{"id":4518,"date":"2020-01-13T20:00:20","date_gmt":"2020-01-13T17:00:20","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=4518"},"modified":"2020-01-24T16:06:39","modified_gmt":"2020-01-24T13:06:39","slug":"borderline-kisilik-bozuklugu","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/borderline-kisilik-bozuklugu\/","title":{"rendered":"Borderline Ki\u015filik Bozuklu\u011fu"},"content":{"rendered":"\n

\u201cAn\u0131 co\u015fkuyla, abartarak ya\u015fayan, sonra birden t\u00fcketen, bulundu\u011fu \u00e7evre, durum hatta bir \u015fark\u0131 bile de\u011fi\u015fse ayn\u0131 yo\u011funlu\u011fu ba\u015fka bir yere y\u00f6nelten…\u201d <\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Bu c\u00fcmleyi okudu\u011funuzda akl\u0131n\u0131za ilk hangi hastal\u0131k geliyor? Bipolar hastal\u0131\u011f\u0131 m\u0131? Ah evet \u00e7o\u011fumuz ayn\u0131 hataya d\u00fc\u015ft\u00fck. Ama bu tan\u0131m asl\u0131nda okudu\u011fum bir kitapta* Borderline Ki\u015filik Bozuklu\u011funu tasvir etmek i\u00e7in kullan\u0131lm\u0131\u015ft\u0131. Borderline Ki\u015filik Bozuklu\u011fu \u00e7o\u011fu zaman bipolar ile kar\u0131\u015ft\u0131r\u0131lan karma\u015f\u0131k bir bozukluktur. \u0130\u015fte bu anla\u015f\u0131lmas\u0131 zor ki\u015filik bozuklu\u011funda ki\u015finin kendine ait \u00f6zg\u00fcveni \u00e7ok y\u00fcksek iken birden kendini \u00e7ok fazla bo\u015f ve de\u011fersiz hissedebiliyor. Yaln\u0131z kalmay\u0131 hi\u00e7 sevmiyorlar ve i\u00e7lerinde s\u00fcrekli bir bo\u015fluk hissi ile ya\u015f\u0131yorlar. Normal bir insan i\u00e7in \u00f6nemsiz g\u00f6r\u00fclebilen bir davran\u0131\u015f onlar i\u00e7in b\u00fcy\u00fck bir \u00f6nem arz ediyor ve bundan \u00e7ok fazlaca etkileniyorlar. Tabi ki a\u015f\u0131r\u0131 terk edilme korkusuyla beraber depresyon da \u00e7ok s\u0131k g\u00f6r\u00fcl\u00fcyor.<\/p>\n\n\n\n

*= Aret Vartanyan, Siyah G\u00f6zya\u015f\u0131 (\u0130stanbul: A7 Kitap Yay\u0131nc\u0131l\u0131k, 2018), 244.<\/p>\n\n\n\n

Hadi biraz daha ayr\u0131nt\u0131l\u0131 tan\u0131yal\u0131m bu hastal\u0131\u011f\u0131. \u00a0Borderline Ki\u015filik Bozuklu\u011fu (BKB) \u00e7ok s\u0131k g\u00f6r\u00fclen ama \u00e7ok\u00e7a g\u00f6zden ka\u00e7\u0131r\u0131lan bir psikolojik rahats\u0131zl\u0131kt\u0131r. Gen\u00e7 yeti\u015fkinlik d\u00f6neminde ve de\u011fi\u015fik ko\u015fullarda ortaya \u00e7\u0131kan bu rahats\u0131zl\u0131k, \u00e7o\u011fu zaman bipolar hastal\u0131\u011f\u0131 ile kar\u0131\u015ft\u0131r\u0131lan karma\u015f\u0131k bir sendromdur. Bu sendromda ki\u015finin di\u011fer insanlar ile ili\u015fkilerinde ve benlik alg\u0131s\u0131nda, duygulan\u0131mda bozukluk ba\u015f g\u00f6sterirken; ani d\u00fcrt\u00fcsellik ile ki\u015fide kendine zarar verme, intihar, kumar oynama, tehlikeli cinsel ili\u015fkiler, a\u015f\u0131r\u0131 yemek yeme ve madde kullan\u0131m\u0131 vb. gibi a\u015f\u0131r\u0131 u\u00e7 noktalarda davran\u0131\u015flar g\u00f6r\u00fclebilir.Bir yandan benlik alg\u0131s\u0131ndaki bozukluk ve bu nedenle ge\u00e7irdi\u011fi \u00f6fke n\u00f6betleri, insan ile ili\u015fkilerine b\u00fcy\u00fck zarar vermekte iken, duygudurumun \u00e7abuk de\u011fi\u015fmesi ve zay\u0131flam\u0131\u015f d\u00fcrt\u00fc kontrol\u00fc ise \u015fiddet i\u00e7in zemin olu\u015fturarak ki\u015finin kendine ve \u00e7evresine zarar verme ihtimalini de artt\u0131rmaktad\u0131r.\u00a0 Ayr\u0131ca BKB tan\u0131s\u0131n\u0131 koymak \u00e7ok zordur \u00e7\u00fcnk\u00fc di\u011fer duygudurum bozuklar\u0131 ile \u00e7o\u011fu zaman kar\u0131\u015ft\u0131r\u0131lmaktad\u0131r.<\/p>\n\n\n\n

