Borderline Personality Disorder

My Experience as a Psychiatrist Treating BPD
I am a Harvard-trained expert who has been successfully treating patients with BPD and other types of personality disorders for over 25 years. You can contact me by telephone at (617) 932-1548 or by email at David@DrDavidBrendel.com. Or you can schedule a video consultation via ZocDoc.

Symptoms of BPD
The hallmark of BPD is emotional dysregulation. People with BPD experience mood instability, anger, irritability, volatile relationships, and a wide range of impulsive behaviors. They tend to be highly reactive to interpersonal stress, especially in close relationships with family members and significant others. They struggle with fears of abandonment and lack a strong personal identity. They may cycle between extremes of idealizing and devaluing important people in their lives. When dealing with stress, they can experience severe depression, anxiety, and even transient paranoia. BPD is often comorbid with major depression, bipolar disorder, anxiety disorders, eating disorders, and substance abuse.

Some of the impulsive and self-destructive behaviors seen in BPD include substance abuse, binge eating, and various forms of self-injury (such as cutting, burning, or overdosing on medications). People with BPD may escalate into suicidal ideation and actions. At times they voice suicidal thoughts as calls for help or interpersonal provocations, but their statements should always be taken with the utmost seriousness. Some studies have shown that up to 10% of people with BPD will die by suicide.

Patients, families, and clinicians have understandable concerns about the stigma of mental health conditions like BPD. But it is essential that psychiatrists accurately diagnose the condition, explain the diagnosis to patients and their loved ones, and formulate evidence-based treatment plans.

Treatment for BPD
There has been rigorous research on treatments for BPD for over 30 years. The research shows that the vast majority of people with BPD will have a positive outcome if they receive appropriate mental healthcare.

There is no medication that is FDA-approved specifically for BPD, but there are many medications that can be helpful for some of the symptoms. For example, antidepressant medications may reduce anger and suicidal thinking, mood stabilizers can reduce emotional dysregulation, sedative medications can promote healthy sleep, and temporary use of antipsychotic medications can moderate paranoid thinking.

There are also evidence-based psychotherapy treatments that can be extremely helpful for BPD. These modalities include both individual and group therapy. The most well-established approach is dialectical behavior therapy (DBT) which has four pillars: emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness.

Other psychotherapy approaches include cognitive-behavioral therapy (CBT), mentalization-based treatment (MBT), and transference-focused psychotherapy (TFP). Family members and loved ones of people with BPD may also benefit from their own counseling and psychoeducation.

Feel free to contact me with questions or to schedule a consultation. I hope that my experience and expertise with BPD will provide you with greater understanding, reassurance, and a strong plan for recovery and thriving in the future.If you think that you or someone you care about may be suffering from borderline personality disorder, please contact me or schedule a psychiatry appointment.