the influencer Gustavo Tubarão revealed on his social networks, on Sunday (29), that he suffers from borderline personality disordera psychiatric condition that, according to estimates, affects between 1.6% and 5.9% of the general population.
Also called borderline personality disorderits main characteristics are hypersensitivity to rejection and “instability of interpersonal relationships, self-image and affections, and marked impulsiveness that appears in early adult life and is present in various contexts”, according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition).
“My mood changes every five minutes. I reached a point where I couldn’t take this quick mood change anymore. Sometimes I’m in a place with a group, I’m happy, all of a sudden a deep sadness hits, five minutes pass , I’m happy again”, said the influencer in an excerpt from the video.
The manual, which is the world’s main reference for identifying mental disorders, attributes to the borderline a direct relationship with the feeling of abandonment.
One of the characteristics taken into account when diagnosing a patient involves precisely checking whether the person makes “desperate efforts to avoid real or imagined abandonment”.
“[Pacientes com borderline] experience intense fears of abandonment and experience inappropriate anger even in the face of realistic short-term separation or when unavoidable changes in plans occur (eg, sudden despair in reaction to the clinician’s announcement that the appointment is over; panic or rage when someone important for them if you are a few minutes late or need to cancel an appointment)”, describes the guide.
Gustavo Tubarão also recalled that he had previously been diagnosed with other psychiatric disorders, such as depression, anxiety and panic disorder, but stated that the borderline person can manifest symptoms of all these conditions.
“Imagine a circle and inside that circle there are several other circles, one is depression, another ball is panic disorder, the other ball is anxiety, the other ball is ADHD [transtorno de déficit de atenção com hiperatividade]. this circle [maior] it’s borderline. I was lucky in life with a combo of a bad train on a single head.”
Individuals with borderline disorder often have mood disorders (80% to 96% of them); anxiety disorders (88%); substance abuse (64%); eating disorders (53%); ADHD (from 10% to 30%); bipolar disorder (15%) and somatoform disorders (10%).
He also said that he sometimes has “a lot of anger” and “such an emptiness” that he doesn’t know how to explain it.
These are, in fact, some signs that may indicate borderline disorder, according to the DSM-5.
Patients often have “episodic dysphoria, irritability or intense anxiety usually lasting a few hours and only rarely lasting more than a few days”, in addition to “frequent displays of irritation, constant anger, recurrent physical fights”.
The young man, who is currently 23 years old, still vented that he thought about taking his own life at times. The guide also describes the “recurrence of suicidal behavior, gestures or threats or self-mutilating behavior” as an indication of borderline.
He revealed that he had problems with drugs, but that he no longer uses them because he had a very bad experience.
“Why did I use drugs? Because anyone with borderline is compulsive. There was a day when I stuck so much drug in my bud that I ended up taking an overdose.”
Patients with borderline personality disorder may still manifest this impulsiveness in the form of sex, excessive spending, irresponsible driving, and binge eating.
In a 2022 article, American researchers Jennifer Chapman, Radia T. Jamil and Carl Fleisher state that borderline has multifactorial causes, genetic predisposition being one of them.
“Environmental factors that have been identified as contributing to the development of borderline personality disorder primarily include childhood maltreatment (physical, sexual, or neglect), found in up to 70% of people with BPD [transtorno de personalidade borderline]as well as maternal separation, inadequate maternal attachment, family boundaries, parental substance abuse, and severe parental psychopathology,” they add.
Diagnosis and treatment
Only trained professionals, such as psychiatrists and psychologists, are capable of diagnosing borderline disorder..
The symptoms described above do not necessarily indicate this condition. Experts will take into account a number of factors.
Gustavo Tubarão told his followers that the “good part” of the story is that he can now control his emotions.
“It took me 23 years to discover a train, and today I have the knowledge and control of my head, of what will do me good and what will not do me good. […] My borderline level is very low, it’s not exaggerated, because I treat it. I don’t think I’ve ever been better, because if I wasn’t, I would never open up.
Treatment for the disorder depends on psychotherapy. According to the article by the North American researchers, three types are indicated:
• Mentalization-based therapy: “helps patients manage emotional dysregulation by feeling understood, allowing them to be more curious and make fewer assumptions about the intentions of those around them.
• Dialectical behavior therapy: “combines mindfulness practices with concrete interpersonal and emotion regulation skills.”
• Transference-focused psychotherapy: “concentrates on using the patient-therapist relationship to develop the patient’s awareness of problematic interpersonal dynamics.”
No medication is available for the treatment of borderline disorder. Antidepressants such as SSRIs (selective serotonin reuptake inhibitors), mood stabilizers and antipsychotics “have shown limited efficacy in studies aimed at controlling symptoms such as anxiety, sleep disturbance, depression or psychotic symptoms,” according to the researchers.
There is no talk of curing the borderline, but a study with 290 patients hospitalized and diagnosed with the disorder showed good rates of disappearance of symptoms.
They were followed up for 16 years and reassessed every two years. In that period, 35% had achieved borderline remission after two years; 91% after ten years; and 99% after 16 years.
The authors of the paper point out that “unfortunately remission was associated with impoverished social relationships, leading them to suggest that patients may appear to have remission because they avoid interpersonal relationships rather than gradually developing better interpersonal skills. Once achieved, remission was sustained for more than eight years in 75% of patients”.