Borderline personality disorder is mainly treated using psychotherapy, but medication may be added. Your doctor also may recommend hospitalization if your safety is at risk.
Treatment can help you learn skills to manage and cope with your condition. With treatment, you can feel better about yourself and live a more stable, rewarding life.
Psychotherapy — also called talk therapy — is a fundamental treatment approach for borderline personality disorder. Your therapist may adapt the type of therapy to best meet your needs. The goals of psychotherapy are to help you:
- Focus on you current ability to function
- Learn to manage emotions that feel uncomfortable
- Reduce your impulsiveness by helping you observe feelings rather than acting on them
- Work on improving relationships by being aware of your feelings and those of others
- Learn about borderline personality disorder
Types of psychotherapy that have been found to be effective include:
- Dialectical behavior therapy (DBT). DBT can include group or individual therapy designed specifically to treat borderline personality disorder. DBT uses a skills-based approach to teach you how to manage your emotions, tolerate distress and improve relationships.
- Schema-focused therapy. Schema-focused therapy can be done individually or in a group. It can help you identify unmet needs that have led to negative life patterns, which at some time may have been helpful for survival, but as an adult are hurtful in many areas of your life. Therapy focuses on helping you get your needs met in a healthy manner to promote positive life patterns.
- Mentalization-based therapy (MBT). MBT is a type of talk therapy that helps you identify your own thoughts and feelings at any given moment and create an alternate perspective on the situation. MBT emphasizes thinking before reacting.
- Systems training for emotional predictability and problem-solving (STEPPS). STEPPS is a 20-week treatment which involves working in groups that incorporate your family members, caregivers, friends or significant others into treatment. STEPPS is used in addition to other types of psychotherapy.
- Transference-focused psychotherapy (TFP). Also called psychodynamic psychotherapy, TFP aims to help you understand your emotions and interpersonal difficulties through the developing relationship between you and your therapist. You then apply these insights to ongoing situations.
- General psychiatric management. This treatment approach relies on case management and focuses on making sense of emotionally difficult moments by considering the interpersonal context for feelings. It may integrate medications, groups, family education and individual therapy.
Although no drugs have been approved by the Food and Drug Administration specifically for the treatment of borderline personality disorder, certain medications may help with symptoms or co-occurring problems such as depression, impulsiveness, aggression or anxiety. Medications may include antidepressants, antipsychotics or mood-stabilizing drugs.
Talk to your doctor about the benefits and side effects of medications.
At times, you may need more-intense treatment in a psychiatric hospital or clinic. Hospitalization may also keep you safe from self-injury or address suicidal thoughts or behaviors.
Recovery takes time
Learning to manage your emotions, thoughts and behaviors takes time. You may need many months or years of treatment, and you may always struggle with some symptoms of borderline personality disorder. You may experience times when your symptoms are better or worse. But treatment can improve your ability to function and help you feel better about yourself.
Because treatment can be intense and long term, you have the best chance for success when you consult mental health providers who have experience treating borderline personality disorder.
July 30, 2015
- Personality disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed July 1, 2015.
- Borderline personality disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/borderline-personality-disorder/index.shtml. Accessed July 1, 2015.
- Silk KR. Borderline personality disorder: Epidemiology, clinical features, course, assessment, diagnosis, and differential diagnosis. http://www.uptodate.com/home. Accessed July 1, 2015.
- Silk KR. Treatment of borderline personality disorder. http://www.uptodate.com/home. Accessed July 1, 2015.
- Newlin E, et al. Personality disorders. Continuum: Lifelong Learning in Neurology. 2015;21:806.
- Gonzalez CA (expert opinion). Mayo Clinic, Rochester, Minn. July 16, 2015.
- Palmer BA (expert opinion). Mayo Clinic, Rochester, Minn. July 12, 2015.