psychiatry. Adolescents with borderline disorder often suffer from low self-esteem, intense mood swings, and deep self-hatred and hatred towards their own body. They have great difficulty forming relationships and being alone. Chronic self-injury, suicide attempts, drug use, and eating disorders are typical. Most of those affected have difficulty completing their education and training. Many spend years in psychiatric hospitals. According to experts, the intensity of the disorder only decreases around the age of 40.

Extreme Emotions

The mental disorder is triggered by errors in emotion regulation. This means that inhibitory connections between the front brain areas and the centers of emotional processing do not work. "Those affected experience emotions much more intensely, stormily, and persistently than healthy individuals," says Bohus. "Sometimes the emotions are so strong that reality is no longer perceived or only perceived in a haze." Those affected report feeling outside of their own bodies in these situations.

Sexual Abuse Often the Cause

In addition to a genetic predisposition, the causes of the disease are largely due to disturbances in childhood development. According to the DGPPN, over 60 percent of borderliners report severe sexual abuse in childhood - especially within the family. "Changes in the structure of the brain can also be attributed to early experiences of violence," explains Bohus. Emotional neglect, early experiences of loss, and severely disturbed relationships in the family also contribute. However, this does not explain all cases. Nearly 40 percent of borderliners surveyed developed the disorder without childhood sexual abuse.

Possible Therapies

Effective treatment options include dialectical behavior therapy, mentalization-based therapy, and schema therapy. Group therapy and antidepressant medication may also be beneficial.