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Treatments and drugs
By Mayo Clinic staffBorderline personality disorder treatment may include psychotherapy, medications or hospitalization.
Psychotherapy
Psychotherapy — also called talk therapy — is a fundamental treatment approach for borderline personality disorder. Types of psychotherapy that have been found effective include:
- Dialectical behavior therapy (DBT). DBT was designed specifically to treat borderline personality disorder. Generally done through individual, group and phone counseling, DBT uses a skills-based approach combined with physical and meditation-like exercises to teach you how to regulate your emotions, tolerate distress and improve relationships.
- Cognitive behavioral therapy (CBT). With CBT, you work with a mental health counselor (therapist) to become aware of inaccurate, negative or ineffective thinking; view challenging situations more clearly and objectively; and search for and put into practice alternative solution strategies.
- Mentalization-based therapy (MBT). MBT is a type of talk therapy that helps you identify and separate your own thoughts and feelings from those of people around you. MBT emphasizes thinking before reacting.
- Schema-focused therapy (SFT). SFT combines therapy approaches to help you evaluate repetitive life patterns and life themes (schema) so that you can identify positive patterns and change negative ones.
- Transference-focused psychotherapy (TFP). Also called psychodynamic psychotherapy, TFP aims to help you understand your emotions and interpersonal difficulties through the developing relationship between you and your therapist. You then apply these insights to ongoing situations.
Medications
Medications can't cure borderline personality disorder, but they can help associated co-occurring clinical problems, such as depression, impulsiveness and anxiety. Medications may include antidepressants, antipsychotics and anti-anxiety drugs. Medications must be appropriately prescribed by your doctor, in adequate doses, and with consistent supervision through scheduled follow-up visits.
Hospitalization
At times, you may need more intense treatment in a psychiatric hospital or clinic. Hospitalization can also keep you safe from self-injury or suicidal thoughts or behaviors.
Because treatment can be intense and long term, you have the best chance for success when you consult mental health providers who have experience treating borderline personality disorder.
- Borderline personality disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/borderline-personality-disorder/complete-index.shtml. Accessed July 16, 2012.
- Personality disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed July 17, 2012.
- Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed July 17, 2012.
- Silk KR. Borderline personality disorder: Epidemiology, clinical features, diagnosis, and differential diagnosis. http://www.uptodate.com/index. Accessed July 17, 2012.
- Silk KR. Borderline personality disorder: Treatment and prognosis. http://www.uptodate.com/index. Accessed July 17, 2012.
- Gunderson JG. Borderline personality disorder. New England Journal of Medicine. 2011;364:2037.
- Leichsenring F, et al. Borderline personality disorder. The Lancet. 2011;377:74.
- Alarcon RD (expert opinion). Mayo Clinic, Rochester, Minn. July 31, 2012.
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