Borderline personality disorder (BPD) is a challenge to treat not
only because it is complicated and stigmatized, but also because
its symptoms reflect ingrained patterns of thinking and behavior.
Although it is heterogeneous in nature, causing different
clusters of symptoms in different people, the disorder has three
major clinical components: a fragile sense of self that impairs
relationships with other people, impulsiveness, and emotional
volatility. Many patients with BPD also have other mental health
problems, such as a mood disorder or post-traumatic stress
Drugs may be moderately helpful at reducing particular symptoms,
such as depression or anxiety, but they do not address core
personality traits and behaviors. As such, psychotherapy remains
the mainstay of treatment for patients with BPD, although there
is no "one-size-fits-all" treatment.
Dialectical behavior therapy is probably the most common
psychotherapy used for BPD, but other options have emerged. A
review of four psychotherapies concluded that all were equally
effective overall, but that each had specific advantages. As
such, clinicians and patients can decide on an individual basis
which treatment is most appropriate.
The impact of BPD extends well beyond the individual patient,
causing suffering in family members as well. Loved ones, like
therapists, may struggle with how to respond constructively to a
patient's volatile moods and demands. For that reason, family
members may also benefit from psychotherapy.
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