Borderline Personality Disorder

There are good long-term outcomes for people experiencing BPD who engage in a comprehensive treatment plan. Most experience the best results using a combination of psychotherapy, peer and family support and medications (when indicated) to address their symptoms. People with BPD often have other co-occurring conditions and their treatment plan should address these as well.

Work with your treatment team to understand the risks and benefits of each of these individual courses of action as well as how they work with each other.

Psychotherapy

Psychotherapy is considered the cornerstone for treating BPD because it aims to address the emotional dysregulation associated with the condition. A hallmark of effective treatment is learning to master dysregulation with coping skills, insight and acceptance. There are several types of psychotherapy that have shown to be effective in doing this:

  • Dialectical behavioral therapy (DBT) focuses on teaching coping skills to combat counterproductive urges, regulate emotions and improve relationships. Involving individual and group work, DBT encourages practicing mindfulness techniques such as meditation, regulated breathing and self-soothing. DBT has been shown to be effective in reducing suicidal behavior, psychiatric hospitalization, treatment dropout, substance abuse, anger and interpersonal difficulties. Learn more about DBT.
  • Cognitive behavioral therapy (CBT) helps address the negative thinking and behaviors associated with BPD. The goal of this therapy is to recognize negative thoughts and learn effective coping strategies.
  • Mentalization-based therapy (MBT) teaches people how to become conscious of their internal states and how to develop empathy for other people’s experiences. This treatment is also used to explore emotions and develop alternative explanations for negative interactions with others.

Medications

There is no singular medication designed to specifically treat the core symptoms of BPD. Medications can be useful in treating certain symptoms associated with BPD, such as depression and anxiety. They can also be used to help increase a person’s ability to engage in psychotherapy.

Level of Care

While most people can live in the community during their treatment (outpatient), higher levels of care may be useful at moments when more intensive clinical support is needed. For example, a hospital inpatient unit can provide a safe environment for a person with BPD who is actively suicidal.

In the DBT framework, the goal is usually to learn coping skills while in the community; it is not organized around inpatient care. Though, there are some facilities that have a DBT track in inpatient-partial hospital program, which is a model where you sleep at home and attend during the day. It’s important to determine the level of care you or your loved one might require before engaging in (and throughout the duration of) treatment.

 

Reviewed December 2017