Borderline Personality Disorder is a serious psychiatric illness. But there is hope. With appropriate treatment many show improvement in one year. Over time, 80% of BPD sufferers reduce their symptoms.
People with BPD have extreme difficulties regulating their emotions. Common problems include anger, chaotic relationships, impulsivity, unstable sense of self, suicidal attempts and thoughts, self-harm, shame, fears of abandonment, and chronic feelings of emptiness.
People with BPD often have intense and stormy relationships. Attitudes toward family, friends and loved ones may shift suddenly. Relationship problems are common and the behaviors are difficult for loved ones to manage effectively. Additionally, stress in relationships can make for even more challenges.
It is estimated that more than 14 million American adults, distributed equally between men and women, have BPD. It is as common as schizophrenia or bipolar disorder: an estimated 11% of outpatients, 20% of psychiatric inpatients and 6% of primary care visits meet the criteria for the disorder. Obtaining an accurate diagnosis can be difficult.
Research, treatment options and family education are decades behind compared to other major psychiatric disorders. The costly personal, social and economic toll of BPD makes it a significant national public health burden and issue. However, the impact of BPD remains largely unrecognized.
BPD rarely stands alone. People with borderline personality disorder often have other diagnosis. This is called co-morbidity or having co-occurring disorders. Common co-occurring disorders include substance abuse, eating disorders, anxiety disorders, bipolar disorder as well as other personality disorders. Over half the BPD population suffers from Major Depressive Disorder. When depression and BPD co-occur, the depression often does not lift with medication until the borderline personality disorder symptoms improve.
There has been considerable progress in the last 25 years both in understanding and treating BPD. Now there are treatments shown to be effective. The most researched and well known are Dialectical Behavior Therapy (DBT) and Mentalization Therapy (MBT). Unfortunately, inpatient and outpatient treatment options for this disorder are limited.
There is no specific medication approved to treat BPD. People with BPD are often prescribed medications to treat their symptoms. Research shows that medications can be moderately effective for anger, impulsivity and depression. Both patients and doctors need to be aware that more often than not the response is modest at best. Those with BPD can be to be quite sensitive to the side effects of the medications. It is important to discuss these side effects with a doctor before deciding on ones own that the medication is not good or too troublesome to continue to take. Clinicians trained to treat BPD use medication as an addition to, not a replacement for, talk therapy.