What People Report Online: A Social Media Analysis of Borderline Personality Disorder Treatments
A crowdsourced look at 348,651 public Reddit posts and comments written between October 1, 2025 and September 30, 2026: which therapies and medicines people with borderline personality disorder (BPD) mentioned, and how often they said one helped. These are self-reported experiences, not clinical results.
Social media analysis, not a clinical study
Read this first
- An analysis of public online posts. It is not a clinical trial, and it is not a meta-analysis of clinical trials. Nobody's diagnosis, treatment, dose, or outcome was checked.
- Self-selected experiences. People choose whether to post. Those who are struggling, switching, or very pleased are more likely to write than people who are simply doing fine, and people can only report on the therapies they were able to get.
- No medicine is approved for BPD. The U.S. Food and Drug Administration (FDA) has approved no medicine for borderline personality disorder, so every medicine below is used off-label. A 2022 Cochrane review of 46 randomized trials found that antipsychotics, antidepressants, and mood stabilizers made little to no difference to BPD severity compared with placebo, though most of that evidence was very low certainty. Cochrane review, 2022
- Therapy comes first. The National Institute of Mental Health (NIMH) says psychotherapy is the main treatment for BPD and that the benefits of medicine are unclear. NIMH
- Online ratings favor habit-forming medicines. A 2015 study of 103,411 consumer drug reviews on WebMD found that drugs with addictive properties were rated higher online than the drugs they were compared with, and drugs used off-label were rated lower. Benzodiazepines carry an FDA boxed warning about addiction, dependence, and withdrawal. Adusumalli and colleagues, 2015 FDA benzodiazepine warning
- Not a recommendation. A high place in a table below means many posters said it helped them, not that it works or that it is right for you. Talk with a health care provider before starting, stopping, or changing any treatment.
- Posts and comments collected
- 348,651
- In BPD communities or mentioning BPD
- 320,793
- Naming a therapy or medicine
- 21,411
- People and treatments with a first-person report
- 13,853
- Read by the language model (random sample)
- 4,621
How much to trust these percentages
The labels come from a small language model, checked against a fresh random sample of 200 reports that were labeled by hand without seeing its answers. It agreed with the hand labels 82.5% of the time on the outcome (Cohen's kappa 0.65, where 0 is chance and 1 is perfect agreement), which meets the target of 0.6 we set before checking. Of the reports it called "helped", 73.9% were read the same way by hand. In that sample the hand labels marked 65.7% of clear outcomes as helped and the model marked 66.7%. The intervals below show only the uncertainty from sampling, not from labeling, so most gaps between neighboring treatments are smaller than the combined error. Read the tables as a rough picture of what people wrote, not a scoreboard.
Details of the checkTalk therapies and skills programs
How often people said a therapy helped
For each therapy, up to 200 people who wrote about doing it were picked at random, and a language model read each person's most recent post or comment about it. The percentage is the share of people with a clear outcome (helped, did not help, or mixed) who said it helped their emotions, relationships, urges, or life overall. The shaded bar is the 95% confidence interval. A therapy needs at least 50 people with a clear outcome to be ranked. Dialectical behavior therapy (DBT) includes skills groups; DBT self-help covers people working through DBT workbooks or apps on their own.
| Rank | Therapy | People with a clear outcome | Said it helped (95% interval) | Said they dropped out |
|---|---|---|---|---|
| 1 | Internal family systems therapy (IFS)General talk therapy | 63of 92 people the model read as describing their own use | 92.1%82.7% to 96.6% | 1.6% |
| 2 | DBT self-help (workbooks and apps)Self-help | 66of 105 people the model read as describing their own use | 90.9%81.6% to 95.8% | 1% |
| 3 | Dialectical behavior therapy (DBT)Therapy with strong research support for BPD | 56of 101 people the model read as describing their own use | 76.8%64.2% to 85.9% | 1% |
| 4 | Eye movement desensitization and reprocessing (EMDR)General talk therapy | 64of 89 people the model read as describing their own use | 68.8%56.6% to 78.8% | 1.5% |
| 5 | Cognitive behavioral therapy (CBT)General talk therapy | 64of 86 people the model read as describing their own use | 29.7%19.9% to 41.8% | 3.5% |
Overlapping intervals mean the difference between two therapies could be chance. Structured therapies such as DBT and mentalization-based treatment (MBT) have the most trial evidence for BPD; see the treatment catalog for what each involves.