\u00a0\u00a0 BKB\u2019nun toplumda yayg\u0131nl\u0131\u011f\u0131 %2 ve \u00f6l\u00fcm oran\u0131 %6,7-8,5 olarak belirtilmi\u015ftir. Yani BKB toplumsal a\u00e7\u0131dan \u00f6nem ta\u015f\u0131yan b\u00fcy\u00fck bir sorundur. Ayr\u0131ca yap\u0131lan bir \u00e7al\u0131\u015fmada, ruh sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n %84\u2019\u00fc, BKB hastalar\u0131na tedavi ve bak\u0131m vermenin di\u011fer hasta gruplar\u0131ndan \u00e7ok daha zor oldu\u011funu belirtmi\u015ftir. Bu y\u00fczden bu hasta grubunun tan\u0131s\u0131 ve tedavisi b\u00fcy\u00fck \u00f6nem arz etmektedir. Hastalar\u0131n \u00e7ok y\u00fcksek k\u0131sm\u0131nda depresyon ve anksiyete g\u00f6r\u00fcl\u00fcrken, \u00e7ok da az olmayan bir k\u0131sm\u0131nda ise madde ve alkol ba\u011f\u0131ml\u0131\u011f\u0131 g\u00f6r\u00fclmesi, dikkat edilmesi gereken ba\u015fka bir y\u00f6n\u00fcd\u00fcr. BKB hastalar\u0131n\u0131n bebeklikte kullan\u0131lan ilkel bir savunma mekanizmas\u0131 kulland\u0131klar\u0131 \u00f6ne s\u00fcr\u00fclm\u00fc\u015f ve k\u00f6t\u00fc y\u00f6nlerini etraf\u0131ndaki ki\u015filere yans\u0131tarak iyi kalma \u00e7abas\u0131 i\u00e7inde olduklar\u0131 g\u00f6sterilmi\u015ftir.<\/p>\n\n\n\n

Tan\u0131\nKriterleri<\/strong><\/p>\n\n\n\n

Borderline Ki\u015filik Bozuklu\u011fu\u2019nun tan\u0131s\u0131n\u0131n \u00e7ok zor oldu\u011fundan ve di\u011fer duygudurum bozukluklar\u0131ndan g\u00fc\u00e7 bir \u015fekilde ayr\u0131t edildi\u011finden bahsetmi\u015ftik.\u00a0 \u015eimdi bu tan\u0131s\u0131 zor olan hastal\u0131\u011f\u0131n kriterlerine g\u00f6z atal\u0131m;<\/p>\n\n\n\n

1- Ger\u00e7ek ya da hayali bir terk\nedilmeden ka\u00e7\u0131nmak i\u00e7in \u00e7\u0131lg\u0131nca \u00e7aba harcamak.<\/p>\n\n\n\n

2- Kar\u015f\u0131s\u0131ndakileri a\u015f\u0131r\u0131 b\u00fcy\u00fct\u00fcp,\ng\u00f6klere \u00e7\u0131karma ve a\u015f\u0131r\u0131 de\u011fersizle\u015ftirip, g\u00f6zden d\u00fc\u015f\u00fcrerek, yerin dibine sokma\ngibi ba\u015fkalar\u0131na a\u015f\u0131r\u0131 de\u011fer, de\u011fersizlik verme ile giden tutars\u0131z ili\u015fkiler.<\/p>\n\n\n\n

3- Kimlik karma\u015fas\u0131 denilen kendini\nalg\u0131lay\u0131\u015f\u0131nda, \u00f6nem verilen k\u00fclt\u00fcrel- ahlaki de\u011fer anlay\u0131\u015f\u0131nda de\u011fi\u015fkenlikler.<\/p>\n\n\n\n

