In crisis or thinking about suicide?Call or text 988, or chat at 988lifeline.org (988 Suicide & Crisis Lifeline, free, 24/7).Emergency: call 911.
BPD AtlasBorderline personality disorder
BPD Atlas

Treatments & Support

Psychotherapy, or talk therapy, is the main treatment for borderline personality disorder (BPD), and several structured therapies have research support. The U.S. Food and Drug Administration (FDA) has not approved any medicine for BPD. Each card links to its source: the National Institute of Mental Health (NIMH), the American Psychiatric Association (APA) practice guideline, a Cochrane review, or the National Institute for Health and Care Excellence (NICE) guideline from England.

No single therapy is best

Several structured psychotherapies work for borderline personality disorder, and none has emerged as the single best. The right fit depends on your symptoms, preferences, and what is available near you.

American Psychiatric Association · Updated borderline personality disorder practice guideline (news release, Dec 10, 2024)Cochrane review (2020) · Psychological therapies for people with borderline personality disorder (PubMed record)

Medicines are not a first-line treatment

No medicine is FDA approved for BPD, and reviews of the research have not found one that treats its core symptoms. A provider may suggest a medicine as an add-on to therapy for a specific symptom or for another condition, such as depression. Never stop a medicine without talking to the prescriber.

National Institute of Mental Health · Borderline personality disorder (brochure)Cochrane review (2022) · Pharmacological interventions for people with borderline personality disorder (PubMed record)

Taking a medicine, or been offered one? What guidelines say about medicines for BPD, questions to ask, how often to review them, and why not to stop suddenly. Source

Medicines and BPDWhat people report onlineDiary card

Dialectical behavior therapy (DBT)

First-line · most studied

individual therapy plus group skills training

Intense emotions · self-harm · relationships

A therapy developed specifically for borderline personality disorder (BPD). It uses mindfulness, an awareness of your present situation and emotional state, and teaches skills to manage intense emotions, reduce self-destructive behavior, and improve relationships.

Show details

What it is
A therapy developed specifically for borderline personality disorder (BPD). It uses mindfulness, an awareness of your present situation and emotional state, and teaches skills to manage intense emotions, reduce self-destructive behavior, and improve relationships.
Evidence and guidelines
There is no U.S. Food and Drug Administration (FDA) approval process for psychotherapies. DBT was the subject of about one-third of the 75 trials in a 2020 Cochrane review. Compared with usual treatment, it reduced BPD severity and self-harm and improved daily functioning, though the review rated this evidence as low quality. Guidance from England's National Institute for Health and Care Excellence (NICE) suggests a comprehensive DBT program for women with BPD when reducing repeated self-harm is a priority.
What it involves
The American Psychiatric Association (APA) guideline describes a typical program as 6 to 12 months of weekly individual therapy (about an hour) and weekly group skills training (about 90 minutes), with skills coaching by phone between sessions.
Keep in mind
It asks for steady time and practice, including homework. Some people do well with that structure and others prefer an insight-oriented approach, so ask what fits you.
National Institute of Mental Health · Borderline personality disorder (brochure)Cochrane review (2020) · Psychological therapies for people with borderline personality disorder (PubMed record)National Institute for Health and Care Excellence · Borderline personality disorder: recognition and management (CG78) recommendationsAmerican Psychiatric Association · Practice guideline for the treatment of patients with borderline personality disorderNational Institute of Mental Health · Psychotherapies

Mentalization-based treatment (MBT)

First-line option

individual and group therapy

Making sense of feelings in relationships · self-harm

Mentalizing is the ability to reflect on your own thoughts and feelings and those of other people. MBT helps people notice and make sense of what they and others feel, especially during stressful moments in relationships, and find more realistic responses.

