Skodol A. Borderline personality disorder: Epidemiology, clinical features, course, assessment, and diagnosis. Treatment of borderline personality disorder. Newlin E, et al. Personality disorders. Continuum: Lifelong Learning in Neurology. National Alliance on Mental Illness. Starcevic V, et al. Pharmacotherapy of borderline personality disorder: Replacing confusion with prudent pragmatism. Current Opinion in Psychiatry. Veterans Crisis Line. Department of Veteran Affairs. Accessed May 10, Palmer BA expert opinion.
Mayo Clinic, Rochester, Minn. June 1, National Registry of Evidence-based Programs and Practices. An individual who is seen as a friend one day may be considered an enemy or traitor the next. These shifting feelings can lead to intense and unstable relationships. Not everyone with borderline personality disorder experiences every symptom. Some individuals experience only a few symptoms, while others have many.
Symptoms can be triggered by seemingly ordinary events. For example, people with borderline personality disorder may become angry and distressed over minor separations from people to whom they feel close, such as traveling on business trips.
The severity and frequency of symptoms and how long they last will vary depending on the individual and their illness. The cause of borderline personality disorder is not yet clear, but research suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing borderline personality disorder. Likewise, there may be people without these risk factors who will develop borderline personality disorder in their lifetime.
Borderline personality disorder has historically been viewed as difficult to treat. But, with newer, evidence-based treatment, many people with the disorder experience fewer or less severe symptoms, and an improved quality of life. It is important that people with borderline personality disorder receive evidence-based, specialized treatment from an appropriately trained provider. Other types of treatment, or treatment provided by a doctor or therapist who is not appropriately trained, may not benefit the person.
Many factors affect the length of time it takes for symptoms to improve once treatment begins, so it is important for people with borderline personality disorder and their loved ones to be patient and to receive appropriate support during treatment. A licensed mental health professional—such as a psychiatrist, psychologist, or clinical social worker—experienced in diagnosing and treating mental disorders can diagnose borderline personality disorder by:.
Borderline personality disorder often occurs with other mental illnesses. Co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with the symptoms of borderline personality disorder.
For example, a person with borderline personality disorder may be more likely to also experience symptoms of depression, bipolar disorder, anxiety disorders, substance use disorders, or eating disorders. Borderline personality disorder is also associated with a significantly higher rate of self-harm and suicidal behavior than the general public.
People with borderline personality disorder who are thinking of harming themselves or attempting suicide need help right away. The service is available to everyone. The deaf and hard of hearing can contact the Lifeline via TTY at All calls are free and confidential. The treatments described on this page are just some of the options that may be available to a person with borderline personality disorder. Psychotherapy is the first-line treatment for people with borderline personality disorder.
A therapist can provide one-on-one treatment between the therapist and patient, or treatment in a group setting. Therapist-led group sessions may help teach people with borderline personality disorder how to interact with others and how to effectively express themselves.
It is important that people in therapy get along with, and trust their therapist. The very nature of borderline personality disorder can make it difficult for people with the disorder to maintain a comfortable and trusting bond with their therapist. Because the benefits are unclear, medications are not typically used as the primary treatment for borderline personality disorder.
However, in some cases, a psychiatrist may recommend medications to treat specific symptoms such as:. Certain medications can cause different side effects in different people. Talk to your doctor about what to expect from a particular medication. Some people with borderline personality disorder experience severe symptoms and need intensive, often inpatient, care. Others may use some outpatient treatments but never need hospitalization or emergency care.
Families and caregivers of people with borderline personality disorder may also benefit from therapy. Some borderline personality disorder therapies include family members, caregivers, or loved ones in treatment sessions. This type of therapy helps by:. More information about finding a health care provider or treatment for mental disorders in general is available on our Help for Mental Illness webpage. Learning about BPD can help you to:. Learning about BPD was the most important thing I did to help understand the pain that my partner was going through.
I learned how to best help her in moments of extreme emotional pain. I am now able to de-escalate situations quicker, leaving my partner comforted instead of feeling distant. It has improved our relationship a great deal and brought us closer.
What is a care plan? The care plan is a written document that says what care your relative or friend will get and who is responsible for it. A care plan should always include a crisis plan. A crisis plan will have information about who to contact if they become unwell. You can use this information to support and encourage them to stay well and get help if needed. Can I be involved in care planning?
As a carer you can be involved in decisions about care planning. Your relative or friend needs to give permission for the NHS to share information about them and their care. These techniques can help you when you feel anxious. Website : www. They have some useful information sheets and a workbook for people who are experiencing problems with coping with their feelings. And for people experiencing distress. BPD World Provides information and support to people affected by personality disorders.
It has an online support forum. Samaritans Can be contacted by telephone, letter, e-mail and mini-com. There's also a face-to-face service, available at their local branches. They are open 24 hours a day, every day of the year. Telephone : Email : jo samaritans. Telephone : Website : www. Sane Line Work with anyone affected by mental illness, including families, friends and carers.
