Treatment for BPD can be difficult and long-term, lasting years in many cases. People who have the best chance for success seek out treatment for themselves and find a therapist experienced in BPD. Success depends on sticking to the therapy and taking responsibility for your own problems.

Treatment for BPD usually involves a combination of:

• Psychotherapy. The most effective types of counseling appear to be long-term therapy and dialectical behavior therapy (DBT). Long-term therapy focuses on internal experiences, relationships and self-destructive behaviors. DBT is a form of cognitive behavior therapy that focuses on coping skills — learning how to take better control of behaviors and emotions.

• Medications. Doctors use a variety of medications to treat borderline personality disorder. The choice of a medication may depend on your particular symptoms and whether medications you try initially work for you. Medications aren't cure-alls, nor are they intended to take the place of psychotherapy. Doctors may first prescribe antidepressant medications such as the selective serotonin reuptake inhibitors (SSRIs) fluoxetine (Prozac, Sarafem) and sertraline (Zoloft) or the related antidepressant venlafaxine (Effexor). For severe behavior problems, doctors may prescribe the neuroleptic medication haloperidol (Haldol).

• Other medications that doctors may use include monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) and tranylcypromine (Parnate); the mood stabilizer lithium (Eskalith, Lithobid); the anticonvulsants carbamazepine (Carbatrol, Tegretol) and divalproex (Depakote); and the benzodiazepines alprazolam (Xanax) and clonazepam (Klonopin)

There's no one path to recovery from BPD. The condition appears to be worse in young adulthood and may gradually diminish with age. Many people with BPD attain greater stability in their lives during their 30s and 40s.

Today, psychotherapy combined with medications can be effective at reducing or eliminating many of the most troublesome signs and symptoms of BPD. Many people once in psychic misery now feel good about themselves and are able to sustain loving relationships and enjoy meaningful careers.

• counseling

• psychotherapy