It is common in both general and clinical populations, affecting roughly 1.6% of the U.S. population and 20% of the psychiatric inpatient population. 1 BPD is usually treated with psychotherapy. Unlike other mental disorders, medication is typically not the first-line approach to treating BPD.
Full Answer
How is borderline personality disorder (BPD) treated?
BPD is usually treated with psychotherapy. Unlike other mental disorders, medication is typically not the first-line approach to treating BPD. No medications are approved by the FDA for the treatment of BPD at the moment. This condition cannot be cured, so the goal of treatment is to reduce symptoms and improve quality of life for people with BPD.
What is the prognosis of borderline personality disorder (BPD)?
There is a good prognosis for patients with borderline personality disorder. A longitudinal study of 290 inpatients diagnosed with borderline personality disorder and reassessed at 2-year intervals over 16 years yielded the following rates of remission:[12] 35% remission after 2 years
What is the prevalence of BPD?
While 1.6% is the recorded percentage of people with BPD, the actual prevalence may be even higher. In a recent study, over 40% of people with BPD had been previously misdiagnosed with other disorders like bipolar disorder or major depressive disorder. 3
How common are comorbid psychiatric disorders in borderline personality disorder (BPD)?
Comorbid psychiatric disorders are extremely common in patients with BPD. Mood disorders, particularly MDD, SUDs, anxiety disorders, and eating disorders are more frequently seen in patients with BPD, compared with patients with other PDs.
What percentage of people with BPD recover?
Recovery in borderline personality disorder (BPD) has predominantly been viewed in the context of symptom improvement and no longer meeting diagnostic criteria. Longitudinal studies have demonstrated that symptom remission is a common occurrence, with remission rates ranging between 33 and 99% [1].
What percentage of people with BPD are hospitalized?
The importance of elucidating this issue is underscored by estimates that BPD prevalence ranges from 15% to 25% in inpatient settings.
What percent of people have borderline?
Borderline personality disorder causes significant impairment and distress and is associated with multiple medical and psychiatric co-morbidities. Surveys have estimated the prevalence of borderline personality disorder to be 1.6% in the general population and 20% in the inpatient psychiatric population.
How many people on average have BPD?
It's been estimated that approximately 1.6 % of adults in the United States struggle with BPD. The number may actually be much higher than that, and many experts believe that the correct number may actually be closer to six percent. Even at 1.6%, that's over five million Americans who have this disorder.
How effective is BPD treatment?
Current research shows that treatment can decrease the symptoms and suffering of people with BPD. Talk therapy is usually the first choice of treatment (unlike some other illnesses where medication is often first.) Generally, treatment involves one to two sessions a week with a mental health counselor.
How long is BPD recovery?
Remission Rates A study published in 2012 followed 290 patients with BPD every two years for 16 years. What they found was that remission (defined as no longer meeting the diagnostic criteria for at least two years) tended to occur spontaneously within two to eight years of the diagnosis and initial treatment.
Are people with BPD smart?
Many people with BPD are deep thinkers, intuitive feelers, and many are intellectually gifted. Contrary to popular belief, most BPD sufferers are highly introspective and self-aware. With a process of healing and transformations, they can be the most empathic leaders and visionaries.
How common is BPD in the world?
Research shows that around 1 in 100 people live with BPD. It seems to affect men and women equally, but women are more likely to have this diagnosis. This may be because men are less likely to ask for help. BPD is sometimes called emotionally unstable personality disorder (EUPD).
What is the mortality rate of BPD?
The standardized mortality ratio of patients with BPD compared to the general population was 8.3 (95% CI [7.6, 9.1]). More than three inpatient admissions per year or a comorbid diagnosis of substance use disorder correlated with a higher mortality rate.
How serious is borderline personality disorder?
Borderline personality disorder (BPD) is a serious, long-lasting and complex mental health problem. People with BPD have difficulty regulating or handling their emotions or controlling their impulses.
What percentage of teens have borderline personality disorder?
It is being more and more demonstrated that the diagnostic criteria for BPD are as reliable, valid, and stable in adolescence as they are in adulthood. BPD is estimated to affect between 0.9% and 3% of teenagers in the community,6 which is equivalent to the prevalence in adults.