Mentioned, but too few clear outcomes to rank
- Psychodynamic: 45 clear outcomes from 58 people
- Schema therapy: 29 clear outcomes from 48 people
- MBT: 29 clear outcomes from 48 people
- ACT: 9 clear outcomes from 12 people
- TFP: 9 clear outcomes from 11 people
Medicines, all used off-label
How often people said a medicine helped
Same method as for therapies. Here the outcome is the writer's mental health: BPD symptoms such as mood swings, anger, urges, or emptiness, and also depression, anxiety, or how they feel overall. A medicine that only helped sleep counts as unclear. Groups: selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are antidepressants; mood stabilizers include anticonvulsants and lithium.
| Rank | Medicine | People with a clear outcome | Said it helped (95% interval) | Dependence or withdrawal mentioned | Side effects mentioned (any, then most common) |
|---|---|---|---|---|---|
| 1 | QuetiapineSeroquel · Antipsychotic | 65of 123 people the model read as describing their own use | 72.3%60.4% to 81.7% | 2.5% | Any 23% · Tiredness or sedation 7.5% · Weight gain or appetite change 5.5% |
| 2 | LamotrigineLamictal · Mood stabilizer | 83of 115 people the model read as describing their own use | 67.5%56.8% to 76.6% | 0% | Any 12% · Rash 3% · Tiredness or sedation 2.5% |
| 3 | LithiumLithobid · Mood stabilizer | 81of 98 people the model read as describing their own use | 65.4%54.6% to 74.9% | 0.5% | Any 12.5% · Weight gain or appetite change 3% · Tiredness or sedation 2% |
| 4 | BupropionWellbutrin · Other antidepressant | 64of 96 people the model read as describing their own use | 64.1%51.8% to 74.7% | 0% | Any 13% · Emotional numbness 2% · Rash 1.5% |
| 5 | SertralineZoloft · Antidepressant (SSRI) | 83of 114 people the model read as describing their own use | 51.8%41.2% to 62.2% | 1% | Any 18% · Weight gain or appetite change 4% · Tiredness or sedation 3.5% |
| 6 | EscitalopramLexapro · Antidepressant (SSRI) | 75of 98 people the model read as describing their own use | 50.7%39.6% to 61.7% | 0.5% | Any 12% · Emotional numbness 4.5% · Weight gain or appetite change 2.5% |
| 7 | FluoxetineProzac · Antidepressant (SSRI) | 81of 109 people the model read as describing their own use | 50.6%40% to 61.2% | 0.5% | Any 16.5% · Tiredness or sedation 4.5% · Emotional numbness 3.5% |
| 8 | AripiprazoleAbilify · Antipsychotic | 71of 104 people the model read as describing their own use | 46.5%35.4% to 58% | 0.5% | Any 26.5% · Weight gain or appetite change 9% · Restlessness (akathisia) 4.5% |
| 9 | VenlafaxineEffexor · Antidepressant (SNRI) | 61of 108 people the model read as describing their own use | 45.9%34% to 58.3% | 8% | Any 19.5% · Tiredness or sedation 4% · Emotional numbness 2% |
Overlapping intervals mean the difference between two medicines could be chance. Rankings reflect what posters wrote, not how well a medicine works. In randomized trials, these medicines have not been shown to treat BPD itself. Cochrane review, 2022
Mentioned, but too few clear outcomes to rank
- Lurasidone: 49 clear outcomes from 64 people
- Olanzapine: 47 clear outcomes from 61 people
- Duloxetine: 42 clear outcomes from 58 people
- Ketamine or esketamine: 35 clear outcomes from 41 people
- Hydroxyzine: 25 clear outcomes from 41 people
- Cariprazine: 28 clear outcomes from 40 people
- Mirtazapine: 24 clear outcomes from 39 people
- Risperidone: 26 clear outcomes from 38 people
- Gabapentin: 27 clear outcomes from 36 people
- Lorazepam: 23 clear outcomes from 34 people
- Clonazepam: 19 clear outcomes from 32 people
- Citalopram: 28 clear outcomes from 32 people
- Propranolol: 24 clear outcomes from 29 people
- Valproate: 19 clear outcomes from 25 people
- Diazepam: 14 clear outcomes from 24 people
- Alprazolam: 12 clear outcomes from 23 people
- Topiramate: 12 clear outcomes from 20 people
- Paroxetine: 13 clear outcomes from 20 people
- Brexpiprazole: 13 clear outcomes from 16 people
- Naltrexone: 10 clear outcomes from 12 people
Side effects and dependence
What else people mentioned about medicines
Share of all sampled people for each medicine whose post or comment described each problem with their own use of it. The language model decided whether the text describes any side effect, and whether it mentions dependence, tolerance, or withdrawal; the kind of side effect was then tagged by keywords where the model found one. A mention is not a confirmed side effect, and people often post because something went wrong, so these are not side effect rates.
