Handling the Immediate Aftermath
Take some deep breaths. You might feel angry at whoever diagnosed you or overwhelmed with dealing with your new diagnosis. Instead of feeling stressed or anxious or letting your thoughts get the best of you, practice self-care for several days. Focus on taking care of yourself and not on jumping to conclusions about your diagnosis or treatment. Go for a walk, talk a bath, read a book, meditate, or do something that feels calming and enjoyable to you. Check out How to Practice Self Care for more tips. Avoid turning to drugs or alcohol as a way to cope with your feelings.
Remind yourself that you’re okay. You may feel like your sense of identity has changed and you don’t know what to do with yourself. Calm yourself by saying, “I am okay the way I am. I am not bad, and nothing bad is happening to me this moment.” Nothing bad is happening to you, and nothing has truly changed beyond your awareness. Remember that having a diagnosis can be a good thing. It allows you to find useful treatments, and some people may find that it gives them closure. Borderline personality disorder is just a name. It does not define who you are or what you are worth. You are still the same person who you were before. Now you just have one more piece of information about yourself.
Experience your feelings. It’s normal to have various emotions after receiving a mental health diagnosis. You may feel relief, shock, denial, shame, confusion, or powerless. Don’t be ashamed of how you feel, but let yourself feel these emotions as completely valid and okay. Recognize that it’s normal to have many emotions about a diagnosis and allow yourself to feel them as they occur. You may fear having to tell people or facing social stigma of mental illness or personality disorders. Don’t get too far ahead into the details now, and instead, focus on what you feel and how you feel it. If you feel sad, note where in your body you feel that sadness and express it however you see fit. If you want to cry, journal, or just listen to your feelings, that’s okay. While it may not feel great now, imagine how much better you’re going to feel once you start getting better!
Educate yourself on BPD. Borderline personality disorder is not a disease or a marker of a “bad” person. It’s simply a category of similar symptoms from people who tend to have a trauma history. Yes, knowing that many people with BPD have a trauma history can help you cope with feelings of shame and enable you to realize that this diagnosis is not your fault. Learn what symptoms are typical and how BPD affects those who have it.
Stay away from stigma. Some people, media sources, and movies see those with BPD as scary, reckless, and as the most extreme cases. Not everyone with BPD has the most extreme case, and symptoms may vary from one person to another. If you read things on the internet or talk to people who make sweeping generalizations about people with BPD, take a step back or do not associate with them. Remind yourself that you are not borderline, but that you have a diagnosis of BPD, and that it doesn’t have to define you. Remember that you are still a unique person with unique skills, characteristics, and problems. A diagnosis can't change who you are. A diagnosis simply puts a name to your symptoms. While it might seem scary, the symptoms would exist with or without a diagnosis. Once you have a diagnosis, however, you can take steps towards healing.
Exploring Therapeutic Options
Start dialectical behavior therapy (DBT). Therapy is the main treatment used for borderline personality disorder. Dialectical behavior therapy (DBT) was specifically designed to treat borderline personality disorder and includes learning skills to manage your emotions more effectively. DBT uses four modules (mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness) to target specific characteristics of borderline personality disorder. DBT often has you working with an individual therapist as well as in group therapy. Group therapy can be very effective, so don't be afraid to try it out.
Explore other therapy options. If DBT doesn’t sound like a good fit, there are other approaches to treating BPD through therapy. Find a therapist and therapy approach that feels like a good fit. Therapies aimed to help BPD include schema therapy (which identifies unmet needs that have lead to negative patterns), Mentalization-based therapy (MBT) (which allows you to identify your thoughts and emotions and see them from a new perspective), and psychodynamic therapy (which helps you understand your emotions and interpersonal difficulties as reflected through the therapeutic relationship). When you find an approach and a therapist that seems like a fit, stay with it. Even if you go through a difficult period, try to work through the challenge. It is normal to struggle to sometimes.
