Treatment for Borderline Personality Disorder
A diagnosis for borderline personality disorder may be shocking, disappointing, or concerning. But despite the impact it can have on a person’s life, BPD responds favorably to treatment. Those who suffer from it can expect to find lasting relief, if they emerge from the shadows to ask for the help they need. Psychotherapy is the cornerstone of BPD treatment plans, normally complemented by a combination of medication, skills training, education, and holistic healing methods that restore wellness and vitality.
Getting a Diagnosis
Diagnosing borderline personality disorder (BPD) can be a tricky proposition for mental health professionals. Its symptoms partially overlap with other types of mental illness, its prevalence has long been underestimated, and it often develops in the presence of co-occurring disorders that produce similar or conflicting symptoms, any of which can complicate diagnosis.
But once an accurate diagnosis for BPD has been made, the chances for recovery are excellent. BPD sufferers who seek professional help will have access to specialized therapies and other treatment methods with a proven track record of success.
Planning a Comprehensive Borderline Personality Disorder Treatment Program
Before treatment for borderline personality disorder begins, a clinician with expertise in this area should be selected to manage and coordinate the patient’s overall recovery program. Goals or milestones will be created, to motivate the patient and help them maintain a sustainable pace of recovery. Healing programs will be adjusted as they unfold to incorporate new approaches or strategies when progress stalls or is lacking.
While there will be some variation between individuals, the overall outline or structure for a BPD recovery plan will generally include the following essential features:
- Individual, group, and family psychotherapy. Medication-centered treatment has become the norm for many forms of mental illness, with therapy playing a supporting role. But with BPD the equation is reversed. Therapy remains the centerpiece of all BPD treatment plans, and special therapeutic approaches have been developed to cope with the unique symptoms of this surprisingly common condition.
- Medication. There are no drugs that specifically target borderline personality disorder. But there are still pharmaceutical medications available that can help ameliorate the symptoms of BPD, or its accompanying disorders.
- Education and life skills training. Classroom sessions that inform patients about the specifics of their mental health disorders, and/or provide instruction in techniques for the self-management of symptoms and their associated life complications, have become standard in mental health treatment regimens.
- Holistic healing methods. Included as a complement to more traditional style of therapy, holistic mind-body techniques are valuable to BPD sufferers for two reasons—first, because they are useful for stress reduction, and second, because they can help people develop more self-awareness and self-control.
- Additional treatment services for co-occurring health disorders. If other mental health disorders or substance use disorders are diagnosed, treatment programs must address those issues at the same time as they attend to the symptoms of BPD.
Individuals with borderline personality disorder who are suicidal, harming themselves compulsively, or undergoing severe episodes of dissociative symptoms may need to be hospitalized in a psychiatric facility until the crisis passes.
Types of Therapy for BPD
In both outpatient and inpatient treatment programs, psychotherapy is the core of a borderline personality disorder healing program. Most men and women seeking treatment for BPD will receive individual, group, and family-based counseling, with sessions offered as regularly as necessary.
While everyone’s program will include a few unique twists, most healing plans will include at least one or two the following forms of psychotherapy:
Dialectical Behavior Therapy (DBT)
Considered the gold standard of BPD therapies, dialectical behavior therapy was developed specifically to treat this disorder. With a practical orientation that focuses on overall health and quality of life, DBT teaches skills in emotional regulation, stress management, mindfulness and self-awareness, and interpersonal communication.
Mentalization-based Therapy (MBT)
Another therapy created for the benefit of BPD patients, mentalization-based therapy is designed to enhance the BPD sufferer’s ability to relate their behavior and feelings with specific mental states, not only in themselves but in other people. With this knowledge in hand, the patient can begin to expand their understanding of their condition as a prelude to eventual recovery.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is a fundamental part of most mental health disorder treatment regimens, including those that offer assistance to people with BPD. During CBT sessions, patients are taught to convert negative thought patterns into more positive and constructive mental states, until this habit becomes engrained.
Eye Movement Desensitization and Reprocessing (EMDR)
Through physical movements and mental focus, EMDR therapy helps patients with mental health issues work through past traumas safely and in an environment where the entire focus is on healing and recovery.