Show details

What it is
Mentalizing is the ability to reflect on your own thoughts and feelings and those of other people. MBT helps people notice and make sense of what they and others feel, especially during stressful moments in relationships, and find more realistic responses.
Evidence and guidelines
MBT had the second most trials in the 2020 Cochrane review (seven). Compared with usual treatment, it appeared to reduce self-harm and suicidality, based on low-quality evidence.
What it involves
Typically 12 to 18 months of weekly individual therapy (about 50 minutes) and group therapy (75 to 90 minutes). In versions for teenagers, family therapy takes the place of the group.
Keep in mind
Like other structured therapies, it depends on a clinician trained in the approach. Ask about their training.
American Psychiatric Association · Practice guideline for the treatment of patients with borderline personality disorderCochrane review (2020) · Psychological therapies for people with borderline personality disorder (PubMed record)National Alliance on Mental Illness · Borderline personality disorder

Transference-focused psychotherapy (TFP)

Structured option

a psychodynamic individual therapy

Intense emotions · relationships · sense of self

A manual-based therapy rooted in psychodynamic ideas. It looks at the strong, often all-good or all-bad pictures of oneself and others that show up in relationships, including with the therapist, to help a person see themselves and others in a more balanced and realistic way.

Show details

What it is
A manual-based therapy rooted in psychodynamic ideas. It looks at the strong, often all-good or all-bad pictures of oneself and others that show up in relationships, including with the therapist, to help a person see themselves and others in a more balanced and realistic way.
Evidence and guidelines
The APA guideline lists TFP among the structured psychotherapies with research support for BPD. The 2020 Cochrane review found no clear difference in benefit between the different BPD-tailored therapies it compared with usual treatment.
What it involves
Typically 12 to 18 months of individual sessions, 45 to 50 minutes each, twice a week.
Keep in mind
Twice-weekly sessions are a bigger time commitment. Ask how often sessions happen and for how long.
American Psychiatric Association · Practice guideline for the treatment of patients with borderline personality disorderCochrane review (2020) · Psychological therapies for people with borderline personality disorder (PubMed record)

Schema therapy

Structured option

also called schema-focused therapy · individual or group

Long-standing patterns of thinking, feeling, and behaving

Works with schemas: deep patterns in how a person sees themselves and others that grow out of early experiences. It combines a supportive bond with the therapist with behavioral, cognitive, and experiential techniques, emotional awareness training, and a personal plan for managing distress.

Show details

What it is
Works with schemas: deep patterns in how a person sees themselves and others that grow out of early experiences. It combines a supportive bond with the therapist with behavioral, cognitive, and experiential techniques, emotional awareness training, and a personal plan for managing distress.
Evidence and guidelines
The APA guideline lists schema therapy among the structured psychotherapies with research support for BPD. The 2020 Cochrane review found no clear difference in benefit between the different BPD-tailored therapies it compared with usual treatment.
What it involves
In clinical trials it has been given as 50-minute individual sessions twice a week for 3 years, or as weekly 90-minute group sessions for 8 months.
Keep in mind
Programs vary a lot in length and format. Ask what the program near you involves.
American Psychiatric Association · Practice guideline for the treatment of patients with borderline personality disorderCochrane review (2020) · Psychological therapies for people with borderline personality disorder (PubMed record)

Good psychiatric management (GPM)

Structured option

a practical approach many clinicians can learn

Relationships · work and daily life · learning about BPD

A practical, case-management style approach that sees BPD as reflecting high sensitivity in relationships. It focuses on improving work and social life, includes education about BPD, and uses medicines only when clinically appropriate.

Show details

What it is
A practical, case-management style approach that sees BPD as reflecting high sensitivity in relationships. It focuses on improving work and social life, includes education about BPD, and uses medicines only when clinically appropriate.
Evidence and guidelines
The APA guideline lists GPM among the structured approaches for BPD and notes that it is relatively easy for clinicians to learn, which can make it easier to find.
What it involves
Usually weekly sessions over about 12 months, with a plan agreed in advance for contact between sessions and for crises.
Keep in mind
Ask whether your clinician has trained in GPM, and what the crisis plan will be.
American Psychiatric Association · Practice guideline for the treatment of patients with borderline personality disorder

Cognitive behavioral therapy (CBT)

Evidence-based

talk therapy

Core beliefs · mood swings · self-harm

Helps people identify and change core beliefs and behaviors that come from inaccurate views of themselves and others, and improve how they interact with others.