4- Kendine zarar verme olas\u0131l\u0131\u011f\u0131\nfazla olan, iki ya da daha \u00e7ok durumda sonunu d\u00fc\u015f\u00fcnmeden, aniden yap\u0131lan\neylemler (aniden \u00e7ok para harcama, madde kullan\u0131m\u0131, h\u0131zl\u0131 ve tehlikeli ara\u00e7\nkullanma, birden a\u015f\u0131r\u0131 yemek yeme, \u00f6nceden d\u00fc\u015f\u00fcn\u00fclmeyen uygunsuz cinsel\ndavran\u0131\u015flar).<\/p>\n\n\n\n

5- Yineleyen bir \u015fekilde intihar\ngiri\u015fimleri, intihar tehditleri, kendi kendine zarar verme (b\u0131\u00e7ak, jilet vs.\nile kendi cildini kesme, sigara ile kafay\u0131 yakma).<\/p>\n\n\n\n

6- Duygu durumunda a\u015f\u0131r\u0131 tepkiye\nba\u011fl\u0131 olarak s\u00fcrekli duygusal de\u011fi\u015fkenlik hali (saatler i\u00e7inde de\u011fi\u015fen\ns\u00fcrelerde birbirini izleyen \u00f6fkelilik, \u00fcz\u00fcnt\u00fc, kayg\u0131, sevin\u00e7 d\u00f6nemleri).<\/p>\n\n\n\n

7- Ki\u015finin kendisini s\u00fcrekli olarak\nbo\u015flukta hissetmesi.<\/p>\n\n\n\n

8- \u00d6fkeye kontrol\u00fcnde g\u00fc\u00e7l\u00fck (s\u0131k\ns\u0131k kavgalara kar\u0131\u015fma, y\u00fcksek sesle hakaret, \u00e7\u0131\u011fl\u0131k atma).<\/p>\n\n\n\n

9- Stresle ili\u015fkili, gelip ge\u00e7ici,\nkendine k\u00f6t\u00fcl\u00fck yap\u0131laca\u011f\u0131 d\u00fc\u015f\u00fcnceleri ya da dissosiyatif belirtiler.<\/p>\n\n\n\n

    Yukar\u0131daki kriterlerden 5 tanesini ta\u015f\u0131yan ki\u015filer, borderline ki\u015filik bozuklu\u011funa sahiptirler.<\/p>\n\n\n\n

BKB\nEtiyolojisi <\/strong><\/p>\n\n\n\n

\u00a0 Daha \u00f6ncede bahsetti\u011finiz gibi BKB karma\u015f\u0131k ve anla\u015f\u0131lmas\u0131 zor bir sendromdur ama ayn\u0131 zamanda etiyolojisi de \u00e7ok fakt\u00f6rl\u00fcd\u00fcr. Ortaya \u00e7\u0131k\u0131\u015f\u0131n\u0131 a\u00e7\u0131klayan bir\u00e7ok teorem mevcuttur ve \u00e7o\u011fu zaman \u00e7ocukluk d\u00f6nemine ait travmalar\u0131n \u00f6nemi vurgulansa da etiyolojisi hala tam olarak a\u00e7\u0131klanamam\u0131\u015ft\u0131r. BKB hastalar\u0131n\u0131n \u00e7ocukluk travmalar\u0131nda cinsel istismar\u0131n y\u00fcksek oldu\u011fu ve ciddi BKB semptomlar\u0131 g\u00f6steren hastalar\u0131n b\u00fcy\u00fck bir \u00e7o\u011funlu\u011funun \u00e7ocukluk d\u00f6neminde Dikkat eksikli\u011fi ve hipaeraktivite (DEHB) tan\u0131s\u0131 ald\u0131\u011f\u0131 g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Ve hastal\u0131\u011f\u0131n patolojisinde ise yaln\u0131zl\u0131\u011fa tahamm\u00fcl edememenin yatt\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclm\u00fc\u015f. Ayr\u0131ca geneti\u011fi \u00fczerinde yap\u0131lan \u00e7al\u0131\u015fmalar, genetik ge\u00e7i\u015fin %40 oldu\u011funu g\u00f6stermi\u015ftir.<\/p>\n\n\n\n

