In recent years, there has been an increasing focus on the importance of mental health and its impact on overall well-being. Mental health conditions can affect anyone at any time, and seeking help and support is crucial to managing these conditions. At nspm, we understand the importance of creating accurate, reliable and informative content to support individuals and communities. In this second post in a series of articles, we asked Associate Medical Writer Liam Mealey to explain his experience with treating mental health patients in his previous role as a general medical practitioner.

Emotionally unstable personality disorder – identifying a gap in understanding

As a former general medical practitioner, I was well aware of the importance of staying informed about the latest and most effective therapies available to patients. It was essential to conduct research and keep up-to-date with the latest findings. I could then share this knowledge in an easy-to-understand way.

Emotionally unstable personality disorder, also known as EUPD or borderline personality disorder, is a chronic mental health condition that can significantly impact individuals’ lives, affecting their ability to work, regulate emotions, and establish relationships.1 Sadly, up to one in ten people with EUPD die by suicide.2 Along with EUPD, patients may also experience major depressive disorder (MDD), characterized by low mood, fatigue, and anhedonia.3

While researching, I noticed a gap in our understanding of how to treat MDD in patients also diagnosed with EUPD. Consequently, I examined all available research on this topic and summarized it as part of a university project, posing the question, “What is the most effective treatment for patients with both MDD and EUPD?”

The findings were:

  1. Dialectical behaviour therapy (DBT), which focuses on teaching individuals skills to manage intense emotions, improve relationships and reduce self-destructive behaviours, has been studied the most out of all the treatments available. It may help patients with MDD in EUPD, however this difference may not be noticeable to patients. DBT is an intensive talking therapy and involves meeting with a therapist several times a week over the course of a year.
  2. There are other talking therapies available that require less time commitment from patients, but they have only been tested in a small number of patients so far. Further research is needed to see how helpful they are in these circumstances.
  3. It can be difficult to tell apart the symptoms caused by MDD from those caused by EUPD – this makes measuring improvement more complicated.

This research helped me to aid patients with EUPD in making more informed decisions about their treatment.


  1. Skodol, A. E. et al. (2002). Functional impairment in patients with schizotypal, borderline, avoidant, or obsessive-compulsive personality disorder. The American journal of psychiatry, 159(2), 276–283.
  2. Paris, J., & Zweig-Frank, H. (2001). A 27-year follow-up of patients with borderline personality disorder. Comprehensive psychiatry, 42(6), 482–487.
  3. Black, D. W. et al. (2004). Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention. Journal of personality disorders, 18(3), 226–239.