Does BPD get worse with age?
Borderline personality disorder usually begins by early adulthood. The condition seems to be worse in young adulthood and may gradually get better with age.
How is BPD treated?
BPD is usually treated with psychotherapy. Unlike other mental disorders, medication is typically not the first-line approach to treating BPD. No medications are approved by the FDA for the treatment of BPD at the moment. This condition cannot be cured, so the goal of treatment is to reduce symptoms and improve quality of life for people with BPD.
What are the risk factors for BPD?
Risk factors of BPD overlap with those of other mental disorders that commonly co-occur with borderline personality disorder, including mood disorders like bipolar disorder, anxiety disorder, eating disorders (particularly bulimia), substance abuse, and post-traumatic stress disorder. Symptomatically, these conditions also overlap with BPD.
What is the goal of DBT?
The goal of DBT is to address the symptoms of BPD by replacing maladaptive behaviors with healthier coping skills. DBT is available in the form of a skills training group, which is designed to target behavioral skill deficits that are common in patients with BPD, including an unstable sense of self, chaotic relationships, fear of abandonment, emotional lability, and impulsivity and individual psychotherapy. 5
What is borderline personality disorder?
Borderline personality disorder (BPD) is characterized by unstable moods, impulsive behaviors, and volatile relationships. It is common in both general and clinical populations, affecting roughly 1.6% of the U.S. population and 20% of the psychiatric inpatient population. 1. BPD is usually treated with psychotherapy.
How effective is DBT?
DBT is effective at reducing self-harm behaviors and suicide attempts, as well as the number of days spent in psychiatric hospitals. 6 One study found at the end of the first treatment year, 77% of patients no longer met criteria for BPD diagnosis. 6.
Can CBT help with BPD?
Several forms of CBT are specifically designed for treating BPD. The very nature of borderline personality disorder can make it difficult for people with the disorder to maintain a comfortable and trusting bond with their therapist. 4 .
Does borderline personality disorder overlap with depression?
Symptomatically, these conditions also overlap with BPD. For example, a person with borderline personality disorder may have symptoms that meet the diagnosis of major depression, including chronic feelings of emptiness, suicidal thoughts and behaviors, and self-harm.
What happens if you have a family history of BPD?
If you have a family history of BPD, you’re more likely to develop the condition. Differences in the brain: In people with BPD, the parts of the brain that control emotion and behavior don’t communicate properly. These problems affect the way the brain works.
What are the most common behaviors of people with BPD?
Impulsive and dangerous behavior: Episodes of reckless driving, fighting, gambling, substance abuse and unsafe sexual activity are common among people with BPD. Self-destructive behavior can be difficult or impossible to control.
How does borderline personality disorder affect people?
Without treatment, people with BPD have an increased risk of drug and alcohol abuse, depression, self-harm and suicide. Many people with BPD experience unstable or chaotic personal relationships ...
What is borderline personality disorder?
Borderline personality disorder (BPD) is a mental illness. It usually appears during adolescence or early adulthood. People with BPD have extreme mood swings, unstable relationships and trouble controlling their emotions. They have a higher risk of suicide and self-destructive behavior. Symptoms often lessen over time, ...
Why do people with BPD feel uncomfortable?
Fear of abandonment: It’s common for people with BPD to feel uncomfortable with being alone. They have a strong fear of being abandoned or rejected. They might track their loved ones’ whereabouts or stop them from leaving. Or they might push people away before getting too close to avoid rejection.
What causes BPD?
Causes of BPD include: Abuse and trauma: People who have been sexually, emotionally or physically abused have a higher risk of BPD. Neglect, mistreatment or separation from a parent also raises the risk. Genetics: Borderline personality disorder runs in families.
What does it feel like to have BPD?
Depression: Many people with BPD feel sad, bored, unfulfilled or “empty.” Feelings of worthlessness and self-loathing are common, too.
What is the treatment for BPD?
Trusted Source. of people in the United States. Its main treatment is psychotherapy, otherwise known as talk therapy. Talk therapy teaches people vital skills for managing their thoughts and emotions. There are many types, and each has its own aims and methods.
What are the best therapies for BPD?
