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Borderline Personality Disorder Treatment

Borderline Personality Disorder (BPD) is a mental health condition characterized by pervasive patterns of instability in relationships, self-image, and emotions. Belonging to the family of Cluster B Personality Disorders, individuals with BPD may experience intense mood swings, impulsive behavior, and difficulty forming stable interpersonal connections. Borderline Personality Disorder (BPD) is often treated through a combination of psychotherapy, medication, and support from mental health professionals. Additionally, support groups and family therapy play crucial roles in providing a comprehensive support system for individuals with BPD. Treatment plans are often tailored to the individual’s unique needs and challenges to foster long-term emotional stability and improved quality of life.

Borderline Personality Disorder Diagnosis

The diagnosis of Borderline Personality Disorder (BPD) is similar to diagnosing most personality disorders, typically involves a thorough assessment by mental health professionals, often including psychiatrists, psychologists, or licensed therapists. Diagnostic criteria are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which clinicians use to identify specific symptoms and patterns associated with BPD.

The diagnostic process involves a comprehensive evaluation of the individual’s thoughts, emotions, behaviors, and interpersonal relationships. It may also include interviews with the person and, if possible, collateral information from friends or family members. To meet the criteria for BPD, an individual must exhibit a pervasive pattern of instability across multiple domains. While self-reporting plays a significant role, an accurate diagnosis requires a skilled clinician’s expertise to differentiate BPD from other mental health conditions. A thorough understanding of the individual’s history, symptoms, and functioning is crucial, ensuring a precise diagnosis that forms the basis for an effective and tailored treatment plan.

Therapy for Borderline Personality Disorder

Therapy plays a pivotal role in treating Borderline Personality Disorder (BPD), and several approaches have shown efficacy in helping individuals manage symptoms and improve their overall well-being. Dialectical Behavior Therapy (DBT) is a widely recognized and effective therapeutic approach for BPD. It focuses on enhancing emotional regulation, interpersonal skills, distress tolerance, and mindfulness.

Cognitive-behavioral therapy (CBT) is another commonly used method that addresses distorted thought patterns and behaviors associated with BPD. Schema-focused therapy targets the underlying negative patterns and beliefs developed during childhood that contribute to BPD symptoms. Mentalization-based therapy emphasizes understanding one’s own and others’ mental states to enhance interpersonal relationships. Transference-focused psychotherapy aims to explore and understand problematic relationship patterns.

Group Therapy and Family Therapy are also beneficial, providing support and improving communication within a structured environment. The choice of therapy depends on individual needs and preferences, and often, a combination of therapeutic approaches is employed for a comprehensive and tailored treatment plan.

Medication Treatment for Borderline Personality Disorder

Medication management is often considered as part of a comprehensive treatment plan for Borderline Personality Disorder (BPD), although medications alone are not typically the primary intervention. Medications may be prescribed to target specific symptoms associated with BPD. Commonly used medications include:

Mood Stabilizers

Mood stabilizers are prescribed to help people with BPD even out dramatic mood swings and impulsive behaviors. Commonly prescribed mood stabilizers for those with BPD include:

  • Lithobid (lithium)
  • Depakote (valproate)
  • Lamictal (lamotrigine)
  • Tegretol or Carbatrol (carbamazepine)

Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) or other antidepressants may be prescribed to alleviate symptoms of depression or anxiety. Antidepressants were originally developed for people with major depressive disorder and other disorders characterized by low mood. But many people with BPD are treated with these medications as well.

There are many types of antidepressants that have been studied for use with BPD. These include tetracyclic and tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs).

Common antidepressants used for BPD treatment include:

  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)
  • Venlafaxine (Effexor)
  • Duloxetine (Cymbalta)
  • Fluvoxamine (Luvox)
  • Bupropion (Wellbutrin)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)

Antipsychotics

In some cases, antipsychotic medications can be used to address mood instability and distortions in thinking. Antipsychotics can be useful for treating BPD symptoms such as anger, aggression, impulsivity, and cognitive–perceptual disturbances.

Common antipsychotics include:

  • Abilify (aripiprazole)
  • Geodon (ziprasidone)
  • Risperdal (risperidone)
  • Seroquel (quetiapine)
  • Zyprexa (olanzapine)

It’s essential to note that medication management for BPD is individualized, and the choice of medication depends on the specific symptoms and needs of the person.

LifeStance psychiatrists excel in tailoring medication regimens for individuals with Borderline Personality Disorder (BPD), demonstrating a nuanced understanding of the disorder’s diverse symptoms. With their expertise, they navigate the complexities of BPD, selecting the optimal combination of medications to address specific manifestations, ensuring a personalized and effective treatment approach.

photo of LifeStance provider Nicholette Leanza, LPCC-S
Clinically Reviewed By:
Nicholette Leanza, LPCC-S
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Nicholette is a faculty member at John Carroll University’s Clinical Counseling program, and she is also the host of the LifeStance podcast, Convos from the Couch.

Medically Reviewed By:
Nicholette Leanza, LPCC-S
View Profile

Nicholette is a faculty member at John Carroll University’s Clinical Counseling program, and she is also the host of the LifeStance podcast, Convos from the Couch.