Borderline Personality Disorder

To the Editor:

Re “Surviving Myself” (Op-Ed, nytimes.com, Aug. 7):

Colton Wooten provides a great service by openly describing the experience of self-cutting, but any discussion of this topic would be enriched by including mention of borderline personality disorder.

According to studies, this disorder affects between 1.3 and 6 percent of the American population. Central to this disorder are depressed mood and self-harm, along with difficulties with relationships and a confused sense of self.

It is important to know about borderline personality disorder because of its frequent co-occurrence with depression and the fact that, when both are present, efforts to treat the depression without treating the borderline personality disorder do not work.

Many cases of “treatment-resistant depression” involve borderline personality disorder. As Mr. Wooten points out, treatment involves helping the patient to be able to put seemingly intolerable affect states into words rather than into action.

Frank Yeomans
New York
The writer is a clinical associate professor of psychiatry and the director of training at the Personality Disorders Institute, Weill Cornell Medical College.