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Helping Yourself & Others

Personality disorders are difficult to treat, but promising treatments are giving people hope.

People with borderline personality disorder can get better with professional help. Seeking treatment and then sticking with it is the most important thing you can do to reclaim your life. Treatment is available and can help you live a rewarding life.

Promising new therapies

Borderline personality disorder has shown some responsiveness to therapy. Therapy involves learning about your condition and thinking and talking about how you feel, think, and behave. If possible, find a mental health care provider familiar with treating personality disorders. Several therapies have shown promise for the treatment of borderline personality disorder.

Transference-focused psychotherapy. Transference-focused psychotherapy works through the relationship between you and your therapist. When emotions and difficulties inevitably arise in the relationship, the therapist will help you understand and work through them. You can then use what you have learned in your relationship with your therapist to improve your relationships with family, friends, and others.

Dialectical behavior therapy. Dialectical behavior therapy focuses on developing skills for handling stress, regulating emotions, tolerating negative emotions, and improving relationships. DBT was developed specifically to treat borderline personality disorder, and research has shown it to be an effective approach.

Schema therapy. This therapy is based on “schemas,” which are “broad, pervasive themes regarding oneself and one's relationship with others, developed during childhood and elaborated throughout one's lifetime, and dysfunctional to a significant degree.” In schema therapy, a therapist trained in the therapy helps you to recognize and switch out of self-defeating schema modes as quickly as possible, get in touch with your core feelings, and get your emotional needs met in healthier ways.

With these advances in treating borderline personality disorder and new theories about the underlying thoughts, emotions, and styles of personality disorders in general, the hope is that more breakthroughs for treatment will occur.

Medication may help

Although no medication is specifically approved to treat borderline personality disorder, a number of medications can be used to manage some of the specific symptoms or other conditions that also may be present.

Four types of medications, in combination with therapy,  may help (from the Mayo Clinic):

  • Antidepressants: For feelings of depression, anger, impulsiveness, moodiness, or hopelessness
  • Mood stabilizers: For balancing out mood swings and reducing impulsive or aggressive behavior
  • Antianxiety medications: For lessening anxiety or distress; they have been known to increase impulsive behavior
  • Antipsychotic medications or neuroleptics: For regaining touch with reality and sometimes for anxiety or anger

Side effects

Most medications have side effects and their effectiveness may vary from person to person. Sometimes a side effect outweighs the benefit of a particular medication. It’s important to be monitored closely by a healthcare provider when taking any medication. Finding the right type of medication and dosage may also take time.

When is hospitalization a good option?

Sometimes a serious situation requires a serious solution. If a person’s behavior puts himself or others at risk, or a person is unable to provide his own care, hospitalization might be a necessary short-term solution. Options include a psychiatric hospital with 24-hour inpatient care, or day hospitalization. Another option may be residential treatment, which involves a therapeutic place to live.

For family and friends

Helping a loved one cope with a mental illness is an extremely difficult effort. The challenges, mysteries, and unpredictability—not to mention such stressors as risky behavior, violence, and suicide attempts—all take a huge toll. Learning how to manage your own emotions and provide loving support can feel like an impossible mountain to climb. The good news is that in addition to new research and treatments, there are also many support services and networks to tap into.

One of the most important things you can do for someone who suffers from borderline personality disorder is to help her seek treatment and then help her stick with it. Being supportive and caring and setting clear boundaries for behavior that you will not tolerate can help motivate your loved one to start and stay with a treatment plan. Some practical supports include taking her to appointments, becoming familiar with the treatment and healthcare providers, and being patient and encouraging. It will probably take a while to see improvements; recovery is typically slow.

Other ways to help include staying organized and on top of things by having permission to discuss your friend or loved one’s condition with her healthcare providers, and having a list of medications she is taking, having emergency phone numbers handy for family members, hospitals or support lines. And maybe most important of all, don’t forget to take a break and take care of yourself, getting rest, exercise, and attending to your own personal needs so you have the patience and stamina to be the supporter that you want to be.

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