Table of Contents
Anxiety Medications For Borderline Personality Disorder
Medication for borderline personality disorder (BPD) can help treat symptoms associated with BPD such as depression, mood instability, anxiety, anger, and impulsivity. There are several different types of BPD medications, including antidepressants, antipsychotics, and mood stabilizers. There is no one medication that treats a personality disorder like BPD; however, a combination of behavioral therapies and medication can help manage symptoms. This article shall discuss anxiety medications for borderline personality disorder.
A borderline personality disorder is a mental health condition characterized by long-term patterns of self-destructive behavior, impulsivity, intense emotions, and challenging relationships. Anxiety can also be a symptom of BPD, but research suggests that anxiety disorders often occur alongside borderline personality disorder.
Estimates indicate that 75% to 90% of people with BPD also have an anxiety disorder at some point during their lives.
To date, there are no medications approved by the Food & Drug Administration (FDA) to treat borderline personality disorder (BPD). However, some individuals with BPD are prescribed anti-anxiety medications, also known as “anxiolytics,” to treat the intense anxiety and agitation associated with BPD. Whether this is an option for you depends on your unique situation and your doctor’s recommendations.
Like any medication, however, treatment with anti-anxiety drugs has both advantages and drawbacks. Here are some things to remember and ask your doctor if your psychiatrist is considering prescribing anti-anxiety medications for your BPD symptoms.
Prescribing anti-anxiety medications to treat symptoms of BPD is considered off-label use. However, these medications may also be prescribed to treat anxiety disorders that may co-occur with borderline personality disorder.
Are Anti-Anxiety Medications for BPD Effective?
Unfortunately, there is very little research to indicate whether anti-anxiety medications for BPD are actually effective. There are a few published papers that describe patients with BPD who have found relief from symptoms when taking these medications, but no controlled clinical trials have examined the usefulness of anti-anxiety medications for BPD.
Research has been mixed on these medications’ overall effects.
On an individual basis, some have reported significant improvement in their BPD symptoms. There is also some research suggesting that benzodiazepines may worsen the symptoms of BPD in some individuals.4 Some people report worsened symptoms when taking certain drugs like Xanax because it heightened their urges for impulsive behaviors.
It is essential to seek treatment for anxiety if you have BPD. Research has found that having a co-morbid anxiety disorder leads to worse treatment outcomes and increases the risk of self-injury and suicide in people with BPD.2
Types of Anti-Anxiety Medications
The most commonly prescribed anti-anxiety medications are called benzodiazepines. Some examples include:
- Ativan (lorazepam)
- Klonopin (clonazepam)
- Xanax (alprazolam)
- Valium (diazepam)
Unfortunately, these may not be the best choice for individuals with BPD who also have substance use problems, because benzodiazepines can be habit-forming.5 For this reason, benzodiazepines are usually only prescribed for short-term anxiety relief.
There are some non-benzodiazepine anti-anxiety medications that are not habit-forming, and these may be an alternative to medications from the benzodiazepine family. These tend to be more frequently recommended, as they can help you transition as you make progress in your therapy and recovery.
Risks and Side Effects of Anti-Anxiety Medications
It’s important to know that these drugs can have significant side effects, particularly in people with BPD since they have not been thoroughly tested in that population.
The most common side effect of anti-anxiety medication is feeling sleepy, fatigued, or groggy. Other side effects include impaired coordination and memory problems.
You should not take anti-anxiety medication if you drink, as it can worsen the foggy effect. Many anti-anxiety medications should not be taken by pregnant women or women trying to become pregnant.
Medications from the benzodiazepine family should not be mixed with other sedating medications or alcohol.
Do not stop taking benzodiazepines without talking to your doctor first. Benzodiazepine withdrawal can be potentially risky, so your doctor will gradually taper your dose over time to minimize withdrawal complications.
Questions to Ask Your Psychiatrist
You should talk to your psychiatrist before you start taking anti-anxiety medications or any other type of medication for BPD. If you have any concerns, let them know. Make sure you understand the risks and side effects and be sure to have an in-depth discussion about the reasons you are being prescribed a certain medication.
Other Treatments for Anxiety and BPD
While anxiety medications are one option for treating anxiety in BPD, psychotherapy is another option that can be used as an alternative or alongside medication. However, research on these treatments tends to be limited since people with BPD are often excluded from trials due to their symptom severity, suicidal behaviors, or other co-occurring issues that require immediate interventions.
Types of therapy that may be helpful include:
- Dialectical behavior therapy (DBT)
- Cognitive behavior therapy (CBT)
- Schema-focused therapy
- General psychiatric management
Of the limited studies that have been conducted, three randomized-controlled trials found that people with anxiety and BPD did experience improvements comparable to people without BPD. More research is needed to understand how these therapies might be helpful to people with BPD who also have anxiety.
I hope you find this article helpful.
