The onset of borderline personality disorder (BPD) is primarily linked to childhood abuse and neglect. There can be genetic and biological factors, but those occurrences are not as common. If you are suffering from BPD you may be wondering what is the best treatment for BPD. Mental health professionals who study BPD describe the associated symptoms as adaptations to traumatic events and chaotic environments during early childhood development. For this reason, the most successful BPD treatments focus on processing traumatic events and learning to gain control of emotions.
The Importance of Accurate Diagnosis
So, you might be asking yourself “Can BPD be cured?” “What are the cures for BPD?” or “Do BPD treatment options really work?”
Personality disorders are notably more difficult to treat than mood disorders as they pertain to the individual’s actual personality or character rather than just their transient state. Personality is at the “trait” level and is generally thought to be enduring and stable over time. This is in contrast to moods that are at the “state” level and are more transient and malleable.
Having said that, research into the treatment or management of borderline personality disorder has rendered promising results. But it’s extremely important to be correctly diagnosed before starting any treatment plan.
The 10 personality disorders can be categorized into three clusters: Cluster A (eccentric or odd), cluster B (erratic or dramatic) and cluster C (fearful or anxious). Personality disorders in each cluster share certain similarities. For this reason, it can sometimes be tricky to distinguish between them and for therapists to pinpoint which one their patient has.
Identifying the Disorder Informs the Treatment
The line of treatment will differ depending on which personality disorder you might have, so having an accurate diagnosis from the beginning is paramount to a successful treatment strategy.
The current way of diagnosing personality disorders involves the use of the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5-TR). It offers the most widely accepted criteria for diagnosis and should be used by any psychological professional administering a diagnosis.
Mistaking borderline personality disorder for antisocial personality disorder, for example, could lead to the wrong treatment delivery. This would ultimately complicate your overall management plan and success. While treatment for people with an antisocial personality disorder might focus on educating the individual on why being considerate of others is beneficial to them, treatment for BPD is different.
BPD treatment options typically involve some form of cognitive-behavioral therapy, with dialectical behavior therapy proving to be the most efficacious. Dialectical behavior therapy has four components:
- Skills training
- Individual therapy
- Phone coaching
- Consultation team
Treatment options for borderline personality disorder include therapy, medication, lifestyle changes, or a combination of any of these options.
Counseling to Treat Borderline Personality Disorder
Psychotherapy is a fundamental treatment option for those who are diagnosed with BPD. A therapist who is experienced with the treatment of BPD will set the following goals:
- Learn about BPD including how and why it presents
- Prioritize your ability to function on a daily basis
- Reduce impulsiveness by managing your feelings
- Improve relationships by being more self-aware
- Develop coping skills for BPD
Types of Effective Methods of Psychotherapy
Mentalization-based therapy. MBT is a talk therapy method that reinforces thinking before reacting.
Schema-focused therapy. Conducted individually or in a group therapy setting, schema-focused therapy looks at your hierarchy of needs and identifies healthy ways to get your needs met.
Transference-focused psychotherapy. TFP focuses on developing healthy relationships as a way to better understand your emotions and struggles with interpersonal relationships.
Dialectical behavior therapy. DBT can be implemented either individually or in a group setting. The therapy is a skills-based approach designed to teach you to handle distress in healthy ways and improve relationships.
The Importance of Medical Integration to Treat BPD
If you suspect that your symptoms and behaviors are consistent with BPD, it is important to schedule a full medical workup from your primary care doctor. Many times BPD symptoms can occur as the result of other undiagnosed medical ailments. Nearly half of the people with BPD experience anxiety, mood or substance use disorders as well. Responsible health care providers will rule out other health issues and evaluate for co-occurring conditions before diagnosing you with BPD. Once a diagnosis is made, the combined genetic and environmental risk factors for developing BPD can be effectively met with a treatment plan that integrates both therapy and medication.
Medication to Treat Borderline Personality Disorder
Personality disorders, such as BPD, typically develop by the end of adolescence or early adulthood. Symptoms of BPD are established during early childhood years, retained in the psyche, and cause changes in behavior and self-identification. Because BPD is oftentimes the result of severe trauma, therapy is most effective and using medications to treat BPD is less common.
Health care providers will carefully evaluate you before prescribing medication. One reason is that BPD patients have an increased likelihood of self-harm which makes prescribing medications that could be used to overdose a viable concern. Historically, clinicians believed that BPD was nearly impossible to treat and ruled out pharmacotherapy as an option. Modern-day treatments include interventions using medications and have proven successful.
