What are the treatments for borderline personality disorder? Once an accurate diagnosis is made, developing a comprehensive treatment plan is important. Typically the treatment plan will include psychotherapy strategies, medications to reduce symptom intensity, and group, peer and family support. One overarching goal is for the person with BPD to increasingly direct their care plan as they learn what works and what is counterproductive for them. Psychotherapy is the cornerstone of treatment for individuals who live with BPD. Dialectical behavioral therapy (DBT) is the most well researched and effective treatment for BPD. DBT focuses on teaching coping skills to combat destructive urges, encourages practicing mindfulness (e.g., meditation, regulated breathing and relaxation), involves individual and group work, and is often quite successful in helping people with BPD to control their symptoms. DBT has been shown to reduce the outcome of suicide in research studies for people who live with BPD. Becoming a DBT therapist requires special training and supervision. If you are interested in DBT, be sure to understand the qualifications of the therapist in this specialized treatment. While cognitive behavioral therapy (CBT), psychodynamic psychotherapy and certain other psychosocial treatments are useful for some people with BPD, the majority of people with this illness will find dialectical behavioral therapy (DBT) to be the most useful form of psychotherapy. Medications can be an important component to the care plan, yet is important to know that there is no single medication treatment that can “cure” borderline personality disorder. Furthermore, no medication is specifically approved by the FDA for the treatment of BPD. Medications are however useful in treating specific symptoms in BPD and may support and enhance essential psychotherapy efforts. For example, off label use of a number of medications may manage key symptoms, including valproate (Depakote) that may be useful in decreasing impulsivity, omega-3 fatty acids (fish oil) that may be helpful in decreasing mood fluctuations, and naltrexone (Revia), which has helped some people decrease their urges for self-injury and the use of antipsychotic medication may help with symptoms of disorganized thinking. Relief of such symptoms may help the individual change the harmful patterns of thinking and decrease the detrimental behaviors that disrupt their daily activities. Medication treatment of coexisting medical and mental illnesses, such as anxiety or depression, is also very important in the treatment of BPD. Co-occuring conditions are common and require attention in the care plan. The use of psychiatric medications should be discussed at length with one’s psychiatrist as individuals with BPD may be at increased risk of experiencing side effects from their medications due to the large number of medications that many people with this illness are prescribed. The use of psychiatric medications should be discussed at length with one’s psychiatrist to understand the risks and benefits of any treatment choice and to get a better sense of the literature upon which the recommendation is based. While not usually indicated for the chronic symptoms of BPD, short-term inpatient hospitalization may be necessary during times of extreme stress, impulsive behavior, or substance abuse. In other cases however, inpatient psychiatric hospitalization may be paradoxically detrimental for some people with BPD. The support of family and friends is of critical importance in the treatment of BPD as many people with this illness may isolate themselves from these relationships in times of greatest need. Family and friends can be most helpful in encouraging their loved one to engage in proper treatment for this complicated illness. With the support of family and friends, involvement in ongoing treatment, and efforts to live a healthy lifestyle—regular exercise, a balanced diet and good sleeping habits--most people with borderline personality disorder can expect to experience significant relief from their symptoms.
Posted on: Thu, 22 Aug 2013 17:00:01 +0000
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