Living With Borderline Personality Disorder

If you have been diagnosed with borderline personality disorder (BPD), you may be relieved that you now know why you have felt or behaved a certain way. You may also feel overwhelmed about the treatment ahead, how to get the support you need, and how to deal with the condition day-to-day. With care and support, you can learn to manage your symptoms and live with BPD.

How to manage lifestyle changes

Managing stress

Stress is your body’s reaction to life changes and events, both good and bad. Stress can play a major role in BPD, so it is important to learn how to cope with stress. Some techniques to cope with stress include:

• Meditation, muscle relaxation, and breathing exercises.
• Exercise. Find a type of exercise or physical activity that you enjoy. Even a short daily walk can help to lower stress levels.
• Getting enough good quality sleep.
• Spending time on hobbies that you enjoy, such as listening to music or spending time outdoors.

Medicines

Your health care provider may suggest certain medicines if he or she feels that they will help to improve your condition. Avoid using alcohol and other substances that may prevent your medicines from working properly (may interact). It is also important to:

• Talk with your pharmacist or health care provider about all medicines that you take, their possible side effects, and which medicines are safe to take together.
• Make it your goal to take part in all treatment decisions (shared decision-making). Ask about possible side effects of medicines that your health care provider recommends, and tell him or her how you feel about having those side effects. It is best if shared decision-making with your health care provider is part of your total treatment plan.

If you are taking medicines as part of your treatment, do not stop taking medicines before you ask your health care provider if it is safe to stop. You may need to have the medicine slowly decreased (tapered) over time to lower the risk of harmful side effects.

Relationships

People with BPD often experience unstable relationships. This may be due to:

• Difficulty trusting others.
• Feeling uncertain or suspicious of other people’s motives.
• Worrying that others are judging you.
• Feeling disappointed or easily angered by others.
• The physical effects that you experience when having upsetting thoughts.

Take these steps to maintain or improve healthy relationships:

• Before having conversations, take time to steady your breathing and calm yourself down. Remember that even though you have negative feelings, you still care about the other person.
• If you need to, take a break from the other person to calm yourself down. Make a commitment to return to the discussion after you both become calm.
• When you are calm, talk with your partner about how you can work together when upsets happen.
• Do not take dramatic action (such as leaving the relationship or harming yourself or others) while you are upset.
• Remember that it is okay to have feelings, and know that they will pass.

Other treatment options

Other treatments options involve approaches that work with the mind, body, and emotions, such as:

• One-on-one or group therapies, such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT).
• Mindfulness-based meditation. This can help you relax and focus on the present moment.

How to recognize changes in your condition

Everyone has a different response to treatment for BPD. Some signs that your condition may be improving include:

• Having fewer fights or disagreements.
• Life seeming more peaceful.
• Feeling more able to trust others.
• Fewer or no incidents of self-harm.
• Being more thoughtful before taking action on important issues.
• Having a willingness to take responsibility for your discomfort and not blame others.

Watch for the following signs, which may mean that your condition is getting worse:

• Blaming others for making you feel anger, sadness, hurt, or fear.
• Feelings of intense rage that you aim at others.
• Not trusting people you are emotionally close with, and being suspicious of intentions.
• Intense feelings of fear, anger, and loneliness.
• Thinking about or engaging in self-harm.

Where to find support

Talking to others

• Give your loved ones information about BPD, and encourage them to learn about the condition.
• Along with discussing your condition, talk with your loved ones about other things that interest you. Try not to focus only on your condition.
• Emphasize how important it is for you to stick to routines.

Finances

Not all insurance plans cover mental health care, so it is important to check with your insurance carrier. If paying for co-pays or counseling services is a problem, search for a local or county mental health care center. Public mental health care services may be offered there at a low cost or no cost when you are not able to see a private health care provider.

If you are taking medicine for BPD, you may be able to get the generic form, which may be less expensive than brand-name medicine. Some makers of prescription medicines also offer help to patients who cannot afford the medicines that they need.

Follow these instructions at home:

• Find people and surroundings that comfort you.
• Maintain a daily routine. Try to eat meals, wake up, and go to sleep at around the same times every day.
• Make a written crisis plan. Include important phone numbers, such as the local crisis intervention team. Make sure that your loved ones are aware of this plan.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider and therapist. This is important.

Questions to ask your health care provider

• If you are taking medicines:
  • How long do I need to take medicine?
  • Are there any long-term side effects of my medicine?
  • Are there any alternatives to taking medicine?
• How will I benefit from therapy?
• How often should I follow up with a health care provider?

Contact a health care provider if:

• Your symptoms get worse or they do not get better.
• You develop new symptoms.

Get help right away if:

• You have thoughts of hurting yourself or others.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• You can cope with the stress of borderline personality disorder (BPD) by following prescribed treatment. Your treatment may include medicine, therapy, or both.
• Encourage your loved ones to attend either one-on-one or family therapy sessions with you.
• Encourage family and friends to learn about BPD and get the support they need in dealing with your condition.
• Take over-the-counter and prescription medicines only as told by your doctor.