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  • Q&A with Australian Health Practitioners

    Do I need treatment for borderline personality disorder?

    20 years ago I was diagnosed with Borderline Personality Disorder,very contextually related and never gave it much credence. In my 20's used to self mutilate a lot, still carry the scars at 47. Believed I dealt with the depression through self will. Increasingly over the last 5 years I have become erratic in moods, now days I can cycle between being up and down in a matter of hours. I get euphoric and then cycle down to depression and aggression. Its having a major impact on my family life.

    I am pretty desperate to get advice but terrified about being labelled. The self harm desires have come back very seriously, although I am yet to indulge in that impulse.

    I am pretty much freaked out by all of this.
  • Find a professional to answer your question

  • 4


    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    I can only offer you general (not clinical health professional) advice.

    As far as the recurrence of your desire to self-injure is concerned, you may find it helpful to join this forum: . It is a world-wide community which helps its members to find coping mechanisms other than self-injury.

    Disclosure: I am one of its volunteer administrators.

    From my job as an admin there I have the impression that many people who self-injure have been given the BPD label, which they often dislike. Many members have reported that they have found Dialectical Behavioural Therapy (DBT) helpful in dealing with the constellation of signs which can lead to a BPD label.

    Perhaps finding a clinical psychologist with expertise in using DBT approaches with his/her clients would be a good plan?

    All the best.

  • 1




    Nesh Nikolic

    Clinical Psychologist, Psychologist

    Nesh Nikolic is a Clinical Psychologist based in Canberra whose skills are in helping people with personal, emotional, motivational and relationship problems. As well as … View Profile

    The term borderline personality disorder describes what someone experiences as part of their everyday life.  Borderline personality is like any other personality in that there are certain traits and characteristics that a person experiences and some of these can cause us some grief… For example someone might experience a trait of stubbornness which can at times be unhelpful.  Having said that, stubbornness can also be helpful at times.

    With regards to whether you need to seek treatment, there are options that look at developing ways to work around and with traits.  You could look into dialectical behaviour therapy (DBT) or acceptance and commitment therapy both of which have emperical evidence for treating borderline type expereinces.

    Good luck with it.

  • 1


    I am a psychologist in private practice.I also lecture and supervise psychologists/psychology students at University.I work with clients who suffer from depression and anxiety. I … View Profile

    I am sorry to hear that you are having such a rough time lately. From what you have said, things are pretty painful for you right now. It sounds like you really could benefit from some psychological counselling. If it is the Label that stopps you from getting support, you may feel relieved to know that not all psychologists feel the need to label their clients. Psychologists of the Humanistic traditions tend to shy away from giving lables, and focus more on helping a person work through the issues that they want to resolve. 

    I suggest you can get counselling without a label, if that is what you prefer. You can discuss this issue in the first session with a psychologist. Look for someone who says they work in a Humanistic or Client Centred way, and it is most likely that you will get someone who can work with you without feeling that a Label is important.

  • 1




    Lyndon Barei

    Clinical Psychologist, Counsellor, Psychologist, Psychotherapist

    Lyndon's area of expertise is the treatment of Borderline Personality Disorder with Dialectical Behaviour Therapy. Lyndon also specialises in working therapeutically with adult clients who … View Profile

    Some of the key elements of Borderline Personality Disorder are thoughts/actions around self-harm and suicidality, rapid-cycling moods and frequent angry outbursts. While these features do not in themselves mean that you have BPD it's clear that you are suffering and that your relationships are being impacted.

    Regardless of whether BPD is the diagnosis, I, like the previous responders, would recommend Dialectical Behaviour Therapy as a therapy to give you the skills to better regulate your emotions, problem-solve, tolerate distress and keep you from self-harm.

    Be mindful when seeking out DBT that there are many health professionals who claim to do DBT. In fact, DBT when done correctly involves individual therapy, skills group, homework and after hours phone coaching for a period of 12 months. In short, it is alot of work from both client and therapist but is highly effective.

  • 1


    I have been working in Eltham, Melbourne as a relationship and family counsellor for over twelve years. I draw on current theory and research about … View Profile

    It may be that you are wanting to work through your issues in a way that supports you to make sense of them yourself, rather than having a label imposed on you that implies that because your symptoms fit a particular diagnossis then you ‘should’ respond to a particular kind of treatment.

    It may well be that you find DBT or ACT approaches helpful, and I certainly think Simon's suggestions to find a commuity of support for yourself to help prevent self-harming is an excellent one. However what may be as important, or even more important, is to have a space to develop your own understanding about what is going on, so that you can think about what solutions may be the most helpful to you. A skilled counsellor or psychotherapist can assist you with this - look for someone who also has expertise in working with self-harm from a contextual framework (that is - assisting you to think about what is going on for you in your world that drives you to desparate measures such as self-harm, aggression etc).

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