Show details

What it is
Helps people identify and change core beliefs and behaviors that come from inaccurate views of themselves and others, and improve how they interact with others.
Evidence and guidelines
The National Institute of Mental Health (NIMH) says CBT can help reduce mood swings, anxiety symptoms, and self-harming or suicidal behavior in people with BPD.
What it involves
One-on-one or in a group, with a licensed mental health professional.
Keep in mind
Ask whether the therapist has experience treating BPD specifically.
National Institute of Mental Health · Borderline personality disorder (brochure)National Alliance on Mental Illness · Borderline personality disorderNational Institute of Mental Health · Psychotherapies

Systems Training for Emotional Predictability and Problem Solving (STEPPS)

Add-on program

a 20-week skills group

Managing emotions and behavior · family involvement

A group program that teaches about BPD and builds skills for managing emotions and behavior, with a session for family members. Participants track their own thoughts, feelings, and behavior during the program.

Show details

What it is
A group program that teaches about BPD and builds skills for managing emotions and behavior, with a session for family members. Participants track their own thoughts, feelings, and behavior during the program.
Evidence and guidelines
STEPPS is designed to add to other treatment, not replace it. The APA guideline includes it among the structured approaches for BPD.
What it involves
Weekly 2-hour groups for 20 weeks, plus one 2-hour session for family members.
Keep in mind
It does not include individual therapy, so it is usually paired with other care.
American Psychiatric Association · Practice guideline for the treatment of patients with borderline personality disorder

Family therapy and family programs

Support for loved ones

for parents, partners, and other loved ones

Understanding BPD · skills · stress at home

Having a loved one with BPD can be stressful, and family members may unintentionally act in ways that make symptoms worse. Therapy for family members and caregivers helps them understand and support the person and cope with their own needs.

Show details

What it is
Having a loved one with BPD can be stressful, and family members may unintentionally act in ways that make symptoms worse. Therapy for family members and caregivers helps them understand and support the person and cope with their own needs.
Evidence and guidelines
NIMH says more research is needed on how much family therapy helps with BPD, though studies of other mental disorders show that involving family can support treatment. Guidance from England says to ask the person directly whether they want family involved in their care.
What it involves
The free Family Connections program from the BPD Alliance runs mostly online, for example as 12 weekly 2-hour classes, for adults whose loved one is 13 or older. A formal diagnosis is not required.
Keep in mind
NIMH suggests family members see a different therapist from the one their loved one sees.
National Institute of Mental Health · Borderline personality disorder (brochure)BPD Alliance · Family Connections programNational Institute for Health and Care Excellence · Borderline personality disorder: recognition and management (CG78) recommendations

Medicines for BPD itself

None FDA approved

what the evidence and guidelines say

Not a first-line treatment

No medicine is FDA approved to treat BPD. When medicines are prescribed for it, they are used off-label, meaning for a purpose they are not approved for. There is no medicine made specifically for the core symptoms.

Show details

What it is
No medicine is FDA approved to treat BPD. When medicines are prescribed for it, they are used off-label, meaning for a purpose they are not approved for. There is no medicine made specifically for the core symptoms.
Evidence and guidelines
A 2022 Cochrane review of 46 randomized trials (2,769 people) found that, compared with placebo, antipsychotics, antidepressants, and mood stabilizers made little to no difference to BPD severity, self-harm, suicide-related outcomes, or daily functioning, mostly based on very low-certainty evidence. Low-certainty evidence suggested antipsychotics and mood stabilizers may slightly reduce problems in relationships. NICE says medicines should not be used specifically for BPD or its individual symptoms, and the APA found no evidence that any medicine treats the core symptoms.
What it involves
NIMH says the benefits of medicine for BPD are unclear and that it is not a first-line treatment.
Keep in mind
Cochrane notes that people with BPD often receive several psychiatric medicines at once for long periods. The APA recommendations aim to limit taking many medicines at once and for a long time.
Cochrane review (2022) · Pharmacological interventions for people with borderline personality disorder (PubMed record)National Institute for Health and Care Excellence · Borderline personality disorder: recognition and management (CG78) recommendationsAmerican Psychiatric Association · Updated borderline personality disorder practice guideline (news release, Dec 10, 2024)National Institute of Mental Health · Borderline personality disorder (brochure)National Alliance on Mental Illness · Borderline personality disorder

