The National Institute for Health and Care Excellence (NICE), an organization that produces guidelines on best
practice in health care suggests that the following kinds of talking
treatments could help treat BPD.
Dialectical Behavior Therapy (DBT): A treatment specifically developed for BPD. It first
focuses on the suicidal and other self-destructive behaviors of the person. When
the person is no more suicidal, cognitive behavioral therapy identifies then
tries to change the negative thinking patterns of the person and presses for
positive behavioral changes. It teaches patients the skills to cope with and
change unhealthy behaviors, control intense emotions, reduce self-destructive
behavior, manage distress, and improve relationships. It uses individual and group
therapy to help learn skills to manage emotions.
Metallization Based Therapy (MBT): A long-term talking treatment which aims to improve the
ability to recognize and understand your and other people’s mental states, and
helps examine thoughts about yourself
and others to see if they’re valid.
Therapeutic communities (TCs): Therapeutic communities (TCs) are structured environments
designed to help people with long-standing emotional problems and a history of
self-harming. Here people with a range of complex psychological conditions and
needs come together to interact with each other and take part in therapy. The therapy
teaches them skills needed to interact socially with others. Most TCs are
residential where you stay for around one to five days a week.
There is no specific medication to treat BPD. Even though medication
isn’t recommended by National Institute for Health and Care Excellence (NICE)
guidelines, it is seen that it may be helpful for a person who has another mental
health condition alongside BPD like depression, anxiety disorder, bipolar disorder etc. These may include:
are mood-boosters. They extend the activity
of particular chemicals in the brain which are thought to be involved with
regulating mood such as nor-adrenaline and serotonin.
stabilizers: Mood stabilizers can be used to reduce anxiety, anger, depression, impulsivity,
or attempts at self-harm related with borderline
Psychiatric drugs used to treat those mental health
problems whose symptoms consist of psychotic experiences. Although BPD is not a psychotic
disorder, research has shown that antipsychotic medications may be effective in
reducing some of the symptoms of
BPD like anger and hostility, intense mood shifts, and
cognitive symptoms, like paranoid thinking. That being said, research shows
that antipsychotics are not effective in improving anxiety, depressed
mood, and impulsivity
Different borderline types such as discouraged, impulsive,
petulant and self destructive borderline face different issues in their work
environment affecting their colleagues, productivity, subordinates and
themselves while also increasing the turnover rate for these individuals,
decreasing the satisfaction and increasing the level of dissatisfaction. Overall,
the problems faced by BPD patients in their work environments include,
relating appropriately with co-workers and supervisors: They
might develop unstable relationships with their coworkers based on their
idealization and devaluation thinking patterns. They may be overly dependent on
their supervisors affecting their work and productivity. Fear of abandonment
many make the person cling to their colleagues.
response to work/social situations: People with BPD
might act according to their own emotions and feelings even when the situation
does not demand that like being angry when they need to stay calm. Being sad
when they should be happy in a group setting which makes them look weird to
other people and they may end up alone feeling guilty and confirming to their
selves that they are unwanted, unworthy and useless.
concentrating on work activities: The symptoms of
feeling empty and dissociation from the self affects concentration levels.
Stress diverts their mind towards the problems that may not even exist thus no solution
can be found for them making the person feel guilty.
and angry behavior: Severe unstable and unpredictable
mood swings can cause people to get angry every now and then with or without
reason. The trigger is often reported to be relationship or social factors. It
may cause frustration and feelings of guilt once the anger subsides. Excessive
guilt heightens the BPD symptoms which affect their work.
to take decisions: Identity disturbances lead to
questions like “who am I?” and “why do I exist?” which clouds the mind and make
the person unaware of what he wants and what he should do, which makes him
unable to take effective decisions.
SUITABLE WORK ENVIRONMENT
suffer from BPD face certain hardships in their work environment making it hard
for them to stay in a job and be satisfied. They should look for jobs that do
not trigger their symptoms as much and avoid those that trigger them to a
greater extent. The suitable work environment for them should have or be;
Working in a clean,
neat and organized environment helps relieve stress and think clearer. A
cluttered office results in a cluttered mind. The mind distracts less
and the person can concentrate more on his work and encourages him to work.
work hours: Limited work hours give the person
time to relax and attend his therapy sessions on regular basis thus relieving
with less people interaction: As BPD symptoms are
intensified the more the person interacts with people, jobs that do not require
much social interaction unlike marketing and media jobs which demand social
exposure are good for BPD patients.
or less competitive than other jobs: Competition in
work environment may increase stress levels in many BPD patients like working
as a salesperson might not be a good idea.
and flexible: Jobs in which the person can put his
ideas into work such as being an artist or an author are good for BPD patients
as they also have flexible working time often adjusted according to the artist’s
If a person cannot find a job he/she fits into,
self-employment is a choice for BPD patients too as they don’t have to work
under anyone. Working from home such as being a freelance programmer or a
graphics designer might keep the person in job for longer period.