TREATMENT THERAPYThe National Institute for Health and Care Excellence (NICE), an organization that produces guidelines on bestpractice in health care suggests that the following kinds of talkingtreatments could help treat BPD.Dialectical Behavior Therapy (DBT): A treatment specifically developed for BPD. It firstfocuses on the suicidal and other self-destructive behaviors of the person. Whenthe person is no more suicidal, cognitive behavioral therapy identifies thentries to change the negative thinking patterns of the person and presses forpositive behavioral changes. It teaches patients the skills to cope with andchange unhealthy behaviors, control intense emotions, reduce self-destructivebehavior, manage distress, and improve relationships. It uses individual and grouptherapy to help learn skills to manage emotions.Metallization Based Therapy (MBT): A long-term talking treatment which aims to improve theability to recognize and understand your and other people’s mental states, andhelps examine thoughts about yourselfand others to see if they’re valid.
Therapeutic communities (TCs): Therapeutic communities (TCs) are structured environmentsdesigned to help people with long-standing emotional problems and a history ofself-harming. Here people with a range of complex psychological conditions andneeds come together to interact with each other and take part in therapy. The therapyteaches them skills needed to interact socially with others.
Most TCs areresidential where you stay for around one to five days a week. MEDICATION There is no specific medication to treat BPD. Even though medicationisn’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 mentalhealth condition alongside BPD like depression, anxiety disorder, bipolar disorder etc. These may include:Anti-depressants: Antidepressantsare mood-boosters. They extend the activityof particular chemicals in the brain which are thought to be involved withregulating mood such as nor-adrenaline and serotonin.Moodstabilizers: Mood stabilizers can be used to reduce anxiety, anger, depression, impulsivity,or attempts at self-harm related with borderlinepersonality disorder.
Anti-psychotics:Psychiatric drugs used to treat those mental healthproblems whose symptoms consist of psychotic experiences. Although BPD is not a psychoticdisorder, research has shown that antipsychotic medications may be effective inreducing some of the symptoms ofBPD like anger and hostility, intense mood shifts, andcognitive symptoms, like paranoid thinking. That being said, research showsthat antipsychotics are not effective in improving anxiety, depressedmood, and impulsivityin BPD.
WORK ISSUESDifferent borderline types such as discouraged, impulsive,petulant and self destructive borderline face different issues in their workenvironment affecting their colleagues, productivity, subordinates andthemselves 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,Difficultyrelating appropriately with co-workers and supervisors: Theymight develop unstable relationships with their coworkers based on theiridealization and devaluation thinking patterns. They may be overly dependent ontheir supervisors affecting their work and productivity. Fear of abandonmentmany make the person cling to their colleagues. Inappropriateresponse to work/social situations: People with BPDmight act according to their own emotions and feelings even when the situationdoes not demand that like being angry when they need to stay calm. Being sadwhen they should be happy in a group setting which makes them look weird toother people and they may end up alone feeling guilty and confirming to theirselves that they are unwanted, unworthy and useless. Difficultyconcentrating on work activities: The symptoms offeeling empty and dissociation from the self affects concentration levels.Stress diverts their mind towards the problems that may not even exist thus no solutioncan be found for them making the person feel guilty.
Impulsiveand angry behavior: Severe unstable and unpredictablemood swings can cause people to get angry every now and then with or withoutreason. The trigger is often reported to be relationship or social factors. Itmay cause frustration and feelings of guilt once the anger subsides.
Excessiveguilt heightens the BPD symptoms which affect their work.Inabilityto take decisions: Identity disturbances lead toquestions like “who am I?” and “why do I exist?” which clouds the mind and makethe person unaware of what he wants and what he should do, which makes himunable to take effective decisions. SUITABLE WORK ENVIRONMENTPeople whosuffer from BPD face certain hardships in their work environment making it hardfor them to stay in a job and be satisfied. They should look for jobs that donot trigger their symptoms as much and avoid those that trigger them to agreater extent. The suitable work environment for them should have or be;Organized:Working in a clean,neat and organized environment helps relieve stress and think clearer. Acluttered office results in a cluttered mind.
The mind distracts lessand the person can concentrate more on his work and encourages him to work.Limitedwork hours: Limited work hours give the persontime to relax and attend his therapy sessions on regular basis thus relievingthe symptoms. Jobswith less people interaction: As BPD symptoms areintensified the more the person interacts with people, jobs that do not requiremuch social interaction unlike marketing and media jobs which demand socialexposure are good for BPD patients. Notor less competitive than other jobs: Competition inwork environment may increase stress levels in many BPD patients like workingas a salesperson might not be a good idea.Expressiveand flexible: Jobs in which the person can put hisideas into work such as being an artist or an author are good for BPD patientsas they also have flexible working time often adjusted according to the artist’sdesires.Self-employment: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 workunder anyone. Working from home such as being a freelance programmer or agraphics designer might keep the person in job for longer period.