How is borderline personality disorder treated?
Borderline personality disorder has historically been viewed as difficult to treat. But with newer, evidence-based treatment, many people with borderline personality disorder experience fewer and less severe symptoms, improved functioning, and an improved quality of life. It is important for patients with borderline personality disorder to receive evidence-based, specialized treatment from an appropriately-trained mental health professional. Other types of treatment, or treatment provided by a provider who is not appropriately trained, may not benefit the patient.
Many factors affect the length of time it takes for symptoms to improve once treatment begins, so it is important for people with borderline personality disorder and their loved ones to be patient and to receive appropriate support during treatment.
It is important to seek—and stick with—treatment.
Studies indicate that borderline personality disorder patients who don’t receive adequate treatment are more likely to develop other chronic medical or mental illnesses and are less likely to make healthy lifestyle choices. Borderline personality disorder is also associated with a significantly higher rate of self-harm and suicidal behavior than the general population.
Suicide and Self-Harming Behaviors
Borderline personality disorder is associated with higher rates of suicide and self-harming behaviors. Patients with borderline personality disorder who are thinking of harming themselves or attempting suicide need help right away.
The treatments described below are just some of the options that may be available to a person with borderline personality disorder.
Psychotherapy
Psychotherapy is the first-line treatment for people with borderline personality disorder. It can be provided one-on-one between the therapist and the patient or in a group setting. Therapist-led group sessions may help teach people with borderline personality disorder how to interact with others and how to express themselves effectively. It is important that people in therapy get along with and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with this disorder to maintain a comfortable and trusting bond with their therapist.
Two examples of psychotherapies used to treat borderline personality disorder includeDialectical
Behavior Therapy (DBT)andCognitive Behavioral Therapy (CBT).
DBT, which was developed for individuals with borderline personality disorder, uses concepts of mindfulness and acceptance or being aware of and attentive to the current situation and emotional state.
DBT also teaches skills to control intense emotions, reduce self-destructive behaviors, and improve relationships.
CBT can help people with borderline personality disorder identify and change core beliefs and behaviors that underlie inaccurate perceptions of themselves and others and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.
Medications
Medications are not typically used as the primary treatment for borderline personality disorder as the benefits are unclear. However, in some cases, a psychiatrist may recommend medications to treat specific symptoms, such as mood swings, depression, or other mental disorders that may occur with borderline personality disorder. Treatment with medications may require care from more than one medical professional.
Certain medications can cause different side effects in different people. Individuals should talk to his or her provider about what to expect from a particular medication.
Other Elements of Care
Some people with borderline personality disorder experience severe symptoms and require intensive, often inpatient, care. Other people may need outpatient treatments but never need hospitalization or emergency care.
Therapy for Caregivers and Family Members
Families of people with borderline personality disorder may also benefit from therapy. Having a relative with the disorder can be stressful, and family members may unintentionally act in ways that worsen their relative’s symptoms.
Some borderline personality disorder therapies include family members in treatment sessions. These sessions help families develop skills to better understand and support a relative with borderline personality disorder. Other therapies focus on the needs of family members to help them understand the obstacles and strategies for caring for someone with borderline personality disorder. Although more research is needed to determine the effectiveness of family therapy in borderline personality disorder, studies on other mental disorders suggest that including family members can help in a person’s treatment.
What research is being done to improve the diagnosis and treatment of borderline personality disorder?
Research on borderline personality disorder is focusing on biological and environmental risk factors, with special attention on symptoms that may emerge at a young age. Researchers are conducting studies focused on adolescents at risk for borderline personality disorder to develop methods that help identify the disorder early. Borderline personality disorder research is also focused on the development and evaluation of psychotherapy and pharmacological interventions to prevent self-harming and suicidal behaviors, which occur at a high rate among people with borderline personality disorder.
Source: Adapted from information provided by the National Institute of Mental Health (NIMH) open licence.
