BPD Treatment, Borderline Personality Disorder Causes, & Signs

BPD Treatment Options

BPD is primarily treated with psychotherapy. The three proven therapies that work well for individuals with this disorder are:

• Mentalizing-Based Therapy (MBT): It helps patients manage emotion dysregulation by feeling understood, allowing them to be more curious and make fewer assumptions about the intentions of the people around them.
• Dialectical behavior therapy (DBT): DBT combines mindfulness practices with concrete interpersonal and emotion regulation skills.
• Transference-focused Psychotherapy (TFP): This type of therapy uses the patient-therapist relationship to develop the patient’s awareness of problematic interpersonal dynamics.

MBT and DBT each involve individual and group treatment over 12 to 18 months. [3]

DBT is an established psychotherapy based on the theory that BPD arises when emotionally vulnerable individuals grow up in an environment that is invalidating or dysfunctional. It is designed to help individuals accept themselves and develop skills for change. Typically, a 12-month program involves five components:

• Group skills training to introduce effective and practical skills that can replace other negative behaviors used to respond to emotional distress.
• Individual psychotherapy helps individuals set and meet goals, be motivated, and apply their practical skills.
• Telephone coaching to provide in-the-moment support when people with BPD experience distress and help them with applying their DBT skills.
• Case management strategies empower individuals to control their lives and care.
• The DBT consultation team helps therapists stay motivated and competent to avoid burnout and share knowledge to provide the best treatment possible.

DBT is used with people living with BPD as well as people living with PTSD, substance use disorders, suicidal behavior, and self-harm.

BPD Medications

No medications are FDA-approved for the treatment of borderline personality disorder.

According to research in the US NCBI PubMed Journal Review, overprescription of off‐label medicines is common in patients with BPD. Nearly three-quarters of patients with BPD were taking antidepressants, 55% benzodiazepines, 40% mood stabilizers, and 35% antipsychotics. [4]

The risks of medication use in BPD include:

• Interactions with substances of abuse.
• Addiction potential.
• Increased risk of suicidal tendencies and disinhibition.
• Severe side effects.
• A high risk for self‐injury with pills.
• Psychological risks such as diverting attention and energy from psychotherapeutic aims, thus altering the effectiveness of psychotherapy.

Consult your doctor if you’re considering taking any medications. They may ask about your symptoms and how they affect your quality of life and may guide you with the proper prescription.

BPD Symptoms

People with BPD may experience intense mood swings and feel uncertainty about how they see themselves. Their feelings for others can change quickly and swing from extreme closeness to dislike. They also tend to view things in extremes, such as all good or bad. Their interests and values can change quickly, and they may act impulsively or recklessly. [5] Other most common symptoms include:

• Intense fear of abandonment.
• Unstable and extreme relationships.
• Uncertain self-image.
• Impulsive and risky behaviors.
• Recurrent suicidal thoughts or self-harming behaviors.
• Extreme mood swings.
• Chronic feelings of emptiness.
• Difficulty controlling anger.
• Paranoia and dissociation.
• Intense and unstable sense of identity.

What are the Risk Factors for BPD?

The NIMH Studies suggest that genetic, environmental, and social factors may increase the likelihood of developing borderline personality disorder. [6] These factors may include:

• Family history of BPD or other mental health disorders.
• Childhood trauma or abuse.
• Neglect during childhood.
• Unstable family environment.
• Genetic predisposition.
• Brain abnormalities or dysfunction.
• Being female (BPD is diagnosed more frequently in women than men).
• Personal history of mood disorders or substance abuse.
• Impulsivity and emotional reactivity in temperament.
• Peer or social influences during adolescence.

BPD vs Bipolar Disorder

BPD and bipolar disorder are often confused because they both involve mood swings. However, they’re different in so many ways. To put it simply:

Learn More:

• Bipolar Depression Symptoms, Causes, Effects, and Treatment
• Mental Health Assessment for Mental Illness Treatment
• Understanding Dual Diagnosis
• Mental Health Treatment. Warning Signs, Types of Treatment, Therapies, Medications, and How To Get Help.

What Causes BPD Splitting?

To split something means to divide it. Those with BPD tend to distinguish themselves, other people, and situations in black and white, with no middle ground. It happens because of difficulties in handling mixed feelings. A person with BPD might switch between seeing someone as all good or bad without recognizing the shades in between. Their emotions paint everything in bright colors or deep shadows, making it hard to see the gray areas. [7]

What is Quiet BPD?

Quiet borderline personality disorder, also known as “high-functioning” BPD, means you often keep your intense thoughts and feelings inside rather than express them outwardly.

The NIMH Study reveals that males with BPD were characterized by explosive temperaments as well as high levels of novelty seeking and harm avoidance. In contrast, high levels of harm avoidance described the symptoms of BPD in females but not novelty seeking.

Although women with BPD tend to be quieter, they are more likely to experience eating, mood, anxiety, and posttraumatic stress disorders. [8]