The main treatment for borderline personality disorder (BPD) is a combination of counseling and medication.
The goal of counseling, also called psychotherapy or talk therapy, is to help you learn how to manage your emotions. For example, you can observe your feelings ("I feel very angry right now") instead of acting on them. It helps you function in your daily life and relationships. Counseling can happen in a one-on-one setting with a therapist or in a group.
Depending on your symptoms and situation, your counselor may use one of these types of psychotherapy:
- Dialectical Behavior Therapy (DBT) began as a way to help manage crisis behavior, such as suicidal behavior or self-harm. It is the most commonly recommended therapy for BPD. It works with the concept of mindfulness, or being present in the moment. This helps you be aware of your emotions, moods, and behavior. You learn skills like how to tolerate negative emotions and how to communicate effectively.
- Cognitive Behavioral Therapy (CBT) focuses on changing the basics of what you believe about yourself and others.
- Schema-Focused Therapy is similar to CBT in how it reframes negative thoughts about yourself into positive ones.
Medication may also be used to treat your symptoms. Since depression and anxiety can be a big part of BPD, anti-depressant and anti-anxiety medicines can be helpful. If you experience intense times of distorted thinking, your counselor may suggest an anti-psychotic medication.
Since behaviors of self-harm like cutting and suicide attempts are part of the symptoms of BPD, you may need to receive treatment in the hospital.
It’s possible to change the way you think, feel, and react to situations. It just takes time and effort. Being consistent with your treatment -- taking medications on schedule, keeping counseling appointments -- is the best way to start.
Routine is helpful in other ways, too. Regular meal and sleep times let your body know what to expect. Try to exercise daily too. It keeps stress levels low. Take a walk, don't sign up for a marathon -- it's important to set goals you know you can accomplish without getting overwhelmed.
Eat more fruits and vegetables and less junk food. Steer clear of alcohol and drugs.
Surround yourself with people you can trust, including family, friends, and your treatment team. Talk with them about how you're feeling. It's better than keeping it all bottled up inside. If you notice a person or situation that triggers you, write it down and talk to your counselor about it.
The best medicine of all is being kind to yourself. Build support for yourself and use it. Having BPD isn't your fault, but you can change how it affects your life.