Written by:Elizabeth Keohan, LCSW-C, MSW

Published On: June 21, 2022

Medically reviewed by: Jill E. Daino, LCSW-R

Reviewed On: June 21, 2022

Updated On: May 3, 2024

Overview

While there’s no cure, and we don’t quite know what causes borderline personality disorder, there are several ways to treat borderline personality disorder (BPD) effectively. The chronic mental health condition known as BPD affects an estimated 1.6% of the population. It’s marked by dramatic mood swings, anger, feelings of abandonment, and difficulty managing emotions or maintaining relationships.

Treatment for BPD can include:

  • Psychotherapy
    • Dialectical behavior therapy (DBT)
    • Schema-focused therapy
    • Mentalization-based therapy (MBT)
    • Systems training for emotional predictability and problem-solving (STEPPS)
    • Transference-focused psychotherapy (TFP)
  • Medication
  • Holistic/natural treatment options

We’re covering all of these options here, so you can be as informed as possible when it comes to treating BPD and living a healthy, happy, productive life with rewarding, fulfilling relationships.

Psychotherapy (or Talk Therapy) for Borderline Personality Disorder

Psychotherapy — also called talk therapy — is by far the most effective psychological treatment for BPD and other personality disorders. Talk therapy involves working with a licensed mental health professional, either a psychiatrist, psychologist, or therapist to analyze and change things that are having a negative impact on your life. For example, you might discuss your fears or your childhood.

Depending on the style of treatment, psychotherapy may be one-on-one with a therapist, or it can be in a group setting where one or more therapists work with several people at a time.

How does psychotherapy treat BPD?

Psychotherapy helps you address issues specific to BPD. It aims to identify the root of anxiety and feelings of abandonment or worthlessness. It can also focus on teaching you skills to help you better communicate with others and manage your anxiety and depression.

Psychotherapy helps you:

  • Learn about BPD
  • Manage uncomfortable emotions
  • Focus on how to function in a healthy way
  • Learn how not to be impulsive
  • Not act immediately
  • Improve relationships by allowing you to become more aware of your emotions

Types of psychotherapy for BPD

Several types of psychotherapy are used to treat borderline personality disorder. The best one will depend on you and your individual symptoms. Major types of psychotherapy used as psychological treatment for BPD and other personality disorders include:

  • Dialectical behavior therapy (DBT): DBT was developed specifically to treat BPD. It uses a skills-based approach to help you better manage your emotions and develop healthier relationships. DBT is done as group and individual therapy.

“Dialectical behavioral therapy (DBT) is a multifaceted, comprehensive approach that teaches skills beyond just individual talk therapy. With the addition of group learning, the benefits of emotional regulation and distress tolerance are taught in a supportive way that helps increase confidence and potential for mindful management.”

Licensed Certified Social Worker-Clinical, (LCSW-C), LICSW, MSW Elizabeth Keohan
  • Schema-focused therapy: Schema-focused therapy helps you identify the root causes of negative life patterns. You’ll learn how to get your needs met while using healthier behavior.
  • Mentalization-based therapy (MBT): This type of therapy is used to treat borderline personality disorder by emphasizing thinking before reacting. You’ll focus on identifying what thoughts and feelings you have so you can begin looking at things in a different (more productive) manner.
  • Systems training for emotional predictability and problem-solving (STEPPS): STEPPS is a 20-week treatment option that includes family members, close friends, and caregivers in a group setting. It’s used in conjunction with other forms of BPD therapy.
  • Transference-focused psychotherapy (TFP): Sometimes called psychodynamic therapy, TFP seeks to help you better understand relationship difficulties and unhealthy, intense emotions by examining a growing relationship between you and your therapist.

Medications for Borderline Personality Disorder

While generally not the first line of treatment, medications are sometimes prescribed for people with BPD. There’s no FDA-approved medication to treat borderline personality disorder, but some types can be effective in treating major common symptoms that are typical to BPD, like anxiety and depression.

It’s important to point out that no single BPD medication will be effective for everyone. Each individual, and each case of BPD, is unique since there are different types of BPD, and medication is rarely, if ever, used without therapy.

How does medication treat BPD?

Medication that’s used to treat BPD works by easing some of the debilitating and distracting symptoms common to the disorder. It might help some people get to a calm place by controlling their anxiety or impulses, for example, so they can begin to focus on deeper issues.

Types of medication for BPD

Several medications are used to treat BPD symptoms like mood swings, depression, and anxiety.

