Borderline Personality Disorder, Revisited

by John M Oldham MD

In a previous blog entitled “Trust and treatment of borderline personality disorder” (December, 2021), I provided a link to an article on the same topic in Clinical Psychiatry News, in which several colleagues and I were interviewed about treatment strategies for patients with BPD. I was recently contacted by Vumedi, a video education platform for doctors and healthcare professionals, to participate in Vumedi Week 2025 (https://www.vumedi.com/channel/vumedi-week-2025/tab/psychiatry-3/). Posted this month, August 2025, the program includes “a special collection of videos with the goal of highlighting how to approach common and challenging conditions,” ranging across many medical specialties. Here is a link to the video I provided (https://www.vumedi.com/channel/vumedi-week-2025/tab/psychiatry-3/video/expert-tips-on-borderline-personality-disorder-management/), entitled “Expert Tips on Borderline Personality Disorder Management.” In it, I summarize our new dimensional thinking about personality disorders in general. Then I discuss the recently published new version of an evidence-based practice guideline for the treatment of patients with BPD. This guideline was developed by a Workgroup of the American Psychiatric Association, in which I participated.

Don’t forget that in this NPSP25 website, we provide information comparing personality disorders with non-pathological personality styles, in what we call a Continuum. Using that conceptual model, individuals with a prominently “mercurial” personality style might have “emotional roller coaster” features that, if too extreme, could lead to impairment in functioning characteristic of patients with BPD. In another previous blog entitled “The History of npsp25.com” (November, 2024) there is a link to an earlier Vumedi video in which I discuss the origins of this website and of the Continuum model in detail.