Wednesday, March 7, 2012

Borderline Personality Disorder: Current Treatments, Part 1


Treatment for BPD usually consists of several different components.  A combination of drug treatment, individual counseling, and group therapy are the common regiment. Over the next three articles, the current available modalities will be explored. This article is going to focus on the use of medications to address the more troubling BPD symptoms.

Most individuals with BPD only seek help after they have exhausted their social support system, risked a job or two, or have gotten into legal trouble. They may also be in financial difficulty, abusing drugs or alcohol, and have contemplated or attempted suicide. Their life is careening out of control.
It is not surprising that most BPD sufferers are experiencing significant psychological symptoms when they initially seek treatment. A list of these symptoms can be found here. A first important step in getting the proper treatment is to seek an evaluation with a psychiatrist familiar in the peculiarities of BPD. Most insurance companies have a list of providers by geographical area. Primary care physicians and mental health counselors are also  excellent resources for a recommendation of a psychiatrist who specializes in BPD.
Once a thorough psychiatric evaluation is completed, BPD clients are often prescribed medication. Drug treatment for BPD may include a combination of one or  more classes of medications. Antidepressants, most notably Serotonin Reuptake Inhibitors (SSRIs), have been shown effective at improving overall mood and reducing impulsivity. Neuroleptics and Atypical Antipsychotic medications, such as Zyprexa, Risperal, Seroquel, and Abilify, are helpful at improving emotional overreaction and rational thinking. A mood-stabilizing agent, such as Depakote, Tegretrol, Lamictal, and Topamoz, may also be included to reduce emotional turmoil and to improve the therapeutic benefits of the other medications. The treating psychiatrist will prescribe one or more of these medications to best address the individual’s symptoms.
Medication is just one part of the therapeutic regiment to address the BPD sufferers’ problems. Individual and group therapy are often another facet of treatment for BPD. The next article will explore Dialectical Behavior Therapy and its benefits.
For an excellent resource on the current drug treatments for BPD, please see Dr. Friedel’s book, Borderline Personality Disorder Demystified:An Essential Guide for Understanding and Living with BPD (2004).

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