Borderline Personality Disorder
Affecting millions worldwide, Borderline Personality Disorder (BPD) is one of the most misjudged mental health conditions today. Characterized by the inability to regulate one's emotions, borderline personality disorder can make a person feel unstable, uncertain, and insecure. Because this disorder's issues start in childhood, it can take many years for a person to be appropriately diagnosed with Borderline Personality Disorder. Therapy was once thought to be ineffective for treating this condition, but newer treatment methods like DBT and BPD online therapy are now helping people overcome their self-destructive relationship patterns and create lives that are much more manageable.
Symptoms And Signs Of Borderline Personality Disorder
The National Institute of Mental Health (NIH) defines Borderline Personality Disorder as an illness marked by an ongoing pattern of varying moods, self-image, and behavior. There are a variety of psychological therapies available to people with BPD, and they all take their own approach. Options include schema therapy, mentalization based therapy and transference focused psychotherapy. Therapy focuses on each individual’s BPD symptoms, and it’s important that each client trusts their therapist throughout the process.
An individual with Borderline Personality Disorder often displays uncertainty and mood swings with how they perceive themselves and others.
Specific signs and symptoms of BPD:
- Extreme efforts to avoid being abandoned (sometimes the abandonment is only imagined.)
- Unstable relationships and patterns with friends and family.
- Frequent mood swings when emotionally triggered that range from love (idealizing) to anger or hatred (devaluing).
- Disturbance of identity/unstable sense of self.
- Inappropriate bouts of anger that seem uncontrollable and are usually followed by other intense emotions.
- Impulsive behavior or actions that are self-destructive such as unsafe sex, reckless driving, binge eating, and spending sprees.
- Regular feelings of emptiness or boredom
- Threats, as well as the recurring thought of suicide and cutting.
- The feelings of dissociation, for instance, seeing oneself from the outside body as well as cutting off from oneself is another symptom found in the borderline disorder
The nine criteria listed above are used to diagnose Borderline Personality Disorder. Therapy takes place after an accurate mental health analysis and diagnosis, but not every person with a Borderline Personality Disorder experiences every single symptom. Some people struggle with only a few of these issues while another individual experiences all of the criteria at one point or another. To be diagnosed with Borderline Personality Disorder, a person has to experience at least 5 out of 9 symptoms.
Borderline Personality Disorder Diagnosis
According to the Mayo Clinic, Borderline Personality Disorder is diagnosed through the following steps:
- An interview with a doctor/mental health professional trained in diagnosing and treating personality disorders.
- Discussing of symptoms, past experiences.
- A psychological evaluation and medical exam.
Many Borderline Personality symptoms often mirror other psychological diseases. Therefore, it is historically harder to diagnose and treat than many other mental health conditions. Children are rarely diagnosed with Borderline Personality Disorder since emotional instability is common and somewhat normal in people under the age of 18.
Lots of people self-diagnose, figuring out that they have Borderline Personality Disorder through online assessments or research, but it is important to get an official evaluation before pursuing the following treatment options.
Therapies And Treatment
Borderline Personality Disorder is considered hard to treat for two main reasons. First, many mental health officials stigmatize the disorder and believe the stereotype that "BPD can't be treated." Some therapists even decline to treat patients with BPD, assuming that they will be wasting their time.
The second treatment hurdle has to do with the most common cause of Borderline Personality Disorder. A personality disorder by definition is compromised by ingrained patterns of thinking-which are difficult to change. Most people with Borderline Personality Disorder experienced childhood trauma that caused them to develop unhealthy coping mechanisms early in childhood. It can be many years before they realize that their way of dealing with problems and other people isn't working. The reversal of these patterns can be difficult.
Still, people diagnosed with this disorder shouldn't give up hope. Treatment options are available for Borderline Personality Disorder. Therapy is the place to start.
Psychotherapy
Psychotherapy is a line of Borderline Personality Disorder therapy for individuals with this disorder. Also known as "talk therapy" this treatment option help people with emotional issues, depression, personality disorders, and other mental health issues improve symptoms and solve problems.
