Borderline Personality Disorder Treatment

What is Borderline Personality Disorder (BPD)?

Being able to feel emotions is part of what makes us human. But when we fail to regulate them, it can impact our relationships and ability to function. When you develop borderline personality disorder, you may feel overwhelmed and struggle with managing your emotions. Whether you need help with BPD or want to assist a loved one with the condition, let’s discuss different treatment approaches and therapies, including an inpatient treatment program.

BPD is one of the mental health conditions in the category of personality disorders. It’s characterized by a consistent pattern of instability with respect to your self-image, emotions, and relationships. It also causes you to behave impulsively. If you have BPD, it’s likely that your views about yourself and others shift rapidly, which can lead to emotional pain and suffering. According to the National Institutes of Health, prevalence rates of BPD are around 1.6 percent among the general population. Meanwhile, about 20 percent of the inpatient population has a BPD diagnosis. Research indicates that the BPD prevalence rate is higher among women than men.

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Signs and Symptoms of BPD

Borderline personality disorder begins in early adulthood, and you may present with the following symptoms:

Making efforts to avoid abandonment
Experiencing intense and unstable relationships because of alternating between phases of idealization and devaluation
Disturbed sense of self
Self-damaging impulsive behavior in two or more areas, such as substance abuse and sex
Suicidal behavior, threats, or gestures
Abrupt shifts in mood
Persistent feelings of emptiness
Intense emotions such as anger and difficulty in controlling them
Transient paranoid ideation or dissociation induced by stress

Causes of Borderline Personality Disorder

There’s no specific cause that can lead to borderline personality disorder. Rather, it can be attributed to a combination of factors, such as the following:

Genetics: There’s evidence that the condition runs in families, so there’s a high chance of inheriting the condition from a parent if they suffer from the condition.

Neurotransmitter Imbalance: Studies indicate that neurotransmitter dysfunction can play a role in the development of certain borderline personality disorder traits, such as impulsivity and aggression.

Differences in Brain Development: Research on the brains of people with BPD show reduced volume of brain areas like the orbitofrontal cortex, amygdala, and hippocampus.

A response to Trauma: As a response to early trauma, lack of attachment or difficult events in childhood as a coping mechanism that develops as an intelligence of the system.

In addition to the above-mentioned causes, certain environmental factors can trigger the development of BPD as well. These include long-term distress, physical or sexual abuse, or childhood neglect. Similarly, growing up in the same household as a family member with a mental illness like substance use disorder or bipolar disorder can increase the risk of developing BPD as well.

How is Borderline Personality Disorder Diagnosed?

To diagnose you with borderline personality disorder, you’ll need to go through a series of assessments and evaluations by a licensed mental health practitioner and a physician.

A physician will perform a medical evaluation to rule out the possibility that your symptoms are the result of a medical condition or substance abuse.
Then, your mental health care provider will perform a psychiatric assessment, which can also include looking at your family history and speaking with close friends and family.
Lastly, a psychiatrist will compare your symptoms with the criteria mentioned in the DSM-5.

Inpatient Treatment for Borderline Personality Disorder (BPD)

When you have borderline personality disorder, you have a higher likelihood of engaging in impulsive, self-destructive behavior, self-harm, explosive anger, and extreme emotional mood swings. All of these can put you at risk of experiencing or causing potential injury.

In these situations, it’s possible that your family and friends will be unequipped to provide adequate support and assistance. Therefore, the best approach is to seek treatment at a residential facility like URP Behavioral Health. When you’re part of an inpatient treatment program, you’ll be under constant supervision and receive regular therapy in a calm and comfortable environment.

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How Is Borderline Personality Disorder Treated?

To treat borderline personality disorder, your mental health care provider will use more than one approach. Rather, they'll develop a multi-faceted plan that involves a variety of therapies like schema focused therapy, mentalization based therapy, and dialectical behavior therapy.

Psychotherapy Treatment for BPD

The main approach to treating BPD involves psychotherapy, which can take a number of forms. Commonly known as talk therapy, it is adapted according to your needs to help manage symptoms and improve your condition.

A trained mental health professional will conduct sessions with a group, your family members, or one-on-one. In these sessions, you’ll get a chance to talk about your condition and learn skills to manage uncomfortable emotions.

