Borderline Personality Disorder (cont.)
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What Is the Treatment for Borderline Personality Disorder?
Although psychiatric hospitalization may often be used to address the suicidal and other safety crises of individuals with BPD, it is unclear how beneficial that intervention is. In contrast, partial hospitalization has shown some promise as an intervention for individuals with BPD who are not in imminent danger of mortally harming themselves or others. Partial hospitalization involves the sufferer receiving intensive mental health treatment for several hours per day then returning home each afternoon or evening. Therapeutic communities are living arrangements that provide a safe, nurturing, and structured environment for individuals with BPD that they may not have received as a child. Those communities can play an important role in the care for these individuals.
Most practitioners will use some form of psychotherapy to treat BPD. Dialectical behavior therapy (DBT) addresses problems that individuals with borderline personality disorder often have relating to others and managing their behaviors and feelings. Psychoanalytic psychotherapy involves the mental health professional helping the person with BPD explore deep feelings and the ways they manage those feelings (defenses) in ways that are not constructive. Interpersonal psychotherapy focuses on helping people with BPD relate to others in healthier, more appropriate ways.
Psychotherapy remains the mainstay of treatment for BPD. Many practitioners use techniques to help BPD sufferers better regulate their emotions and interact with others. Given the constraints of health insurance-funded treatment, mental health providers are often limited to supporting patients in their daily emotional and interpersonal struggles rather than directly treating their symptoms.
What Are the Medications for Borderline Personality Disorder?
While medications can be helpful in reducing some of the specific mood symptoms of BPD, they by no means cure the disorder. Given the high number of mood problems that characterize this illness, practitioners take care to try and minimize the number and doses of medications in order to avoid exposing the person with BPD to numerous side effects. Using multiple medications at the same time, also called polypharmacy, can also put the person at risk for attempting to use their supply of medications to commit suicide.
Despite these risks, careful use of medications can help achieve some symptom relief in certain people with BPD. Examples of antidepressants include medications that affect the activity of the chemical serotonin in the brain (serotonergic medications) like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). They are often used due to the combinations of high effectiveness and relatively low occurrence of serious side effects. Other antidepressants that practitioners frequently use to address mood symptoms for individuals with BPD include antidepressants that impact the activity of serotonin as well as epinephrine and norepinephrine, like venlafaxine (Effexor) and duloxetine (Cymbalta), as well as those that affect the activity of dopamine in the brain like bupropion (Wellbutrin). Older antidepressants like tricylics are not used as often as they used to be due to difficulties with possible side effects and the possibility of overdose.
Medically Reviewed by a Doctor on 11/21/2016
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