Personality disorder treatment
How personality disorder, including emotionally unstable (borderline) personality disorder, is understood and treated, mainly through specialist talking therapies, with a compassionate, recovery-focused approach.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Personality disorder describes long-standing patterns that cause distress, often linked to painful or traumatic experiences; it is treatable and is not a character flaw or a choice.
- The main treatment is structured talking therapy, such as DBT or MBT, delivered with consistency and compassion; medicines do not treat the disorder itself.
- Recovery is realistic: with the right therapy and support, many people improve a great deal over time, and the outlook is hopeful.
- Self-harm and suicidal thoughts can be part of this, and they are taken seriously. If you are at immediate risk or have thoughts of suicide or self-harm: call 999 or go to A&E anywhere in the UK. For urgent mental-health support, call 111 and choose the mental-health option in England, Scotland or Wales; in Northern Ireland call Lifeline free on 0808 808 8000, or contact your GP out-of-hours service. You can also call Samaritans free on 116 123, or text SHOUT to 85258, anywhere in the UK.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
Structured therapies such as DBT and MBT can reduce self-harm, distress and crises over time
Medicine alone is not a treatment for personality disorder, and being placed on several medicines is not a substitute for therapy.
You are heard, a shared understanding is built, safety is considered, and you leave with the start of a plan and a clear crisis plan.
Consistent, respectful, hopeful care led by structured therapy.
You are heard, a shared understanding is built, safety is considered, and you leave with the start of a plan and a...
A structured therapy such as DBT or MBT begins. Early on, the focus is often on safety, building skills and...
Over a programme that usually runs for many months, you build skills, work on relationships and past experiences...
As things become more stable, the focus moves to maintaining progress, relationships, work or study, and reducing...
What is personality disorder treatment?
The term 'personality disorder' describes long-standing patterns of thinking, feeling and relating to others that cause distress and difficulty in daily life and relationships. It is a label that many people find unhelpful or stigmatising, and some services now prefer terms such as 'complex emotional needs'. Whatever it is called, it usually reflects deep difficulties that often grow out of painful or traumatic experiences, especially in early life. It is not a character flaw or a choice.
The most talked-about type is emotionally unstable, or borderline, personality disorder (EUPD or BPD). People may experience intense and rapidly changing emotions, fear of abandonment, unstable relationships and self-image, impulsive behaviour, and at times self-harm or suicidal thoughts. These experiences are real and treatable, and people can and do recover or improve a great deal.
Treatment is mainly through structured talking therapies, delivered with consistency, respect and hope. Medicines are not a treatment for personality disorder itself, though they may sometimes help with specific problems such as depression or anxiety. The relationship with a trusted, compassionate clinician is central.
This guide is general information, not personal medical advice. The right approach for you should be agreed with your own mental-health team.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Compassionate assessment and formulation
A clinician works with you to understand your experiences and history, including any trauma, and builds a shared picture (a 'formulation') of what is happening and why...
Dialectical behaviour therapy (DBT)
A structured therapy that teaches skills to manage intense emotions, distress, relationships and impulsive behaviour, including self-harm. Recommended particularly where...
Mentalisation-based therapy (MBT)
A therapy that helps you understand your own and others' thoughts and feelings, which can ease conflict in relationships and reduce distress and self-harm.
Other structured therapies
Approaches such as schema therapy, cognitive analytic therapy (CAT) and structured clinical management can also help. The best fit depends on you and what is available.
Preparing for your treatment
- Before the appointment, if you can, note what you find hardest and how it affects your life and relationships.
- Think about what you would like to change, and what has helped or not helped in the past.
- Write down any thoughts of self-harm or suicide, so they can be shared safely and supported.
- List any medicines you take, and any alcohol or drug use, as these affect mood and impulsivity.
- Note any history of difficult or traumatic experiences, only as much as you feel able to share.
- Bring someone you trust if that helps, and any previous letters or assessments.
- Be reassured that a good service will treat you with respect, take your distress seriously, and offer hope.
