Psychotherapy Provides Lasting Benefits for Borderline Personality Disorder
Borderline Personality Disorder
Borderline personality disorder is one of 10 distinct personality-based mental illnesses officially recognized by the American Psychiatric Association. People diagnosed with the condition have at least five out of a potential nine symptoms that indicate the presence of seriously unstable patterns of thought and mood, seriously unstable day-to-day behavior and/or seriously unstable personal connections with other people. Examples of specific BPD symptoms include a rapidly changing and volatile mood, frequent involvement in risky or hazardous behavior, lack of accurate self-perception, the onset of paranoia in stressful situations, participation in “cutting” or other self-harming behaviors and repeated threats of suicide or attempts to commit suicide.
Roughly 1.6 percent of all U.S. adults have borderline personality disorder, the National Institute of Mental Health reports. Most people first develop symptoms of the illness during their teenage years or during the first phase of adulthood. Current guidelines prevent doctors from making an official diagnosis of the disorder (or any other personality disorder) in a teenager or younger child. Substantial numbers of people affected by BPD also have other serious mental health problems, including such things as substance use disorder (substance abuse/addiction), eating disorders, anxiety disorders and major depression.
BPD and Dialectical Behavior Therapy
As many as four out of every five people with borderline personality disorder will make plans to commit suicide or carry out a suicide attempt. Unfortunately, up to 9 percent of people with the disorder actually kill themselves. Dialectical behavior therapy is a form of psychotherapy specifically designed to decrease the odds that a person with BPD will try to commit suicide. People who participate in this therapy learn to understand the underlying reasons for their rapid and volatile shifts in mood, learn to identify the circumstances that make such mood shifts likely to occur and learn how to change their reactions to such triggering circumstances. Crucially, people participating in dialectical behavior therapy also learn how to accept their unpleasant states of mind rather than rejecting them out of hand.
Are There Lasting Benefits?
In the study published in Psychotherapy and Psychosomatics, researchers from the United Kingdom’s Queen Mary University of London used a project involving 80 people diagnosed with borderline personality disorder to gauge the lasting benefits of dialectical behavior therapy. Forty of the study participants enrolled in a one-year course of therapy, while the remaining 40 participants received a standard one-year course of BPD treatment that did not include dialectical behavior therapy. Six months after treatment came to an end, the researchers compared the BPD-related hospitalization rates of the two groups. In the year prior to participating in the study, the members of both groups had been hospitalized for roughly the same number of days.
Nineteen of the participants who initially enrolled in dialectical behavior therapy completed a full course of treatment; the researchers were able to obtain the hospitalization records for 14 of these individuals. All told, two of the 14 participants required hospitalization during the six-month period of time under consideration; just one of these individuals had remained active in dialectical behavior therapy. In contrast, 11 of the study participants who did not receive the therapy required hospitalization. Based on these findings, the researchers concluded that completion of dialectical behavior therapy can significantly decrease the odds that a person with borderline personality disorder will experience symptoms severe enough to merit a hospital stay. Critically, this decrease in odds lasts for a substantial amount of time.
The researchers also looked at the impact that dialectical behavior therapy has on the chances that a person with borderline personality disorder will engage in self-harming behavior. They concluded that, six months after treatment, completion of a course of the therapy does not meaningfully reduce the risks for such behavior.