| Medicine | Any side effect | Weight gain or appetite change | Tiredness or sedation | Emotional numbness | Sexual side effects | Rash | Brain fog or memory problems | Sleep problems or vivid dreams | Restlessness (akathisia) | Nausea or stomach upset | Headaches or dizziness | Dependence or withdrawal |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Quetiapine | 23% | 5.5% | 7.5% | 1% | 0.5% | 0.5% | 0.5% | 1.5% | 0.5% | 0.5% | 1.5% | 2.5% |
| Lamotrigine | 12% | 1.5% | 2.5% | 0% | 0% | 3% | 1% | 1.5% | 0.5% | 1% | 0% | 0% |
| Lithium | 12.5% | 3% | 2% | 2% | 0.5% | 0% | 0% | 0% | 1% | 1% | 2% | 0.5% |
| Bupropion | 13% | 1% | 0.5% | 2% | 1% | 1.5% | 0% | 1% | 0% | 0.5% | 0.5% | 0% |
| Sertraline | 18% | 4% | 3.5% | 3.5% | 2% | 0% | 1% | 1% | 0.5% | 0.5% | 2% | 1% |
| Escitalopram | 12% | 2.5% | 1.5% | 4.5% | 1% | 0% | 2% | 1.5% | 0% | 0.5% | 0% | 0.5% |
| Fluoxetine | 16.5% | 3% | 4.5% | 3.5% | 1% | 0% | 1.5% | 3% | 0.5% | 1.5% | 0.5% | 0.5% |
| Aripiprazole | 26.5% | 9% | 3.5% | 2.5% | 0% | 0% | 0% | 2% | 4.5% | 0.5% | 1% | 0.5% |
| Venlafaxine | 19.5% | 1.5% | 4% | 2% | 1% | 0% | 0.5% | 1.5% | 1% | 1% | 0.5% | 8% |
Online reports and research
How this compares with the clinical evidence
DBT was the subject of about one-third of the 75 trials in a 2020 Cochrane review of talk therapies for BPD. Compared with usual treatment, it reduced BPD severity and self-harm and improved daily functioning, though the review rated this evidence as low quality. MBT had the second most trials (seven).
A 2022 Cochrane review of medicines found low-certainty evidence that antipsychotics and mood stabilizers may slightly reduce problems in relationships, but its authors concluded that no medicine seems effective for treating BPD itself. People online may be describing relief from depression, anxiety, or sleep problems, or a short-term change.
The American Psychiatric Association (APA) suggests that any medicine be time-limited, aimed at a specific symptom that can be measured, and added to psychotherapy rather than used instead of it.
Guidance from England's National Institute for Health and Care Excellence (NICE) says antipsychotics should not be used for medium- or long-term treatment of BPD.
Partners, family, and friends
Posts from loved ones were counted separately
r/BPDlovedones and r/BPDPartners are communities for people close to someone with BPD. Their 27,858 posts are left out of the tables above, because they describe someone else's treatment. 790 of them named a therapy or medicine, most often DBT (520), EMDR (90), CBT (56), Sertraline (31), Alprazolam (28). In the other communities, the language model also set aside reports about someone else's use.
Method
How this was done
Data
Public Reddit posts and comments written between October 1, 2025 and September 30, 2026, downloaded on October 8, 2026 from Project Arctic Shift, an archive of Reddit data made for researchers. Every post and comment in r/BPD, r/BorderlinePDisorder, r/BPDrecovery, and r/DBT; every post in r/BPDlovedones and r/BPDPartners, which are counted separately; and only the posts that mention BPD or borderline in r/mentalhealth, r/CPTSD, and five medicine communities. Comments in the general and loved ones communities were not collected.
