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Borderline Personality Disorder

What Type Of Therapy Is Best For Borderline Personality Disorder?

Borderline Personality Disorder abbreviated

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health disorder. As defined by the National Institute of Mental Health (NIH), “borderline personality disorder is an illness characterized by an ongoing pattern of varying moods, behavior, and self-image.” It is highly common for individuals with BPD to lack the ability to foster and maintain meaningful, lasting relationships. The symptoms that are associated with borderline personality disorder make it difficult to diagnose. In order to secure the most effective treatment an individual must obtain an accurate diagnosis from a qualified mental healthcare provider. The Food and Drug Administration (FDA) has yet to approve a medication explicitly designed to treat borderline personality disorder. While there are other types of therapeutic modalities that can be helpful in treating someone with BPD (e.g., schema-focused therapy, mentalization-based therapy, etc.), the most frequently relied upon type of psychotherapy used to treat BPD is called dialectical behavior therapy (DBT). Treatment for BPD will help an individual learn strategies, techniques, and tools to effectively manage the symptoms associated with borderline personality disorder, reducing the severity of symptoms experienced and increasing one’s quality of life. 

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that places greater emphasis on the psychosocial aspect of therapy. Marsha M. Linehan initially developed it in the 1980s, to help treat chronically suicidal people with borderline personality disorder. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD and has also proven effective in treating individuals with other mental health conditions. DBT utilizes four main strategies for teaching individuals’ skills that help with effectively changing their behaviors. They include the following, as provided by Behavioral Tech

  1. Core mindfulness: the practice of being completely present and aware in the moment. 
  2. Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it.
  3. Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions. 
  4. Interpersonal effectiveness: authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging.

DBT is comprised of three distinct settings: weekly individual therapy sessions, weekly DBT group skills training sessions, and as-needed phone coaching. The entire DBT program (provided skills modules are not repeated) usually lasts about six months long, as approximately six weeks are allocated to each of the four skills modules. DBT is based on the notion that change can be balanced with self-acceptance. It can help people learn how to regulate emotions and foster change. This gives individuals struggling with BPD the opportunity to build meaningful and stable lives. Although BPD is considered to be a chronic condition, there are a variety of treatment options available to a person diagnosed with borderline personality disorder. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

Common Signs Of Borderline Personality Disorder

man with borderline personality disorder

Borderline personality disorder is one of ten personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Each of the ten personality disorders is categorized into one of three clusters (cluster A, cluster B and cluster C). The personality disorders that make up each clusters share similar symptoms and have overlapping characteristics. According to the American Academy of Family Physicians (AAFP) cluster A is characterized as odd or eccentric personalities; cluster B is characterized as dramatic, emotional, or erratic personalities; and cluster C is characterized as anxious or fearful personalities. Borderline personality disorder is classified as a cluster C personality disorder. The National Institute of Mental Health explains, “Borderline personality disorder is an illness marked by an ongoing pattern of varying moods, self-image, and behavior.” The cause of borderline personality disorder remains unknown. There are, however, certain risk factors (e.g. brain structure and function, genetics, environmental, cultural and social influences, etc.) that have been noted as potentially contributing to its development. Due to the illusive nature of its symptoms paired with the fact that many symptoms overlap with other mental health ailments, BPD is notoriously known as one of the most difficult mental health illnesses to diagnose. 

Signs and Symptoms

The symptoms of borderline personality disorder typically result in overarching interpersonal relationship complications and impulsive actions. The Mayo Clinic provides examples of signs and symptoms that are commonly exhibited in individuals with borderline personality disorder, some of which include, but are not limited to the following:

  • Engaging in risky and/ or impulsive behaviors (i.e. reckless driving, excessive gambling, binge eating, substance abuse, unsafe sex…etc.)
  • Intense fear of abandonment
  • Suicidal ideations
  • Self-injury
  • Severe mood swings (i.e. elation, irritability, shame, anxiety…etc.)
  • Pattern of unstable relationships
  • Irrational displays of anger
  • Distorted self image
  • Feelings of emptiness
  • Stress related paranoia

Some individuals may experience numerous symptoms of BPD, while others may only experience a few symptoms. Research has indicated that individuals with borderline personality disorder may experience intense episodes of depression, anxiety and/ or anger that could last from a few hours to several days long. Every individual is different and has the propensity to exhibit a unique combination of signs and symptoms related to borderline personality disorder.

