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Diane is a 16-year-old girl diagnosed with major depressive disorder and borderline personality disorder. Her symptoms are inappropriate anger, emotional instability, and intense fear of abandonment, causing suicidal ideation. Diane had taken an overdose of acetaminophen after an argument with an older sibling. She had a history of suicide attempts and had declined outpatient treatment during the discharge after her first admission. Dialectical Behavior Therapy (DTB) is the most effective in treating Dianes Borderline Personality Disorder (BPD) and severe depression symptoms. I would use DTB to train Dianes emotion regulation, distress tolerance, and mindfulness to distract her suicidal thoughts. Through one-on-one dialect, I will train her to decrease impulsivity and make conscious decisions. During the last days of DTB treatment, I will test and ensure that Diane can use the learned skills and perceive them as effective. After implementation of the skills, I will conduct a follow up to monitor her suicidal ideation and severe depression.
The treatment goals for Diane are oriented toward eliminating her life-threatening behavior, distress tolerance, emotional regulation hence interpersonal efficiency. DTB will transform her thinking patterns and destructive behaviors. Patients suffering from borderline personality experience unbearable living, and DTB has an overarching goal of changing patients perspectives toward living (Lin et al., 2019). This is achieved by helping the patients draw the line between valid and extreme emotions. My preliminary diagnostic considerations for Dianes borderline personality and major depressions are genetics and childhood abuse. Genetics seemingly made Diane vulnerable to BPD since her older sibling had been diagnosed with similar symptoms. Lin et al. (2019) show a strong link between childhood neglect, trauma, and BPD. Diane experienced childhood trauma from her fathers physical assault and parental disputes.
Reference
Lin, T. J., Ko, H. C., Wu, J. Y. W., Oei, T. P., Lane, H. Y., & Chen, C. H. (2019). The effectiveness of dialectical behavior therapy skills training group vs. cognitive therapy group on reducing depression and suicide attempts for borderline personality disorder in Taiwan. Archives of Suicide Research, 23(1), 82-99. Web.
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