Some types of medications frequently used for people living with BPD include:

  • Antidepressants: Antidepressants can help treat low mood, sadness, and anxiety that’s related to BPD, but they’re typically not effective on symptoms like impulsive behavior and anger. Selective serotonin reuptake inhibitors (SSRIs), tricyclic and tetracyclic antidepressants, and monoamine oxidase inhibitors (MAOIs) all might be prescribed to treat BPD. Some common ones include:
  • Antipsychotics: These medications are used to treat dramatic mood swings, delusions, paranoia, anxiety, hostility, anger, and impulsivity. Some of the common antipsychotics used to treat BPD can include:
    • Abilify (aripiprazole)
    • Geodon (ziprasidone)
    • Risperdal (risperidone)
    • Seroquel (quetiapine)
    • Zyprexa (olanzapine)
  • Anti-anxiety medication: Commonly used to treat the anxiety that often accompanies BPD, some of the types of anti-anxiety medications might include:
    • Ativan (lorazepam)
    • Buspar (buspirone)
    • Klonopin (clonazepam)
    • Valium (diazepam)
    • Xanax (alprazolam)
  • Mood stabilizers: Certain mood stabilizers or anticonvulsants have been found effective in treating impulsivity and emotional instability in people with BPD. Some medications that might be prescribed are:

“Using medication for borderline personality disorder (BPD) can depend on the individual treatment plan with the provider, as there’s no one-size-fits-all approach. Antidepressants and mood stabilizers have been shown to impact positive outcomes and should be advised by a professional clinician who also has a positive grasp on your psychosocial history, challenges, and symptoms.”

Licensed Certified Social Worker-Clinical, (LCSW-C), LICSW, MSW Elizabeth Keohan

Holistic Treatment for Borderline Personality Disorder

In addition to psychotherapy and medication, some people dealing with BPD find help through the use of holistic and natural treatments. There are several natural options to consider in addition to other forms of BPD treatment. They might include:

  • Vitamin C supplements: Those looking to learn how to treat BPD naturally might turn to vitamin C. This common supplement may be helpful for people with BPD with anxiety and nervous tension. According to a 2015 study, taking 500 mg of vitamin C a day reduced anxiety in the study’s subjects.
  • Foods containing omega-3 fatty acids: Foods with omega-3 fatty acids may also be a good choice for people who want to learn how to treat BPD holistically. Foods like salmon, walnuts, sardines, and mackerel have been cited as effective treatments for BPD by several studies, including a 2003 research study by McLean Hospital in Belmont, MA.
  • Magnesium: Another natural treatment for BPD symptoms is magnesium. This supplement can be particularly effective for people who suffer from migraines or who have depression or high anxiety associated with BPD. One 2015 study found that people dealing with BPD had very low levels of magnesium. It was discovered that some subjects who took drugs based on organic salts of magnesium for one year had improved enough to reduce the need for other medication.

Benefits of a holistic approach

When it comes to how to treat BPD naturally, holistic and natural treatments can be a great way to supplement some of the more traditional ways of treating BPD (like therapy and medication). Certain holistic options have been found very effective at managing some common BPD symptoms. They might be a great tool for anyone wanting to know how to treat borderline personality disorder without as much (or possibly any) medication.

One of the key assets of holistic remedies is that they can offer a sense of control over treatment.

“BPD presents a range of diverse symptoms, moods, and episodes, and at times, it can be unpredictable with regard to their occurrence, frequency, and severity. If these are coupled with a dual diagnosis, there’s a layer of complexity added to the overall picture. If you can control your daily health routines and nutrition, and you have a healthy sleep schedule, it can be easier to notice when you’re feeling out of sorts and stressed by other negative triggers.”

Licensed Certified Social Worker-Clinical, (LCSW-C), LICSW, MSW Elizabeth Keohan

Borderline Personality Disorder Treatment Effectiveness

Every case of BPD is unique. Effective BPD treatment starts with finding a therapist you trust and who you’re comfortable talking with. It can often take trying several treatment options and medication combinations before you find something that works. Several studies, including one by researchers in the Netherlands, have found different types of psychotherapy to be the most effective treatment for BPD.

Find Treatment for BPD

The most important takeaway here is that if you or a loved one is living with BPD, you don’t have to suffer or just deal with the symptoms of this condition. Many effective treatments can help you enhance your quality of life, improve your unstable relationships, and feel less angry, anxious, or out of control.

For best results, you should look for a therapist with experience in treating people with BPD. Start by consulting your primary care physician or using online resources.

Online therapy platforms, like Talkspace, offer a unique approach to therapy. You can find a skilled, trained therapist to help you treat borderline personality disorder when and where it’s convenient for you.

Reach out today to learn more about how Talkspace can give you your life back. There is treatment for BPD, and you can take control of your future.

See References

Elizabeth Keohan, LCSW-C, MSW

Licensed Talkspace Therapist, Elizabeth Keohan has enjoyed working with clients in communities from Washington DC through rural Maine over the course of her career. While she has worked extensively with those experiencing anxiety and depression, she embodies a unique comfort working with the bereaved. Elizabeth combines a compassionate, holistic approach with Cognitive Behavioral Theory (CBT), to help clients counter their somatic response to stress, anxiety, mood, grief and loss.

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