Their helpline is open between pm and They also provide a free text-based support service called Textcare and an online supportive forum community where anyone can share their experiences of mental health.
Telephone : pm — pm every evening Textcare : www. Support Line They offer confidential emotional support to children, young adults and adults by telephone, email and post. They work with callers to develop healthy, positive coping strategies, an inner feeling of strength and increased self-esteem to encourage healing, recovery and moving forward with life.
Their opening hours vary so you need to ring them for details. Telephone : E-mail : info supportline. They offer accredited confidential, anonymous and free support, information and signposting to people anywhere in the UK through their helpline and webchat service. Their helpline is open between 5pm and midnight every day of the year. Telephone : 58 58 58 Webchat : through the website Website : www.
My Black Dog Provides peer support webchat with volunteers who have experienced mental illness. Available evenings and weekends. Check the website for opening times. Websit e: www. Papyrus UK Work with people under 35 who are having suicidal feelings. And with people who are worried about someone under Their helpline is open 9am — 10pm in the week. And between 2pm and 10pm at weekends and bank holidays. Telephone : 41 41 Email : pat papyrus-uk. Shout can help with urgent issues such as suicidal thoughts, abuse or assault, self-harm, bullying and relationship challenges.
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Borderline personality disorder This section has information on borderline personality disorder BPD , including symptoms, causes and treatments. If you would like more advice or information you can contact our Advice and Information Service by clicking here. Download Borderline personality disorder factsheet. Share: Contact us:. Overview BPD means that you feel strong emotions that you struggle to cope with.
You may feel upset or angry a lot of the time. Around 1 in people live with BPD. There are different reasons why people get BPD. A lot of people who live with a diagnosis of BPD have had traumatic experiences in their childhood. If you are someone living with a diagnosis of BPD, it is more likely that you will self-harm. And have challenges with relationships, alcohol or drugs. There is help available. There are different ways to treat BPD. The NHS should normally offer you therapy.
Need more advice? If you need more advice or information you can contact our Advice and Information Service. Contact us Contact us. About What is borderline personality disorder BPD? Symptoms What are the symptoms of BPD? Everyone will experience BPD differently. If you live with BPD, you may have difficulties with: being impulsive.
This could be a feeling of being disconnected from your own body. Or feeling disconnected from the world around you. You might not have a sense of who you are. Not everyone will experience all these symptoms. Sam's Story. Sam Sam's Story. You can find more information about: Personality disorders by clicking here. Dissociation and dissociative disorders by clicking here. Self-harm by clicking here. Anxiety disorders by clicking here.
Depression by clicking here. PTSD by clicking here. Drugs, alcohol and mental health by clicking here. Bipolar disorder by clicking here.
There is no evidence though of a particular gene being responsible for BPD. Brain chemicals — problems with levels of your brain chemicals, particularly serotonin.
Brain development — many people who live with BPD have smaller, or more active, parts of their brain. These parts of the brain are affected by your early upbringing. And can affect the regulation of your emotions, behaviour and self-control.
They can also affect you planning and decision making. Environmental factors — a number of environmental factors seem to be common with people who live with BPD.
These can include: experiencing abuse, experiencing long-term fear or distress as a child, being neglected by 1, or both, of your care-givers as a child, and growing up with a family member who had a serious mental health condition.
Such as bipolar disorder or a problem with alcohol or drugs. The first step to get help is to speak to your GP. It may help if you keep a record of: how distressed you feel, any risks to yourself or other people, and details of anything you have done to try and reduce your levels of anxiety and distress.
They will talk to you about: how you manage your day to day life, relationships and work, coping strategies that you use, your strengths, areas in your life that you find difficult. Extreme reactions to feeling abandoned. Unstable and intense relationships with others Confused feelings about your self-image or your sense of identity. Being impulsive in ways that could be damaging. For example, spending, sex, substance abuse, reckless driving, and binge eating Regular self-harming, suicidal threats or behaviour.
Long lasting feelings of emptiness or being abandoned. Inappropriate or intense anger. And difficulty controlling your anger. For example, losing your temper or getting into fights. Intense, highly changeable moods. Dissociation is a feeling of being disconnected from your own body.
What treatment should the NHS offer me? Should I be offered medication? What psychological treatment should I be offered? Your doctor will also think about: how much BPD is affecting you, how much you are willing to engage with therapy, if you want to change how react to your thoughts and feelings, if you will be able to work effectively with a counsellor, and the personal and professional support that is available.
These include: art therapy, drama therapy, music therapy, and dance movement therapy. What treatment should I get if I am in crisis? Your GP should: assess the level of risk to yourself or others, talk to you about previous mental health crises.
And what skills you have used to cope with these, help you to use these skills and focus on your current problems, help you to identify changes which you can put in place to manage your current problems, and offer you a follow-up appointment.
This should include a list of support numbers for out-of-hours teams and crisis teams.
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