Medicines for other conditions or specific symptoms

Off-label · add-on only

for example antidepressants or mood stabilizers, prescribed off-label

Depression · anxiety · other diagnosed conditions

A provider may suggest medicine as an add-on to therapy for a specific symptom, such as mood swings or depression, or to treat a separate condition such as depression, anxiety, or post-traumatic stress disorder (PTSD).

Show details

What it is
A provider may suggest medicine as an add-on to therapy for a specific symptom, such as mood swings or depression, or to treat a separate condition such as depression, anxiety, or post-traumatic stress disorder (PTSD).
Evidence and guidelines
The APA suggests any medicine be time-limited, aimed at one specific symptom that can be measured, and added to psychotherapy, with all medicines reviewed at least every 6 months. NICE says to treat co-occurring depression, PTSD, or anxiety within a structured BPD treatment program.
What it involves
Agree on the target symptom, how long to try the medicine, and when to review it. Regular reviews help find medicines that are not helping and could be tapered or stopped.
Keep in mind
Each medicine has its own label, side effects, and warnings. Do not stop a medicine without the help of a provider, who can lower the dose slowly and safely.
National Institute of Mental Health · Borderline personality disorder (brochure)American Psychiatric Association · Updated borderline personality disorder practice guideline (news release, Dec 10, 2024)National Institute for Health and Care Excellence · Borderline personality disorder: recognition and management (CG78) recommendationsNational Institute of Mental Health · Mental health medications

Short-term medicine during a crisis

Short-term only

guidance from England

A crisis, usually for no longer than 1 week

NICE says short-term use of a sedating medicine may be considered cautiously during a crisis, as part of the overall treatment plan.

Show details

What it is
NICE says short-term use of a sedating medicine may be considered cautiously during a crisis, as part of the overall treatment plan.
Evidence and guidelines
NICE advises using a single medicine with few side effects, low potential for misuse, and relative safety in overdose, at the lowest dose that works, and planning to stop it, usually within 1 week. It also says antipsychotics should not be used for medium- or long-term treatment of BPD.
What it involves
When there is a significant risk of overdose, NICE suggests prescribing fewer tablets more often, and reviewing the whole plan once the crisis has passed.
Keep in mind
This guidance is from England, and U.S. practice may differ. Medicine is not a substitute for crisis support: call or text 988 at any time.
National Institute for Health and Care Excellence · Borderline personality disorder: recognition and management (CG78) recommendations

Therapy descriptions come from NIMH and the APA practice guideline; evidence statements come from Cochrane systematic reviews and the NICE guideline. Cochrane rates most of this evidence as low or very low quality, so results may change as more research is done. Checked October 8, 2026.

Everyday support

Things that can help alongside treatment

Habits and plans that public health sources describe. They can help alongside care; they are not a substitute for diagnosis or treatment.

Bring your crisis plan and your diary card to appointments so your care team can see what is working.

A crisis plan you made in advance

Planning ahead

A crisis plan lists your likely triggers, self-help strategies that work for you, and who to contact when they are not enough.

Guidance from England says a care plan for borderline personality disorder should include one, shared with you and your primary care doctor.

Keep a copy where you can find it fast, and add 988 to it.

National Institute for Health and Care Excellence · Borderline personality disorder: recognition and management (CG78) recommendations

Body, movement, and calm

Healthy habits

Eating well and exercising help, and meditation, yoga, or tai chi can relieve stress.

The National Alliance on Mental Illness (NAMI) lists these among the ways to help yourself alongside treatment.

They support treatment; they do not replace it.

National Alliance on Mental Illness · Borderline personality disorder

Alcohol and drugs

What to avoid

Alcohol and drugs can disturb emotional balance and interact with medicines.

