Treatment for borderline personality disorder (BPD) may involve individual or group psychotherapy. You will get this from professionals within a community mental health team (CMHT).
The CMHT provide day-to-day support and treatment. They will make sure you have as much independence as possible.
A CMHT can include:
- social workers
- community mental health nurses who have specialist training in mental health conditions
- pharmacists
- counsellors and psychotherapists
- psychologists and psychiatrists - the psychiatrist is usually the senior clinician in the team
- occupational therapists
Your GP can refer you to the CMHT.
Individual care plans
The CMHT will create an individual care plan with you. This will ensure that you receive the right treatment for your needs.
There are 4 stages:
- An assessment of your needs and goals.
- A care plan created with your mental health team to identify goals and a plan to meet those goals.
- The appointment of a key worker.
- Regular reviews of your individual care plan.
Psychotherapy
Treatment for BPD usually involves psychological therapy, also known as psychotherapy. There are different types of psychotherapy. They all involve taking time to help you get a better understanding of how you think and feel.
Your psychotherapist can suggest ways to resolve your problems. They can help you change your attitudes and behaviour.
Your psychotherapist can be a psychiatrist, psychologist or other trained mental health professional. Do not be afraid to ask about their experience.
Some of the recommended therapies are:
- dialectical behaviour therapy (DBT)
- mentalisation-based therapy (MBT)
- arts therapies
Dialectical behaviour therapy (DBT)
Dialectical behaviour therapy (DBT) is a type of therapy designed to treat people with BPD. It is delivered by a DBT Team.
DBT usually involves weekly individual and group skills sessions.
You will work with your therapist and the other people in your group sessions to learn new skills.
Mentalisation-based therapy (MBT)
Mentalisation-based therapy (MBT) is a type of long-term psychotherapy used to treat BPD.
MBT recognises that people with BPD have a poor capacity to understand their own and other people's mental states and motivation.
The goal of MBT is to improve your ability to recognise your own and others' mental states. You learn to step back from your thoughts about yourself and others and examine them to see if they're valid.
You might get MBT in a hospital, where you would stay as an inpatient.
Treatment includes:
- individual sessions with a therapist
- group sessions with other people
- out-of-hours telephone support
Arts therapies
Arts or creative therapies are not the first treatments you can get for BPD. But they have shown some benefits for people with BPD. These therapies can be given on an individual basis or as part of a group.
Therapies include:
- art therapy
- dance movement therapy
- drama therapy
- music therapy
Arts therapies aim to help people who are finding it hard to express their thoughts and feelings. The therapy focuses on creating something as a way of expressing your feelings.
Trained therapists run the course. You will be encouraged to think about how your creative work may relate to your thoughts and experiences.
A course of art therapy usually involves weekly sessions, which last up to 2 hours.
Treating a crisis
You will get telephone numbers to use if you think you may be having a crisis. This is when your symptoms are severe and you have an increased risk of self-harm.
One of these numbers is likely to be your community mental health nurse or DBT therapist.
Other numbers may include an out-of-hours social worker and crisis resolution team (CRT).
You may get a short course of medicine, such as a tranquiliser, to calm your mood. This happens in a small number of cases. This medicine is usually prescribed for 7 days.
Medicine
There is no medicine currently licensed to treat BPD.
You can use medicine if you have another mental health condition, such as:
Mood stabilisers or antipsychotics are sometimes prescribed to:
- help mood swings
- ease psychotic symptoms
- reduce impulsive behaviour
Content supplied by the NHS and adapted for Ireland by the HSE