Treatment

Although borderline personality disorder is considered a chronic mental health condition, there are a variety of treatment options available for individuals diagnosed with BPD, which can help individuals, learn to manage their symptoms. The most common method of treatment for borderline personality disorder is dialectical behavior therapy (DBT). Marsha M. Linehan developed DBT in the late 1980s, specifically to better treat chronically suicidal individuals with borderline personality disorder. Dialectical behavior therapy is based on the cognitive behavioral therapy (CBT) approach, and places greater emphasis on the psychosocial aspect of therapy. With proper treatment, an individual diagnosed with borderline personality disorder can learn to effectively navigate his or her symptoms of BPD and go on to lead a happy and fulfilling life. 

Disclaimer: 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment.

What Causes Borderline Personality Disorder?

woman with hands in face

Borderline personality disorder (BPD) is a serious mental health illness that is one of ten personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). According to National Institute of Mental Health (NIH), BPD is characterized by “pervasive instability in moods, interpersonal relationships, self-image, and behavior.” This instability interferes with one’s ability to function in his or her daily life, long-term planning, as wells as an individual’s sense of identity. Individuals diagnosed with borderline personality disorder often experience swift mood swings, including intense episodes of depression, anger and/ or anxiety that could last as short as a couple of hours to as long as several days. The symptoms associated with BPD frequently result in highly unstable patterns of social relationships. This chronic condition is also associated with high rates of self-injury and suicidal behavior.

Signs and Symptoms

Every individual is different and will exhibit a somewhat unique set of BPD signs and symptoms. The Mayo Clinic provides several commonly reported signs and symptoms to include the following:

  • Intense fear of abandonment
  • Rapid changes in self-image and self-identity 
  • Impulsive, risky and/ or dangerous behavior (i.e. engaging in unprotected sex, substance abuse, reckless driving, gambling, etc.)
  • Suicidal ideation
  • Wide and extreme mood swings
  • Periods of stress-related paranoia
  • Self-inflicted social isolation
  • Ongoing feelings of emptiness
  • Irrational, inappropriate, and/ or intense bouts of anger

It is important to note that any combination of the above signs and symptoms could manifest as a result of BPD. The severity and length of time they persist will vary, as they will depend on each individual. 

Causes

While there is no singular reason behind why an individual develops borderline personality disorder, there are several contributing factors that have been noted as potentially increasing one’s susceptibility to BPD. These factors can include, but are not limited to the follow, as provided by the National Institute of Mental Health

  • Genetics: people with a family history (i.e. parent, sibling, etc.) with BPD may be at increased risk of developing borderline personality disorder. Psychology Today assert that BPD is approximately five times more common among people with close biological relatives with BPD. 
  • Environmental factors: growing up in an unstable, neglectful, and/ or abusive environment could increase one’s risk for developing BPD. 
  • Brain factors: some studies have indicated that individuals diagnosed with BPD have structural and/ or functional abnormalities, specifically in the areas of the brain that reign over one’s emotional regulation and impulse control. Furthermore, deviations from typical serotonin (hormone that works to stabilize one’s mood, happiness and feelings of well-being) production could increase one’s susceptibility to BPD. 

Treatment

The nuanced needs of an individual diagnosed with borderline personality disorder will inform his or her individualized treatment plan. Individualized treatment plans could comprise of a variety of therapeutic modalities some of which could include individual psychotherapy, group therapy, and/ or creative arts therapies. Dialectical behavior therapy (DBT), a form of cognitive behavioral therapy (CBT), was specifically designed to help treat individuals diagnosed with borderline personality disorder. Since it was developed in the late 1980s, it is highly common for DBT to be integrated into one’s treatment plan, as it has become the gold standard for treating BPD. Components such as nutritious eating habits, frequent self-care practices, engaging in regular exercise, obtaining ample sleep, and practicing various relaxation techniques (i.e. yoga, meditation, etc.) can also be included in one’s treatment plan. Recovery from BPD will require steadfast commitment, and will be a life-long process. With proper mental health treatment and support, an individual diagnosed with borderline personality disorder can go on to live a healthy and fulfilling life.