Borderline personality disorder (BPD) is a complex mental health condition that affects millions worldwide — the symptoms can be overwhelming and profoundly impact various parts of your life. But the good news is that effective treatments are available to help manage and navigate the challenges of BPD.
If you or one of your loved ones struggle with BPD, you understand its unique challenges. It can feel isolating and frustrating, as others may not fully comprehend what you’re going through or the difficulties you face in maintaining emotional balance and stability. That’s why it’s essential to seek the support of a therapist specializing in treating BPD. They can provide the expertise and guidance necessary to help you navigate this complex condition.
Key takeaways
- BPD is a personality disorder — not a mood disorder — characterized by intense emotional swings, unstable relationships, impulsivity, and a fragile sense of self.
- Dialectical behavior therapy (DBT) is the most widely recognized evidence-based treatment for BPD and has strong research support for reducing symptoms.
- You don’t need to wait for a crisis to seek help — the earlier treatment begins, the better the long-term outcomes tend to be.
- When looking for a therapist, prioritize someone with specific experience treating BPD and training in DBT or other evidence-based approaches.
- BPD is highly treatable — many people with BPD significantly improve with the right therapeutic support.
Understanding BPD
Borderline personality disorder, referred to as BPD, is a mental health condition affecting thoughts, emotions, and behaviors. BPD has a point prevalence of approximately 1.6% in the general population, with a lifetime prevalence of up to 5.9%. While BPD has historically been diagnosed more often in women — a figure driven largely by clinical sampling bias — more recent community-based studies suggest the actual prevalence is approximately equal across genders. People with BPD may struggle with regulating their emotions and maintaining stable relationships. This can lead to intense mood swings, impulsivity, and difficulties with self-image. BPD is a personality disorder that requires professional diagnosis and treatment.
Signs and symptoms
While the exact start of BPD symptoms varies from person to person, it’s generally observed that the signs and symptoms of BPD become more apparent during later teens or early adulthood.
Some common signs of BPD include:
- Intense fear of abandonment
- Unstable and intense relationships
- Frequent and unpredictable mood swings
- Chronic feelings of emptiness
- Impulsivity and engaging in risky behaviors
- Self-destructive behaviors, such as self-harm or suicidal thoughts
- Eating disorders like binge-eating
- Difficulty managing anger and intense emotions
- Unstable self-image and sense of identity
- Feeling disconnected from yourself, other people, or the world around you
Symptoms of BPD can vary from person to person. While one person with BPD may experience occasional mood swings and a moderate fear of abandonment, another may have frequent and intense mood swings and an overwhelming fear of abandonment.
What causes BPD?
The exact cause of BPD isn’t known, but genetic, family, and social factors can contribute. Risk factors for BPD include mental health issues such as:
- Abandonment during childhood or adolescence
- Major transitions, such as changing careers or moving
- Having a disrupted family life with constant conflict or instability
- Poor communication within the family and other relationship issues
- Experiencing emotional, physical, or sexual abuse
These stressors can increase the chances of developing BPD, although they don’t guarantee it. Symptoms may progress or resolve with time.
Treatments
While there is no known cure for BPD, effective treatments are available to help you manage your symptoms and improve your quality of life.
Psychotherapy, specifically dialectical behavior therapy (DBT), is a type of therapy that’s widely recognized as the most effective treatment for BPD. DBT focuses on developing essential skills for emotion management, distress tolerance, relationship improvement, and mindfulness cultivation. In therapy, a holistic approach is commonly taken, considering your overall well-being, including physical, mental, emotional, social, and spiritual aspects.
In addition to psychotherapy, mental health professionals may prescribe medications specifically targeting symptoms commonly associated with BPD, such as depression, anxiety, or impulsivity.
Mental health professionals will help you to find the right combination of therapies and support that works best for you. Treatment can take the form of individual therapy or family therapy. With proper treatment and support, you can develop better coping skills, leading to a more fulfilling and meaningful life.
