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Borderline Personality Disorder (BPD)

What Is Borderline Personality Disorder (BPD) and How Is It Treated?

Borderline Personality Disorder (BPD) is a mental health disorder linked to early traumatic experiences. According to the National Center for Biotechnology Information (NCIB), “surveys have estimated the prevalence of borderline personality disorder to be 1.6% in the general population and 20% of the psychiatric inpatient population.” BPD is characterized by extreme mood swings, rapid changes of interests and values, and substantial uncertainty about a person’s place in the world. Individuals with BPD often engage in risky and dangerous behavior, including drug and alcohol abuse, promiscuity, and self-injurious behaviors, like cutting and suicide attempts.

Create Recovery Center helps those who are struggling with a dual diagnosis of substance addiction or impulse control disorders and BPD. If you or a loved one needs intensive residential treatment, outpatient therapy, or partial hospitalization, we have a program that can suit your needs. Our expert clinical team is here to help those suffering from BPD learn how to manage the common symptoms of BPD, like:

  • “Black-and-white,” “all-or-nothing” thinking styles where everything is either “all good” or “all bad,” with little in between
  • Sudden and intense shifts of perceptions and moods
  • Intense fear of real or imagined abandonment in personal relationships
  • Disturbance of identity due to an unstable self-image
  • Dangerous, impulsive, and risky behaviors, like:
    • Binge-eating
    • Substance and alcohol abuse
    • Unsafe sexual practices
    • Reckless driving
    • Cutting or other Self-Injurious Behaviors (SIBs)
    • Spending sprees
  • Suicidal ideation and threats of suicide
  • Chronic feelings of emptiness
  • Inappropriate, intense, or uncontrollable anger
  • Difficulty building trust and maintaining meaningful relationships
  • Unstable relationships due to extremes of perception between:
    • Devaluation: reduction of another’s value
    • Idealization: exaggeration of another’s positive attributes.

There Is Hope: Treatment for Borderline Personality Disorder

Treating Borderline Personality Disorder (BPD) with a co-occurring addiction can include multiple strategies to address all aspects of the disorder and addiction, such as:

Group therapy
One-on-one counseling
Support groups
Family therapy
Holistic treatment
Medication to treat co-occurring mood swings, depression, and anxiety

At Create Recovery, our staff can help you find the best approach for your personalized treatment plan. Our comprehensive program is precipitated on the philosophy of “meeting people exactly where they are.” Our team is comprised of caring, knowledgeable, and sympathetic professionals who are passionate about helping those struggling with BPD and addiction. We offer therapy based on one of the most effective treatments for BPD: Dialectical Behavioral Therapy.

What Is Dialectical Behavioral Therapy (DBT)?

According to a National Center for Biotechnology Information (NCBI) study published in March 2016, DBT is “currently the only empirically supported treatment for BPD.” DBT is one of the only evidence-based practices for treating BPD effectively. The clinical team of Create Recovery can incorporate DBT in the therapeutic treatment of those with BPD.

DBT is a type of Cognitive Behavioral Therapy (CBT) catered to the unique needs of those with BPD (although DBT can also be useful for other mental health issues!) Cognitive Behavioral Therapy looks at challenging the negative thoughts and perceptions that can influence our feelings and behaviors. DBT differs by focusing specifically on the concept of “dialectics” or the interactions of conflicting and opposing ideas. DBT helps those with BPD by “bridging the gap” between extreme viewpoints that appear to be in opposition. By creating a conduit between opposing views, the person with BPD can learn to see that everything is not “black-and-white,” but that they are many gray and neutral areas in life.

The skills a person learns in DBT focus on four areas:
  1. Mindfulness – learning to live in and accept the present moment for what it is.
  2. Interpersonal Relationships – obtaining skills, like communication and assertiveness, to build and maintain strong relationships.
  3. Emotional Regulation – learning to identify emotions and appropriately respond to events.
  4. Distress Tolerance – learning to tolerate discomfort and frustration.
Individuals work on these areas with a therapist through various exercises, workbooks, and talk-therapy sessions. Building these skills can help a person succeed in life by focusing not only on symptom management but also on healthy replacement skills. Create Recovery can help you learn these skills that have a proven track record for treating BPD. Other therapy modalities and treatments can also help treat some of the other co-occurring disorders, like anxiety, depression, Post-Traumatic Stress Disorder (PTSD), and addiction that may be present with BPD.

Do I Have Borderline Personality Disorder?

If you believe you or a loved one may be suffering from Borderline Personality Disorder, our assessment may be a beneficial tool. Although the assessment can not be used as a definitive diagnosis, it can help to determine how many symptoms associated with BPD a person may be facing.

We base our assessment questions on the criteria laid out by the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Regardless to the results of the assessment, it is important to note that any mental health disorder must be diagnosed by a trained medical professional.

When a Loved One Has BPD: How to Help

If a loved one, family member, or friend has BPD, you might have difficulty maintaining the relationship. Remember that your loved one has symptoms of a disorder that can be treated. The symptoms of BPD can be taxing on interpersonal relationships, and the person with BPD might push away those trying to help them. One of the most challenging aspects of treating BPD is that the characteristics of the disorder can corrode otherwise healthy and helpful relationships.

