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Borderline personality disorder

Treatment of borderline personality disorder

Psychological treatments (talking therapies) are the best way to treat BPD. These treatments usually involve talking with a health professional one-to-one, or sometimes attending special groups.

Medication is not recommended as a person’s main treatment for BPD. For someone who is already receiving psychological treatment, medication may be helpful to manage particular symptoms.

Electroconvulsive therapy (ECT) does not work for BPD.

Goals of treatment

For many people with BPD, important goals are:

  • to overcome emotional problems (such as depression, anxiety and anger)
  • to find more purpose in life (e.g. by making a positive contribution to their community)
  • to build better relationships
  • to learn how to understand and live with yourself
  • to improve physical health.

When should treatment start?

Early treatment is best for people with BPD. It is important to get a diagnosis as soon as possible, so that a health professional (e.g. your GP, psychiatrist, or clinical psychologist) can arrange the right treatment.

Even if your diagnosis is not certain, you can still start treatment. Many of the psychological treatments that are effective for BPD can also be useful for other mental health conditions.

Young people, including teenagers, can have BPD and can start treatment as soon as the diagnosis is made.

Psychological treatment (talking therapy)

Several types of psychological treatment are effective for treating BPD.

Psychological treatment can be provided by psychiatrists and psychologists. It is sometimes also provided by GPs, nurses, social workers and occupational therapists with special training.

BPD treatments that are available in some parts of Australia and New Zealand include:

  • dialectical behaviour therapy (DBT)
  • cognitive behavioural therapy (CBT) designed especially for people with BPD
  • mentalisation-based treatment (or ‘mentalisation’) – a type of psychodynamic psychotherapy, although this is less common.

The availability of BPD treatments differs between regions.

More about psychological treatments

One type of psychological treatment may not suit everyone.

If possible, you should be given a choice between treatments that are available.

Young people with BPD symptoms should be given psychological treatments that are especially designed for their age group (if available). Treatment for young people should be for a planned period of time – not continued indefinitely.

People aged under 25 years may benefit from treatment in specialised mental health services designed for young people.

If you have another mental health condition as well as BPD, both conditions should be managed at the same time. Examples of common conditions include eating disorders, drug and alcohol problems, depression and anxiety.

Will I need medication?

Medication is not recommended as a person’s main treatment for BPD. Medication can make small improvements in some BPD symptoms, but does not improve BPD itself.

Your doctor may prescribe medication to manage particular symptoms in the short-term.

You may need medication for a short while during a crisis. Normally this medication should be stopped soon afterwards.

More about medication for mental illness

Will I need to go to hospital?

Hospital treatment is not a standard treatment for BPD.

Hospital treatment is generally used only for short-term care when really necessary, for example to deal with a serious crisis. If you need to go to hospital, it should be to achieve specific goals that you have agreed with your doctor.

About psychiatric hospitals

Page last reviewed Apr 2017 | C1038V1

This is a general guide only, and does not replace individual medical advice. Please speak to your doctor for advice about your situation. The RANZCP is not liable for any consequences arising from relying on this information. Subject matter experts, people with lived experience of mental illness and carers all contributed to this fact sheet.