This article explores the potential benefits of five types of therapy for people with BPD: 1 dialectical behavior therapy (DBT) 2 mentalization-based therapy (MBT) 3 schema therapy (ST) 4 transference-focused therapy (TFP) 5 systems training for emotional predictability and problem solving (STEPPS)
How long does BPD stay in remission?
91% went into remission after 10 years. 99% were in remission after 16 years. In this study, 75% of participants experienced remission for at least 8 years. However, therapy does not cure BPD — the symptoms can come and go throughout a person’s life.
What is the purpose of DBT?
The aim is to teach skills that enhance mindfulness, help tolerate distress, regulate emotions, and manage relationships. Clinical psychologist Dr. Marsha Linehan developed DBT for people with BPD and suicidal thoughts. It is similar to cognitive behavioral therapy, but DBT focuses more on emotions and relationships.
What is included in a DBT?
DBT usually includes weekly individual therapy, a group training session, homework tasks, and telephone support from the therapist, if needed.
What is the treatment for borderline personality disorder?
Psychotherapy, or talk therapy, is the main treatment for borderline personality disorder (BPD). Several types of therapy may benefit people with BPD, and each type takes a different approach. This article explores the potential benefits of five types of therapy for people with BPD:
How to help someone with depression?
For depression or sadness: Write a comforting letter to yourself, watch a favorite TV show or film, or listen to uplifting music.
How many people have BPD?
BPD is a mental health condition that affects approximately 1.6% of the general population. One older research study found that after 2 years of therapy, 35% of individuals with BPD were in remission, meaning they had fewer symptoms and felt much better.
What is the best treatment for BPD?
The most effective treatment for BPD is individual psychotherapy and, sometimes, group therapy . Right now, there aren’t any FDA-approved medications for BPD; however, in some cases, antidepressants and mood stabilizers may be helpful.
What are the symptoms of BPD?
Other symptoms of BPD can include extreme changes in mood, impulsive behavior, chronic feelings of emptiness, relationship difficulties, and substance use. BPD can also cause you to see others as entirely good or bad, which is a defense mechanism called “ splitting .”.
What happens when you have BPD?
BPD can cause profound fears of abandonment and rejection.
How to treat borderline personality disorder?
Treatments. Talk therapy . Medications. Self-care. Next steps. Borderline personality disorder (BPD) can have a big impact on your mood, relationships, and daily life. The good news is that therapy and a good self-care routine can greatly reduce your symptoms and improve your quality of life. BPD means something different for everyone.
What are the other mental health issues that can be caused by BPD?
If you’ve been diagnosed with BPD, you may also experience other mental health concerns, such as depression, anxiety, eating disorders, or attention deficit hyperactivity disorder (ADHD). An effective treatment plan should consider all co-occurring issues, too.
Is BPD a treatable condition?
BPD means something different for everyone. For years, many people believed that the condition was untreatable. However, with recent advances in therapeutic methods, we now know that effective treatments are, in fact, available.
What are the best medications for BPD?
Medications can be helpful in treating some of the symptoms of BPD. 5 While drugs are not always needed, some of the more commonly prescribed include: 1 Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) commonly used in first-line therapy 2 Antipsychotics, such as Zyprexa (olanzapine) which is known to reduce impulsivity, hostility, and psychotic symptoms of BPD 3 Mood stabilizers, including Topamax (topiramate), Lamictal (lamotrigine), and Depakote (valproate semisodium) which may be useful in treating BPD aggression 4 Anti-anxiety medications, including Ativan (lorazepam), Klonopin (clonazepam), Xanax (alprazolam), and Valium (diazepam)
How many co-occurring conditions are there in BPD?
People with BPD will often meet the criteria for other personality disorders as well. The average number of co-occurring conditions in BPD is three . These co-occurring conditions (also known as comorbidities) can make treatment far more complex and result in delayed or missed diagnoses due to overlapping symptoms.
How long does it take for BPD to go into remission?
What they found was that remission (defined as no longer meeting the diagnostic criteria for at least two years) tended to occur spontaneously within two to eight years of the diagnosis and initial treatment.
What is the backbone of BPD?
