Borderline personality disorder (BPD) treatment

A personality disorder is a challenging mental health problem often characterised by rigid, structured, and repeated patterns of feeling, thinking and behaving. This condition is usually treated using individual or group therapy. Find further information on treatment/counselling options and the symptoms of BPD below.

What is BPD?

Personality disorders consist of a number of separate conditions and symptoms which all affect how people manage their emotions and relationships with others. This can cause the sufferer to behave in a way which is upsetting to others or causes harm to themselves. The different disorders can be broadly grouped into three clusters: A, B and C. Not infrequently, sufferers may meet diagnostic criteria for more than one disorder, which may be from different clusters.

  • Cluster A – individuals in cluster A typically behave in odd or eccentric ways. They can be cut off emotionally from others. Cluster A includes paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder.
  • Cluster B – individuals in cluster B behave in dramatic, erratic, or impulsive ways. They tend to struggle to regulate their feelings and swing between positive and negative views of others. Cluster B includes borderline (emotionally unstable) personality disorder, histrionic personality disorder, narcissistic personality disorder and antisocial personality disorder.
  • Cluster C – individuals in cluster C typically struggle with overwhelming fear and anxiety. They tend to worry a lot, and as a result, can behave in a very withdrawn manner. Cluster C includes obsessive compulsive personality disorder, avoidant personality disorder and dependent personality disorder.

BPD is thought to affect 2% of adults, with three quarters of those diagnosed being female. Sufferers can also be prone to substance abuse, depression and other mood disorders.

Treatment options for BPD

For a long time, it was thought that personality disorder was untreatable, as it involved deep rooted patterns of thought and behaviour. This is no longer accepted to be the case. BPD  treatment can be psychological (talking therapies) or can involve medication.

Psychological therapies

These may take the form of group sessions or individual work. There are a number of different types of psychological therapy which have been shown to be effective in the treatment of BPD, all of which have different underlying theoretical approaches. Cognitive behavioural therapy (CBT) and dialectal behaviour therapy (DBT) are commonly used in the treatment of personality disorder.

Pharmacological treatment

This includes the use of antipsychotic, antidepressant, and mood stabilising medication. As the precise package of treatment will be based on the needs of the individual patient, it is difficult to generalise. The aim of treatment is to help sufferers live fulfilling lives, and to cope more effectively with their difficulties.

Priory are able to treat BPD at a number of our specialist hospitals - click here to read more on our locations.

What are the causes of BPD?

As with so many mental health problems, the exact causes of personality disorder and BPD are unknown. The majority of mental health problems occur in response to a number of factors, including genetic, social and environmental causes. Personality disorder is thought to be due to a combination of genetic predisposition as well as particular life experiences, which may or may not include incidents of trauma or abuse. 

  • Genetics: research on the inheritance of normal personality has found that some personality traits (e.g. narcissism) are more likely to be inherited than others. In addition, individuals with certain personality disorders are more likely to have relatives with mental illnesses (e.g. individuals with Cluster A personality disorders have been found to be more likely to have relatives with schizophrenia or schizophrenia-like disorders)
  • Verbal abuse: child abuse and neglect have consistently been found to be risk factors for the development of personality disorders in adulthood. Children who experience verbal abuse were three times as likely as other children to have borderline, narcissistic, obsessive-compulsive or paranoid personality disorders in adulthood
  • Sexual abuse: sexually abused children demonstrate the most consistently elevated patterns of psychopathology. Physical abuse in childhood showed an extremely strong correlation with the development of antisocial and impulsive behaviour in adulthood.

What are the symptoms of BPD?

Personality disorder symptoms can begin to appear in adolescence, and continue into adulthood. The personality disorder can range from mild to very severe, and an individual may be more or less symptomatic at different times in their life. Personality disorder symptoms typically become more pronounced during times of stress. Symptoms include:

  • Intense emotions that can change quickly (for example feeling happy in the morning and low in the afternoon)
  • Acting impulsively and engaging in potentially harmful behaviour
  • Difficulty in making and keeping stable relationships
  • Worries about being abandoned, feeling lonely and empty
  • Difficulty with self-identity, not having a strong sense of who you are or this changing dependent on company
  • Paranoia, having psychotic experiences such as seeing or hearing things that are not real
  • Self-harming behaviour and thoughts of suicide

Diagnosing BPD

BPD typically involves unusual and unstable mood levels, and ‘black and white’ thinking that goes from one extreme to the other. Other characteristics include chaotic personal relationships, low levels of self-image, identity and behaviour, alongside a disturbance in a person's sense of oneself.

Diagnosis must satisfy general and specific criteria:

  • Behaviour which deviates markedly from the individual's culture
  • An enduring, inflexible and pervasive pattern of behaviour across a range of personal and social situations
  • The behavioural pattern leads to clinically significant distress or social, occupational and personal impairment
  • The pattern is consistent and lengthy, tracing back to adolescence or early adulthood
  • The pattern is not attributable to consequences of any other kind of mental health problem
  • The pattern is not due to substance abuse or a medical condition such as a head injury

While BPD can manifest itself in children and teenagers, like personality disorder, therapists are discouraged from making a formal diagnosis of anyone before they are 18 years old. This is due to the nature of adolescence and an evolving personality during this time.

Helping someone who has BPD

If you are concerned for a loved one who may be suffering from BPD, Priory can help. We understand that it can be very concerning to see someone that you care about struggle with a mental health issue but there are steps that you can take to help both them and yourself.

Priory's approach to BPD treatment

Priory have a nationwide network of hospitals and wellbeing centres that specialise in the treatment of BPD. Our treatment programmes are led by experts including consultant psychiatrists, psychologists, occupational therapists and mental health nurses who aim to significantly improve the lives of those living with BPD. 

We help those with a personality disorder to cope more effectively with their difficulties. We enable individuals to lead a more positive lifestyle for the future, as well as reducing the level of risk to themselves and others. Therapy that Priory recommends for this condition includes CBT and DBT.

For further details on how Priory can provide you with further assistance regarding Borderline personality disorder (BPD) treatment, please call 0800 840 3219. For professionals looking to make a referral, please click here