ABSTRACT
People with borderline personality disorder (BPD) typically will have patterns of remarkable instability in their interpersonal relations and emotional states, often exhibiting patterns of impulsivity. If a patient has mild BPD symptoms and appears to not want, or will not ask for, medications, then no medications are warranted and psychotherapy is the best treatment option. Patients with BPD can be very difficult yet very rewarding to treat. In training, clinicians often see the most severe and hospitalized BPD patients, but in the outpatient setting there is wide ranging severity. The severity and chronicity of symptoms must cause psychosocial distress to reach the level of a true disorder. Suffering from a personality disorder often affords less acute and sustained effectiveness from psychopharmacologic management alone. Unlike bipolar disorder, patients with BPD never truly have discrete "episodes" as they live with BPD symptoms longitudinally and daily.
