Therapy is widely considered the first-choice treatment for borderline personality disorder (BPD). But psychiatric care can also help people manage BPD symptoms in some cases.
Psychiatrists can prescribe medication to help you manage certain BPD symptoms. They can also identify and treat symptoms of co-occurring conditions (if present).
In addition to prescribing medication, a psychiatric provider can collaborate with other members of your care team and offer recommendations for other supports that can improve your mental health.
Borderline personality disorder (BPD) is a mental health condition characterized by abrupt mood changes, impulsivity, unsafe behavior, and emotional dysregulation. Left untreated, BPD can also make it difficult to sustain healthy relationships. In severe cases, it can increase the risk of suicide.*
Fortunately, with the right support, BPD can be managed. The first-choice treatment for BPD is therapy. Dialectical behavioral therapy (DBT), in particular, focuses on helping people regulate their emotions, manage challenging behaviors, and improve their relationships.
In addition, medication can be used to manage symptoms of conditions that occur alongside BPD. For example, if you have anxiety or depression and BPD, certain medications can provide relief from symptoms of those conditions.
If you have BPD (or suspect you do), you may wish to consider working with a psychiatric provider. Psychiatrists and psychiatric mental health nurse practitioners (PMHNP) both specialize in mental health and are skilled in diagnosing and treating complex conditions like BPD.
*BPD carries an increased risk of suicidality. If you’re having thoughts of harming yourself, don’t hesitate to ask for help. You can contact the National Suicide and Crisis Lifeline by dialing 988 from any phone. The counselors there will provide confidential support and resources to help keep you safe.
When to see a psychiatrist about BPD
There’s no right or wrong reason to see a psychiatrist for BPD. This is a personal decision you can make with the help of your care team. But it might be a good idea in certain scenarios.
For example, maybe you:
Would like to be evaluated for BPD and have complex medical and/or mental health needs
Suspect that you have BPD but may have been misdiagnosed, so you’d like a second opinion
Have been trying to treat your BPD with therapy but are still unable to manage your symptoms
Have other mental health concerns besides BPD, and you’d like to explore the possibility of taking medication to manage them
Experience intense anger and/or impulsivity that negatively affects your functioning
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What to expect from psychiatric BPD treatment
If you decide to try psychiatric treatment for BPD, it’s important to know what to expect. Your psychiatric provider can be an important part of your care team. But keep in mind that you may still need to work with other providers, depending on your needs.
During your first meeting with a psychiatric provider, they’ll review your history and ask about your symptoms. Your provider will want to discuss when your symptoms began, what makes them better or worse, and how they affect your life. This will help them assess whether you show symptoms of BPD. Your provider will also want to know about your family history, including whether you’re related to anyone with BPD or another mental health condition.
Once a BPD diagnosis is confirmed, you and your provider will move into treatment planning. During this phase, your psychiatric provider will determine the best types of support for your needs. This is a highly individualized process. But they may recommend things like therapy or lifestyle changes.
In some instances, your psychiatrist or PMHNP may also prescribe medication. If they do, they’ll monitor its effectiveness over time. If at any point you experience unwanted side effects or have other concerns, don’t hesitate to speak up. Your provider’s job is to help you find the right medication for you. They can recommend alternatives and help you brainstorm other solutions. This process is called medication management, and it’s a core component of psychiatric care for BPD.
Getting started with psychiatry for BPD
If you’re interested in accessing psychiatric care for BPD, you can start by:
Verifying your coverage: If you plan to use health insurance for BPD care, you may want to verify your plan’s coverage. Call the number on the back of your card, or use your health plan’s member portal to determine what types of psychiatric care your plan will pay for.
Asking for a referral: Let your therapist, doctor, or other provider know that you want to see a psychiatrist for a BPD evaluation. Describe your symptoms, and ask them if they can refer you to a psychiatric provider who can help.
Searching online: If you can’t get a referral from a provider, you can search for one online. Most directories and telehealth platforms list providers’ specialties, and you can look for a psychiatrist with expertise in BPD.
Making your first appointment: Your first appointment with a psychiatric provider is a good time to make sure that you’re a good fit for one another. They’ll likely ask lots of questions to get to know you better. But you can ask them questions too. For example, you may wish to inquire about their approach to BPD care and the treatment approaches they use to manage it.
As a psychiatric provider, I’ve seen patients with BPD improve with psychiatric care. This is often because we can use medications to help with co-occurring mental health conditions, like depression, anxiety, and PTSD.
Halee Fullerton, PMHNP-BC
Clinical reviewer
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BPD is a complex mental health condition. Left untreated, it can lead to emotional instability, rocky relationships, and unsafe behavior. Dialectical behavioral therapy (DBT) is one of the most effective treatments for BPD. But, in some instances, psychiatric care can play a role in BPD treatment too. Psychiatrists can prescribe medication for certain BPD symptoms and co-occurring conditions. They can also collaborate with other providers and make recommendations for supports that can improve the quality of life for people living with BPD.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Halee Fullerton, PMHNP-BC
Halee is a psychiatric nurse practitioner with experience treating children, adolescents, and adults. She has worked in outpatient community health with children/adolescents as well as inpatient substance use disorder treatment. She currently sees patients via outpatient telehealth. Before becoming a psychiatric nurse practitioner, she worked in emergency rooms, medical-surgical units, long-term care facilities (including Alzheimer/dementia units) and the intensive care unit.
She chose a career in mental health because she wanted to help people and to contribute to breaking down stigma around mental health. She is especially passionate about working with people who are navigating substance use disorders, depressive disorders, and anxiety/trauma-related disorders. She has three labradoodles that she adores.
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