What to Expect When Getting Treatment for Borderline Personality Disorder

Borderline personality disorder (BPD) is a complex mental health condition that affects an estimated 1.4% of the adult U.S. population. Additionally, nearly 75% of people diagnosed with BPD are women.[1] Characterized by intense emotions, unstable relationships, impulsive behaviors, and a fluctuating sense of self, BPD can significantly disrupt daily life. But there’s hope. With the right treatment plan, many people living with BPD experience long-term improvements in mood regulation, interpersonal functioning, and overall quality of life.

In this article, we’ll walk through what you can expect when seeking treatment for borderline personality disorder, covering the process from diagnosis to ongoing therapy options, common challenges, and meaningful outcomes.

Understanding Borderline Personality Disorder (BPD): A Quick Overview

Borderline personality disorder falls under Cluster B personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

People with BPD often experience:[1]

• Intense mood swings
• Impulsive behaviors (e.g., binge eating, substance abuse, reckless driving)
• Unstable sense of self
• Fear of abandonment
• Suicidal behavior or self-harm
• Difficulties in interpersonal relationships

Many also have co-occurring mental health conditions, such as major depressive disorder, bipolar disorder, eating disorders, post-traumatic stress disorder (PTSD), or substance abuse.

First Step: Getting an Accurate Diagnosis

The journey toward treatment begins with a mental health evaluation by a trained mental health professional — typically a psychiatrist, psychologist, or clinical social worker. Since BPD shares symptoms with other mental disorders, such as bipolar disorder or PTSD, an accurate diagnosis is crucial.

Key parts of the assessment include:

• Clinical interviews about your medical history, relationships, emotions, and behaviors
• Standardized screening tools and diagnostic criteria
• Family interviews (with consent) to provide a broader picture
• Evaluation for related conditions or risk factors, such as adverse childhood experiences

Diagnosis is typically not made in children or early teens unless symptoms are persistent and severe, though research suggests early indicators can be present.

Treatment Options: What’s Proven to Work

a. Dialectical Behavior Therapy (DBT)

The first-line treatment for BPD is dialectical behavior therapy (DBT), developed by psychologist Marsha Linehan. DBT combines individual therapy, group therapy, and skills training to help patients:[2]

• Manage intense emotions
• Reduce impulsive behaviors
• Improve interpersonal effectiveness
• Decrease self-harm and suicide attempts

DBT skills modules include:

• Mindfulness
• Distress Tolerance
• Emotion Regulation
• Interpersonal Effectiveness

Research shows that DBT significantly reduces suicidal behavior, hospitalization, and self-destructive behaviors in BPD patients.[2]

b. Mentalization-Based Therapy (MBT)

MBT helps people understand their own and others’ thoughts, beliefs, and feelings. It improves emotional regulation and social skills, especially in those with difficulty distinguishing thoughts from emotions.

c. Transference-Focused Psychotherapy (TFP)

TFP uses the therapeutic relationship to explore unconscious conflicts and improve interpersonal relationships. It’s a longer-term approach that delves into the emotional underpinnings of BPD.

d. Medications

There’s no FDA-approved prescription drug specifically for BPD. However, medications may be used to treat co-occurring conditions like:

• Depression (e.g., SSRIs)
• Anxiety
• Mood instability or intense anger

These are prescribed cautiously and always in conjunction with talk therapy.

Individual vs Group Therapy: What’s the Difference?

Individual Therapy Sessions

These provide one-on-one time with a therapist to explore your personal history, borderline personality disorder experiences, and emotional patterns. This is where deep work happens — processing trauma, building coping strategies, and stabilizing mood.

Group Therapy or Skills Training Groups

These sessions are focused on learning and practicing skills in a group setting. It’s also a powerful way to see you’re not alone. Many BPD patients find comfort and insight through peer interaction.

Combined Treatment

Most effective treatment plans combine individual and group therapy, ensuring both depth and practice of skills.

What Progress Looks Like

While BPD is considered a serious mental illness, it’s also highly treatable. Research shows that symptoms improve significantly with structured treatment.

Within 1 year of DBT:[3]

• Many patients see reduced suicidal ideation
• Fewer episodes of intense emotions
• Better relationship stability

Within 5-10 years:[3]

• Up to 88% of BPD patients experience remission from symptoms
• Long-term stability is possible with continued care and healthy lifestyle choices

What Challenges Might Arise?