What happens
Assessment usually takes one or more appointments. A clinician gives you time to talk about your experiences, relationships and history, and works with you to understand what is happening, including the role of any past trauma. They will ask, sensitively, about self-harm and suicidal thoughts, so the right support can be offered. The aim is understanding and a shared plan, not just a diagnosis.
Most treatment happens in the community. Together you agree a plan that usually centres on a structured talking therapy, such as DBT or MBT, alongside a clear crisis plan and support with daily life. Hospital admission is generally avoided where possible, because it is not usually helpful for personality disorder and can sometimes make things harder.
Good care is consistent and respectful. A trusted relationship with a clinician or therapist, who does not give up on you, is one of the most important parts of treatment. If other conditions such as depression or PTSD are present, these are treated as part of the wider plan.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Medicine alone is not a treatment for personality disorder, and being placed on several medicines is not a substitute for therapy.
- Brief or one-off therapy is unlikely to be enough; structured therapies usually run over many months.
- Routine private outpatient care is not appropriate for an acute crisis with serious risk, which needs urgent assessment.
- Hospital admission is not usually helpful and can sometimes make things harder, so it is generally avoided where possible.
Delay or rearrange if…
- You are at immediate risk or having thoughts of suicide or self-harm - seek urgent help first.
- You are in an acute crisis that needs stabilising and a safety plan before starting a therapy programme.
- Heavy alcohol or drug use is affecting safety and needs addressing alongside.
- Another urgent problem, such as a serious eating disorder or untreated PTSD, needs attention first or in parallel.
Alternatives to discuss
- NHS community mental-health and specialist personality disorder services.
- Different structured therapies, such as DBT, MBT, schema therapy or cognitive analytic therapy, depending on fit and availability.
- Treatment for conditions that occur alongside, such as depression, PTSD or substance use.
- Peer support and voluntary-sector services for people with complex emotional needs.
- Support with relationships, housing, work and physical health as part of recovery.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Structured therapies such as DBT and MBT can reduce self-harm, distress and crises over time
- Therapy builds practical skills to manage intense emotions and difficult relationships
- A shared understanding of your difficulties can be a relief and a foundation for change
- Consistent, compassionate support reduces the sense of being passed around or written off
- Treating conditions that occur alongside, such as depression or PTSD, improves overall wellbeing
- Many people improve a great deal and go on to live fuller, more stable lives
Risks & complications
- Therapy can feel hard or bring up painful feelings, especially early on, even when it helps overall
- Progress is gradual and uneven, with good and difficult periods
- Building trust with a service or therapist can take time, particularly after past poor experiences
- Distress or self-harm may increase for a time when difficult issues are being worked on
- Being prescribed medicines that do not treat the disorder itself, sometimes several at once
- Inconsistent care or frequent changes of clinician, which can be unsettling and unhelpful
- A crisis with serious self-harm or a suicide attempt, which needs urgent help
- Being treated dismissively or with stigma, which is harmful and not acceptable practice
The biggest issues are safety and the quality of care. Self-harm and suicidal thoughts can be part of this and are taken seriously, with a clear crisis plan agreed in advance. Just as important, people with this diagnosis have too often experienced stigma or being passed around services. Good care is the opposite: consistent, respectful, hopeful and led by structured therapy. Medicines do not treat personality disorder itself, so being put on several medicines is not a substitute for the right therapy and support.
