Borderline Personality Disorder Treatment

Identifying Borderline Personality Disorder

The earmarks of borderline personality disorder (BPD) include a persistent pattern of instability in interpersonal relationships, self-image and emotions. Those with BPD also exhibit a high level of impulsiveness.

Personality disorders cannot be diagnosed until the individual is 18, and since this disorder is fully evident in most people by early adulthood, the patterns have been established and have persisted for years. BPD shows up in a variety of settings, not just at work or at home and is accompanied by frequent changing and fluctuating emotions and feelings. Since the person with BPD is unable to sustain relationships properly, their relationships may be labeled as shallow. 

 Borderline personality disorder affects about two percent of the general population, being more prevalent in females than males. 75 percent of BPD diagnoses that are made are in females. As with most disorders of this nature, borderline personality disorder typically decreases in intensity as the individual ages. Often the extreme symptoms are considerably reduced by the time the person is in their 40s or 50s.

Treatment for BPD

Overcoming borderline personality disorder is very challenging. With treatment and support though, many people are able to return to work and resume their normal lives. However, treatment for borderline personality disorders tends to be ongoing. Many people with the illness require lifetime support.

Psychotherapy is the treatment of choice when it comes to borderline personality disorder. Medications can be useful in treating some of the symptoms, but new coping skills, emotion regulation or making changes requires more hands-on treatment.

Personality disorders, by definition, are entrenched methods of coping in life - the world, social and personal relationships, dysfunctional emotions and modalities that often don't work, especially under stress. As a result, treatment tends to be lengthy, usually lasting for a year or more.

Dialectical Behavior Therapy, an approach developed by Marsha Linehan, has been the most successful psychotherapeutic treatment for borderline personality disorder to date. Its focus is to teach the individual how best to control their lives, emotions and themselves through the vehicle of self-knowledge, emotion regulation and cognitive restructuring. It is conceptual training and is done in a group setting. If a person has a problem with concepts, then this type of therapy is not an appropriate option for them.

There are other types of psychological treatments that are used, although they are not as effective as the Linehan method. These other treatments focus more on social learning and conflict resolution. While they have a measure of success, they do not get to the core problem of this disorder, which is difficulty in expressing appropriate emotions to important people in their lives.

Hospitalization is generally discouraged with borderline personality disorder. It is important to encourage people with the disorder to learn to survive on their own and in the community, and this cannot be done in a hospital setting. However, for those at risk for self-harm, hospitalization may be recommended for a short period.

Day treatment or partial hospitalization may be a better choice for many sufferers as it offers them a safe place to stay during the day, but also requires them to function on their own in the evenings.

Medications, especially when combined with psychotherapy, are often quite helpful in reducing the symptoms of borderline personality disorder. There are numerous borderline personality disorder medications available. Antidepressants help to relieve depression and anxiety in patients. SSRIs, like Celexa, Prozac, and Zoloft, are commonly prescribed.

Anti-psychotics are also helpful in reducing mood swings, mania, and episodes of self-harm. New atypical anti-psychotics are now being prescribed and include Zyprexa, Risperdal, Seroquel, Clozaril, and Abilify. Anticonvulsants like Depakote, Topamax, and Lamictal can also help to reduce mood swings.

If you have borderline personality disorder, talk with your doctor about all your treatment options. With hard work, the symptoms of borderline personality disorder can be brought under control. 


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