Borderline Personality Disorder Treatment (BPD)

DBT skills

Dialectical behavior therapy (DBT) teaches concrete skills for emotion regulation, distress tolerance, and steadier relationships — tools you can use between sessions when feelings run high.

Good Psychiatric Management

Good Psychiatric Management (GPM) uses weekly sessions, honest diagnosis, and case management to reduce impulsive and self-harming behavior. In a 2009 randomized trial (McMain et al.), the general-psychiatric-management approach GPM is built on matched DBT on key outcomes while being far less intensive to deliver.

A coordinated plan

No medication treats BPD itself, so when we do prescribe, it's aimed at a specific symptom — using evidence-based, non-controlled options — and your prescriber and therapist work from the same plan rather than running on separate tracks.

Getting started

Intake & evaluation

A thorough first visit to understand your symptoms, history, and relationships — and to tell BPD apart from bipolar disorder and other conditions that can mimic it. We share the diagnosis with you plainly and verify your insurance before you start.

Your plan, together

Your clinician walks you through a clear plan built on DBT skills or GPM, with medication reserved for a specific target symptom, and explains the reasoning behind each choice and what to expect in the first few weeks.

Follow-up & adjustment

Regular follow-ups and secure messaging let us track what's working, build skills over time, and space visits out as you stabilize. BPD has a hopeful course — most people improve, and many no longer meet criteria years later.

Both bring dramatic mood instability, but timing and triggers separate them. In BPD, mood shifts are fast and reactive — set off by conflict or a fear of abandonment and often settling within hours — while bipolar mood episodes are sustained over days to weeks and less tied to what's happening between people. Bipolar tends to be a lifelong, episodic illness, whereas BPD characteristically improves and often remits with age.

Bipolar II is easy to blur with BPD because hypomania can look like impulsivity and irritability rather than obvious euphoria. The tell is duration and independence from context: hypomania runs for days at a stretch regardless of what's going on around the person, while BPD's mood swings shift hour to hour and follow what's happening in relationships. A missed hypomanic episode is one reason a BPD label sometimes gets applied to what is actually bipolar II.

The chronic emptiness of BPD can read as depression, and the two often coexist. But BPD's low moods are typically brief and reactive and sit alongside identity disturbance and unstable relationships, whereas major depression brings a more sustained low mood and loss of interest that doesn't hinge on interpersonal events. When both are present, we treat the depression while the DBT or GPM work continues.

Cost & coverage

Insurance and self-pay

We're in-network with major commercial plans — including Aetna, Cigna, UnitedHealthcare/Optum, Anthem/Blue Cross Blue Shield, and Humana — and Medicare where licensed. We verify your benefits before your first appointment, so you know your cost up front. Prefer not to use insurance? Transparent self-pay rates are available.