Psychotherapy. The backbone treatment for BPD is psychotherapy , also known as talk therapy. 4 Among the various approaches: Cognitive behavioral therapy (CBT) is the foundational structured approach to talk therapy incorporated into all other forms of psychotherapy .
What are the other mental health disorders that are associated with BPD?
According to a report from the National Institute of Mental Health (NIMH), 85% of people with BPD will have at least one other mental health disorder, including anxiety disorders, impulse-control disorders, substance abuse or dependence disorders, and mood disorders (like major depressive disorder or MDD). 1 .
What is MBT therapy?
Mentalization-based therapy (MBT) aims to improve mentalization (the process by which we make sense of each other and ourselves, implicitly and explicitly).
How to be a good therapist?
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 .
What is a BPD?
Borderline personality disorder (BPD) is 1 of 4 cluster-B disorders that include borderline, antisocial, narcissistic, and histrionic. Borderline personality disorder (BPD) is characterized by hypersensitivity to rejection and resulting instability of interpersonal relationships, self-image, affect, and behavior.[2] .
What percentage of people have borderline personality disorder?
Surveys have estimated the prevalence of borderline personality disorder to be 1.6% in the general population and 20% of the psychiatric inpatient population.[3] A personality disorder is a disorder involving a rigid and unhealthy pattern of thinking. Personality disorders are prevalent in the general population and more so in clinical populations.
Why is borderline personality disorder studied?
Patients with borderline personality disorder have been shown to utilize extensive treatment resources and are at increased morbidity and mortality compared with the general populations. This is perhaps the reason why borderline personality disorder has been studied more extensively than other personality disorders.
How to treat borderline personality disorder?
Treatment of borderline personality disorder relies on psychotherapy . Three evidence-based therapies are effective for patients with borderline personality disorder. First, mentalizing-based therapy (MBT) helps patients manage emotion dysregulation by feeling understood, allowing them to be more curious and make fewer assumptions about the intentions of the people around them. A second therapy, dialectical behavior therapy (DBT) combines mindfulness practices with concrete interpersonal and emotion regulation skills. Third, transference-focused psychotherapy (TFP) focuses on using the patient-therapist relationship to develop the patient's awareness of problematic interpersonal dynamics. MBT and DBT each incorporate individual and group treatment over 12 to 18 months. For adolescents, family therapy may be an appropriate substitute for group therapy, though not always.
What is personality disorder?
Introduction. A personality disorder is a disorder involving a rigid and unhealthy pattern of thinking. Personality disorders are prevalent in the general population and more so in clinical populations.
Is attachment related anxiety the same as borderline personality disorder?
The exception to the misleading use of the word anxiety is that patients with borderline personality disorder often have a fear of being alone; in other words, they have attachment-related anxiety. However, attachment-related anxiety is not necessarily similar in etiology or treatment to recognized anxiety disorders.
Is there a difference between male and female borderline personality disorder?
No significant difference in rates of borderline personality disorder was found between females and males in the general population. In the clinical setting, however, the ratio of female to male has been reported as 3:1. These studies challenged previous reports that borderline personality disorder was more prevalent in women.
How often are patients with BPD seen?
Patients with BPD are very frequently seen in all types of clinical settings. They account for 10% of outpatients,120% of inpatients,2and 6% of patients presenting to family medicine,3despite a community prevalence of 1% to 2%.4In the community, there is an equal gender ratio, despite women being seen 3 to 4 times more frequently in clinical settings.4If they are not seen as part of a long-term follow-up or a treatment program, they are typically seen when in crisis.5This has given many the impression that patients with BPD are always in crisis and never recover from their illness, leading to this group of patients being highly stigmatized in the mental health care system.6,7Patients with BPD do suffer intensely, but their prognosis is often better than expected and the outcomes are further improved with appropriate treatment.
What are the most common psychiatric disorders in BPD patients?
