Borderline personality disorder is a widely popular psychiatric disorder characterized by extreme mood swings, irrational responses, impulsivity, and unstable emotions. Individuals who have borderline personality disorder are likely to come off as aggressive and difficult in their relationships; they tend to have strong opinions, and even polite disagreement is seen as a personal insult.
This condition is painful for both patients and their loved ones. The 'black-and-white' thinking that categorizes the disorder often causes intense conflict, jealousy, and emotional pain to a person with borderline personality disorder. Understanding the treatment options available can help patients find the right approach for their condition and learn to manage their symptoms so they can lead happier, stabler lives.
Schema-focused therapy is a common therapy used for the treatment of borderline personality disorder. Patients with this condition struggle with intense emotions and polarized thinking patterns. In psychology, a schema is a deeply held belief and set of thinking patterns that define how we view ourselves and the world around us.
Schema-focused therapy helps patients identify distorted thinking patterns, relate them to past events that caused them and develop more productive, healthier views. Patients with borderline personality disorder are prone to lash out in fits of anger, so a schema-focused approach to therapy can help them identify their thoughts and feelings when they are angry, understand why they react so intensely, and develop better ways to cope with and express their emotions.
Patients who undergo schema-focused therapy are likely to experience greater control over their emotions and less distressing, maladaptive thinking. Their new coping strategies and perspectives can help them communicate better and maintain peace in their relationships.
Due to reduced impulse control and a tendency to partake in risky, self-destructive behaviors, individuals with borderline personality disorder may require emergency hospitalization. Some patients may check themselves into the hospital for being suicidal or contemplating self-harm; others may be involuntarily committed during a time of psychological crisis, which a family or concerned friend may refer to as a 'breakdown.'
The main goal during hospitalization is to stabilize the patient. If a person with borderline personality disorder is checked into the emergency room, a doctor will treat any immediate physical injuries and then refer them to a hospital psychologist. The psychologist will then evaluate the patient's mental state and determine whether they need additional inpatient treatment or refer them to outside help.
Inpatient treatment will focus on stabilization through one-on-one counseling, group therapy and, possibly, medication. Once discharged, a patient may either be referred to a partial hospitalization program or outpatient therapy. Continuing treatment with a psychologist or psychiatrist after discharge is vital to the prolonged management of symptoms and the reduction of future hospitalizations or emotional crisis.
Dialectical Behavior Therapy
Dialectical behavior therapy is a relatively new form of therapy designed by Marsha Linehan, Ph.D. It was originally intended to treat patients suffering from suicidal thoughts, but it is now the standard therapeutic method for treating borderline personality disorder.
Dialectical behavior therapy is a modified form of cognitive behavioral therapy that incorporates additional skills that help patients regulate their emotions, organize their thoughts, and develop stronger coping mechanisms. Mindfulness, acceptance, and distress tolerance are major components of dialectical behavior therapy, and they help patients with borderline personality disorder become more accepting and secure in their emotions.
This form of therapy is typically broken down into individual therapy, group skills, telephone support, and weekly support meetings for therapists to ensure the effectiveness of treatment. Studies show dialectical behavior therapy has been highly effective in treating borderline personality disorder.
In some cases, medication is used alongside therapy to help manage the symptoms of borderline personality disorder. Individuals who have depression or anxiety along with borderline personality disorder, for example, can benefit from exploring different medication options with their doctor or a psychiatrist. Many borderline personality disorder patients have co-occurring disorders such as major depressive disorder or generalized anxiety disorder. The role of medication in these cases is to reduce unpleasant feelings, stabilize moods and reduce symptoms such as paranoia, anxiety, anger, and impulsivity.
Medication is not a means of curing borderline personality disorder. While some patients may benefit from taking medication, they must address their thinking and behaviors through therapy. Only with a licensed mental health professional can someone with borderline personality disorder gain the emotional security, self-awareness, and coping strategies they need to overcome their condition and improve their lives.
Good Psychiatric Management
The willingness to improve and treat their condition plays a large role in a patient's success. While dialectical behavioral therapy, medication, and other forms of talk therapy can help someone with borderline personality disorder adopt more adaptive models of behavior and thinking, a lack of motivation or resistance to treatment will lead to poor outcomes.
Patients with borderline personality disorder must understand ongoing treatment with a therapist they trust can help them overcome their symptoms with time and patience. A therapist can help someone with borderline personality disorder manage symptoms that often seem to come out of nowhere. Managing borderline personality disorder alone is difficult, especially in the earliest stages of treatment when there is a lack of sense awareness, greater impulsivity, and unstable emotions.
Even after symptoms have been reduced, good psychiatric management can help a patient develop the skills they need to thrive beyond the present. Regardless of whether emotions or thinking patterns emerge in the future, a therapist can provide the support and strategy patients to help navigate their relationships with themselves and others.