Borderline Personality Disorder Treatment for Young Adults

What is borderline personality disorder? Borderline personality disorder (BPD) is a mental disorder marked by instability in relationships, moods, and behavior. But for people with BPD, it’s much more complicated than unstable relationships. Borderline personality disorder is a complex mental health issue. It can manifest itself differently through various subtypes and often disguises itself as another mental illness.
Symptoms and diagnostic criteria

The hallmark symptoms of BPD are unstable relationships, extreme fear of rejection or abandonment, and intense emotions. However, there are many more symptoms that may indicate borderline personality disorder.

In order to be diagnosed with borderline personality disorder, you’ll need to have experienced at least five of the following eight symptoms in a chronic and repetitive pattern.

  • Extreme fear of rejection and abandonment, both real and imagined
  • Stormy personal relationships swinging from idealization to devaluation
  • Unstable self-image
  • Inappropriate bouts of intense anger
  • Chronic feelings of boredom or emptiness
  • Emotional instability, including irritability and anxiety
  • Paranoid and dissociative thoughts
  • Impulsivity leading to reckless and harmful behavior (including self-destructive behaviors)

Borderline personality disorder also has four subtypes, each with its own distinct patterns.

  1. Discouraged borderline personality disorder
  2. Impulsive borderline personality disorder
  3. Petulant borderline
  4. Self-destructive borderline

Not all people with BPD will fit into one of these four subtypes, while some fit into multiple subtypes. You may fit into one of the subtypes at a certain point in life, while later you might fit into another or none at all.

What Causes BPD?

At this point, researchers are not sure about the exact cause for developing borderline personality disorder. There is some evidence that points to a combination of genetic and environmental factors.

Some of the genetic and biological indicators include:

  • A large twin study showed a 42% heritability estimate
  • MRIs show that people with BPD may have a smaller or underdeveloped prefrontal cortex. This is the area that primarily helps regulate behavior, emotions, and self-control.
  • MRIs show that those with BPD may have an overactive amygdala, causing more intense emotions and reactions.
  • Neurotransmitters (responsible for regulating sleep, learning, and mood) may be lower in those struggling with BPD.

Some of the environmental factors include:

  • Social and cultural surroundings
  • Post-traumatic stress disorder (Particularly childhood neglect, abandonment, sexual trauma, emotional trauma, or physical abuse.)
  • Intense or chronic stress
  • Unstable family relationships
  • Parent or caregiver with a substance abuse problem
  • Parent or caregiver with a mental health issue

Is BPD Treatable?

While borderline personality disorder might not be “curable”, you can absolutely treat and manage the symptoms of it. There are several forms of therapy that have been effective in treating BPD. If your symptoms are mild and non-interruptive, you can probably address BPD symptoms in outpatient therapy. If you’re like the many young adults whose BPD symptoms have impeded their relationships and their progress in life, you may need to use some of the following treatment options in a more intense treatment setting.

  • What are Treatment Options?
    Borderline personality disorder treatment almost always includes talk therapy. Within talk therapy, your therapist may use a specific “modality” (or type) or treatment to help you overcome BPD symptoms. You’ll see those listed below. Some medications prescribed by your doctor or psychiatrist might also help you regulate your emotions and control BPD symptoms.

    • Psychotherapy (talk therapy)
      • DBT skills
        Dialectical behavior therapy, or DBT, was developed as a way to manage the symptoms of borderline personality disorder. This form of therapy teaches skills for mindfulness, emotion regulation, interpersonal effectiveness, distress tolerance, and finding middle ground.
      • Transference-focused therapy
        Like DBT, transference-focused psychotherapy was also developed specifically to help those with borderline personality disorder. With transference-focused therapy (or TFP), you use the relationship with your therapist to play out the challenges you experience internally and in interpersonal relationships. Your therapist then helps you process these challenges so that you’re able to apply solutions outside of therapy.
      • Schema-focused therapy
        Often, we have developed a way of responding to certain experiences that worked for us at the time, but no longer serves us in the present. Schema therapy helps you identify the need you are trying to meet, and how to meet these needs in a healthier, more effective way.
      • Mentalization-based therapy
        For people with BPD, identifying and understanding emotions while they’re happening can be nearly impossible. Mentalization-based treatment (or MBT) helps to identify current emotions and to determine whether your emotion fits the facts of the situation. When you better understand your emotions, you’ll be able to react accordingly.
    • Medication management

Not everyone with borderline personality disorder is prescribed medication, but there is some evidence that medications can help you manage BPD symptoms. There are several medication options depending on an individual’s symptoms. The most common medications used to treat BPD are antipsychotic medications and mood stabilizers. It’s also common to be prescribed multiple medications to treat BPD and any co-occurring disorders you’re experiencing. Medication can help you stabilize your mood, lessen impulsivity, and prevent suicidal behavior.

Borderline personality disorder is treatable. If you think you might have BPD, seek professional help immediately. Through therapy and medication, you can overcome BPD symptoms and live a healthy life with secure relationships.


Photo by Illia Cherednychenko on Unsplash