If substance use is part of the picture, the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline on the Resources page can point you to treatment.

Tell your care team about any substance use; it helps them plan safer care.

National Alliance on Mental Illness · Borderline personality disorder

Connection and peer support

Connection

Sharing your thoughts, fears, and questions with others who have the same condition can help.

NAMI suggests finding emotional support from others with lived experience, for example through peer groups.

Advice from peers does not replace advice from your care team.

National Alliance on Mental Illness · Borderline personality disorder

Clinical trials

Borderline personality disorder studies looking for volunteers

40 studies listed under borderline personality disorder were recruiting worldwide on ClinicalTrials.gov as of October 8, 2026. Below are all 8 that have at least one site in the United States and an up-to-date record.

Talk with your doctor before joining a trial

A listing here is not a recommendation. Studies test treatments that may not work or may have side effects, and each one has its own rules about who can join. Ask your care team whether a study fits, and keep up your current treatment unless they say otherwise. A research study is not emergency care: in a crisis, call or text 988.

Find a study near you

This opens ClinicalTrials.gov with recruiting borderline personality disorder studies already selected. Type your city or ZIP code in the Location box to see studies close to home.

Search recruiting studies

New to research studies?

How clinical trials work, from the National Institute of Mental Health
Who it is for
Kind of treatment
Phase
RecruitingNo phase (therapy or device study)Therapy, skills, or training

A precision medicine approach to target engagement for emotion regulation

With depression, anxiety, or another condition

What is tested:
Checking the Facts, Opposite to Emotion Action, Mindfulness of Current Emotions
Who can join:
Ages 18 and older · Borderline Personality Disorder, Emotional Regulation
Where:
1 US site in Ohio
Sponsor:
Matthew Southward, PhD
Titles on ClinicalTrials.gov

Brief title: A Precision Medicine Approach to Target Engagement for Emotion Regulation

Official title: A Precision Medicine Approach to Target Engagement for Emotion Regulation

NCT05651295 on ClinicalTrials.gov
RecruitingPhase 2Therapy, skills, or trainingOther

Mindfulness-based neurofeedback to augment psychotherapy for adults with borderline personality disorder

Borderline personality disorder

What is tested:
mindfulness-based Neurofeedback, control Neurofeedback
Who can join:
Ages 18 to 60 · Borderline Personality Disorder
Where:
1 US site in Connecticut
Sponsor:
Yale University
Titles on ClinicalTrials.gov

Brief title: Mindfulness-based Neurofeedback to Augment Psychotherapy for Adults With Borderline Personality Disorder

Official title: Mindfulness-based Neurofeedback to Augment Dialectical Behavior Therapy (DBT) for Adults With Borderline Personality Disorder (Aim 1)

NCT06446765 on ClinicalTrials.gov
RecruitingNo phase (therapy or device study)Therapy, skills, or training

Cognitive reappraisal training for borderline personality disorder

Borderline personality disorder

What is tested:
Cognitive Reappraisal by Distancing, Downregulate condition
Who can join:
Ages 18 to 55 · Borderline Personality Disorder
Where:
1 US site in New York
Sponsor:
Icahn School of Medicine at Mount Sinai
Titles on ClinicalTrials.gov

Brief title: Cognitive Reappraisal Training for Borderline Personality (BPD)

Official title: Cognitive Reappraisal Training Targeting Emotion Circuits As a Therapeutic Intervention in Borderline Patients

NCT06772831 on ClinicalTrials.gov
RecruitingNo phase (therapy or device study)Brain stimulation or device

Treatment of borderline personality disorder with repetitive transcranial magnetic stimulation (rTMS)

Borderline personality disorder

What is tested:
Transcranial Magnetic Stimulation (TMS)
Who can join:
Ages 18 to 65 · Borderline Personality Disorder, Borderline Personality
Where:
2 US sites in California
Sponsor:
University of California, Los Angeles
Titles on ClinicalTrials.gov

