Borderline Personality Disorder Treatment
Specialized medication support for emotional regulation and symptom management
Understanding Borderline Personality Disorder
Living with BPD can feel like riding an emotional tidal wave. One moment you might feel deeply connected to someone, and the next, you're convinced they're going to abandon you. Your emotions can shift dramatically within hours—from feeling okay to overwhelming sadness, rage, or emptiness. You might do things impulsively to cope with intense feelings, only to regret them later. Relationships feel impossibly complicated, and you might wonder who you even are underneath all the emotional chaos.
BPD isn't about being "too sensitive" or "dramatic"—it's a real condition that affects how you experience and regulate emotions, relate to others, and see yourself. Many people with BPD have experienced trauma or invalidating environments that taught them not to trust their own feelings. The good news: BPD is highly treatable. With the right combination of therapy and medication, people with BPD can develop emotional regulation skills, build stable relationships, and find peace.
You might be experiencing:
Our Medication Approach
While specialized therapy (particularly DBT—Dialectical Behavior Therapy) is the primary treatment for BPD, medication can be very helpful for managing specific symptoms like mood instability, anxiety, impulsivity, and brief psychotic episodes. We don't treat BPD with a single medication, but rather target specific symptom clusters to improve your quality of life while you develop skills in therapy.
Mood Stabilizers (For Emotional Dysregulation)
Help reduce mood swings, impulsivity, and anger outbursts. Can provide a more stable emotional baseline.
- Lamotrigine: Often well-tolerated, helps with mood instability and impulsivity
- Valproate: Can reduce anger, impulsivity, and mood lability
- Helps create emotional stability to engage more effectively in therapy
Antidepressants (For Depression and Anxiety)
SSRIs and SNRIs can help with co-occurring depression, anxiety, and emotional sensitivity.
- May reduce emotional reactivity and improve baseline mood
- Helpful for anxiety symptoms and panic attacks
- Often used in combination with other medications
Atypical Antipsychotics (Low Dose)
At low doses, can help with emotional dysregulation, anger, impulsivity, and brief psychotic symptoms under stress.
- Options include quetiapine, aripiprazole, olanzapine (low dose)
- Can reduce cognitive distortions and paranoia during stress
- We monitor for metabolic side effects
Medications We Use Cautiously
Benzodiazepines and stimulants require extra caution in BPD due to risks of dependence and worsening impulsivity.
- Benzodiazepines only for acute crisis situations, not long-term
- We prefer non-addictive alternatives whenever possible
Our Prescribing Philosophy
- Target specific symptoms rather than trying to "cure" BPD with medication
- Medication supports therapy—it doesn't replace it
- Regular check-ins to assess effectiveness and adjust as needed
- Collaboration with your therapist for integrated treatment
- Avoid polypharmacy—we use the fewest medications necessary
Therapy & Lifestyle Changes
Therapy—particularly evidence-based approaches designed for BPD—is the most effective treatment. Medication can help manage symptoms, but learning emotional regulation skills, distress tolerance, and interpersonal effectiveness through therapy creates lasting change.
Therapy Approaches We Recommend
Dialectical Behavior Therapy (DBT) - Gold Standard
Specifically developed for BPD. Teaches mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. Combines individual therapy with skills training groups. DBT has the strongest evidence for treating BPD.
Mentalization-Based Therapy (MBT)
Helps you understand your own mental states and those of others. Improves your ability to reflect on emotions before reacting, reducing impulsive behaviors and relationship conflicts.
Schema-Focused Therapy
Addresses underlying patterns and beliefs formed in childhood that contribute to BPD symptoms. Helps you develop a healthier sense of self.
Transference-Focused Psychotherapy (TFP)
A specialized psychodynamic approach that examines relationship patterns through the therapeutic relationship itself. Helps you develop a more integrated sense of self and others.
Lifestyle Changes That Make a Real Difference
Regular Sleep Schedule
Poor sleep worsens emotional dysregulation. Consistent sleep is foundational to stability.
- Same bedtime and wake time every day
- Avoid screens before bed, create a calming routine
Build Structure and Routine
Predictable daily routines reduce emotional reactivity and provide stability. Create structure around meals, exercise, self-care, and sleep.
Avoid Substance Use
Alcohol and drugs worsen emotional dysregulation, increase impulsivity, and interfere with therapy progress. Sobriety supports recovery.
Practice DBT Skills Daily
Skills like mindfulness, opposite action, and self-soothing only work if you practice them regularly—not just during crises. Make skills practice part of your daily routine.
Build a Support Network
Identify safe people you can reach out to during difficult moments. Consider joining a DBT skills group or BPD support group to connect with others who understand.
Develop Healthy Coping Strategies
Replace harmful coping mechanisms (self-harm, substance use, impulsive behaviors) with healthier alternatives like exercise, art, journaling, cold water immersion, or calling a friend.
Recovery Is Real
BPD can feel overwhelming, but it's one of the most treatable personality disorders. With the right therapy and medication support, you can learn to regulate emotions, build stable relationships, and create a life worth living. You deserve that chance.