Engage in trauma therapy. If you experience acute or prolonged trauma, start treatment for the trauma right away. Some options to explore include eye movement desensitization and reprocessing (EMDR), exposure therapy, somatic experiencing (SE), and trauma-focused cognitive behavior therapy (TF-CBT). The trauma may affect your daily living, and for this reason, it’s important to address it up front. You may be able to resolve some of the emotional pain and work through deep wounds with trauma-focused therapy.
Attend group support. Dialectical behavior therapy (DBT) often has a group therapy component. However, you may choose to attend group therapy for treatment in addition to individual treatment or to attend a support group. Being a part of a group can help you learn new skills and practice your skills in a safe environment. You can also benefit from reaching out to others with BPD and gaining insight from their experiences. Call your local mental health clinic and community centers to see whether groups are offered for BPD.
Feeling Grounded and Stable
Talk to someone immediately if you are considering suicide. If you feel like things are too much and you cannot take them and want an out, get help immediately. If you work with a mental health provider, contact him or her first. If you do not have a therapist, call your physician or go to the nearest emergency department. You can also call emergency services or a suicide helpline, such as 988 (you can also text this number) in the USA or Canada. Some signs of suicide include talking or thinking about killing yourself, selling your possessions, increasing alcohol or drug use, feeling like you have no purpose and are a burden to others, socially withdrawing, and acting reckless or out of control.
Explore medication options. Some people supplement therapy with medications. While there are no medications specifically designed for BPD, some symptoms can be addressed through pharmaceuticals. For example, if you suffer from mood swings, you may benefit from a mood stabilizer, and an antipsychotic can help with feelings of rage or disorganized thoughts. Talk to a psychiatrist about medication. Your psychiatrist will help you manage your symptoms through medication. Yet, be aware that you may try several prescriptions and experience side-effects before finding one that suits you. Medications will not cure you, but they can stabilize your mood so that therapy is more effective.
Practice coping skills. Find ways to help you deal with stress and cope better. Practice relaxation methods every day to help you manage your stress. Practicing for 30 minutes each day can help stabilize your moods. You can practice coping skills when stressors arise individually as well. Start a mindfulness practice. First start with focusing on your breathing when you are feeling distressed or anxious. Turn your thoughts and emotions to focusing on each inhale and exhale to help you enter a calm space. For long-term methods, try engaging in a relaxation practice every day. Get into daily yoga, qigong, tai chi, and meditation. Find the one that appeals to you and do it every day. Taking care of yourself is one of the best things you can do for your physical and mental health.
Process your feelings with loved ones. It’s important to feel supported by the people in your life as you experience shock or any other strong emotions about your recent diagnosis. Being near people who love you and care about you can be important during this time. Surround yourself with family and close friends to support you. Talk to someone who will listen to you and be helpful during this time. Continue to use your social support throughout your treatment. Build your social support from people who will listen to you and respect you.
Express your needs. Especially after immediately receiving your diagnosis, you may feel out of sorts and need help from others to get back into a normal life. However, people may not know how to support you. If you have a need, be direct and kind about it. Use “I” statements to express your feelings and your needs. For example, you may say, “I don’t want advice, I just want someone to listen right now.” You can also say, “I am looking for advice and would appreciate some guidance about this.” Be honest with others about how you’re feeling and what you’re needing. Say, “It’s hard for me to take in all the information at once, and I feel really overwhelmed. I feel like I’m shutting down and need some help. Can you help me with household needs this week?”
Increase your social circle. If you don’t feel supported by the people in your life, consider increasing your social circle with friends who care about you and whom you care about. It can be difficult to build friendships and find closeness with others. Yet, remind yourself that it’s important to have friends that will help you and support you through difficult times. You can also engage in activities that interest you, such as hiking, boating, or woodworking. Find groups of other people who share similar interests as you and start attending meetings or events. Having something in common gives you an instant bond. Another great way to meet new people and make friends is through volunteering. Volunteer at your local spiritual community, mentor disadvantaged children, or take dogs for a walk at your local shelter. There are plenty of ways to get involved in your local community and give back. Check out How to Volunteer for more information.
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