Can Borderline Personality Disorder (BPD) Be Cured?

What Is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) is a mental health disorder that is typically comprised of instability and conflict in interpersonal relationships. Common symptoms of BPD include intense and unpredictable emotions, impulsivity, urges to harm oneself or die by suicide, and an unstable self-image. In general, BPD symptoms tend to peak at a younger age and recede with age.^1,2 The long-term potential for recovery is generally positive, although some personality traits and/or symptoms may last.²

Is BPD Curable?

It’s understandable to wonder whether BPD can be cured, but the term “cure” is misleading. It implies that a person would have zero symptoms, and a sense of finality. Terms such as “long-term recovery” or “remission” are more accurate, because they allow for the possibility (and likelihood) that symptoms may rise and fall over time. Overall, recovery or remission of BPD often means that the person does not meet the criteria for the diagnosis.

Can You Recover From BPD?

While there are no definitive conclusions as to whether BPD is curable, there are several ongoing studies that report a range in symptom recovery over time.^2,4,5,6,7 The term “in recovery” often indicates that an individual may still have urges to perform certain actions, but does not act on them due to healthy coping skills and strategies.⁴  However, ongoing difficulties may persist, such as interpersonal challenges, emotional dysregulation, or troubles at work.⁵ 

There are two frequently-referenced long-term studies of individuals with BPD. One 20-year study found that sustained remission, meaning many years without any sort of recurrence of symptoms, is difficult to obtain.⁴ After 10 years, 50% of the participants had sustained symptom resolution and good social and work functioning for more than two years. 93% of the participants had at least two years of remission and 86% had at least four years of remission. Overall, BPD recovery rates range from 33% to 99% due to differences in participants and the definition of “recovery.”⁵

Recent statistics on recovery in BPD include:

• In a study of 231 patients over 16 overs, 60% met the criteria for recovery lasting 2 years.⁴
• A 10-year study of 175 participants showed that 85% met the criteria for remission.⁶
• 92.2% of 64 patients participating in a 27-year study met the criteria for recovery.⁷
• 74% of 101 children ages 15 to 18 still met the criteria for BPD after 2 years⁸

Treatment for Borderline Personality Disorder

BPD does not “go away,” but there are a variety of effective treatments for borderline personality disorder. Psychotherapy is typically the first recommendation when developing a treatment plan for BPD. However, medication may be prescribed based on presenting symptoms.

Like any mental health issue or diagnosis, having the appropriate treatment is key to management and recovery. This is particularly important in the case of BPD, because people with BPD may experience symptoms related to self-injurious behavior, and suicidal thoughts and actions. It is estimated that about 70% of people diagnosed with BPD will attempt suicide at least once in their life, so professional mental health therapy is paramount for those with BPD.¹³

Therapy

The most effective and well-known treatment for borderline personality disorder is dialectical behavior therapy (DBT). Statistics regarding the efficacy of DBT for BPD differ based on populations, length of follow-up, and measures of success. One study found that 77% of participants no longer qualified for the DBT diagnosis after one year.^9,10,11

While DBT is considered the gold-standard treatment for BPD, additional therapies may also be utilized. These include cognitive behavioral therapy (CBT) for BPD, schema therapy, mentalization-based therapy (MBT), STEPPS, and others.

It’s best to work with a mental health professional to determine the correct type for you based on your specific needs or the needs of your loved ones. First, choose a therapist or mental health agency with training and experience in treating borderline personality disorder. You can start your search in an online therapist directory. From there, ensure that the therapist-client relationship feels like a good fit and that you have a comprehensive treatment plan.

Medication

Medications for BPD are another common element of a comprehensive treatment plan. Mental health medications are typically prescribed based on their symptoms. For example, if a client has ongoing depression, a medication for depression (such as a selective serotonin reuptake inhibitor (SSRI)) may be prescribed.¹²

It is important to discuss with your doctor what medications may be most appropriate for what you are experiencing. Trying different medications can be frustrating, and it is OK to voice concerns or hesitations with your provider.

How to Cope With BPD

A BPD diagnosis may be overwhelming or frustrating. In some cases, it might be a relief to finally have a label and explanation for what you or a loved one has been experiencing. Regardless of the initial reaction, one will need to cope with the diagnosis because there is no BPD cure.

Below are some ways to cope with the symptoms of BPD:

• Treat co-occurring issues: It is important to treat co-occurring mental health conditions such as anxiety, depression, or bipolar disorder. Many co-occurring diagnoses feed into and influence one another, making a comprehensive treatment plan the best option.
• Educate yourself about BPD: Learn about a BPD diagnosis and how others have recovered. This may help you or a loved one feel hopeful, provide helpful examples of the path ahead, and potentially build community.
• Explore holistic wellness: Overall health and wellness are the foundation for your mental health. You can target your holistic wellness efforts toward your specific needs and symptoms, such as yoga for anxiety and mindfulness for BPD.
• Develop community: You don’t have to do this alone. If pursuing DBT, ensure that your treatment includes a group component or find a support group. Having connections with people with shared experiences will help you to feel less isolated. You may find that you can learn a lot from how others manage their symptoms and experience relief, but it is important to keep in mind that your experience is unique to you.
• Involve family and friends: Including trusted family and/or friends in treatment can help them to support the person in need.
• Learn about treatment options: Reviewing the possible treatment options will help you to be an informed consumer of any services.
• Reinforce your basic self-care skills: Everyone can benefit from foundational self-care skills, such as getting adequate restful sleep, movement/exercise, eating nutrient-dense food, or limiting screen time. Self-care helps develop self-love and is a good foundation for any mental health recovery.
• Develop a safety plan: Borderline personality disorder can include self-harming and/or suicidal thoughts/actions. Because of this, familiarize yourself with crisis hotlines and resources in your area. Make a plan for if you or someone you know are wanting to hurt themselves or die by suicide; call 9-1-1 or go to your local emergency department.

Final Thoughts

Is BPD curable? No, not technically. However, the right treatment plan can meaningfully improve one’s ability to function. Plus, borderline personality disorder symptoms are likely to improve over time, and it is possible to recover and go on to experience a full life.