It's important to realize that psychotherapy isn't "one size fits all." There are many different types of psychotherapy. One of the most promising treatments for personality disorder being Dialectical Behavior Therapy, a kind of Cognitive Behavior Therapy.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is a type of talk-therapy used to treat various mental health issues including Borderline Personality Disorder. Benefits include:
- Better management of symptoms
- Help to cope with grief/loss
- Healing of past trauma
- Recovery from problems that medication can't assist with
- Better regulation of emotions
- Healthier relationships/resolution of conflicts
During CBT, a licensed counselor or other mental health professional encourage their patient to talk about his or her thoughts and feelings. Specific problems are often targeted, especially when goal-oriented therapy tactics are used. Generally, with someone with Borderline Personality Disorder, therapy sessions that are CBT in nature are structured like this:
- A problem or issue is discussed
- The client is made aware of his or her thoughts, feelings through this discussion
- Any negative thinking, behaviors, beliefs or patterns are addressed
- These negative patterns are 'reshaped,' and new ways of responding are pinpointed
Dialectical Behavior Therapy (DBT)
DBT is a form of CBT (see above) that has proven beneficial for those struggling with Borderline Personality Disorder. The goal of Dialectical Behavior Therapy is to equip those with Borderline Personality Disorder with skills and coping mechanisms that allow Borderline Personality Disorder patients to better deal with overwhelming emotions and relationship conflict. One great thing about DBT therapy is that it is structured and provides assistance in four specific areas:
- Mindfulness skill focuses on improving a person's ability to present in the current moment and accept things as they are.
- Distress Tolerance. This area helps you better tolerate and learn from suffering.
- Emotional Regulation. The focus of emotional regulation is helping patients change and manage intense emotion causing problems in an individual's life.
- Interpersonal Effectiveness. This section consists of techniques that allow an individual to communicate with other people assertively, strengthen relationships as well as maintain self-respect.
How Dialectical Behavior Therapy Works
With Borderline Personality Disorder, therapy sessions help the person discover ways of holding opposite perspectives at once, avoiding black and white, and promoting balance. Dialectical Behavior Therapy differs from traditional CBT in the fact that it works on changing long-term patterns and daily life, not just specific goals. One main focus of DBT is to encourage patients to 'build a life worth living.'
Specific things that are important to know about DBT:
- With BPD, therapy sessions using DBT are personalized. No two treatment plans are alike, and this customization allows for better-targeted management of symptoms.
- All about improvement, DBT focuses on securing a more robust sense of self and self-image.
- It can also help people learn to be more confident and stand up for themselves, teaching those with BPD to say "no" when necessary.
- DBT can help target addiction and addictive behaviors that often plague people with BPD.
- Emotional intelligence is gained through DBT tools since they teach creating boundaries, protecting self-interest, and patience.
Common DBT skills recommended to patients include:
- DEAR MAN: People struggling to communicate effectively can use the "DEAR MAN" to better express themselves. The acronym stands for describe, express, assert, reinforce, mindful, appear, and negotiate.
- Radical Acceptance: The act of accepting our reality instead of holding on to unrealistic expectations or wallowing in victimized statements like "this isn't fair" and "this shouldn't be happening."
- Nonjudgmental Stance: Avoiding assigning value or "right" and "wrong" to situations. For example, one of your coworkers shows up late for work, causing you to have to stay 20 extra minutes. Instead of thinking negative thoughts like "she doesn't respect my time" and getting upset, someone practicing this skill will take a nonjudgmental stance and instead focus on facts "I don't like staying late, so this has made me a little upset."
- Opposite to Emotional Action: Instead of stuffing down painful emotions or acting on them, this therapy strategy for BPD helps people find opposite ways of acting that are not self-destructive.
- The Wise Mind: This theory holds that we have three types of thoughts/emotional behaviors. The first is the 'reasonable mind' and the second the 'emotional mind.' The third is a balance of the two, known as 'wise mind.' This strategy helps those struggling with emotional regulation find a middle ground.
Finding The Right Therapist
You will want to find a therapist who is trained in DBT and knows how to use these tools to address the self-destructive and harmful aspects of Borderline Personality Disorder.
More than any other condition, it is vital that those struggling with Borderline Personality Disorder find someone who is comfortable with DBT and knows that when it comes to Borderline Personality Disorder, therapy is both necessary and beneficial.
For this reason, calling a random therapist you find on Yelp or see in a local ad isn't recommended. Instead, you might consider using a therapy matching service such as BetterHelp and allowing them to match you with the perfect mental health counselor for you. Having therapy tailored to your needs will make recovery much more likely.
Frequently Asked Questions (FAQs)
Can you self treat BPD?
Treating Borderline Personality Disorder on your own won’t get the best results, and you shouldn’t feel alone in working on your mental health.
BPD is a serious mental disorder that is best treated by mental health professionals. There are a variety of therapy models that can be utilized to help offset BPD symptoms, such as schema focused therapy. Talk therapy and group therapy can both be utilized within BPD treatment.
Can BPD be treated with medication?
There isn’t a prescription medication that is designed specifically to treat BPD. However, some research suggests that medication could be helpful for some people with BPD; more specifically, if people with BPD do have a co occurring mental health condition, good psychiatric management may be particularly beneficial alongside therapy. BPD symptoms can cause extreme stress or distress for people with BPD and may feel unmanageable prior to seeking the support of mental health professionals, which is why reaching out for support can be so crucial.
BetterHelp does not prescribe medication. Make sure that you consult with a qualified medical professional before you stop, change, or start a new medication or medication routine.
