Prof. Dr. Nevzat Tarhan Highlights Relationship Between Borderline and Bipolar

Psychiatrist Prof. Dr. Nevzat Tarhan stated that 96% of individuals with borderline personality disorder are diagnosed with bipolar disorder when followed throughout their lives, adding that some studies refer to these as 'sub-bipolar' or 'subthreshold bipolar'. Psychiatrist Prof. Dr. Nevzat Tarhan said, "50% of borderline personality disorder improves with a biological approach, with mood-stabilizing medications, and 50% with therapy." Prof. Dr. Tarhan, who noted that antisocial disorder is more common in men, also stated, "Borderline personality disorder is observed more in women."

Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, evaluated the topic of borderline personality disorder.

"Borderline personality disorder is one of the group that includes narcissistic personality disorder"

Prof. Dr. Nevzat Tarhan stated that personality disorders are divided into three main clusters, and borderline personality disorder is one of the dominant personality disorders characterized by a lack of empathy, known as Cluster B. He said, "Borderline personality disorder is one of the group that includes narcissistic personality disorder, obsessive-compulsive personality disorder, and antisocial personality disorder. It is also translated into Turkish as 'boundary personality disorder'. The individual cannot define their social, emotional, or personal boundaries. This person cannot define their boundaries in their relationship with themselves, their inner world, or their relationships with the external world, whether in social, family, or work contexts. That is why it is called boundary personality disorder."

"Borderline individuals cannot even recognize their social boundaries or the boundaries within their own inner world"

Prof. Dr. Tarhan emphasized the importance of a person knowing their limits, stating, "There is a saying, 'He who knows his limits knows his Lord'... In essence, knowing one's place means knowing one's boundaries. Someone who knows their own strength, capacity, and limits becomes respectable. However, these borderline individuals cannot even recognize their social boundaries or the boundaries within their own inner world. They don't know when to be sad or when to laugh; they lack emotional literacy. They are unaware of their own emotions."

"If a person receives a subthreshold bipolar diagnosis, medication treatment is necessary"

Prof. Dr. Tarhan also pointed to the relationship between borderline personality disorder and bipolar disorder, stating, "Individuals with borderline personality disorders have been followed throughout their lives, and 96% of them have received a bipolar diagnosis. It creates a fertile ground for bipolar disorder. That is why some research refers to these as sub-bipolar. It's a sub-form of bipolar. They call it subthreshold bipolar. It is related to subthreshold mood disorder. If one receives a subthreshold bipolar diagnosis, medication treatment is already necessary."

"A borderline mother profusely kisses her child in the morning, then in the afternoon says 'Why did I give birth to you?'"

Prof. Dr. Tarhan noted that patients improve with medication and that individuals thought to have borderline disorder are actually subthreshold bipolar. He said, "This type of bipolar does not have manic and depressive periods. It's subthreshold. You might think this is just their personality. But it improves with treatment. Because research shows that these individuals have a serotonin gene defect in their brain. They have serotonin gene disorders. For example, these individuals either exaggerate things excessively or completely disparage them. They elevate the other person to the sky in an instant. For example, a borderline mother will profusely kiss her child in the morning, and in the afternoon say, 'God damn you, why did I give birth to you?' This is borderline motherhood. These individuals experience an identity crisis.

"They are constantly unstable. They are also impulsive in spending money"

Prof. Dr. Tarhan also explained that borderline individuals are never calm or soothing. He noted, "These individuals act on the first impulse that comes to mind. They immediately believe what they hear. They drive very dangerously. They are very impulsive sexually. They are also very impulsive regarding substance use, eating, and relationships. They frequently exhibit suicidal behaviors. And they always have a chronic feeling of emptiness inside. They are anxious individuals. They cannot relax or calm themselves. There is inconsistency. They are constantly unstable; they are unbalanced personalities. They are also impulsive in spending money. They tend to act without thinking of the consequences. There is also identity confusion. Normally, identity confusion is experienced during adolescence. Social identity, ethnic identity, sexual identity—confusion about these occurs, and a decision is made. These individuals cannot resolve their identity confusion in adolescence."

"Those living with them cannot understand when they are sad, angry, or happy..."

Prof. Dr. Tarhan stated that because these individuals can never define themselves and cannot be at peace with themselves, they cannot maintain healthy human relationships. He said, "The first step of mental health starts with ourselves. Self-awareness is knowing oneself, self-management is managing oneself. Because these individuals experience identity confusion and cannot know themselves, their unhappiness is also contagious. Those living with them cannot understand when they are sad, angry, or happy... You can never predict what they will do."

