Treatment of Borderline Personality Disorder and BD

The Treatment of Borderline Personality Disorder and Bipolar Disorder


Borderline personality and bipolar disorder are very different, but because some of the symptoms of the two disorders are similar, they can be very difficult to tell apart. This is true even for many psychologists and medical doctors, and so the disorders are often misdiagnosed by those lacking the appropriate training and experience.

dr-parker-wilson-denver-therapist-counselor-250x350 Doctor Parker Wilson, Psychotherapist, Counselor, And Director Of The Awakened Mind Institute, Denver Psychotherapy Center

Because both disorders typically begin in adolescence, they are often dismissed by doctors as exaggerated teenage angst and rebellion. They then sometimes advise families to begin a "tough love" regimen, which leaves the suffering adolescent with no alternative to spiraling and acting out; and in a desperate attempt to suppress the disorder, these teens then begin to self-medicate with drugs and alcohol, sex, and sometimes these teen patients cope by self-mutilating (e.g., "cutting," skin picking, etc). Of course, this doesn't work, and thus "tough love" only worsens the disorders.

Below, you can listen to Dr. Parker Wilson's public talk, offered in Denver, CO, on the topic of: What Is Happiness - A Buddhist Psychological Perspective (31 minutes):

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There is a much better way of coping with borderline personality disorder and bipolar disorder. The staff at the Awakened Mind Institute has over 15,000 hours of experience in the treatment of borderline personality disorder (BPD) and bipolar disorder. The symptoms of borderline personality disorder are primarily treated with dialectical behavior therapy, mindfulness based cognitive therapy, and medication.

Using these methods, Dr. Wilson and his team have a clinical effectiveness rate of nearly 70% when treating BPD (this rate is nearly double most national averages). Bipolar disorder is treated with cognitive behavior therapy, mindfulness based cognitive therapy, and medication. Using these methods, Dr. Wilson has a clinical effectiveness of 85% when treating bipolar disorder.

Common similarities of these two disorders are: a fluctuating and extreme mood, impulsivity and recklessness (usually around drugs, alcohol and sex), self harming behavior (cutting, etc), periodic suicidality, "all or nothing" thinking and languaging, and profound instability in relationship. Obsessive-compulsive behaviors are also common in both disorders as an internal way adolescents use to cope with the most debilitating symptoms of the disorders.


Bipolar disorder is unique in that the disturbances it causes in relationships are based in mood, and often disappear when the mood shifts. When depressed, the teen usually functions from an anxious depression, and thus isolation, withdrawal, and hopelessness emerge. Light to moderate suicidality can occur in the depressed phase, sometimes accompanied by periodic cutting.

  • When the teen is manic, however, then relationships become over-used, exaggerated, enmeshed, and highly impulsive.
  • The teen is also able to see their mood swings as problematic.
  • In essence, usually the teen is aware that something is wrong with their psychology. Because they are aware of the problem on some level, they usually co-operate with medication and therapy, and thus clinical treatment is far more effective and the disease itself does not claim nearly as many lives.


Borderline is characterized by pervasive perceptual and thought distortions about relationship. It is this delutional quality of borderline that makes it such a difficult illness to treat. The patient believes in the reality of the way they see, feel, and understand themselves in relationship.

counselor-psychotherapist-jsamine-crane-250x380Jasmine Crane, Counselor

In essence, borderline personality disorder is a disease that tells you that you do not have a disease. Because the borderline teen is not aware that something is actually wrong with their perceptions of relationship (from their perspective, it is the world that is mis-calibrated), treatment often feels intrusive, unnecessary, and humiliating to them.

  • The patient typically becomes highly resistant and uncooperative with therapy.
  • They also become uncooperative with their medication treatment regime. This is the primary reason that effectiveness rates are so low for the treatment of borderline personality disorder.

While treatment with medication is similar to that of bipolar disorder (SSRI's and mood stabilizers), it is this pervasive perceptual and thought distortion about relationship (in particular among all the symptoms of borderline personality disorder) that often calls for the use of an anti-psychotic medication for the treatment of borderline personality disorder. In the most severe cases, coping with borderline personality disorder is only possible when the patient uses an anti-psychotic medication.

Now, What Is The Actual Distortion About Relationship?

  • A borderline teen will see a romantic relationship as the source of their happiness and well being. Like the earth draws life from the sun, a borderline teen will experience a romantic relationship as being the source of life itself. High school romances are, of course, short-lived and intense by nature, thus when that romantic relationship ends, the borderline teen feels deprived, angry, and destroyed. The teen becomes very angry, and majorly depressed.
  • In a state of deep narcissistic pain and self-pity, they begin to hate their former loved one for "causing" such pain, and a profound suicidality now sometimes emerges here as well. To cope, the teen will typically engage in serious cutting, along with the consumption of drugs and alcohol to numb out the emotions.
  • The teen also begins to "take hostages" around their near obsessive suicidality by passive-aggressively hinting at their impending death to friends, parents, teachers, and therapists. This leaves friends and family feeling deeply manipulated, confused, afraid, and emotionally and physically exhausted.
  • Eventually, for the friends and family, it begins to feel that the borderline teen is truly an "emotional black hole" that consumes entire relationship systems. Also during this majorly depressed phase, a teen can become truly unstable, becoming very aggressive and even violent towards friends and loved ones. Then, usually as a result of a friend or family giving into the borderline teen, she can rapidly shift back to a place of warmth, connection, and seeming health. This is the classic "love you / hate you" dynamic of the borderline personality.

If left untreated, these two disorders place a teen at high risk for all of the following: dropping out of school, teen pregnancy, having more than fifty sexual partners, sexually transmitted diseases, sexual violation and abuse, drug and alcohol addiction, becoming the victim of a violent crime, incarceration and hospitalization, chronic unemployment, suicide, and pre-mature death.

It Doesn't Have To End This Way For You Or Your Loved One. Both Of These Disorders Are Treatable, And In The Expert Hands Of Dr. Parker Wilson, There Is Reason For Hope

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