Borderline Personality Disorder treatment usually consists of a combination of medication and a form of psychological therapy. Patients are also advised to look after their general health and wellbeing, and may be advised to carry out self-help or self-care exercises as part of their healing and recovery process.
There isn’t a medication licensed specifically to treat BPD, and medical experts are divided over whether medicine is helpful. While the National Institute for Health and Care Excellence (NICE) guidelines don’t recommend any particular medication, there is evidence that some medications are helpful for some symptoms. Medications may also be used if you have another associated mental health condition (such as depression or anxiety).
Your mental health professional may prescribe mood stabilisers or antipsychotics, which can help with mood swings, psychotic symptoms (hallucinations or delusions) or to help reduce impulsive behaviour. The medications can help alleviate the symptoms, making day to day life easier. Medication can also be prescribed for the depression and anxiety that often occurs with BPD, and these medications can often help with other symptoms such as night terrors and panic attacks.
Therapy may be carried out by an individual psychotherapists, or you may be put under the care of a community mental health team (CMHT). The goal of the team is to provide day-to-day support and treatment to you. While it may sound frightening to have a CMHT team, they are there to help you.
The team can be made of a variety of people including:
- community mental health nurses (these are nurses with specialist mental health training)
- social workers
- counsellors or psychotherapists
- psychiatrists (your psychiatrist would usually lead the team)
- occupational therapists
For patients with severe symptoms, they may enter into a care plan, known as a care programme approach (CPA). This is a way to make sure you get the right treatment for you, and is carried out in 4 stages:
- an assessment of your needs – both health and social;
- a care plan created specifially for the needs identified in stage one;
- appointment of a key worker, or care coordinator – this would be your first point of contact when reaching out to your CMHT;
- regular treatment reviews to make sure your care is working, and to make changes if needed.
It is important to bear in mind that these people are all working to help you manage your condition and its symptoms, so while it might sound frightening to have a CMHT or a care plan, they are all there to get the best care for you.
Types of Therapy
Most of the time, CBT or DBT may be carried out (see below). These are psychotherapies carried out by a trained professional. You may also be offered other psychotherapy, such as Schema therapy, talking therapies, or alternatives such as art therapy.
Cognitive behavioural therapy (CBT)
The goal of Cognitive Behavioural Therapy (CBT) is to help you to reduce your symptoms by changing the way you think about or interpret situations, as well as the actions that you take in your daily life.
Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy (DBT) is designed to bring about positive changes in your behaviour by changing the way you think – to validate your emotions, and to help open your mind to see other peoples ideas and opinions.
Mentalisation-based therapy (MBT)
Mentalisation is the ability to think about thinking. This means examining your own thoughts and beliefs, and assessing whether they’re useful, realistic and based on reality. This type of therapy will help improve your ability to recognise emotional states – not just your own, but others also – and learn to ‘step back’ from your thoughts.
Borderline Personality Disorder treatment and active participation
All of these therapies require active participation – you need to be willing to work with the psychiatrists and their team.
They are all there to help you, but you need to be involved in the healing and recovery process.