Brief title: Treatment of Borderline Personality Disorder With rTMS

Official title: CLINICAL TRIAL: Treatment of Borderline Personality Disorder by Targeting Ventrolateral Prefrontal-amygdala Circuit With Network-based Neuronavigated Transcranial Magnetic Stimulation

NCT07197502 on ClinicalTrials.gov
RecruitingNo phase (therapy or device study)Brain stimulation or device

Treatment of acute mood depressive episode in borderline personality disorder with repetitive transcranial magnetic stimulation (rTMS)

With depression, anxiety, or another condition

What is tested:
Left Dorsolateral Prefrontal Cortex (L-DLPFC), Dorsomedial Prefrontal Cortex (DMPFC)
Who can join:
Ages 18 to 80 · Borderline Personality Disorder, Depressive Disorder, Major
Where:
1 US site in California
Sponsor:
Stanford University
Titles on ClinicalTrials.gov

Brief title: Treatment of Acute Mood Depressive Episode in Borderline Personality Disorder With rTMS

Official title: Modulating Probabilities: Prediction, Assessment, and Treatment of Acute Mood Depressive Episode in Borderline Personality Disorder With rTMS

NCT04870255 on ClinicalTrials.gov
RecruitingNo phase (therapy or device study)Brain stimulation or deviceTherapy, skills, or training

Neurostimulation vs therapy for problems with emotions

With depression, anxiety, or another condition

What is tested:
Repetitive Transcranial Magnetic Stimulation (rTMS), electrical scalp stimulation, Cognitive Restructuring, Emotional Awareness Training
Who can join:
Ages 18 to 55 · Borderline Personality Disorder, Emotion Regulation
Where:
1 US site in North Carolina
Sponsor:
Duke University
Titles on ClinicalTrials.gov

Brief title: Neurostimulation Versus Therapy for Problems With Emotions

Official title: Neurostimulation Enhanced Cognitive Restructuring for Transdiagnostic Emotional Dysregulation: A Component Analysis

NCT05712057 on ClinicalTrials.gov
RecruitingPhase 1/2Brain stimulation or deviceMedicine

A pilot trial of one-day accelerated transcranial magnetic stimulation (TMS) and D-cycloserine in suicidal people with borderline personality disorder

Suicidal thoughts or self-harm

What is tested:
TMS, D-Cycloserine (DCS)
Who can join:
Ages 18 and older · Borderline Personality Disorder (BPD)
Where:
1 US site in Massachusetts
Sponsor:
McLean Hospital
Titles on ClinicalTrials.gov

Brief title: A Pilot Trial of One-Day Accelerated TMS and D-cycloserine in Suicidal Patients With Borderline Personality Disorder

Official title: A Pilot Trial of One Day Accelerated Intermittent Theta-burst Stimulation Plus D-cycloserine in Suicidal Patients With Borderline Personality Disorder (ONE-D BPD)

NCT07460947 on ClinicalTrials.gov
RecruitingObservational (no treatment given)Survey or observation only

Triage survey for psychiatry research eligibility

With depression, anxiety, or another condition

What is tested:
Survey
Who can join:
Ages 18 and older · Borderline Personality Disorder, Major Depressive Disorder
Where:
6 US sites in Massachusetts, New York, Pennsylvania and 1 more state
Sponsor:
Adams Clinical
Titles on ClinicalTrials.gov

Brief title: Triage Survey for Psychiatry Research Eligibility

Official title: Triage Survey for Psychiatry Research Eligibility

NCT05800925 on ClinicalTrials.gov

Showing 8 of 8 studies · data from the ClinicalTrials.gov public data service, fetched October 8, 2026

See all 40 on ClinicalTrials.gov →

Every recruiting study listed under borderline personality disorder that names borderline personality disorder in its conditions or titles and has at least one US site, leaving out records that look out of date (primary completion date passed and no update in the past 6 months). Interventional studies of any phase and observational studies are both included. Studies with no US site are left out here but appear on ClinicalTrials.gov. Study details change often; always check the study page and contact the study team to confirm who can join. This site does not enroll anyone.

How to use this page

Questions worth bringing about any medicine

Based on NICE guidance on what to discuss

  • 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?