La Tisha San Pedro-Lintag, a licensed marriage and family therapist (LMFT) with Grow Therapy, says that you should “look for a therapist that you feel comfortable with. At the end of the day, I tell my clients, ‘Our time together is a sacred space where you get a chance to show up authentically. If you don’t feel like you can do that, then we should explore why.’ It’s important for a client to have an idea of what they’re looking for in a therapist. There are various theoretical orientations such CBT, DBT, humanistic, attachment, etc. There’s no right or wrong orientation, but as a client you may have preference and that’s OK.”
Did you know?
BPD has a better long-term prognosis than most people expect. Two landmark longitudinal studies found that 85–93% of people with BPD achieved diagnostic remission — meaning they no longer met criteria for the disorder — over a 10-year follow-up period. Symptomatic improvement is the rule, not the exception, particularly with treatment.
When should you seek treatment for BPD?
If you are dealing with BPD, seeking help from a therapist can be an immensely valuable step towards improving your well-being and finding the support you need. Therapists who are experienced in working with BPD can provide the guidance and tools necessary to manage symptoms and improve overall well-being.
If you’re wondering when to seek treatment for BPD, the answer is as soon as possible. Whether you suspect you may have BPD or have already been diagnosed, seeking treatment is a proactive step towards better mental health. Therapy can be beneficial if you experience significant distress, relationship difficulties, or struggle to regulate your emotions. Remember, you don’t have to face these challenges alone.
San Pedro-Lintag says, “Finding a therapist early on can help someone navigate life with a diagnosis of BPD. Working with a therapist can help you navigate relationships, especially with friends and family, which often can be strained as a result of BPD symptoms. Overall, working with a therapist early on can help you learn skills to manage anger, stop self-harming behavior, and improve overall life functioning.”
How can a therapist help you manage your BPD symptoms?
A therapist specializing in BPD can provide invaluable support in managing your symptoms and improving your overall well-being. They are trained to understand the unique challenges associated with BPD and can offer tailored guidance and strategies to help you cope. Whether through DBT or other evidence-based approaches, therapists can help you regulate your emotions, develop healthy coping mechanisms, and improve your relationships. By providing a non-judgmental and supportive environment, therapists empower you to navigate challenges and work towards a more fulfilling and balanced life.
Talking about your feelings and experiences
Your therapist will provide a confidential and safe space for you to express your thoughts, emotions, and experiences. They will actively listen and offer understanding without judgment. Sharing your feelings openly can help you gain clarity and insight into your BPD symptoms.
Setting goals together
In collaboration with your therapist, you will identify the areas of your life you want to improve or the specific BPD symptoms you’d like to manage. Together, you’ll set realistic and achievable goals aligning with your aspirations and well-being.
Learning helpful skills
Therapists specializing in BPD employ various therapeutic techniques to teach you valuable skills for emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness.
Checking progress
During each session, your therapist will assess your progress toward your goals. They will provide feedback, celebrate your achievements, and address any setbacks or challenges you may encounter. Regular progress checks will help you stay on track and adjust as needed.
Keeping things private
Confidentiality is a fundamental aspect of therapy. Your therapist will keep your discussions private, ensuring that your personal information remains confidential unless there is a concern for your safety or the safety of others. This creates a safe and trusting environment for open communication.
Long-term help
BPD therapy is often a long-term commitment, as managing the associated symptoms can take time. Your therapist will work with you to establish a treatment plan with a timeline suited to your needs. They will support you throughout your journey to help ensure long-term stability and well-being.
Remember, each therapy session is a collaborative effort between you and your therapist. With their expertise and your active participation, you can make significant progress in managing your BPD symptoms, enhancing your relationships, and leading a more fulfilling life.
What’s the difference between DBT and other therapies for BPD — and how do I know which one my therapist uses?
DBT is the most rigorously studied therapy for BPD and is widely considered the first-line treatment. It was developed specifically for people with BPD by psychologist Marsha Linehan and focuses on four core skill areas: emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness.