Medications for BPD

As of now, no drugs have been formulated specifically for the treatment of borderline personality disorder. However, your psychiatrist may prescribe medication to alleviate co-occurring symptoms that may occur as a result of BPD symptoms. For instance, anxiety, depression, or aggression.

Therefore, you may have to take antidepressants, mood stabilizers, or antipsychotics as part of your treatment plan. In addition to alleviating co-occurring symptoms, medications can also stabilize your mental condition, making you more receptive to therapy.

Dialectical Behavior Therapy (DBT)

Stemming from cognitive behavioral therapy, DBT is an evidence-based practice that’s designed specifically for the treatment of borderline personality disorder. Dialectical behavior therapy focuses on helping you build four crucial skills, namely distress tolerance, mindfulness, emotional regulation, and interpersonal effectiveness.

Once you develop these skills, you’ll learn to use them to target common BPD symptoms, like emotional stability, fear of abandonment, chaotic relationships, and an unstable sense of self. Similarly, this therapy can also assist in reducing impulsive and self-destructive behaviors.

Transference-Focused Individual Psychotherapy

Individual psychotherapy is a crucial aspect of any treatment plan, and your therapist can implement it using a number of different perspectives. The concept of transference comes from the psychoanalytic perspective and involves projecting how you feel about someone else onto your therapist.

In transference focused psychotherapy, your therapist will work with you to determine the underlying cause of your condition. It’s based on the notion that the way you feel about others will emerge during therapy sessions. Then, your therapist will focus on this aspect to help you build healthy relationships with others.

Nonverbal Therapies

Art therapy is a nonverbal method that’s often used as an additional approach in the treatment of personality disorders. It’s an experiential method of treatment that allows you to express your innermost feelings. It relies on art supplies, the creative process, and the resulting artwork to help you reflect on problematic themes with help from an art therapist. In this way, you have a chance to explore feelings without expressing them verbally.

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References

FAQs for Borderline Personality Disorder

Here are some of the most commonly asked questions regarding borderline personality disorder.

You can learn more about borderline personality disorder by viewing different resources by the National Institute of Mental Health and the Substance Abuse and Mental Health Services Administration. These include:

Journal articles that provide insights on current and previous research regarding the condition.
Statistics that inform you about the rate of personality disorders and prevalence in different parts of the world.
Federal resources such as the introductory guide by SAMHSA
Shareable content that’s designed to spread awareness about the condition.
Brochures and other content to inform the public and increase support for people with BPD.

Of course, the best way to learn more about the condition is to speak with a mental health practitioner, who can give you appropriate advice on managing your condition.

To get help for borderline personality disorder, you can seek out professional services and support groups. Speak with a mental health professional in your area to learn more about local support groups and other services that you can benefit from. And if your symptoms are causing clinically significant distress, it’s best to enroll in a residential program designed to help you manage symptoms and improve your sense of well-being.

Although you can’t prevent borderline personality disorder from developing in the first place, one study explains that it’s possible to prevent new cases among young adults. This is possible by identifying sub-threshold symptoms in children and adolescents. Through early detection and intervention, you can avoid functional impairment and ensure successful outcomes. This is important because delayed intervention and discrimination can lead to negative effects that exacerbate your symptoms and impair your ability to recover.

Before you can help someone who may have a borderline personality disorder, it’s important to know the signs and symptoms. If a loved one goes from one extreme emotion to another, or if it feels like you’re walking on eggshells around them, these are a few signs that they have BPD. You can help them by:

Listening to them.

Focusing on their emotions rather than how they express them.

Make them feel heard.

Distract them with a relaxing activity when their emotions reach a peak.

Discuss options for treatment and offer to go with them for emotional support.

If they engage in self-destructive behavior, call emergency services.

You should speak to your healthcare provider if your symptoms are causing significant impairment to daily activities and negatively affecting your relationships. Similarly, you should do so if you experience the urge to engage in self-destructive behaviors. Your healthcare provider will refer you to a mental health expert who can assess your symptoms and recommend a suitable treatment plan.

Author/Medically Reviewed by:

Dr. Emilio Mantero-Atienza, MD, Ph.D, MPH

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