Taking care of yourself is critical when helping a loved one with BPD. You might want to consider attending support groups and therapy to be your best self while your loved one is going through treatment. Create Recovery believes that strong support networks are critical to recovery from addiction and mental health disorders. Family therapy can be a crucial element to your loved one’s success; your involvement in treatment and aftercare can help them get their life back on track. There is hope for you and your loved one to live successful and happy lives!

Borderline Personality Disorder FAQ


What is Borderline Personality Disorder (BPD)?

Borderline Personality Disorder is a mental health condition characterized by intense emotional instability, unstable relationships, distorted self-image, and impulsive behaviors. People with BPD often experience intense fear of abandonment and have difficulty regulating their emotions.

BPD affects approximately 1.4% of adults in the United States and is more commonly diagnosed in women than men. The condition typically emerges in early adulthood and can significantly impact daily functioning and relationships.

What are the main symptoms of BPD?

The main symptoms of BPD include:

  • Intense fear of abandonment, real or imagined
  • Unstable and intense interpersonal relationships
  • Distorted and unstable self-image or sense of self
  • Impulsive behaviors that are potentially self-damaging
  • Recurrent suicidal behavior or self-harm
  • Emotional instability and intense mood swings
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger
  • Stress-related paranoid thoughts or dissociative symptoms

What causes Borderline Personality Disorder?

The exact cause of BPD is not fully understood, but research suggests it results from a combination of factors:

Genetics: Having a family history of BPD or other mental health conditions may increase risk

Brain structure and function: Differences in areas of the brain that control emotions and decision-making

Environmental factors: Childhood trauma, abuse, neglect, or separation from caregivers

Social factors: Unstable family relationships or cultural factors

It's important to note that experiencing trauma doesn't guarantee someone will develop BPD, and not everyone with BPD has a history of trauma.

How is BPD diagnosed?

BPD is diagnosed by a qualified mental health professional through a comprehensive evaluation that includes:

  • Detailed interview about symptoms and personal history
  • Assessment of current functioning and relationships
  • Review of family mental health history
  • Psychological testing when appropriate
  • Rule out other mental health conditions

A diagnosis requires meeting at least 5 of the 9 criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The symptoms must be present by early adulthood and occur across various situations.

What treatment options are available for BPD?

Several evidence-based treatments have shown effectiveness for BPD:

Dialectical Behavior Therapy (DBT): The gold standard treatment focusing on emotion regulation and interpersonal skills

Cognitive Behavioral Therapy (CBT): Helps identify and change negative thought patterns

Mentalization-Based Therapy (MBT): Improves ability to understand thoughts and feelings

Schema Therapy: Addresses deeply rooted patterns and beliefs

Medication: While no specific medication treats BPD, certain medications can help manage symptoms

Treatment typically involves individual therapy, group therapy, and sometimes family therapy. The most effective approach is often a combination of these methods.

Can someone with BPD recover?

Yes, recovery from BPD is absolutely possible. Research shows that with proper treatment, many people with BPD can achieve significant improvement and lead fulfilling lives. Studies indicate that about 85% of people with BPD achieve remission within 10 years of diagnosis when they receive appropriate treatment.

Recovery typically involves learning new coping skills, developing emotional regulation techniques, and building healthier relationships. While it requires commitment and time, many people with BPD go on to have successful careers, relationships, and overall life satisfaction.

How long does BPD treatment take?

The length of treatment varies significantly depending on individual circumstances, severity of symptoms, and treatment approach. However, most evidence-based treatments for BPD are designed as longer-term interventions:

  • DBT typically lasts 1-2 years
  • Individual therapy may continue for several years
  • Some people benefit from ongoing maintenance therapy
  • Crisis stabilization may be needed initially

While treatment is often long-term, many people begin to see improvements in their symptoms within the first few months of consistent therapy.

Is BPD the same as bipolar disorder?

No, BPD and bipolar disorder are different conditions, though they can sometimes be confused due to some overlapping symptoms:

BPD: Mood changes are typically triggered by interpersonal events and last hours to days

Bipolar: Mood episodes (mania/depression) last weeks to months and may not have clear triggers

BPD: Focuses on relationship patterns and identity issues

Bipolar: Primarily a mood disorder with distinct manic and depressive episodes

It's possible to have both conditions, and accurate diagnosis by a qualified professional is essential for proper treatment.

How can family members help someone with BPD?

Family support is crucial for recovery from BPD. Here are ways family members can help:

  • Learn about BPD to better understand the condition
  • Attend family therapy sessions when recommended
  • Practice patience and avoid taking behaviors personally
  • Set healthy boundaries while remaining supportive
  • Encourage treatment and therapy participation
  • Take care of your own mental health
  • Join support groups for families of people with BPD

Remember that recovery is a process, and having a supportive family can significantly improve outcomes.

Does insurance cover BPD treatment?

Most insurance plans cover mental health treatment, including BPD therapy, thanks to mental health parity laws. Coverage typically includes:

  • Individual psychotherapy sessions
  • Group therapy programs
  • Intensive outpatient programs (IOP)
  • Partial hospitalization programs (PHP)
  • Psychiatric medication management

Coverage details vary by plan, so it's important to check with your insurance provider about specific benefits, copays, and any pre-authorization requirements. Many treatment centers also offer financial assistance or payment plans for those who need them.