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Borderline personality disorder

Borderline personality disorder: Treatment

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 also make sure you have as much independence as possible.

A CMHT can be made up of:

  • 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

Individual care plans

An individual care plan ensures 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 keyworker
  • regular reviews of your Individual care plan

Psychotherapy

Treatment for BPD usually involves a psychological therapy, also known as psychotherapy. There are lots of 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. Therapy for BPD aims to help people get a better sense of control over their thoughts and feelings.

A trained professional will deliver psychotherapy for BPD. This will be a psychiatrist, psychologist or other trained mental health professional. Don't be afraid to ask about their experience.

Some of the recommended therapies are dialectivalbehaiour therapy (DBT), mentalisation-based therapy (MBT) and 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)

A type of long-term psychotherapy used to treat BPD is mentalisation-based therapy (MBT).

MBT recognises that people with BPD have a poor capacity to mentalise.

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 is:

  • individual sessions with a therapist
  • group sessions with other people
  • out-of-hours telephone support

MBT is a long-term type of psychotherapy.

Arts therapies

Arts or creative therapies are not first line interventions. But they have shown some benefits for people with BPD. These can be individual or part of a group.

Therapies may 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 think about whether your work relates to your thoughts and experiences.

A course of art therapy usually involves weekly sessions, which last up to two hours.

Treating a crisis

You will get telephone numbers to use if you think you may be experiencing 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).

In a small number of cases, you may get a short course of medication, such as a tranquiliser, to calm your mood. This medication is usually prescribed for seven days.

Medication

There is no medication currently licensed to treat BPD.

You can use medications if you have another mental health condition, such as:

  • depression
  • anxiety disorder
  • bipolar disorder

Mood stabilisers or antipsychotics are sometimes prescribed to:

  • help mood swings
  • ease psychotic symptoms
  • reduce impulsive behaviour

Page last reviewed: 23/09/2018
Next review due: 23/09/2021

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