Can BPD be cured without therapy?
Borderline Personality Disorder is treatable, but it is a lifelong mental health disorder with no known cure. The good news is that people with BPD show great strides at managing their symptoms with therapy. Evidence based treatment can help improve or treat specific symptoms and decrease distress overall. For example, a professional who works to treat BPD may help someone improve relationships, reduce self destructive behaviors and impulsive behavior, or control intense emotions. As symptoms improve, a person’s treatment goals may change.
How long does therapy take for BPD?
Treating Borderline Personality Disorder is a lifelong journey. Many people find it helpful to do a 1-3 year intensive treatment plan, followed by intermittent or sustained treatment.
Why do therapists find it difficult to treat Borderline Personality Disorder?
Therapy has been proven to be very effective in reducing BPD symptoms, but it is a very complicated and stigmatized mental health disorder.
People with Borderline Personality Disorder commonly also struggle with other mental health disorders, such as substance abuse and post traumatic stress disorder. Between 25% and 60% of people with BPD also have PTSD. This can make treating BPD more challenging, but individual therapy sessions can make all the difference in creating the best treatment plan available.
What triggers Borderline Personality Disorder episodes?
Research suggests that the most common BPD triggers come from interpersonal relationships. Many have strong beliefs and behaviors that are connected to feelings of abandonment, and these can be activated when having issues with friends or family.
Therapy and psychiatric intervention are the best way for people with BPD to improve relationships, control intense emotions, and get a better handle on their thoughts and feelings.
What is the best therapy for BPD?
BPD treatment often entails or includes a type of therapy called Dialectical Behavioral Therapy DBT. DBT is often seen as the golden standard for BPD and is a well-studied form of treatment. Other forms of talk therapy can also be used for the purpose of BPD treatment and co occurring disorders. A treatment plan may include various types of therapy, including group therapy, family therapy, and individual therapy. Someone might attend individual therapy and a systems training therapy group, for example.
On the topic of co occurring disorders, it is very common for those with BPD to live with other mental health conditions or mental health disorders. Common co occurring disorders or concerns for those with Borderline Personality Disorder BPD include but aren’t limited to eating disorders and substance abuse/substance use disorders.
People with BPD are at an increased risk for conditions and concerns such as eating disorders. Anxiety disorders and depression, too, which can be supported by a combination of talk therapy and good psychiatric management, can co-occur in people with BPD. Accordingly, alongside BPD treatment, people with BPD may also seek emotional support or treatment for these concerns alongside forms of care developed specifically for people with BPD.
If you or someone you know lives with an eating disorder or might be, contact the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237.
If you or someone you know lives with a substance use disorder or might be, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) Helpline at 1-800-662-HELP (4357).
Are you born with borderline personality disorder?
Research suggests that environment and family history (having family members who also live with BPD) can both contribute to an increased risk of BPD. Sometimes, BPD is diagnosed in a psychiatric hospital, but it can also be diagnosed in outpatient settings. BPD is diagnosed based on the diagnostic criteria listed in the DSM and is often detected in early adulthood. However, a person younger can be diagnosed under some circumstances. People can work with mental health professionals and may benefit from talk therapy at virtually any age. If a person’s symptoms are a cause for concern, finding mental health professionals who can offer emotional support and aid an individual with symptom reduction can help. The best treatment approach or treatment plan for an individual may vary based on factors such as the mental health disorder or mental health conditions they live with, age, and so on. Even if a person doesn’t have a formal diagnosis of Borderline Personality Disorder BPD, if they experience self destructive behavior/self destructive behaviors (such as self harm) and other BPD symptoms, traits, or signs, like an intense fear of abandonment or impulsive behavior, live with another diagnosis, such as post traumatic stress disorder, or something else that affects their wellbeing, it is important to reach out for help. Mental health professionals can help with a wide range of concerns, including mental health conditions like post traumatic stress disorder and BPD, family life, stress, grief, relationships, and so on. They can help individuals manage distress or tolerate distress, improve relationships, and learn skills that allow a person to increase emotional predictability or work to manage their own thoughts. People with BPD or without BPD may have goals such as moving toward an increased ability to manage distress or working to improve relationships. Though it is possible to live with more than one mental health condition and is actually quite likely, it is relevant to note that some BPD symptoms may overlap with other mental health conditions or mental disorders/mental health disorders. For example, someone may find it tough to control intense emotions even if they don’t have BPD, as emotional dysregulation can have other causes. As symptoms improve, a person’s treatment goals may change. Everyone deserves to get emotional support and care when they need it, and many find that symptoms improve with the care of mental health professionals.
How do you calm down borderline personality disorder?
When struggling with an episode, many common relaxation techniques are a great way to calm symptoms. These include:
- A warm bath
- A walk through nature
- Contact a friend or family member you trust
Phone coaching is also a great option to reduce symptoms from the comfort of your home. In addition to therapy, mood stabilizers are often prescribed for people with BPD in order to reduce risk factors.