Standard DBT includes individual therapy, group skills training, phone coaching, and therapist consultation — it’s intensive by design. Other approaches used for BPD include mentalization-based therapy (MBT), schema therapy, and transference-focused psychotherapy (TFP), all of which have evidence supporting their use. When evaluating a therapist, ask directly whether they are trained in DBT specifically — not just CBT or general talk therapy — and whether they offer the full DBT model or individual components only.
On Grow Therapy, you can filter by DBT as a treatment method to find therapists with specific training.
How to find a BPD therapist near you
You can choose between in-person or online sessions when searching for a therapist. Both formats have advantages, and it’s important to find the one that best suits your needs.
In-person therapy
In-person therapy involves face-to-face interaction, creating a more personal connection with your therapist. It can be preferable for some to have their therapist physically present during their sessions, providing an opportunity for non-verbal communication. In-person therapy also allows a dedicated space to focus entirely on your therapy without distractions.
Online therapy
Online therapy offers convenience and flexibility. You can access therapy sessions from the comfort of your own home, which can be particularly beneficial if you have mobility issues, live in a remote area, or have a busy schedule. Online therapy, also known as telehealth, provides a wider pool of therapists to choose from, as you aren’t limited to your geographical location.
How Grow Therapy can help
Finding a licensed therapist who specializes in BPD near you can feel overwhelming. Still, there are resources available to make the process easier. One such resource is Grow Therapy, a platform dedicated to connecting people with the right therapists for their needs.
There is a comprehensive directory of licensed therapists, including those experienced in treating BPD. The platform lets you search for therapists in your area or explore online therapy options. You can browse through therapist profiles, read about their expertise, and learn more about their therapeutic approach.
The platform has helpful filters to narrow your search based on criteria such as insurance acceptance, therapy modality, and more.
Questions to ask a therapist
Before choosing one therapist over another, consider asking the following questions:
How much experience do you have in treating BPD?
Knowing the therapist’s experience with BPD is important. Inquire about their years of experience working with BPD and how many cases they have treated. This will give you confidence in their ability to understand and address the complexities of BPD.
What methods will you use to help me?
Therapists use various approaches when treating BPD — it can be helpful to gain an upfront understanding of what methods may be adopted for your circumstance. Ask about their therapeutic techniques, such as DBT, cognitive-behavioral therapy (CBT), or psychodynamic therapy. This will give you insight into their approach and whether it aligns with your treatment goals.
How will you customize my treatment?
Each person with BPD is unique, and a personalized treatment plan is essential for success. Inquire about how the therapist will tailor their approach to address your specific needs and goals. Ask how they consider your individual circumstances, strengths, and challenges to ensure that your treatment is effective and meaningful.
How often would I have therapy sessions for BPD?
Discuss the frequency of therapy sessions and ask for recommendations based on your individual needs. Regular therapy sessions are generally beneficial for progress, but it’s important to understand the therapist’s approach to session frequency and whether it aligns with your preferences and availability.
By asking these questions and providing relevant information, you can gather the necessary details to make an informed decision and ensure that the therapist’s expertise and approach align with your needs for effective treatment of BPD. Remember, open communication is essential in establishing a collaborative therapeutic relationship and promoting positive outcomes.
Final thoughts
BPD is one of the most misunderstood diagnoses in mental health — and one of the most treatable. The intensity of emotions and relationship difficulties that come with BPD can be exhausting, both for the person living with it and for the people around them. But those same traits — the depth of feeling, the desire for connection, the sensitivity — are also strengths that therapy can help you understand and work with rather than against.
Finding a therapist with real experience in BPD matters more than finding the fastest one. Ask the questions in this article, trust your instincts about the fit, and don’t give up if the first person isn’t right. Filter by BPD specialty and insurance, read provider profiles, and book directly. Most clients are in their first session within two days.
