There's no single "best" mood stabilizer for Borderline Personality Disorder (BPD); rather, medications target specific symptoms, with lamotrigine, divalproex sodium (Depakote), and topiramate often used for mood instability, anger, and impulsivity, while atypical antipsychotics (like aripiprazole) and SSRIs (like fluoxetine) manage other issues like aggression or depression, alongside therapy. Lamotrigine shows promise for emotional regulation, while divalproex helps with aggression, but treatment is personalized, focusing on symptom clusters.
Use of Mood Stabilizers in Treatment of Borderline Personality Disorder
Overview. Common BPD medications include antidepressants (Prozac, Zoloft, Effexor, Wellbutrin), antipsychotics (Abilify, Seroquel, Risperdal, Zyprexa), mood stabilizers/anticonvulsants (Lithobid, Depakote, Lamictal, Tegretol), and anti-anxiety drugs (Ativan, Xanax, Klonopin, Buspar).
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.
A person with BPD fluctuates between calm and anger, happiness and sadness, affection and coldness, and empathy and anger. Their thoughts, emotions, and behaviors can change at any time. Their powerful emotions can be provoked by any incident, regardless of its seeming insignificance.
Don't…
Borderline personality disorder directly affects how one feels about him or herself, one's behaviors as well as how an individual can relate to others. Psychoanalytic theorists assert that individuals with BPD are often intolerant of being alone, which may be caused by experiencing “annihilation anxiety…
“We are trialling a drug called Memantine, which is an Alzheimer's medication,” Dr Mu said. “Memantine targets the glutamate system in the brain which addresses the cognitive disturbances that make up all of the BPD symptoms.
The "3 C's of BPD" typically refer to advice for loved ones of someone with Borderline Personality Disorder, reminding them: "I didn't cause it, I can't cure it, I can't control it," to help set boundaries and avoid taking on undue responsibility for the person's actions or illness. Another set of "C's" describes core BPD traits for individuals: Clinginess (fear of abandonment), Conflict (intense relationships/moods), and Confusion (unstable self-image).
You might also experience BPD without having any history of traumatic or stressful life events. Or you might have had other types of difficult experiences. If you already experience some of these difficulties, then experiencing stress or trauma as an adult could make things worse.
"Happy pills" typically refer to antidepressants, a class of medications known as selective serotonin reuptake inhibitors (SSRIs).
Objectively measured sleep continuity is also disturbed in BPD, with patients having longer sleep onset latency and wakefulness after sleep onset, more awakenings, shorter total sleep time, and lower sleep efficiency than healthy controls [15,28].
How can I help myself in the longer term?
Lithium (lithium carbonate or lithium citrate)
Lithium is used to treat mania and to prevent further episodes of mania and depression. Common side-effects of lithium include increased thirst and urination, nausea, weight gain and a fine trembling of the hands.
Provide distractions. Sometimes helping to distract someone from difficult feelings can be really useful. Try suggesting activities or tasks, such as watching a film or tidying up. Or you could start something and let them know they're welcome to join in when they feel ready.
Risperidone. Current data have suggested that many symptoms of BPD may be ameliorated with risperidone. In an open-label study (N = 15), risperidone (final mean dosage, 3.27 mg/d) had a statistically significant 21% decrease in BPRS scores from baseline after 8 weeks.
BPD Meltdown
During a meltdown, people may experience extreme mood swings, impulsivity, and difficulty calming down. Understanding how BPD contributes to meltdowns is crucial for developing coping strategies and providing support to manage and navigate these overwhelming emotional experiences.
In 30% up to 90% of cases BPD is associated with abuse and neglect in childhood and these percentages are significantly higher than those registered in other personality disorders (13–15). Some authors proposed affect regulation difficulties as central mediator in the relationship between childhood trauma and BPD (16).
While we see them as “being too serious”, the problem can be bigger than what we think. People exhibiting narcissistic borderline personality disorder are confused between the fear of abandonment and grandiosity. They often idealize someone and start devaluing them as soon as they make a mistake.
Research suggests that benzodiazepines may worsen the symptoms of impulsivity and suicidality in people with BPD, so their use is discouraged.
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.
Although the exact cause of borderline personality disorder is unknown, research suggests that genetic, physical, environmental, and social factors may increase the risk of developing the disorder.
Being friends with someone with Borderline Personality Disorder (BPD) is undeniably challenging. However, with the right understanding, patience, and strategies, you can support your friend effectively while caring for your well-being.
Explains borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD).
Role of Psychotherapy
Dialectical Behavior Therapy (DBT) is currently the most recommended intervention for borderline personality disorder patients experiencing chronic emptiness. DBT targets emotional instability, teaches emotion regulation, and promotes a consistent self-concept.