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Borderline Personality Disorder: Treatment and Management

Borderline Personality Disorder: Treatment and Management

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK)

Version: 2009

PHARMACOLOGICAL AND OTHER PHYSICAL TREATMENTS IN THE MANAGEMENT OF BORDERLINE PERSONALITY DISORDER

Although the treatment of borderline personality disorder with drugs is normally considered to be adjuvant rather than primary treatment, it is surprisingly common. For example, of 112 people identified using a screening instrument as having borderline personality disorder in a national morbidity survey (personal communication from Dr Min Yang, 2007), 31 (28%) were taking antidepressants, 18 (15.5%) sedative and anxiolytic drugs, and four (4%) antipsychotics. Of these, four (13% of the total) were taking one drug only, 34 (30%) were taking two or more drugs, and four were taking five drugs simultaneously. Although this is a small study, these data suggest polypharmacy is common among this client group.

EXPERIENCE OF CARE

This chapter provides an overview of the experience of people with borderline personality disorder and their families/carers. In the first section are first-hand personal accounts written by service users, former service users and a carer, which provide some experiences of having the diagnosis, accessing services and caring for someone with the disorder. It should be noted that these accounts are not representative of the experiences of people with borderline personality disorder, and therefore can only ever be illustrative. The accounts were obtained through contacts of the service users and carers on the GDG, and therefore illustrate a relatively narrow range of experience (the majority are from people whose primary mode of treatment was in a therapeutic community). It should also be borne in mind that writing about borderline personality disorder can be an extremely painful process for many people, which further restricts the number of available personal accounts.

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