Most patient copays $0-$22
Care that’s covered
All our psychiatrists take insurance.
Flexible Scheduling
Virtual visits make showing up easy.
Responsible prescribing
Medication, only as needed.
The core mental health conditions we treat.
What is Borderline Personality Disorder (BPD)?
Borderline personality disorder is a mental health condition characterized by pervasive instability in moods, self-image, interpersonal relationships, and behavior. BPD affects how you think and feel about yourself and others, causing problems with emotional regulation, impulse control, and relationship functioning.
Unlike mood disorders that involve episodes of depression or anxiety, BPD involves ongoing patterns of intense emotional reactivity and unstable relationships. People with BPD often experience emotions more intensely and for longer durations than others, and they have difficulty returning to a stable emotional baseline after distressing events.
When you have BPD, your brain may process emotions and social information differently. Research shows differences in brain regions responsible for emotion regulation, impulse control, and processing social interactions. This can lead to rapid mood shifts, intense reactions to perceived rejection or abandonment, and difficulty maintaining a consistent sense of identity.
Symptoms and Characteristics of BPD
BPD involves a pattern of instability across multiple areas of functioning.
Core Features
Fear of Abandonment: Frantic efforts to avoid real or imagined abandonment, including impulsive actions when separation seems imminent
Unstable Relationships: Intense relationships that alternate between idealization ("they're perfect") and devaluation ("they're terrible")
Identity Disturbance: Unstable self-image or sense of self, including frequent changes in goals, values, career plans, or friendships
Impulsivity: Potentially self-damaging impulsive behaviors in areas like spending, sex, substance use, reckless driving, or binge eating
Suicidal Behavior or Self-Harm: Recurrent suicidal thoughts, threats, gestures, or self-injurious behavior
Emotional Instability: Intense mood swings lasting hours to days, including irritability, anxiety, or dysphoria
Chronic Emptiness: Persistent feelings of emptiness or boredom
Intense Anger: Difficulty controlling anger or frequent displays of temper
Dissociation or Paranoia: Stress-related paranoid thoughts or severe dissociative symptoms
Common Co-Occurring Conditions
Depression and anxiety disorders
Substance use disorders
Eating disorders
Post-traumatic stress disorder (PTSD)
Attention-deficit/hyperactivity disorder (ADHD)
Other personality disorders
Treatment Options for BPD
BPD is treatable, and many people experience significant improvement with appropriate therapy.
Specialized Psychotherapies
Dialectical Behavior Therapy (DBT): The most extensively researched treatment for BPD, focusing on mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness
Mentalization-Based Therapy (MBT): Helps develop the ability to understand your own and others' mental states
Schema-Focused Therapy: Addresses deeply held negative beliefs and patterns from early life
Transference-Focused Psychotherapy (TFP): Uses the therapy relationship to understand and modify relationship patterns
Medications
No medications are FDA-approved specifically for BPD, but medications may help manage co-occurring symptoms:
Antidepressants: SSRIs or SNRIs for depression and anxiety
Mood Stabilizers: May help with emotional instability and impulsivity
Antipsychotics: Low doses for severe symptoms like paranoia or dissociation
Anti-anxiety Medications: For acute anxiety (used cautiously due to dependence risk)
Additional Support
Crisis intervention and safety planning
Skills training groups (often part of DBT)
Family therapy and psychoeducation
Peer support groups
Intensive outpatient or residential treatment programs for severe cases
