THMC Mental Health & Innovation Centre
ADHD and Dementia Assessment
緻安精神健康醫療創新中心
Mental Health Clinic Specializing
in ADHD and Mood Disorders
for Children and Adults
Open as Usual on Saturday Afternoons
自殘和
邊緣性人格障礙
Self-harm and Borderline Personality Disorder
Borderline Personality Disorder is characterized by chronic feelings of emptiness, fear of abandonment, unstable emotions, intense anger, interpersonal problems, recurrent self-harm and transient psychosis. Family conflicts predispose this condition, invalidation from parents and abuse during childhood.
A case of recurrent self-harm
Lynette is a Secondary four student. She came from a single-parent family. She always feels empty and worries her friend may abandon her. She cannot cope with academic stress and problems with her friends. Her mood can change from normal to intense anger and irritability. She often uses a pen knife to cut her wrist. The teacher notices multiple scars on her wrists. Her mother finds it difficult to deal with her self-harm behavior and mood swing.
I thought my daughter, who cuts herself, suffers from depression. What is the difference between depression and borderline personality disorder?
The following features are found in people with borderline personality disorder but not in depressive disorder: chronic feelings of emptiness, fear of abandonment, identity confusion, impulsive behavior (e.g. binge eating), and transient psychosis (e.g., hearing a voice when nobody is around) etc.
What is the impact of borderline personality disorder on academic performance?
Young people with borderline personality disorder often cannot concentrate on their studies due to mood swings. The recurrent self-harm behaviour and interpersonal problems cause concerns to school. They often need to take a leave of absence from school/university.
People with borderline personality disorder complain of mood swings. Do they also have bipolar disorder?
People with borderline personality disorder experience mood swings starting from normal and progressing to intense anger or irritability. In contrast, people with bipolar disorder experience mood swings starting from low (depressive) and progressing to high (manic).
How do psychiatrists help people with borderline personality disorder?
An experienced psychiatrist will attempt to establish a therapeutic alliance or attachment with the patients. Specific psychotherapy techniques will be offered. The psychiatrist will prescribe medications to stabilize the mood, reduce self-harm and impulsive behavior and treat transient psychosis if present.
Source: Academic paper in which Dr Roger Ho is one of the co-authors.
[1] Keng SL, Lee Y, Drabu S, Hong RY, Chee CYI, Ho CSH, Ho RCM. Construct Validity of the McLean Screening Instrument for Borderline Personality Disorder in Two Singaporean Samples. J Pers Disord. 2019 Aug;33(4):450-469. doi: 10.1521/pedi_2018_32_352. Epub 2018 Jun 27. PMID: 29949444.
Husain SF, Tang TB, Yu R, Tam WW, Tran B, Quek TT, Hwang SH, Chang CW, Ho CS, Ho RC. Cortical haemodynamic response measured by functional near infrared spectroscopy during a verbal fluency task in patients with major depression and borderline personality disorder. EBioMedicine. 2020 Jan;51:102586. doi: 10.1016/j.ebiom.2019.11.047. Epub 2019 Dec 24. PMID: 31877417; PMCID: PMC6938854.