Published figures to discuss
Personality disorder varies enormously between people, and so do outcomes, so individual recovery cannot be given as a single reliable percentage. The evidence does, however, support a hopeful picture: structured therapies such as DBT and MBT can reduce self-harm and distress, and many people improve substantially over time. Because robust, transferable figures for individual outcomes are limited, we describe them in words rather than inventing percentages.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Crisis, self-harm or suicidal behaviour | Clinically important in some presentations | A care plan should include warning signs, coping strategies, crisis contacts and what services will do in crisis. | Guide sourcesClinical context |
| Therapy dropout or rupture | Common practical risk | Consistency, boundaries, validation and repair after conflict are central to effective therapy. | NHS - Borderline personality disorder: treatmentnhs.ukSource-linked context |
| Medication overuse | Recognised | Medication may help specific symptoms or comorbid conditions but is not the main treatment for personality disorder itself. | Guide sourcesClinical context |
| Stigma and diagnostic harm | Common if handled poorly | The diagnosis should lead to formulation and support, not exclusion or blame. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery as such. Recovery here means gradually gaining more stability, better relationships and a life that feels more your own. It usually happens over months, through therapy and support, and the outlook is genuinely hopeful: many people improve a great deal.
- Progress that is gradual and uneven, with good and harder periods
- Painful feelings coming up as difficult issues are worked on in therapy
- Needing time to trust a therapist or service, especially after past experiences
- Crises becoming less frequent and less overwhelming over time
- Setbacks happening, and being something to work through rather than a sign of failure
Aftercare
- Attend and stick with your therapy where you can; tell your team if you are struggling rather than dropping out.
- Use the skills you learn, especially for managing intense emotions and urges to self-harm.
- Follow your crisis plan, and reach out early at difficult times rather than waiting until things peak.
- Look after sleep, routine and physical health, and be careful with alcohol and drugs.
- Stay connected with people you trust and any peer support.
- Take any medicine as prescribed and review it, remembering it treats specific problems, not the disorder itself.
- Tell your team promptly if you feel less safe, or if thoughts of self-harm or suicide increase.
- A written crisis plan agreed with your team
- Details of your therapy programme and therapist
- Skills or coping strategies you can use in distress
- Contacts for your care coordinator or community team
- A medicine list and a clear plan for any prescribed
- People you trust who can support you
- Crisis contacts saved: 999 or A&E anywhere in the UK; for urgent mental-health support, 111 and choose the mental-health option (England, Scotland, Wales) or Lifeline 0808 808 8000 / GP out-of-hours (Northern Ireland); Samaritans 116 123; text SHOUT to 85258
⚠ Get urgent help if…
- Thoughts of suicide or harming yourself, or feeling unable to keep yourself safe - get help straight away: call 999 or go to A&E anywhere in the UK. For urgent mental-health support, call 111 and choose the mental-health option in England, Scotland or Wales, or in Northern Ireland call Lifeline free on 0808 808 8000 or your GP out-of-hours service. You can also call Samaritans free on 116 123, or text SHOUT to 85258
- A sudden increase in self-harm, or urges that feel hard to resist
- Feeling completely overwhelmed, hopeless, or that you cannot go on
- Withdrawing from everyone and from support
- Heavy alcohol or drug use to cope, especially with risky behaviour
- A relationship or life crisis that feels unbearable
- Distress that keeps building despite using your usual coping strategies
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
With the right therapy and consistent, compassionate support, many people with personality disorder improve a great deal. Distress, self-harm and crises often reduce over time, and relationships and daily life become more stable. Recovery is realistic, and the outlook is hopeful.
Progress is usually gradual rather than sudden, and there are often setbacks along the way, which are a normal part of recovery rather than a failure. The aim is not a label or a cure on paper, but a life that feels more stable, connected and your own.
These are long-standing patterns, so change takes time and tends to build over months and years rather than weeks. Many people find that, with therapy and support, difficulties ease substantially and may no longer dominate their lives. Setbacks can happen, especially at times of stress, and a clear plan for difficult periods helps people stay on track. Support can usually step down as things improve.
Related tests, treatments or support
Personality disorder often occurs alongside depression, anxiety, PTSD, eating disorders or substance use, and these are treated as part of the wider plan. Support with relationships, housing, work and physical health is also important, because these affect wellbeing and recovery. Care works best when it is joined up and consistent rather than fragmented.
