Psychotherapy is the main treatment for borderline personality disorder (BPD), and
dialectical behavior therapy (DBT) is the best-known therapy built for it. Medication is not a first-line treatment. Long-term research is hopeful: in one 10-year study, 93% of people with BPD had a period of at least two years free of the diagnosis.
According to the National Institute of Mental Health, talk therapy with a licensed, trained professional is the primary treatment for BPD. It can happen one-to-one or in groups, where people practice relating to others and expressing themselves. How long improvement takes varies from person to person. Sticking with treatment matters, and so does support from people close to you.
DBT was developed specifically for people with BPD. It is a form of cognitive behavioral therapy built on one balance: accepting yourself as you are while working to change what isn’t working. Comprehensive DBT, as described by the University of Washington, has four parts:
A weekly class, about 2.5 hours, that teaches skills with practice at home
Usually a weekly session of about 60 minutes, applying the skills to your own problems
Short in-the-moment help using a skill when things get hard between sessions
The therapists' own team meeting, to keep the treatment on track
being fully aware of and present in the current moment.
getting through a painful moment without making it worse.
lowering how vulnerable you are to painful emotions, and changing the ones you want to change.
asking for what you need and saying no, while keeping your self-respect and your relationships.
A workbook, app or video can help you practice these skills, but it isn’t the same as a full DBT program with a trained therapist.
Several other therapies are used and studied for BPD:
helps change core beliefs and behaviors based on inaccurate views of yourself and others.
builds the ability to understand your own and other people's thoughts and feelings.
look at deep-rooted patterns and how they show up in relationships.
A 2020 Cochrane review found that, compared with usual care, DBT improved BPD severity, self-harm and day-to-day functioning, and MBT reduced self-harm and suicidality. The authors rated the evidence as low quality, so more research is needed. Therapy for families and caregivers can also help. Read how to support someone with BPD.
The benefits of medication for BPD itself are unclear, and it is not a first-line treatment. A provider may add it to therapy for specific symptoms, such as mood swings, or for a condition that occurs alongside BPD, such as depression. Don’t start, stop or change medication without talking to your provider.
BPD is not a life sentence. A McLean Hospital study followed 290 people with BPD for 10 years
Setbacks happen, and some symptoms can return, but long-lasting improvement is common. Recovery often means fewer and milder symptoms, steadier relationships, and a life that feels more like your own.
Not sure yet? Our free BPD traits checklist can help you organize what you’ve noticed before you talk to someone. If you’re in crisis, call or text 988 or see crisis support.
Psychotherapy is the main treatment. Dialectical behavior therapy (DBT) was developed specifically for BPD and teaches skills to manage emotions, reduce self-destructive behavior and improve relationships. Cognitive behavioral therapy (CBT) and other approaches also help many people.
Not necessarily. Long-term studies have found that many people with BPD see their symptoms ease significantly over time, especially with treatment. Some challenges can remain, but improvement is common.
Yes. With effective treatment and support, many people with BPD build stable relationships, meaningful work and a good quality of life. Recovery takes time, and sticking with treatment makes a real difference.
Medication isn’t a first-line treatment for BPD itself. A provider may suggest it alongside therapy for specific symptoms or co-occurring conditions, such as depression or mood swings.
It depends on the program. Comprehensive DBT includes weekly individual therapy and a weekly skills group, so ask each provider how long their program runs and what it includes.
National Institute of Mental Health: Borderline Personality Disorder (revised 2025)
University of Washington, Behavioral Research & Therapy Clinics: Dialectical Behavior Therapy
Storebø OJ et al. Psychological therapies for people with borderline personality
disorder. Cochrane Database of Systematic Reviews, 2020
Zanarini MC et al. Time to attainment of recovery from borderline personality disorder.
American Journal of Psychiatry, 2010
