Treatment of Borderline Personality Disorder

Treatment of Borderline Personality Disorder

Like so many personality disorders, borderline personality disorder (BPD) is difficult to treat. Establishing a therapeutic relationship is difficult because of the unstable relationships and intense anger that are characteristic of BPD patients. Mental health professionals are often reluctant to treat people with BPD because their hostility towards the clinical professional and persistent suicidal thoughts and feelings lead to clinician “burnout.”

Treatments for borderline personality disorder (BPD) include group and individual psychotherapy, which are at least partially effective for many patients. A new psychosocial treatment termed dialectical behavior therapy (DBT) developed specifically to treat BPD has shown promise in treatment studies.

Medications such as antidepressants, lithium carbonate, or antipsychotic medication are useful for certain patients or during certain times in the treatment of individual patients. Treatment of any alcohol or drug abuse problems may be necessary before therapy can continue.

Acutely stressful episodes may require brief hospitalization. Outpatient treatment is usually difficult and long-term—sometimes over a period of years.

Treatment goals could include increased self-awareness with greater impulse control and increased stability of relationships. Therapy should help to alleviate psychotic or mood-disturbance symptoms. An increased awareness and capacity for self-observation and introspection should help patients escape the rigid patterns that are so typical of most personality disorders.

Borderline Personality Disorder: Long Term Outlook

The long-term prognosis for borderline personality disorder (BPD) is generally unknown. However, short-term follow-up studies consistently reveal that patients with BPD change little over time.

It is speculated that borderline personality disorder may evolve into more stable personality disorders, or older patients may simply stop seeking treatment.