Transference-focused Psychotherapy (TFP)
In transference-focused psychotherapy, the emphasis is on building a positive, empathic relationship between patient and therapist, and that relationship then acts as a model for the patient’s behavioral and psychological reconstruction.
Schema-focused Therapy (SFT)
This imaginative form of psychotherapy helps patients work through their problems as they alternate between five modes or schemes that define the underlying personality of the BPD sufferer (according to SFT theory): the abandoned and confused child, the angry and impulsive child, the detached protector, the punitive parent, and the healthy adult.
Systems Training for Emotional Predictability and Problem Solving (STEPPS)
STEPPS is a 20-week group outpatient treatment initiative that combines cognitive-behavioral restructuring with practical skills training. Family members and friends are included in the training sessions, in order to help the BPD sufferer build a strong network of helpers and caregivers.
Family psychoeducation sessions offer guidance, information, and emotional support to the loved ones of BPD sufferers, for their benefit and to ensure their full cooperation in the recovery program of the person with the disorder.
Additional Therapies for Co-occurring Disorders
If co-occurring disorders are diagnosed they will require treatment as well. Integrated treatment programs for co-occurring mental or behavioral health conditions are specifically designed to manage multiple disorders simultaneously, and most of the therapies in a standard BPD treatment program are adaptable enough to address any other mental health problems that might be present.
Borderline Personality Disorder Medications
There are no drugs specifically developed for the treatment of borderline personality disorder. However, there are two classes of pharmaceuticals that can combat the most difficult and disabling symptoms of BPD: antipsychotics and mood stabilizers.
Antipsychotics are usually prescribed for schizophrenia, but when administered at lower doses they can help reduce the intensity of the cognitive and perceptual distortions that BPD sufferers sometimes experience. Extreme thinking, paranoia, and dissociative episodes can significantly disrupt the lives of men and women with borderline personality disorder, but antipsychotics can help them manage those symptoms and reconnect with reality.
Mood stabilizers are the drug of choice for BPD sufferers who struggle with impulsivity and are prone to emotional outbursts. They can help reduce the intensity of the explosive anger individuals with BPD sometimes experience, and they can also counteract the disabling anxiety that is such a frequent companion of this pervasive mental health disorder.
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Education, Skills Training, and Holistic Healing Practices
Many BPD sufferers benefit from specialized skills training courses that teach them techniques for coping with BPD symptoms and/or their triggers. Learning self-management skills is vital for the health and welfare of people with mental health disorders, since medications don’t always work and therapists aren’t available 24 hours-a-day outside of residential treatment facilities.
Meanwhile, informational classes can help people with borderline personality disorder deepen their understanding of their conditions, clearing up misconceptions that might hinder their commitment to recovery. The knowledge they gain about BPD can help them recognize symptoms in the early stages, and also give them a much better idea of where they stand on the borderline personality disorder continuum.
Holistic mind-body healing methods are routinely offered in residential mental health treatment centers these days, and they can certainly be beneficial for individuals with BPD during outpatient programs as well. People with this disorder struggle to manage their emotions, and holistic practices are designed to address this exact problem.
Some of the more effective mind-body healing methods for people with mental health disorders include:
- Art or music therapy
- Equine therapy
- Massage therapy
- Tai Chi
- Fitness classes
- Nutritional therapy
Holistic healing methods keep recovering BPD sufferers focused on their overall health and not just their illness, as they re-energize their minds, bodies, and spirits.
The Value of Inpatient Treatment for Borderline Personality Disorder
In clinical settings, borderline personality disorder sufferers comprise 10 percent of those in outpatient treatment, and up to 20 percent of those receiving inpatient treatment at residential facilities. The latter statistic is notable, because it reflects the understanding of mental health professionals that inpatient treatment services are highly valuable for BPD patients during the initial stages of their recovery.
If individuals with borderline personality disorder remain diligent and committed to outpatient treatment, they have a real chance to achieve long-term, symptom-free status. But to ensure the best results, the wisest course of action for most BPD sufferers is to begin their recovery in a residential treatment facility. What they learn during inpatient treatment will stay with them after they return to their regular lives, and give them a strong foundation to build on once they transition to a less intensive outpatient program.
Overall, the outlook following treatment is excellent for men and women with BPD, and that is a testament to how much the mental health profession has learned about this formerly misunderstood condition.