Comorbid psychiatric disorders are extremely common in patients with BPD. Mood disorders, particularly MDD, SUDs, anxiety disorders, and eating disorders are more frequently seen in patients with BPD, compared with patients with other PDs. Even after 6 years of follow-up, over 60% of BPD patients met criteria for a mood disorder and a similar rate for an anxiety disorder.38Presence of a BPD diagnosis is also associated with longer duration to recovery from some psychiatric illness, such as MDD.39Comorbid PDs are also more frequent in patients with BPD, and comorbid avoidant, dependent, and self-defeating PDs were associated with lower rates of remission from BPD.40Comorbid medical conditions are also significant problems for patients with BPD, including irritable bowel syndrome,41osteoarthritis, diabetes, obesity, and others.42Patients with BPD also experience more frequent and more intense pain43with increased use of opiate medications.44In general, rates of psychiatric and medical treatment use, including psychiatric medications, are much higher in patients with BPD and, although there is decline during the first 8 years of follow-up, treatment use remains relatively elevated and unchanged after that.42,45,46It is also notable that overall rates of mortality in BPD are elevated, compared with the general population.32
Why is BPD stigmatized?
BPD is known to be highly stigmatized in mental health settings,6,7,51,52particularly in youth mental health, and part of the reason for the stigma is that BPD is seen as a lifelong disorder that is untreatable.
How long does it take to relapse from BPD?
Most of the specialized treatments for BPD are time-limited and generally of 1 to 3 years’ duration.
How long does it take for BPD to be stable?
This study reported several important findings, including that both parent and teacher ratings of characteristic features of BPD, such as lack of control and aggression, are quite stable during 6 years of follow-up.
What is the DSM-5 for BPD?
DSM-5, like DSM-IV, permits diagnosing a PD (other than antisocial PD) in someone under 18 years of age if the symptoms are “perva sive, persistent , and unlikely to be limited to a particular developmental stage or another mental disorder,”8, p 647as long as symptoms have been present for 1 year or longer.8This review will describe the longitudinal course of BPD in all age groups, with a focus on the functional and symptomatic outcomes of these patients.
How many references were there in Medline?
A MEDLINE search from 1946 until 2015 was conducted using the terms borderline personality disorder and course. A total of 268 references were obtained and these were reviewed for relevance. In addition, references specifically relating to the 2 largest longitudinal studies were reviewed.
What are the results of the BPD study?
The results revealed the following observations: 1 Large-effect-size improvements in depression, anxiety, suicidal ideation, and functional disability among patients with BPD (Cohen’s d ≥ 1.0) and non-BPD patient reference sample (Cohen’s d ≥.80). 2 Clinical deterioration and adverse events in no more than 1.1% of BPD and non-BPD patients on any outcome, with no difference found across cohorts. 3 No influence of BPD diagnosis on the trajectory of continuous depression severity 4 An association between trait emotion dysregulation and initial depression severity.
What is borderline personality disorder?
Borderline personality disorder is characterized by impulsivity, dysregulation, self-injurious behaviors, and suicidal behaviors. Although borderline personality disorder (BPD) has been studied more than any other personality disorder, the role of extended hospitalization for adults with BPD is a point of contention among mental health clinicians.
How many hours of multimodal care are there in a week?
Participants received an average of 59.4 hours per week of multimodal interventions, including “general psychiatric and medical care, continuous nursing care, medication management to reduce adverse polypharmacy, addictions services, health promotion, physical exercise, individual and group psychotherapy, psychoeducational groups, family work, and leisure-time social/recreational activities,” as described in the paper.
Can extended inpatient treatment be used for BPD?
Contrary to long-held beliefs about the utility of extended inpatient treatment for this patient population, the present findings “indicate that extended inpatient treatment can result in significant and clinically meaningful symptomatic and functional improvement in BPD patients without iatrogenic effects ,” the authors wrote.
Can BPD be treated in extended stay?
The results of the study are not at all surprising to me. However, the recommendations that the authors are attempting to rebut, that clinicians should strive to avoid hospitalizing patients with BPD, are absolutely true for the vast majority of patients with BPD in the United States. This reason for this is that the specialized program described is vanishingly rare in the United States and is unavailable to most patients.
Does BPD affect depression?
No influence of BPD diagnosis on the trajectory of continuous depression severity. An association between trait emotion dysregulation and initial depression severity. Surprisingly, rates of nonsuicidal self-injury and suicidal behavior, which are diagnostic criteria for BPD, were low.