BKB ile\nBipolar Ay\u0131r\u0131m\u0131<\/strong><\/p>\n\n\n\n

\u00a0\u00a0Bipolar ile BKB\u2019nun birbirinden ayr\u0131m\u0131 kolay de\u011fildir ve bu borderline tan\u0131s\u0131nda ve tedavisinde g\u00fc\u00e7l\u00fck \u00e7\u0131karmaktad\u0131r. \u00c7\u00fcnk\u00fc tan\u0131 kriterleri olduk\u00e7a \u00f6rt\u00fc\u015fmektedir. Ayr\u0131ca do\u011fru tan\u0131mlama ile tedavi daha da etkili olmaktad\u0131r. \u0130ki hastal\u0131\u011f\u0131n da birlikte g\u00f6r\u00fclebilmesi olduk\u00e7a y\u00fcksektir. Ama birlikte g\u00f6r\u00fclmesinin prognoza ve hastaneye yat\u0131\u015fa etkisinin olmad\u0131\u011f\u0131 kan\u0131tlanm\u0131\u015f olsa da birlikte g\u00f6r\u00fclmeleri \u015fiddet olaylar\u0131nda art\u0131\u015fa neden olabilir.<\/p>\n\n\n\n

BKB\u2019da duygudurum ataklar\u0131 daha k\u0131sa s\u00fcreli ve \u00e7evreye ba\u011f\u0131ml\u0131 olarak ger\u00e7ekle\u015firken; bipolarda daha uzun s\u00fcre ve kendili\u011finden ortaya \u00e7\u0131kar. Ataklar \u00f6timiden* \u00f6fkeye do\u011fru giderken stres fakt\u00f6rleri de b\u00fcy\u00fck rol oynamaktad\u0131r. D\u00fcrt\u00fcsellik \u00e7ok y\u00fcksek oldu\u011fu BKB’de ki\u015finin kendine zarar verici davran\u0131\u015flarda bulunma olas\u0131l\u0131\u011f\u0131 y\u00fcksek iken bipolarda bu durum genellikle depresif haldeyken g\u00f6r\u00fcl\u00fcr ama BKB\u2019da kendine zarar verme daha \u00e7ok \u00fcmitsizlikle ili\u015fkilidir. Ve uzun y\u0131llar sonra hastalar\u0131n \u00e7o\u011fu tan\u0131 kriterlerini kar\u015f\u0131lamaz.<\/p>\n\n\n\n

 \u00d6timi<\/strong>: Normal \u00e7er\u00e7evede (sosyal \u00e7evre taraf\u0131ndan kabul edilir \u00f6l\u00e7\u00fcler i\u00e7inde) oynamalar\u0131 olan duyguduruma verilen isimdir.<\/p>\n\n\n\n

BKB\nTedavisi<\/strong><\/p>\n\n\n\n

      Uzun s\u00fcreli psikoterapik yakla\u015f\u0131m ve duygu\ndurum dengeleyicileri b\u00fcy\u00fck \u00f6nem arz ederken FDA taraf\u0131nda BKB tedavisi i\u00e7in\nhi\u00e7bir ila\u00e7 daha onay almam\u0131\u015ft\u0131r.<\/p>\n\n\n\n

KAYNAK\u00c7A<\/p>\n\n\n\n

  1. http:\/\/www.dusunenadamdergisi.com.tr\/tr\/DergiPdf\/DUSUNEN_ADAM_DERGISI_8c2b06a906c14241a4963d083fccd0a5.pdf<\/a><\/li>
  2. https:\/\/dergipark.org.tr\/tr\/pub\/mad\/issue\/35961\/472712<\/a><\/li>
  3. http:\/\/www.journalagent.com\/phd\/pdfs\/PHD_1_3_133_138.pdf<\/a> <\/li>
  4. https:\/\/www.e-psikiyatri.com\/borderline-kisilik-bozuklugu-nedir<\/a><\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"

    \u201cAn\u0131 co\u015fkuyla, abartarak ya\u015fayan, sonra birden t\u00fcketen, bulundu\u011fu \u00e7evre, durum hatta bir \u015fark\u0131 bile de\u011fi\u015fse ayn\u0131 yo\u011funlu\u011fu ba\u015fka bir yere<\/p>\n","protected":false},"author":190,"featured_media":4523,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"acf":[],"views":911,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/4518"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/190"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=4518"}],"version-history":[{"count":10,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/4518\/revisions"}],"predecessor-version":[{"id":4683,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/4518\/revisions\/4683"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/4523"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=4518"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=4518"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=4518"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}