Follow-up & long-term care
You will have regular contact with your team or therapist to review how therapy is going and to keep your crisis plan up to date. Support can step down as you improve, with a clear way back if you need it. You should always know who your contact is and how to get help, including out of hours and in a crisis.
- Keep using the skills and strategies you learned in therapy.
- Keep your crisis plan up to date and reach out early at difficult times.
- Look after sleep, routine, physical health and relationships.
- Be careful with alcohol and drugs, which can worsen mood and impulsivity.
- Stay connected with support, and treat setbacks as something to work through.
- Review any medicine regularly, remembering it treats specific problems, not the disorder itself.
Repeat, follow-on and what comes next
- It may take more than one therapy, or more than one attempt, to find what helps.
- Treatment plans are adjusted as you progress, and setbacks are worked through rather than seen as failure.
- Understanding and diagnosis may be revised over time as more becomes clear.
- Support can step down as things improve, with a clear way back if needed.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Consistent, respectful, hopeful care led by structured therapy.
- A clear, agreed crisis plan and an urgent route to help, including out of hours.
- A named contact and continuity rather than frequent changes of clinician.
- Treatment of conditions that occur alongside, such as depression or PTSD.
- Support that steps down as you improve, with a clear way back if you need it.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- How much psychiatrist, psychologist and therapist time is involved
- The type and length of therapy programme, such as DBT or MBT, which often runs for many months
- Whether therapy is individual, group, or both
- Whether other conditions, such as PTSD or substance use, also need treatment
- The cost of any medicines and of reviewing them
- How crisis support and follow-up are arranged
- The psychiatrist and therapist fees involved
- The type and expected length of the therapy programme, and how many sessions are included
- Whether assessment, a formulation and a crisis plan are included
- What happens, and how urgent NHS care is accessed, in a crisis
- Which medicines, if any, are included and how they are reviewed
- How follow-up is arranged and charged
- Who to contact, including out of hours and in a crisis
On the NHS? Assessment and therapy for personality disorder are available on the NHS through community mental-health and specialist services, though waits vary; private care may be used for speed or choice, but crises should go through urgent NHS care.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Giving a label without a shared understanding, support or a clear plan for treatment.
- Prescribing several medicines as if they treat the disorder, when they do not.
- Offering therapy that is too brief, or inconsistent care with frequent changes of clinician.
- Not agreeing a clear crisis plan in advance, or not asking sensitively about self-harm and suicide.
- Stigmatising or dismissive attitudes that leave people feeling blamed or written off.
Marketing red flags
- Claims to 'cure' personality disorder quickly with a single programme, retreat or product.
- Promoting medicines or supplements as the main treatment.
- Offering routine private care for what is actually an acute crisis.
- Vague or very short therapy packages presented as full treatment.
- Stigmatising language, or treating people as 'difficult' rather than distressed.
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- Can you help me understand what is going on, rather than just give me a label?
- What structured therapy, such as DBT or MBT, would suit me, and is it available here?
- How long would treatment usually take, and what does recovery realistically look like for me?
- What is my crisis plan, and exactly what should I do at difficult times?
- If I am offered medicine, what specific problem is it for, given that it does not treat the disorder itself?
- Who is my main contact, and how do I get help, including out of hours and in a crisis?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is 'personality disorder' a judgement about my character?
Can personality disorder be treated, or even get better?
Will I be given medication?
What is the difference between DBT and MBT?
Will I have to go into hospital?
Can I get this help on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS - Borderline personality disorder: treatment Royal College of Psychiatrists - Personality disorder Mind - Treatment for personality disorders NICE CG78 - Borderline personality disorder: recognition and management NICE CG77 - Antisocial personality disorder: prevention and management Rethink Mental Illness - Personality disorders NHS England — NHS 111 mental-health crisis support NHS inform Scotland — urgent mental-health help NHS 111 Wales — mental health and wellbeing nidirect — mental health emergency / Lifeline (Northern Ireland) nidirect — GP out-of-hours service (Northern Ireland) nidirect — urgent and emergency care services (Northern Ireland)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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