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- Borderline personality disorder
DBT-informed therapy for intense emotions, unstable relationships, fear of abandonment and self-harm, and support for the people who love someone with BPD.
Borderline personality disorder is one of the most stigmatized diagnoses in mental health, and one of the most treatable. At its core it's a problem of emotional intensity: feelings arrive faster, hit harder and take longer to settle than they do for other people, and that spills into relationships, self-image and impulsive behavior. Many people with BPD grew up in environments where their emotions were dismissed or punished, and many have a history of trauma.
With the right treatment, most people with BPD improve substantially, and a majority no longer meet criteria for the diagnosis within a few years. The treatment that changed this picture is dialectical behavior therapy (DBT), which several of our clinicians are trained in.
What we treat
Personality disorders are diagnosed only by a licensed clinician after a thorough evaluation, and usually not before adulthood. These descriptions follow the DSM-5-TR.
- Borderline personality disorder
- A pervasive pattern, beginning by early adulthood, of instability in relationships, self-image and emotions, along with marked impulsivity, shown by at least five of the features listed above. Severity and presentation vary widely; two people with the diagnosis can look very different.
- Emotion dysregulation without a full diagnosis
- Many people have some BPD features, especially emotional intensity and relationship instability, without meeting the full criteria. The same skills help, and we don't require a label to teach them.
- Self-harm and chronic suicidal thinking
- Non-suicidal self-injury and recurring suicidal thoughts are common with BPD and are addressed directly in treatment with safety planning and skills, not avoided. If you are in immediate danger, call or text 988.
- Other personality-related difficulties
- Long-standing patterns in how you relate to others and see yourself, such as those described in avoidant, dependent or obsessive-compulsive personality disorders, that keep causing the same problems. Our clinicians evaluate and treat these with the same combination of skills and insight-oriented work.
- Co-occurring conditions
- BPD rarely travels alone. Depression, anxiety, PTSD and complex trauma, and eating-related problems are common companions and are treated together, not sequentially.
How we treat it
Dialectical behavior therapy is the best-studied treatment for BPD. It teaches four sets of skills, mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness, inside a relationship that takes your pain seriously and still pushes for change. Our DBT-trained clinicians provide DBT-informed individual therapy and skills work; we don't currently run a full adherent DBT program with 24-hour phone coaching, and we'll tell you if a higher level of care would serve you better. Trauma-focused treatment, including EMDR, is often part of the plan once stability is established. If medication is part of your care, we coordinate with your prescriber.
When to reach out
- Your emotions feel unmanageable and your relationships keep blowing up
- You've been hurting yourself or thinking about suicide
- You've been told you have BPD and want treatment that actually addresses it
- Previous therapy felt like it went nowhere
- Someone you love has BPD and you need help knowing how to support them without losing yourself
Common questions
Is BPD really treatable?
Yes. Long-term studies show that most people with BPD improve significantly with treatment, and many no longer meet criteria for the diagnosis after several years. DBT has the strongest evidence, and other structured approaches also help.
Do you offer full DBT?
We offer DBT-informed individual therapy and skills work with clinicians trained in DBT. A fully adherent DBT program includes a weekly skills group, individual therapy, phone coaching and a therapist consultation team; if that level of care is what you need, we'll say so and help you find it.
Can a teenager be diagnosed with BPD?
The DSM-5-TR allows the diagnosis in adolescents when the pattern is pervasive and persistent for at least a year, but clinicians are appropriately cautious because adolescence involves a lot of normal instability. Whether or not a diagnosis is made, teens with intense emotions and self-harm benefit from DBT skills, and we involve parents.
I'm a family member. Can you help me?
Yes. We see partners and parents of people with BPD for their own support, and family sessions can be part of a client's treatment when the client wants that.
Where to get help for borderline personality disorder
Based on our clinicians' current specialties, this is treated at four locations:
- Carolina Forest (Myrtle Beach, SC)
- Murrells Inlet (Murrells Inlet, SC)
- North Charleston (North Charleston, SC)
- Anderson (Anderson, SC)
Closer to Myrtle Beach, Surfside Beach, West Columbia, Forest Acres, Irmo, Greenville or online? Call (843) 894-0000; the right therapist may be available by video, or we'll suggest the nearest office with the right fit.
Diagnostic descriptions on this page are summarized in plain language from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR, 2022). This page is educational. It is not a substitute for evaluation by a licensed clinician, and only a licensed clinician can make a diagnosis.
Ready when you are.
Call us or submit a short intake form. A Patient Account Representative will match you with a therapist, and most new clients have their first appointment within a few business days.