Around 1 in 100 people worldwide live with borderline personality disorder (BPD). The hallmarks of this mental health condition include negative thoughts, impulsivity, intense fear of abandonment, and difficulty with relationships. People with BPD are also more likely than the general population to engage in self-harm and have a significantly higher rate of suicide.
Getting prompt and effective treatment for BPD symptoms can help people with BPD live happier, more fulfilling lives with healthy, rewarding relationships. This is why it’s so important to be aware of and understand the signs and symptoms of BPD, so you or someone close to you can get early treatment.
Signs of Borderline Personality Disorder
One of the first things people with types of BPD often notice is they have an incredibly hard time maintaining relationships. This pattern can ring true for platonic relationships as well as professional and romantic ones. They also might have great difficulty holding a job. Other signs of BPD can include dramatic mood swings, intense anger, or being overly possessive, jealous, and isolated.
“Individuals diagnosed with BPD typically have difficulties within the context of their relationships because the fear of abandonment is so intense. There are often feelings of low self-worth, unclear depictions of identity, and self-harm because of the hyperfocus on how other people are responding to them. Absorbing the emotional turmoil of the world leaves them feeling reactive and impulsive.”Talkspace therapist Meaghan Rice PsyD., LPC
Despite BPD not having a true cure, treatment can be very beneficial and greatly reduce the severity and frequency of BPD symptoms. Effective treatment can come in the form of therapy, possibly medication, and holistic options. Consistent treatment will allow most people with BPD to have a greater quality of life.
As is true with most mental health conditions, early treatment is likely to increase overall effectiveness. It’s important to note that staying with a treatment plan is critical for reducing BPD symptoms. Often, someone with BPD will start feeling better and might consider stopping treatment, only to have their symptoms return, sometimes even more intensely than before.
Symptoms of Borderline Personality Disorder
Symptoms of BPD can include:
- Difficulty with romantic, work, and other relationships
- Negative thoughts
- Thoughts of self-harm
- Impulsive behavior
- Fear of abandonment
- Extreme and intense anger
- Suicidal thoughts
Not all people with a BPD diagnosis will have every BPD trait ot symptoms. It’s more likely that someone will have just a handful of symptoms from the above list. Symptoms can also change over time. Additionally, it’s not uncommon for comorbid mental health conditions to exist (meaning other conditions can occur at the same time). Some of the most common comorbid conditions that occur with BPD include chronic depression, anxiety, post-traumatic stress disorder (PTSD), and eating disorders.
Managing Symptoms of Borderline Personality Disorder
When it comes to how to deal with borderline personality disorder, psychotherapy (talk therapy) and BPD medication are the most commonly used—and the most effective—forms of treatment for borderline personality disorder symptoms.
“BPD can be treated most effectively with dialectical behavioral therapy (DBT) and medication management. DBT is able to treat the crisis modes as they come up, the emotional instability, and the reactivity. Medications aim to take the edge off and decrease the fear of abandonment, so people can feel more mindful and in the present moment.”Talkspace therapist Meaghan Rice PsyD., LPC
Several types of psychotherapy are used to treat BPD. They include:
- Dialectical behavior therapy (DBT): Arguably one of the most effective types of psychotherapy for BPD, DBT seeks to teach you ways to manage your emotions and create healthier relationships. Dialectical behavior therapy was specifically designed to treat BPD symptoms.
- Schema-focused therapy (ST): This type of BPD therapy is based on the principles of cognitive behavioral therapy (CBT). Schema therapy can help ease the symptoms of BPD by addressing unmet needs from your past that might be contributing to current negative life patterns. After identifying them, you can focus on creating more positive patterns and ways to have your needs met in a healthier manner. ST was developed to treat personality disorders and is very effective in helping with interpersonal relationship difficulties.
- Mentalization-based therapy (MBT): MBT is traditional talk therapy, where you discuss your feelings with a therapist, and together you work on being less reactive and thinking before you act. MBT can be particularly helpful in treating BPD since impulsivity is a key BPD trait and symptom.
- Systems training for emotional predictability and problem-solving (STEPPS): STEPPS is a 20-week program that’s used in conjunction with other types of psychotherapy. It’s done in a group setting with you, your family, your friends, and your partner and/or caregiver.
- Transference-focused psychotherapy (TFP): TFP, also called psychodynamic psychotherapy, helps you better understand your emotions and any interpersonal relationship issues you have stemming from BPD. It uses the growing interaction between you and your therapist.
While we are continuing to explore what causes borderline personality disorder, we do know that psychotherapy is used as an effective tool to treat borderline personality disorder.
Medication for BPD
Although no medication to date has been approved by the Federal Drug Administration (FDA) for the treatment of BPD, some drugs have been found very useful in treating borderline personality disorder symptoms. The right medication can treat depression, anxiety, impulsive behavior, or aggression. Medication can help some people with BPD by:
- Improving functioning: Some medications can make it easier for you to engage in daily functioning and establish and maintain healthy relationships, curtailing those unstable relationships.
- Reducing symptom frequency and severity: Again, while no medication is approved specifically for BPD, some types can help treat symptoms like depression and anxiety very effectively.
- Preventing symptoms from worsening: Especially in the beginning stages of the condition, BPD symptoms often worsen if left untreated. Medication can help prevent symptoms from increasing in intensity over time. It’s important to note that some research suggests BPD symptom severity and frequency can decline with age.
- Decreasing the risk of self-harm and/or suicide: As medication can help with symptom severity, it can be effective in decreasing the risk factor of self-harm and suicidal tendencies.
- Treating comorbid conditions: Specific medications can be beneficial in treating comorbid conditions like anxiety disorders, depression, and eating disorders — all of which commonly coexist with BPD.
- Enhancing willingness to remain engaged in other forms of treatment: Medication might be useful in helping you want to remain engaged in your other treatments, like therapy and some lifestyle changes.
Some of the common medications that might be used to treat BPD symptoms include:
- Mood-stabilizing drugs or anticonvulsants
- Anti-anxiety drugs
In rare cases, especially where self-harm or substance abuse is suspected, some people with a BPD diagnosis may need to be hospitalized until their condition is stabilized. A psychiatric hospital or clinic can offer more intense therapy and better monitor severe symptoms like suicidal thoughts.
When to Seek a Mental Health Professional
Knowing when to seek treatment from a mental health professional is often a personal decision, but a broad approach to take is that you should always look for treatment if your BPD symptoms begin to significantly affect your quality of life.
This includes if you’re having increased trouble at work, in your relationships, or in your day-to-day living. It goes without saying, you should seek treatment immediately if you start to have suicidal behavior or thoughts or self-destructive behavior or thoughts around harming yourself. As we mentioned before, early treatment almost always yields the best results.
The key lesson to learn here is that just because you’re living with BPD doesn’t mean you have to simply deal with your symptoms and suffer in silence. There are several effective ways to treat symptoms of BPD and improve your quality of life. Learning the signs and symptoms and how you can improve them is your first step.
It’s important to find a therapist who’s experienced in treating BPD symptoms. You can talk with your primary care physician, talk to a mental health professional either through in-person or online therapy, or consult an online resource, such as the National Alliance on Mental Health, to get started.