- r/BPD42,552 posts, 220,886 comments
- r/BorderlinePDisorder7,282 posts, 41,010 comments
- r/BPDlovedones24,854 posts
- r/BPDrecovery1,199 posts, 2,223 comments
- r/mentalhealth3,272 posts
- r/BPDPartners3,004 posts
- r/CPTSD1,743 posts
- r/DBT92 posts, 293 comments
- r/Lamotrigine118 posts
- r/lamictal101 posts
- r/latuda21 posts
- r/seroquel1 posts
Steps
- Find therapy and medicine names, counting full names, abbreviations, brand names, and common misspellings (for example Lamictal, lamotrigine, and “lamotragine” all count as lamotrigine).
- Keep candidate first-person reports: the part of the post or comment about that treatment is written in the first person and talks about using it. Usernames were replaced with a one-way code as soon as posts were downloaded.
- For each treatment, pick up to 200 people at random and take each person's most recent candidate report. The model read this sample of 4,621 reports, out of 23,058 candidates, because reading them all on one laptop would have taken too long.
- A language model (Qwen3-4B-Instruct-2507 (4-bit, run locally with llama.cpp), temperature 0) reads each report and answers for that one treatment: is the writer describing their own use, and if so, did it help, not help, give a mixed result, or is the outcome unclear. It must first copy the phrase that supports its answer. For medicines it also says whether the writer mentions any side effect and any dependence or withdrawal; for therapies, whether they dropped out. One rule is applied afterward: “did not help” in the first two weeks counts as unclear.
- Tag the kind of side effect by keyword, only in reports where the model found a side effect.
- Compute the share who said it helped, with a Wilson 95% confidence interval, and rank treatments with at least 50 people with a clear outcome, a threshold set before any results were seen.
Checking the labels
Fresh random sample of 200 reports from the people the model read, excluding the 70-report tuning sample used to write the prompt. Each report was labeled by the artificial intelligence (AI) assistant that built this page, reading each report without seeing the model's answer; not a clinician, using the same written definitions the model was given, and before looking at the model's answers. None of these reports was used to write or adjust the prompt.
- Outcome only (the labels that feed the percentages, with “not their own use” and “unclear” counted together): 82.5% agreement, Cohen's kappa 0.65. Therapies 0.60 (49 reports), medicines 0.66 (151 reports).
- All five labels, including whether it was the writer's own use: 52% agreement, kappa 0.37.
- “Helped” or not: kappa 0.68. Of the 46 reports the model called “helped”, 73.9% were read the same way by hand (the positive predictive value).
- Own use or not: 65.5% agreement.
The target was a kappa of at least 0.6 on the outcome. The outcome labels met it.
- Tuning round 1 (first prompt) (64 reports used to write the prompt, so not validation): agreement 54.7%, kappa 0.40, outcome-only kappa 0.63, "helped" read the same way 66.7%
- Tuning round 2 (revised prompt) (same 64 reports, so not validation): agreement 56.2%, kappa 0.42, outcome-only kappa 0.63, "helped" read the same way 70.6%
Privacy
Only counts are published. No usernames, post links, or quotes appear on this site or in its code, and the downloaded text is kept off the public repository. The scripts that rebuild these numbers are in the site's source code (scripts/social), and the results file is src/data/social-analysis.json.
Limitations
- Posting in a BPD community does not mean someone has a diagnosis, and posts from general communities were kept only when they mentioned BPD or borderline.
- Reddit users skew younger and more online than the people who receive these treatments, and people with strong experiences post more.
- Therapies are judged over months, while some medicines act within hours, so people judge them on different timescales. People often get therapy and medicine at the same time and cannot tell which one helped; reports that credited several treatments together were counted as unclear.
- DBT dominates the therapy reports because it has its own community and is the most widely known BPD therapy. Less common therapies have few reports and wide intervals or are not ranked.
- The labels come from a small language model run on a laptop. The hand labels used to check it were made by the AI assistant that built this page, not by a clinician. Posts often describe several treatments at once, and the model can attach an outcome to the wrong one.
- The model read a random sample of up to 200 people per treatment, not every report. Each person's most recent report was used, even when an earlier one stated a clearer outcome.
- “Helped” is whatever the person meant by it. It does not mean remission, and short-term relief and long-term results are counted the same way.
- Private messages and deleted or removed posts are not included.