Borderline Personality Disorder Treatment, Recovery, and Remission

If you or someone you love has been diagnosed with borderline personality disorder (BPD), your first question may be whether it can be cured. While there is no definitive cure for BPD, treatment can reduce symptom frequency and severity. In fact, with the right treatment approach, you can be well on the road to recovery and remission.

Learn more about your treatment options with borderline personality disorder and how they can help. It's also beneficial to know what you can expect in terms of recovery and remission, as well as ways to cope with this mental health condition.

Borderline Personality Disorder Treatment Goals

In the past, many believed that BPD was untreatable and lumped it together with other hard-to-treat conditions, like antisocial personality disorder (ASPD). As scientists have gained greater insights into the disorder, newer treatment approaches have helped many achieve lasting remission from BPD, in some cases without the use of drugs.

Results can differ, with some responding better than others. But for the most part, with informed and individualized treatment, BPD can be controlled in the same way as diabetes or other chronic conditions. The disease may not go away, but it can be managed in a way that affords a better quality of life.

BPD Remission Rates

Many people notice a natural reduction in their borderline personality disorder symptoms over time. Some also experience recovery in a functional sense, though this is less consistent from one person to another.

According to a review of 11 studies, between 50% and 70% of people with BPD achieve remission over time. These individuals also had reduced depression and improvements in their functional impairment.

Some individual studies suggest that remission rates may be even higher. One such piece of research was published in 2020 and involved 58 people with BPD. Roughly 12 to 18 years after being diagnosed, 81% had symptomatic recession according to the DSM-IV.

Conditions Commonly Co-Occurring With BPD

Many people with BPD have at least one other mental health disorder. Some of the most common include:

• Anxiety disorders
• Mood disorders, such as major depressive disorder (MDD) or bipolar disorder
• Substance use disorders

Studies have found that many people with BPD have three to four co-occurring mental health conditions. These co-occurring conditions, also known as comorbidities, can make treatment more complex and result in delayed or missed diagnoses due to overlapping symptoms.

Borderline Personality Disorder Treatment Approaches

The treatment of BPD can vary based on the severity of a person's symptoms and whether they have any co-occurring disorders. Although, they typically include psychotherapy and medication.

Psychotherapy

Psychotherapy, also known as talk therapy, is the backbone treatment for BPD. Among the various approaches are:

• Cognitive behavioral therapy (CBT) is the foundational structured approach to talk therapy and is incorporated into all other forms of psychotherapy.
• Dialectical behavior therapy (DBT) is a type of CBT that aims to identify and change negative thinking patterns, incorporating skills training to help us control emotions and better tolerate distress.
• Mentalization-based therapy (MBT) aims to improve mentalization or the process by which we make sense of each other and ourselves, both implicitly and explicitly.
• Schema-focused therapy (SFT) seeks to identify and change deeply held thought and behavior patterns associated with our past (usually those we cling to for emotional survival).
• Transference-focused therapy (TFT) helps prevent negative feelings about past experiences and people from being transferred to current experiences and people.
• Systems training for emotional predictability and problem solving (STEPPS) is a 20-week educational program that helps people with BPD identify the behaviors and feelings associated with their diagnosis, also giving them the skills necessary to change these behaviors and manage their feelings.

All of these therapies are appropriate for BPD treatment, approaching the disorder in slightly different ways. There is not one that is inherently better than the others. The choice depends largely on the effectiveness of your interactions with your therapist and your openness to the technique.

Never be afraid to ask why the therapist has chosen a specific therapeutic practice. It can help you better understand the aims of the treatment and decide whether it is the right approach for you.

Medications

BPD medications may be helpful in treating the symptoms common with this condition, especially when used in combination with psychotherapy. While drugs are not always needed, some prescription medication options include:

• Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) commonly used in first-line therapy
• Antipsychotic drugs, such as Zyprexa (olanzapine) which has been found to reduce anxiety, depression, and hostility in people with BPD
• Mood stabilizers, including Topamax (topiramate), Lamictal (lamotrigine), and Depakote (valproate semisodium), which may be useful in treating BPD aggression
• Anti-anxiety medications, including Ativan (lorazepam), Klonopin (clonazepam), Xanax (alprazolam), and Valium (diazepam)

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Coping With Borderline Personality Disorder

If you think you have BPD or have been diagnosed with the condition, here are steps you can take to better cope as you explore treatment options.

• Don't panic. Remember that your chances of remission are good. As with all mental health disorders, early diagnosis and treatment almost invariably afford better results than delayed diagnosis and treatment.
• Seek specialists experienced in BPD. This not only avoids missed diagnoses and comorbidities but also improves your chance of receiving the most up-to-date treatment, ideally with the fewest side effects and complications.

Borderline Personality Disorder Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

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• Find the right therapist for you. Therapy relies heavily on trust and open interaction. Take the time to interview several therapists, zeroing in on someone with whom you feel safe, comfortable, and supported.
• Educate yourself. Take the time to learn about your condition and become an advocate in your own care. You will feel more empowered by doing so and be better equipped to participate as a partner in your treatment.
• Apply new skills. Your treatment shouldn't be confined to medications or therapy sessions. There are plenty of self-help strategies you can incorporate into your life. These include journaling, expressive writing, art therapy, and mindfulness meditation.
• Involve your family. A BPD diagnosis affects the entire family. Treatment is often more successful if others participate as it helps repair emotional fractures that compound your illness. Family therapy can not only help you recover from BPD, but it can also help your family as well.
• Engage in self-care. Getting regular exercise, following a nutritious diet, and managing your stress can all help reduce BPD symptoms.