Appointments
You do not have to wait for a provider to ask about your mental health. Start the conversation, and bring a few things that make the visit more useful.
Write down what you notice
Use the private, unscored checklist to note what you have noticed, add examples, and pick questions to ask. Nothing is stored or sent.
Keep a week of notes
Track emotional distress, urges, what set them off, the skills or coping you used, sleep, alcohol or drugs, and medicines.
Offered a medicine?
What research and guidelines say about medicines for borderline personality disorder, and what to ask before starting one.
First-visit checklist
What to bring
A short list of your questions
Visits are short. Write down what you most want to discuss so the important things come first.
National Institute of Mental Health · Tips for talking with a health care provider
Notes on your symptoms
When they started, how strong they are, and how often they happen. Mention major stress or recent life changes that may be making things harder.
National Institute of Mental Health · Tips for talking with a health care provider
Every medicine and supplement
Include prescriptions, over-the-counter medicines, herbal remedies, vitamins, and supplements, and any medicines you have tried in the past.
National Institute of Mental Health · Tips for talking with a health care provider
What you have tried before
Past therapies, how long they lasted, and what helped or did not. The American Psychiatric Association (APA) recommends that a first assessment include this treatment history.
Your goals for treatment
What you want to change in your life. The APA recommends asking about your goals and preferences as part of the assessment.
Family mental health history
Some mental illnesses run in families, and a close relative with borderline personality disorder may raise risk. Knowing this helps the provider.
National Institute of Mental Health · Borderline personality disorder (brochure)
A friend or relative, if you want one
A companion can offer support, take notes, and help you remember what was discussed.
National Institute of Mental Health · Tips for talking with a health care provider
Roadmap
From first visit to ongoing treatment
Step 1
Start with a primary care provider
If you have concerns about your mental health, a primary care provider can listen and refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker.
- Bring up your concerns even if the provider does not ask first.
- Describe your symptoms honestly, including any self-harm or thoughts of suicide.
- Ask whether a referral for a mental health assessment makes sense.
National Institute of Mental Health · Borderline personality disorder (brochure)
Step 2
A full assessment
A mental health professional asks about symptoms, personal and family history, past treatment, physical health, and safety. A medical exam can rule out other causes.
- Expect questions about relationships, mood, sense of self, and impulsive behavior.
- Share other conditions you have, such as depression, anxiety, or substance use.
- You may be asked to fill in a questionnaire that measures symptoms.
National Institute of Mental Health · Borderline personality disorder (brochure)
Step 3
A written plan, including a crisis plan
The APA recommends a documented, person-centered treatment plan. Guidance from England adds a crisis plan that names likely triggers, self-help strategies that work for you, and who to contact when those are not enough.
- Ask for a copy of your plan and your crisis plan.
- Agree on short-term aims and longer-term goals, such as work or study.
- Decide together whether and how family or friends will be involved.
Step 4
Structured psychotherapy
Psychotherapy is the main treatment. The APA recommends a structured therapy with research support that targets the core features of the disorder, such as dialectical behavior therapy (DBT) or mentalization-based treatment (MBT).
- Ask which structured therapy the clinician offers and what training they have in it.
- Guidance from England advises against brief programs of less than 3 months aimed specifically at borderline personality disorder outside a structured service.
- Medicine, if used at all, is an add-on to therapy, not a replacement.
National Institute of Mental Health · Borderline personality disorder (brochure)
Step 5
Sticking with treatment and reviewing progress
Improvement can take time. NIMH stresses being patient, getting support, and sticking with treatment. Progress should be checked on a broad range of outcomes, and any medicines reviewed at least every 6 months.
- Ask how progress will be measured, for example self-harm, substance use, mood, and daily functioning.
- If therapy will end or change, ask for the transition to be planned with you in advance.
- Tell your care team if things get worse, and use your crisis plan when you need it.
National Institute of Mental Health · Borderline personality disorder (brochure)
Questions to ask about a medicine
- What specific symptom or condition is this medicine meant to help?
- What is the evidence that it helps with that, and what harms are possible?
- How long should I try it, and when will we review whether it is working?
- How does it fit with my therapy?
- Could it interact with my other medicines, alcohol, or drugs?
- What happens if it does not help? Will we stop it?
Questions to ask a therapist
- What are your credentials and experience? Have you treated borderline personality disorder?
- Which approach will you use, and what is the evidence behind it? Is it a structured therapy for borderline personality disorder?
- What are the goals, how long might therapy last, and how will we know if it is working?
- Is medicine an option, and can you prescribe it?
- What are the limits of confidentiality?
Next step