Borderline Personality Disorder Treatment
DBT-informed care with consistent physician availability
What Is Borderline Personality Disorder (BPD)?
Borderline Personality Disorder (BPD) is characterized by intense emotional dysregulation, unstable relationships, impulsive behavior, and an unstable sense of self. People with BPD often experience intense fear of abandonment and may engage in self-destructive behaviors during periods of emotional crisis.
Signs & Symptoms
- Frantic efforts to avoid real or imagined abandonment
- Pattern of unstable, intense interpersonal relationships
- Unstable self-image or sense of identity
- Impulsivity in spending, sex, substances, reckless driving, or binge eating
- Recurrent suicidal behavior or self-harm
- Intense emotional episodes lasting hours to days
- Chronic feelings of emptiness
- Inappropriate, intense anger
Treatment Approaches
Dialectical Behavior Therapy (DBT) is the gold-standard psychological treatment for BPD, teaching skills in mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Medications can address co-occurring depression, anxiety, or impulsivity. Dr. Agresti's consistent availability reduces the abandonment-related distress that often derails treatment.
Why Concierge Psychiatry?
With Dr. Agresti's concierge model, you get his direct cell number, same-day prescription refills, and 24-hour appointment availability — with no membership fee. Experience the difference that direct-access care makes.
Learn About Concierge CareFrequently Asked Questions
BPD is highly treatable, and the majority of patients who engage in evidence-based treatment — particularly Dialectical Behavior Therapy (DBT) — show significant improvement. Research shows that up to 85% of BPD patients no longer meet diagnostic criteria after 10 years with treatment. While emotional sensitivity may persist, the destructive behavioral patterns and relationship instability can resolve substantially.
DBT was specifically developed for BPD by Dr. Marsha Linehan. It teaches four core skill sets — mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness — that directly target the emotional dysregulation at the heart of BPD. Unlike traditional talk therapy, DBT provides concrete, teachable skills that patients can use in crisis moments. Dr. Agresti integrates DBT-informed strategies into his psychotherapy sessions.
Splitting is a defense mechanism where people with BPD perceive others as entirely good or entirely bad, with rapid shifts between these extremes. This black-and-white thinking drives the intense, unstable relationship patterns characteristic of BPD. A person may idealize a partner one day and feel completely betrayed the next. Understanding splitting is a key part of therapy, as it helps patients develop more nuanced, stable views of themselves and others.
While no medication treats BPD as a whole, medications can effectively target specific symptom clusters — mood stabilizers for emotional volatility, low-dose antipsychotics for transient paranoia or dissociation, and antidepressants for co-occurring depression or anxiety. Dr. Agresti's expertise in complex psychopharmacology allows precise targeting of these symptoms while avoiding medications that carry addiction risk in this population.
Fear of abandonment is a core feature of BPD, and inconsistent access to care can trigger the very crises that treatment aims to prevent. Dr. Agresti's concierge model — with direct cell access, same-day appointments, and no membership fee — provides the consistent availability that BPD patients need. Knowing their psychiatrist is reachable reduces crisis escalation and supports the stable therapeutic relationship essential for recovery.