QUESTION:

Is BPD a permanent condition? How many of the symptoms must a person recover from before he/she can give up the stigma of the diagnosis?

Is there new research regarding any treatments for BPD? The literature indicates that short-term therapy is inappropriate for a BPD individual. Even Dr. Linehan's cognitive approach (DBT) keeps only some patients out of the hospital (which is the reason the HMOs are rushing to assume this approach, i.e., to avoid costly hospitalizations), and DBT is NOT correlated with a patient's relief from the emotional pain he/she suffers. So is there any good old or new news for this group of individuals?

DR. HELLER'S ANSWER:

It is clearly a permanent condition, but it is controllable and the individual can have a sensational and successful life - even more so than the average person.

The chronic medical problems - inappropriate mood swings, chronic anger, emptiness, boredom and rejection sensitivity are treatable by SSRI's - particularly Prozac. If the person becomes peaceful, happy, and thinks like a successful person the individual can often stop their medication and have those symptoms stay gone except during stressful times.

The stress problems - while less frequent with treatment - will remain. They are very manageable however with as needed medication and cognitive changes.

My goal for treating borderlines is a sensational life in every area of life, not just stopping hospitalizations. It's absolutely possible. In fact, I haven't had any patient fail to reach this goal if they committed themselves to doing everything possible to get there.

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