A number of research studies have demonstrated that certain types of antidepressants are effective in treating specific symptoms of BPD. For example, SSRIs can reduce emotional instability, impulsivity, self-harm behaviors, and anger. MAOIs have also been shown to effectively treat emotional instability.
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the most commonly prescribed antidepressants for individuals with BPD who are experiencing symptoms of depression.
Because antidepressants have not demonstrated significant high-level evidence of therapeutic benefit, these medications currently lack strong recommendations in treating BPD. Serotonin regulates amygdala hyperreactivity in BPD, thought to be a central neurobiological correlate of affective instability.
Although no drugs have been approved by the Food and Drug Administration specifically for the treatment of borderline personality disorder, certain medications may help with symptoms or co-occurring problems such as depression, impulsiveness, aggression or anxiety.
Borderline personality disorder often occurs with other mental illnesses, such as post-traumatic stress disorder (PTSD). These co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with symptoms of the disorder.
Overcoming BPD without medication is possible, but you should always follow the guidance and treatment plan set forth by your doctor or health care provider. Medication isn't necessarily the primary treatment for BPD in most cases. It's typically only used to treat specific symptoms such as depression or mood swings.
NICE doesn't recommend using medication to treat the ongoing symptoms of BPD. This is because there aren't any drugs that are known to be effective. But we know that in practice doctors often do prescribe medication for people diagnosed with BPD. This could include antidepressants, antipsychotics or mood stabilisers.
Separations, disagreements, and rejections—real or perceived—are the most common triggers for symptoms. A person with BPD is highly sensitive to abandonment and being alone, which brings about intense feelings of anger, fear, suicidal thoughts and self-harm, and very impulsive decisions.
Recognizing a BPD Episode
Intense outbursts of anger are indicative of an episode of BPD as are bouts of depression and anxiety. Eighty percent of those suffering from BPD experience suicidal thoughts and behavior while in the throes of an episode as well.
Concern About Patients Sabotaging Treatment. Sometimes individuals with symptoms of BPD lash out so intensely that it sabotages the treatment in such a way that even the most skilled therapist cannot stop this process. A common example is a patient cutting off all contact, or ghosting the therapist.
Tricyclic Antidepressants for BPD
This category of antidepressants includes amitriptyline (including Amitril, Elavil, and Endep) and nortriptyline (Aventyl and Pamelor). These drugs may worsen Borderline Personality Disorder symptoms in some patients.
Mood stabilizers for borderline personality disorder (BPD) can be effective in reducing BPD symptoms, particularly emotion dysregulation and impulsivity symptoms.
Common anticonvulsants and mood stabilizers for BPD include: Depakote (valproate) Lamictal (lamotrigine) Lithobid (lithium)
Consider cutting out all processed food and sugar for a few weeks and observe your energy level and your emotions. Avoid misusing alcohol or caffeine, as these also can intensify mood instability. BPD sometimes includes symptoms of self-harm or substance abuse.
Mania: People with bipolar disorder act impulsively when they are experiencing a period of mania. People with BPD also tend to act impulsively, but this behavior is unrelated to mania.
For many folks with BPD, a “meltdown” will manifest as rage. For some, it might look like swinging from one intense emotion to another. For others, it might mean an instant drop into suicidal ideation. Whatever your experience is, you're not alone.
Individuals with Borderline Personality Disorder (BPDs) become overwhelmed and incapacitated by the intensity of their emotions, whether it is joy and elation or depression, anxiety, and rage. They are unable to manage these intense emotions.
BPD can be difficult to diagnose because the symptoms are similar to other mental illnesses, such as depression, psychosis and bipolar disorder.
Many mental health professionals do not have a lot exposure or education on BPD, so it's easy for BPD to be misdiagnosed as something else such as bipolar disorder since both disorders involve shifting moods and periods of depression.
Borderline personality disorder usually begins by early adulthood. The condition seems to be worse in young adulthood and may gradually get better with age. If you have borderline personality disorder, don't get discouraged.
BPD in particular is one of the lesser-known mental illnesses, but all the same it is one of the hardest to reckon with. (Some people dislike the term so much they prefer to refer to emotionally unstable personality disorder.)
Vitamin D. Suicidal behaviour can be a key feature of borderline personality disorder. Although research into Vitamin D and BPD specifically is lacking, it is interesting to note that Vitamin D levels have been observed to be significantly lower in individuals who are suicidal (19).