"The suicide rate among individuals with borderline personality disorder is 7.5 percent"

Prof. Dr. Tarhan also stated that such easily angered individuals are suspicious and easily fall apart under stress. He said, "When something goes wrong, they easily unravel. Their suicide rates are very high. If the suicide rate in society is one per thousand, it is 7.5 percent among individuals with borderline personality disorder. That means seven and a half out of 100 people commit suicide. They attempt suicide. It's a high rate. Even if these individuals are happy, they frequently fall into depression and anxiety, experiencing mood disorders. They get into fights very easily."

"Children who cannot find a nurturing environment with a comforting parent model are future borderline candidates"

Prof. Dr. Tarhan also noted that in their inner world, these individuals perceive the world as a dangerous, harmful place, stating that they have maladaptive thought and emotion patterns and believe they are unloved.

Prof. Dr. Tarhan also stated that children who cannot find a nurturing growth environment with a comforting parent model are future borderline candidates, explaining that these individuals constantly approach everyone with suspicion and fear commitment because they believe life is not safe.

"If a 40-year-old person does many things typical of adolescence, it is called borderline"

Prof. Dr. Tarhan also noted that there is a bit of 'borderlineness' in the natural structure of adolescence. He said, "That's why they are called 'delikanlı' (young hothead). A 'delikanlı' boy or a 'delişmen' girl... Prophet Muhammad says, 'Adolescence is a branch of madness.' If a 40-year-old person does many things typical of adolescence, it is called borderline. It is actually a healthy situation for adolescents to be a bit borderline; to react disproportionately, to be restless. An adolescent who is 'like a candle' (too calm, submissive) would actually be unhealthy. Adolescence is a stormy period. If parents provide good guidance to their child during such a period, the child will overcome this period well and learn stress management." 

"It occurs in children of very overly controlling parents"

Prof. Dr. Tarhan pointed to parental attitude errors, stating, "It occurs in children of very overly controlling parents. They interfere with what the child eats and drinks. They constantly keep the child on edge, telling them what to wear and what not to wear. Such children become borderline candidates. Even if the parents calm and comfort the child, the child remains constantly anxious. This also happens in children of parents who say, 'I will raise an excessively perfect child, a project child.' While aiming for perfection, the child completely shifts to the other extreme, oscillating between two poles." 

"Borderline personality disorder cases present with depression and anxiety"

Prof. Dr. Tarhan noted that individuals seek help when their social relationships are disrupted, when they have impulsive spending habits, and when their actions harm their relationships. He said, "Generally, cases of borderline personality disorder present with depression and anxiety. We see them having entered severe depression. Constantly crying, excessively angry. In the background, there is borderline personality disorder. As the depression passes, the individual is made aware of their borderline personality disorder, and impulse control work is done, leading to improvement. 50% of borderline personality disorder improves with a biological approach, with mood-stabilizing medications, and 50% with therapy."

"Borderline personality disorder is easily detected with various personality tests"

Prof. Dr. Tarhan noted that in some cases, there is excessive eating due to borderline personality disorder and impulse control disorder. He said, "In some cases, eating control disorder and anorexia nervosa are also frequently encountered. You cannot predict where, when, or how they will behave. Borderline personality disorder is easily detected with various personality tests. Supportive treatment is administered for at least 6 months. After a certain improvement is achieved, a preventive period begins. They are kept under follow-up for 2 to 5 years. In such situations, individuals with borderline personality disorder become capable of sustaining a marriage and achieving success at work, but the first condition is for the person to become aware. Once they become aware, the solution is easy; if they do not become aware, awareness only begins when they get into significant trouble, and we use that as an opportunity."

"When they don't recognize boundaries, men easily start having legal problems"

Prof. Dr. Tarhan stated that antisocial disorder is more common in men, adding, "Borderline personality disorder is observed more in women. When they don't recognize boundaries, men easily start having legal problems. A personality disorder diagnosis is not made under the age of 18. It is made over the age of 18 because the child's personality has not yet fully developed." 

Prof. Dr. Tarhan noted that while one sibling growing up in the same stress and environment might develop OCD, another could develop borderline personality disorder, stating, "Therefore, genetic predisposition is very important."