Lithium | Therapy of the Borderline Syndrome

Lithium

Lithium is one of the mood stabilisers. This group of drugs is used for borderline personality disorder in off-label use, i.e. without the drugs being officially approved for use in this disease. However, empirical data on the effectiveness of lithium in borderline patients are scarce, and only in individual cases does a positive effect seem possible. For other mood stabilizers such as lamotrigine, valproate and topiramate, several studies have shown a positive effect on impulsiveness and anger, so that they are used more frequently.

Duration of the therapy

In total, dialectical behavioral therapy lasts about 12 weeks if it is accompanied by inpatient treatment. However, since a completed therapy is usually followed by a weekly meeting with the therapist or in an auxiliary group, the follow-up therapy can also last longer. After the 12 weeks, however, the inpatient part of the treatment is finished.

Success

With the help of dialectical behavioral therapy, moderate success was achieved. Since patients with borderline syndrome in particular tend to discontinue therapy, it can be assumed that patients who discontinue therapy achieve far better results. It should be noted that dialectical behavioral therapy achieves by far the best results in this area.

Other therapy approaches, such as conventional behavioral therapy, do not have such good long-term results as dialectical behavioral therapy. Especially the integration into the social and professional life seems to be the most successful with the dialectical behavioral approach. This is why this form of therapy has become the gold standard, i.e. the best therapy in this field.

Inpatient or outpatient therapy

At the beginning of the dialectical behavioral therapy, the therapy was performed exclusively on an outpatient basis. In the meantime, there are clinics that specialize in patients with the borderline syndrome and offer a 12-week inpatient dialectical behavioral therapy. Nevertheless, in-patient therapy is always followed by out-patient therapy because it is important to accompany the patient in his familiar environment and to support him in everyday situations.

Which therapy is better, each patient must decide individually for himself. For some patients it is good to be taken completely out of everyday life and instead go to an inpatient facility where trained staff are available day and night should a problem arise. Nevertheless, outpatient therapy is very important in order to enable the patient to resume a daily routine and everyday life.

That is why outpatient group therapy is particularly suitable after an inpatient stay, as the patient can talk openly with other patients about their experiences and feelings. In addition, there is always the possibility to use the telephone service after an inpatient as well as after an outpatient therapy. In most cases this is the therapist who can be called in an emergency (before a suicide attempt or before the patient hurts himself). However, this should only be used if all other skills learned have failed.