While no medications are FDA-approved specifically for Borderline Personality Disorder (BPD), doctors use drugs like SSRIs (e.g., Prozac, Zoloft), mood stabilizers, and sometimes atypical antipsychotics to target symptoms like depression, impulsivity, or intense emotions, with anxiety often managed by non-habit-forming options like buspirone (BuSpar) or cautiously prescribed short-term benzodiazepines (e.g., Ativan, Xanax) for crisis, due to their addiction risk.
Commonly-prescribed mood stabilizers and anticonvulsants for those with BPD include:
Benzodiazepines most commonly used to treat anxiety disorders are clonazepam (Rivotril)*, alprazolam (Xanax) and lorazepam (Ativan). Also used are bromazepam (Lectopam), oxazepam (Serax), chlordiazepoxide (once marketed as Librium), clorazepate (Tranxene) and diazepam (Valium).
How can I help myself in the longer term?
Complications if Left Untreated
They may experience broken marriages and unplanned pregnancies and deal with dysfunctional interpersonal relationships. The social complexity and mental instability can sometimes lead to severe loneliness and depression when dealing with untreated symptoms associated with BPD.
Challenges with getting a BPD diagnosis
The symptoms of BPD are very broad, and some can be similar to or overlap with other mental health problems, such as: Bipolar disorder. Complex post-traumatic stress disorder (C-PTSD) Depression.
People with Borderline Personality Disorder (BPD) split as a subconscious defense mechanism to cope with overwhelming emotions, particularly fear of abandonment and intense feelings of anxiety, by viewing themselves, others, or situations in black-and-white, all-or-nothing terms (good vs. bad) instead of integrating complex, contradictory qualities. This protects them from pain by simplifying a confusing world, but it leads to rapid shifts between idealizing someone as perfect and devaluing them as terrible, often after minor perceived slights or triggers.
Splitting is a thinking pattern where things feel extreme. When someone is splitting, they may see everything as all good or all bad, perfect or terrible. They may love or hate something with no in between. People with BPD, including those with quiet BPD, often struggle to see the gray area in situations.
Yes, people with Borderline Personality Disorder (BPD) can absolutely live normal, stable, and fulfilling lives, especially with effective treatment like therapy, which helps them manage symptoms and develop coping skills, leading to significant improvement or even remission, though "normal" might look different and require ongoing self-care and support. While BPD is a lifelong condition, symptoms often lessen with age, and with the right strategies, individuals can achieve long-term recovery and a high quality of life.
Partners and family members of people with BPD often describe the relationship as an emotional roller coaster with no end in sight. You may feel like you're at the mercy of your loved one's BPD symptoms—trapped unless you leave the relationship or the person takes steps to get treatment.
Propranolol is a beta blocker first approved by the FDA in 1967 to treat heart conditions and high blood pressure. Today, many clinicians also prescribe it off-label for short-term, situational anxiety because it calms the body's stress response.
4 So if you take either Prozac or Zoloft for depression and struggle to remember your medications, Prozac dosed weekly may be a better option. While it usually takes a few weeks before Zoloft or Prozac to start working, Zoloft seems to work more quickly.
Clonazepam (Klonopin)
Effectiveness: High potency with a longer duration, making it suitable for ongoing anxiety and certain seizure disorders. Safety: It is less likely to cause memory-related side effects compared to some other benzos.
But there are lots of positive things you can do to support them:
Why BPD Symptoms Peak in Early Adulthood. In the 20s, identity formation and independence conflict with emotional vulnerability. Research shows impulsivity and mood swings occur most frequently between the ages of 18-25.
Due to high comorbidity of BPD with addictive disorders, use of substances with high dependence potential should be avoided if possible. The use of unsafe drugs with risk of overdose (tricyclic antidepressants [TCAs], monoamine oxidase inhibitors [MAOIs]) should be avoided.
People with Borderline Personality Disorder (BPD) are triggered by intense emotions, particularly fear of abandonment, rejection, and invalidation, often stemming from past trauma, leading to reactions like sudden anger or self-harm when feeling criticized, alone, or facing instability, sudden changes, or perceived neglect, according to sources like Borderline in the ACT. Common triggers include relationship conflicts, cancelled plans, perceived or real abandonment, reminders of trauma, or unmet needs like sleep, disrupting their fragile sense of self and emotional regulation.
Many Autistic people are misdiagnosed with borderline/emotionally unstable personality disorder (BPD/EUPD), with most professionals preferring to accept the initial diagnosis rather than acknowledging the realities of what it means to be Autistic.
Fear of Abandonment & Being Alone
For many with BPD, the fear of abandonment represents one of the most challenging aspects of living alone. This core symptom can trigger intense emotional responses when physically separated from others for extended periods.
Some common types of delusions that may occur in individuals with BPD include: Persecutory delusions: Believing that one is being mistreated, harassed, or conspired against by others.
BPD Sleep Patterns
Given all of these issues, you might still be asking, “Does BPD cause sleep problems, and if so, which types?” Individuals with BPD demonstrate higher rates of: Hypersomnia which means they sleep too much, and. Insomnia, which means they are unable to sleep enough.
While a marriage can potentially survive BPD, it takes a lot of trust, patience, understanding, and willingness to work together through the issues.
Jobs that draw on empathy, communication, and understanding, traits often strengthened by lived experience with BPD, can also be deeply rewarding. Examples include: Teaching assistant or education support worker. Counsellor, peer support, or mental health worker.
Medications. While no medication is specifically approved to treat BPD, certain medications can help manage symptoms. Antidepressants, mood stabilizers and antipsychotic medications may be prescribed to address mood swings, depression and anxiety associated with BPD.
Patients with BPD showed significantly reduced volumes of both brain structures (left hemisphere hippocampus reduced 15.7%, right hemisphere hippocampus reduced 15.8%, left hemisphere amygdala reduced 7.9% and right hemisphere amygdala reduced 7.5%).