For people with Borderline Personality Disorder, there are many effective treatment options. Whether you decide to opt for schema focused therapy or DBT, finding the best fit for your lifestyle will improve your symptoms overall.
For loved ones of people struggling with BPD, it’s important to take care of yourself while also offering support.
Does Borderline Personality Disorder ever go away?
There is no known cure to BPD. That said, it’s important for people with BPD to find a professional who can treat BPD, and it is possible that symptoms improve. Treatment such as transference focused psychotherapy, schema focused therapy and dialectical behavioral therapy are all proven to help people with Borderline Personality Disorder manage their symptoms long term.
Therapy focuses on helping people with BPD control their thoughts and emotions in order to create healthier relationships and live a more satisfying life overall. BetterHelp is one of the best online therapy programs available to treat BPD.
What happens if Borderline Personality Disorder is left untreated?
Without proper treatment, the effects of BPD can be devastating. It can be difficult for the loved ones of someone who has BPD to maintain relationships with them, and it can cause continuous strain in many aspects of their life. What does this mean in action? Research suggests that evidence based treatment for Borderline Personality Disorder BPD can help individuals with symptom reduction and improve their quality of life. If BPD is left untreated, a person may not have the skills they need to manage BPD symptoms and reap these benefits. Severe symptoms such as self destructive behavior (IE, self harming or self harm, suicial behavior, ideation, or attempting suicide, and other dangerous behaviors) may go unaddressed and continue, as can patterns of intense emotions, unstable relationships, and unstable self image.
Severe symptoms such as self destructive behavior (IE, self harming or self harm, suicidal behavior or ideation, and other dangerous behaviors) may go unaddressed and continue, as can patterns of intense emotions, unstable relationships, and unstable self image.
If you or someone you know experiences thoughts of suicide or suicidal ideation, please contact the National Suicide Prevention Lifeline at 1-800-273-8255.
Dialectical Behavioral Therapy DBT might be suggested first to treat BPD. Transference focused psychotherapy is a great alternative for people that struggle with projecting onto the people that come into their life. This type of therapy helps therapists understand their patients better, and the ways that they may be misattributing feelings of anger or resentment. Mentalization based therapy and schema focused therapy may also be used. It is possible for people with BPD and other personality disorders to benefit from multiple kinds of psychotherapy treatment.
Is BPD a psychotic disorder?
BPD is not a psychotic disorder. BPD stands for Borderline Personality Disorder, and it is listed under the category of personality disorders in the fifth edition of the diagnostic and statistical manual of mental disorders or DSM-5. More specifically, BPD is a cluster B personality disorder. It is said, according to the National Alliance on Mental Illness (NAMI), that around 1.4% of the adult population in the US lives with BPD, and about 1 in every 5 people experience a mental illness of some kind. If you have BPD or think that you might, you aren’t alone, and it is possible to treat Borderline Personality Disorder BPD.
Are People With BPD Intelligent?
They can be. Though MRI scans have shown that the brain health of a person with Borderline Personality Disorder may be different than a person without it, it seems to have no adverse affect on their intelligence.
Many people with BPD can be extremely intelligent and intuitive. It’s only when they’re triggered emotionally and their defense mechanisms have been affected that they lose touch with rational thinking. This is why it's so important that people with Borderline Personality Disorder follow treatment plants and are consistent in taking their mood stabilizers if prescribed to them.
Do therapists hate People With BPD?
No. Licensed therapists do not hate people with BPD. In fact, they want to help them succeed. Mental health professionals can help people with BPD control intense emotions, treat specific symptoms, improve relationships, and mitigate self destructive behavior. People with BPD can live fulfilling lives, and professionals who treat BPD are there to help.
Can a person with Borderline Personality Disorder really love?
Yes, a person with BPD can form close emotional bonds. They do sometimes have trouble forming lasting connections. It can be challenging for a person with BPD to trust within a relationship, and because of that it can be difficult for both the affected person and their partner.
Schema focused therapy is an effective treatment option for those who have Borderline Personality Disorder. Its goal is to restructure and rebalance the ways that emotions are processed, and avoid irrational behavior.
Does BPD go away with age?
If left untreated, Borderline Personality Disorder can get worse over time. Many people find that BPD symptoms can be greatly reduced through an effective treatment plan and mood stabilizers.
If you have BPD, you don’t have to go through it alone. A combination of therapy and mood stabilizers can help you balance your emotional state and adapt. Your brain health and development is something that should always be a priority in your life.
Regardless if you struggle with Borderline Personality Disorder or have a loved one who does, therapy is a great option to help you manage stress and reduce negativity in your life. BetterHelp is one of the best online therapy programs available to you, and has options to match your individual needs.
