BPD Treatment
Treating Borderline Personality Disorder (BPD) is a collaborative effort at Morningside Recovery. The staff at Morningside develops a comprehensive multidisciplinary care plan, specifying the expectations and responsibilities of the client. The treatment plan will set manageable short-term goals and specify steps that the client (and possibly the family) can take to achieve them. It is important to note that studies have shown that brief psychological interventions for BPD don’t work. Therefore, Morningside Recovery helps clients identify long-term goals such as education and employment, which are integral parts of treating BPD.
Treatment for clients with borderline personality disorder, especially those with a co-occurring disorder (dual-diagnosis), begins with structured care and an open and honest theoretical approach used by both the treatment team and the therapists. BPD patients typically function best in highly structured situations and have shown higher levels of psychopathology in unstructured treatment settings. For example, the staff at Morningside makes sure clients adhere to their individual schedules. Routines are established by the clinical staff and clients are monitored for attempts at impulsive sexual behaviors or binge eating.
All therapeutic approaches recognize that BPD is a severe mental illness characterized by a persistent and unreactive low mood. There is usually loss of interest in formerly pleasurable activities, usually accompanied by a range of symptoms including appetite change, sleep disturbance, fatigue, loss of energy, poor concentration, and morbid thoughts. One therapeutic approach is Dialectical Behavior Therapy (DBT), which was developed specifically to treat BPD, and this technique has shown promise in studies. Individual counseling sessions allow clients to work through the painful feelings such as anger, sadness and guilt.
Medication is used sparingly for borderline personality disorder and usually only for individual behaviors such as self-harm, risk-taking behavior and transient psychotic symptoms. However, medication may be part of the overall treatment of co-occurring disorders. Morningside’s clinical staff may cautiously prescribe certain medications to target specific symptoms in an individual client. Recent brain imaging studies show that patients with BPD have individual differences in the ability to activate regions of the prefrontal cerebral cortex, which is thought to act as the regulator or filter of impulse. Serotonin, norepinephrine and acetylcholine are among the chemical messengers in these circuits that play a role in the regulation of emotions, including sadness, anger, anxiety, and irritability. The overall goal is to minimize unnecessary drug treatment, using only what is necessary to manage symptoms, similar to insulin for diabetes or antibiotics for an infection. Moreover, the psychiatric staff at Morningside Recovery is available to adjust dosages so that medication works hand in hand with therapy.
According to Primary Therapist Melissa Bondurant, MA, clients with BPD often exhibit symptoms that can be confused with bipolar disorder, depression, or anxiety. Therapists will take into account when BPD was first diagnosed, symptom severity, how long the individual has been suffering, and past treatment. In the long term, therapy involving discussion groups or support groups is perhaps the most effective treatment for many people suffering from BPD. Group members help each other realize that many people have done the same things and felt the same emotions. That, in turn, helps the individual realize that he or she is not unique in feelings of hopelessness or guilt.
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