People with BPD are often treated with a combination of psychotherapy, peer and family support and medications to address co-occurring symptoms. Work with your treatment team to understand the risks and benefits of all of these course of action together and in combination.
Psychotherapy is a cornerstone for treating a person with BPD. In addition to dialectical behavioral therapy (DBT), which was created specifically for the treatment of BPD, there are several types of psychotherapy that are effective:
- Dialectical behavioral therapy (DBT) focuses on teaching coping skills to combat destructive urges, regulate emotions and improve relationships while adding validation. Involving individual and group work, DBT encourages practicing mindfulness techniques such as meditation, regulated breathing and self-soothing. Developed by Dr. Marsha Linehan, who lives with BPD herself, DBT has been shown to be effective in reducing suicidal behavior, psychiatric hospitalization, treatment dropout, substance abuse, anger and interpersonal difficulties. DBT training is quite intensive and a person who is interested should ask the DBT clinician about their training.
- Cognitive behavioral therapy (CBT) helps change the negative thinking and behavior associated with BPD. The goal of this therapy is to recognize negative thoughts and to teach coping strategies.
- Mentalization-based therapy (MBT) teaches people to become increasingly conscious of their internal states and to develop empathy of other people’s experiences. These skills are then used to explore their own emotions and develop alternative explanations for negative interactions with others.
There is no one medication specifically made to treat the core symptoms of emptiness, abandonment and identity disturbance. Medications can be useful in treating other symptoms associated with BPD, such as anger, depression and anxiety. Medications may include mood stabilizers, antipsychotics, antidepressants and anti-anxiety drugs.
When psychotherapy and medication aren’t enough, hospitalization may be necessary. A hospital can provide a safe environment for a person with BPD who is self-harming or having thoughts of suicide.