Understanding Borderline Personality Disorder and Depression: A Case Formulation
Keywords:borderline personality disorder, depression, case formulation
The co-occurrence of depression and borderline personality disorder (BPD) complicates the formulation thus it must be comprehensive to accurately inform an effective treatment plan. The case is TSN, 22-year-old Malay woman who sought psychological help for having recurrent depressed mood and self-harm. Mood assessment indicated high severity of BPD symptoms, moderate depressive symptoms, and mild anxiety. We formulated the case based on 4P biopsychosocial model, Crowell’s biosocial development model of BPD, and Beck and Bredemeier’s unified model of depression. TSN was temperamental and impulsive as a child. Parental invalidating responses and neglectful environment were reported. The loss of close friend had precipitated BPD traits, which exacerbated by multiple interpersonal losses thereafter. Coping with losses using ineffective strategies have gradually resulting depressive symptoms in TSN. We concluded that BPD traits, rather than depression, had triggered and maintained her depressed mood, thus it is important to focus on treating the BPD psychopathology.
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Copyright (c) 2023 Michelle Poh Kin Choong, Azizah Othman, Mohamed Faiz Mohamed Mustafar
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