Medicines for Borderline personality disorder (EUPD)

What it is

Borderline personality disorder (BPD), also called emotionally unstable personality disorder (EUPD), is a mental health condition characterised by difficulty regulating emotions. People may experience intense and rapidly changing emotions, a deep fear of abandonment, unstable and intense relationships, an unstable sense of self, impulsive or risky behaviour, feelings of emptiness, and, often, self-harm or suicidal thoughts. These experiences are distressing and can make daily life and relationships very difficult. It often begins in the teenage years or early adulthood, and is frequently linked to difficult or traumatic experiences, especially in childhood. It commonly occurs alongside depression, anxiety, PTSD or substance use. Although it can be very challenging, it is a treatable condition, and many people improve significantly over time with the right support.

How it is treated

The main treatment is specialist psychological therapy, and several structured talking therapies designed for this condition (such as dialectical behaviour therapy and mentalisation-based therapy) can be very effective, helping people understand and manage their emotions, reduce self-harm, and build more stable relationships. Support is often provided by community mental health teams, and a consistent, compassionate, long-term approach works best. Medication is not the main treatment but may be used to help specific symptoms or coexisting conditions. Managing crises safely, having a crisis plan, and support during difficult times are important. Treating coexisting conditions and addressing any underlying trauma are part of care. The outlook is more hopeful than once thought: many people experience significant improvement over the years, especially with effective therapy and support.