Sexual abuse can be a particular trigger for suicidal behavior in adolescents with BPD tendencies. Sense of self
People with BPD tend to have trouble seeing their identity clearly. In particular, they tend to have difficulty knowing what they value, believe, prefer, and enjoy. They are often unsure about their long-term goals for relationships and jobs. This can cause people with BPD to feel "empty" and "lost". Self-image can also change rapidly from healthy to unhealthy. People with BPD may base their identity on others, leading to chameleon-like changes in identity. Cognitions
The often intense emotions people with BPD experience may make it difficult for them to concentrate. They may also tend to dissociate, which can be thought of as an intense form of "zoning out". Others can sometimes tell when someone with BPD is dissociating because their facial or vocal expressions may become flat or expressionless, or they may appear distracted and "numb" to emotional stimuli.Dissociation most often occurs in response to a painful event (or something that triggers the memory of a painful event). It involves the mind automatically redirecting attention away from the current event or situation or blocking it out entirely. This is done presumably to protect against - based on similar or related past experiences - what the mind perceives and forecasts as arousing intense negative emotions and unwanted behavioral impulses that the present emotive event might trigger.
Treatment
The malabsorption resulting from lack of bile acid has resulted in elemental formula being suggested, which are low in fat with < 3% of calories derived from long chain triglycerides (LCT). However, reduced very long chain fatty acids (VLCFA) has not been shown to reduce blood VLCFA levels, likely because humans can endogenously produce most VLCFA. Plasma VLCFA levels are decreased when dietary VLCFA is reduced in conjunction with supplementation of Lorenzos oil (a 4:1 mixture of glyceryl trioleate and glyceryl trierucate) in X-ALD patients. Since docosahexaenoic acid (DHA) synthesis is impaired  [59], DHA supplementation was recommended, but a placebo-controlled study has since showed no clinical efficacy. Due to the defective bile acid synthesis, fat soluble supplements of vitamins A, D, E, and K are recommended. Prognosis
Currently, no cure for Zellweger syndrome is known, nor is there a standard course of treatment. Infections should be guarded against to prevent such complications as pneumonia and respiratory distress. Other treatment is symptomatic and supportive. Patients usually do not survive beyond one year of age. References
External links
Zellweger-Syndrome at NINDS
Zellweger syndrome at NIHs Office of Rare Diseases