Borderline personality disorder (BPD)

Explains borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

This page is also available in Welsh.

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What treatments can help?

This page covers:

Talking therapies

Talking therapies are thought to be the most helpful treatment for BPD, although more research is needed into the types of treatments that are most effective.

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – suggests that the following kinds of talking treatments may be helpful:

Dialectical Behaviour Therapy (DBT) – uses individual and group therapy to help you learn skills to cope with difficult emotions. So far, NICE has recommended this treatment for women with BPD who often self-harm, and it's also thought to be helpful for other groups (see our pages on DBT for more information.)
Mentalisation-Based Therapy (MBT) – aims to help you recognise and understand your and other people's mental states, and to examine your thoughts about yourself and others. You can read more about MBT on the NHS Choices pages on BPD.

My DBT journey

"I see a future for myself now that I didn't see before the therapy."

Read this blogger's story

Mentalisation Based Therapy

"I identified with three strangers in a way that I had never been able to with anyone else, ever."

Read Jessica's story

NICE says that other types of talking therapy could potentially be helpful, including:

Cognitive Behavioural Therapy (CBT) – aims to help you understand how your thoughts and beliefs might affect your feelings and behaviour. (See our pages on CBT for more information.)
Cognitive Analytic Therapy (CAT) – combines CBT's practical methods with a focus on the relationship between you and your therapist. This can help you look at how you relate to people, including yourself, and what patterns have developed for you.
Other talking therapies – such as schema-focused cognitive therapy, psychodynamic therapy, interpersonal therapy or arts therapies. (See our pages on talking therapies and arts therapies for more information.)

"DBT helped me hugely to understand myself and my emotions, and to learn that it's all ok. No matter what is happening... it's going to pass. For the first time in 10 years I've come off antidepressants and feel great. I won't ever be 100% stable, but I can accept myself for who I am."

Therapeutic communities

Therapeutic communities are specially designed programmes where you work with a group of other people experiencing mental health problems to support each other to recover. You might live together some or all of the time, or meet up regularly.

Activities can include different types of individual or group therapy, as well as household chores and social activities. The Consortium for Therapeutic Communities provides a directory of therapeutic communities in the UK.

"I have educated myself about emotions, I have learned from books, therapy, psychologists, friends. The most important thing is that it is never too late to learn."

Medication

Psychiatric medication isn't recommended for treating ongoing symptoms of BPD. This is because there aren't any drugs that are known to be effective. However, you might take medication for other mental health problems you're experiencing.

In a crisis situation your doctor might prescribe you a sleeping pill or minor tranquilliser to help you feel calmer, but they shouldn't prescribe these for longer than a week.

"I have found the right medication regime and try to keep my life structured. It is not easy but recovery is possible."

Medication really helps some people but isn't right for others. Before deciding to take any drug, it's important to make sure you have all the facts you need to make an informed choice.

See our pages on things to consider before taking medication and your right to refuse medication for more information. Our pages on coming off medication give guidance on how to come off medication safely.

How can I access treatment?

To get treatment on the NHS you should visit your GP, who can refer you to your local community mental health team (CMHT) for an assessment.

If you receive NHS treatment, it should be in line with NICE guidelines. These say that:

Anyone with possible BPD should have a structured assessment with a specialist in mental health before being given a diagnosis.
You should have a say in the type of treatment you're offered. If you're not getting the type of treatment you think would most help you, it could help to talk to an advocate. (See our pages on advocacy for more information.)

You can read the full guidelines and additional recommendations for BPD in English or Welsh on the NICE website. For details of specialist services in the UK, see the UK Department of Health's personality disorder website.

"I was helpless and hopeless for a long time but when I finally got my head around the fact that only I could make a difference and that there was no magic wand, something clicked."

Will I get the help I need in a crisis?

Unfortunately, you might find that services in your area aren't always able to provide the best possible care to support you.

We know how frustrating and difficult it can be to cope with services that don't provide the exact help you need, exactly when you need it. That's why we're campaigning to improve crisis care across the country.

You can learn more about our crisis care campaign here, and read about the different ways you can take action with Mind.

Can I go private?

Waiting times for talking treatments on the NHS can unfortunately be long. If you feel that you don't want to wait, or that you would like to see a therapist who specialises in the types of experiences you have had (which is often not available on the NHS), you may choose to see a therapist privately. (See our pages on seeking private sector therapy for more information.)

Experiences of treatment and recovery

Watch Lechelle and Debbie talk about how a combination of talking treatments, medication and self-care techniques have helped them develop skills to manage their BPD.

"It began changing for me when one hospital suggested that there was a way forward, that I didn't have to feel so broken forever. It wasn't plain sailing from there, but just realising there was hope... and that other people had gone on to achieve amazing things really inspired me."