Getting treatment for BPD isn’t a straight path. Here are a few things to be prepared for:

• Emotional intensity during sessions
• Difficulty forming a therapeutic alliance
• Trust issues or fear of abandonment with your therapist
• Occasional setbacks or emotional flare-ups
• Resistance to treatment due to fear of change

This is all part of the process. A mental health professional trained in BPD will understand how to navigate these challenges with you.

How Family Members Can Help

BPD doesn’t just affect the individual — it impacts families too. Including family members in psychoeducation or therapy can:

• Improve communication
• Help set healthy boundaries
• Reduce emotional reactivity
• Encourage compassionate support

Some programs offer family therapy or support groups for loved ones.

Making the Most of Treatment

Build a Strong Therapeutic Relationship

Trust and openness with your provider are essential. If you feel the therapist isn’t a good fit, don’t be afraid to try another. The therapeutic relationship is central to healing.

Commit to the Work

Therapy isn’t a passive process. Attend all your sessions, do the homework, and reflect honestly.

Stay Consistent

Symptoms may flare up or ease unexpectedly. Even when you feel “better,” maintenance therapy can prevent relapse.

Consider Lifestyle Changes

A healthy lifestyle supports mental health:

• Regular sleep
• Balanced nutrition
• Physical activity
• Avoiding alcohol and substance abuse
• Stress management

When to Seek Help Immediately

If you or someone you love is showing signs of self-harm, suicidal behavior, or attempting suicide, immediate help is needed. Call emergency services or reach out to a suicide hotline like 988 Suicide & Crisis Lifeline in the U.S.

Never downplay these symptoms — they require urgent intervention and compassionate support.

Get Connected to Reputable BPD Treatment

Living with borderline personality disorder can feel like riding an emotional rollercoaster, but treatment works. Whether it’s dialectical behavior therapy, mentalization-based therapy, or a combination of talk therapy and medications, there are evidence-based paths forward.

Recovery doesn’t mean perfection. It means building emotional resilience, nurturing healthier relationships, and crafting a more stable and fulfilling life.

If you or a loved one suspects signs of BPD, take that first brave step: call New Jersey Behavioral Health Center. The sooner the process begins, the sooner relief — and real healing — can follow.

Frequently Asked Questions (FAQ)

1. Can Borderline Personality Disorder go away on its own without treatment?

While some symptoms may lessen over time, BPD rarely resolves completely without structured intervention. Untreated BPD increases the risk of self-harm, suicide, and relationship instability. Therapy, especially evidence-based approaches like DBT, significantly improves long-term outcomes.

2. Is BPD more common in women than in men?

Yes, BPD is diagnosed more frequently in women, but this may be due to diagnostic biases. Research suggests men with BPD are often misdiagnosed with other disorders like antisocial personality disorder or substance use disorder. The actual gender distribution may be more balanced than previously believed.

3. How long does BPD treatment usually last?

There’s no fixed timeline, but initial treatment typically lasts 6 months to 1 year, with many patients continuing therapy for several years. Long-term management, even at reduced intensity, helps maintain progress and prevent relapse. The timeline depends on severity, co-occurring disorders, and individual response to therapy.

4. Is hospitalization ever required for BPD?

Yes, in cases of acute crisis — such as suicidal behavior, self-harm, or extreme emotional dysregulation — inpatient care may be necessary. Hospitalization is usually short-term and focused on stabilization. Long-term improvement, however, comes from outpatient therapy and community support.

5. Can someone with BPD have a healthy romantic relationship?

Absolutely — but it takes emotional awareness, communication skills, and consistent therapeutic work. Many individuals with BPD build fulfilling relationships once they learn to manage emotional triggers, fears of abandonment, and interpersonal dynamics. Partners may also benefit from psychoeducation or couples therapy.

6. What’s the difference between BPD and bipolar disorder?

Though both involve mood instability, they are fundamentally different:

• BPD involves moment-to-moment emotional reactivity, usually in response to interpersonal stress.
• Bipolar disorder involves distinct mood episodes (depression and mania/hypomania) that last days or weeks and are less situational.

Accurate diagnosis by a mental health professional is essential, as treatment strategies differ.

References:

1. The National Alliance on Mental Illness (NAMI): Borderline Personality Disorder
2. Iranian Journal of Psychiatry: Efficacy of Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder: A Systematic Review of Randomized Controlled Trials
3. Psychiatry Online: Borderline Personality Disorder: Neurobiological Contributions to Remission and Recovery