Borderline personality disorder is often underdiagnosed or misdiagnosed. There is no single test to diagnose BPD. That is why it is vitally important that those who have received a diagnosis of BPD to undergo psychiatric evaluation by a board-certified psychiatrist or qualified mental health professional who specializes in personality disorders.
Diagnosis
The process includes a thorough interview with the patient, and sometimes with family members, to learn about personal and family medical and mental health history. A medical exam is also needed to rule out other causes of symptoms.
After the evaluation, your practitioner may recommend individual therapy, group or family therapy, or more intensive treatment in the form of hospitalization or a day hospital program. A referral to substance abuse treatment may also be provided.
Co-occurring Conditions
BPD patients almost always have co-occurring mental health problems that lead to an exacerbation of the patient's psychological and physical health. These most often include:
- Major Depressive Disorder
- Dysthymia (chronic, mild to moderate depression)
- Substance abuse
- Eating disorders (anorexia, bulimia, binge eating)
- Bipolar disorder
- Antisocial Personality Disorder
- Narcissistic Personality Disorder
- Self-Injury
People with BPD may also have issues with
- Compulsive spending or gambling
- Risky sexual behavior
- Suicidal ideation
- Deceitfulness
It is important when looking for a treatment center or professional specializing in borderline personality disorder, they should have training and expertise in these co-occurring disorders.
For women with BPD, the condition is more likely to co-exist with other disorders such as major depression, anxiety disorders, or eating disorders. BPD is more likely to occur with disorders such as drug or alcohol abuse or antisocial personality disorder in men.
Treatment
Once thought to be challenging to treat successfully, borderline personality disorder can now be treated effectively with psychotherapy. With therapy, symptoms related to BPD improve and most people with BPD can experience significant and long-lasting periods without symptoms and can live meaningful and productive lives.
Psychotherapy is the cornerstone of treatment. It is also known as “talk therapy” and involves sessions between an individual and a therapist. Some people may also need medications. While there is no particular medication approved by the U.S. Food and Drug Administration for BPD, some individuals with the disorder benefit from medications used to treat symptoms such as anxiety, depression, or aggression.
Patients and their families may consider inpatient treatment if outpatient therapy stalls, the patient’s behavior becomes extremely erratic, or therapy is interrupted due to repeated suicide attempts. Another option is day hospital treatment, in which a patient goes to a daily therapy program while still living at home. This treatment option has been found to be helpful in allowing patients to understand their problems and its effect on others, and bring patients in close contact with others who are also working through similar situations. BPD patients tend to support each other—sometimes in a negative way, to be sure, but more often in a very positive way.
With any treatment, articulate and candid discussion is often instrumental breaking down the issues of denial, blaming, and excuses that hinder growth and acceptance of one’s problems. The recognition of the illness and the determination to overcome it have everything to do with successful treatment.
Self Care
When you have borderline personality disorder (BPD), there are things you can do every day to take care of yourself. Here are some helpful tips recommended by the National Institute of Mental Health.
- Talk to your doctor about treatment options and stick with treatment.
- Try to maintain a stable schedule of meals and sleep times.
- Engage in mild activity or exercise to help reduce stress.
- Set realistic goals for yourself.
- Break up large tasks into small ones, set some priorities, and do what you can, as you can.
- Try to spend time with other people and confide in a trusted friend or family member.
- Tell others about events or situations that may trigger your symptoms. They can be a source of support.
- Expect your symptoms to improve gradually, not immediately. It may take time, but you can get better with treatment.
- Identify and seek out comforting and supportive situations, places, and people.
- Continue to educate yourself about BPD.
Support Services
Support services for families are also available. These services are essential, as family and friends deal with a lot of stress related to their loved ones diagnosis. Local chapters of mental health organizations, such as the American Psychiatric Association, can help patients and families find a practitioner in your area.