Does a borderline disorder always have to be treated inpatient?

No, people with borderline disorder can often be treated on an outpatient basis. It also depends on how difficult the current problems and complaints weigh.

If possible: Outpatient before inpatient

Since the treatment of a borderline personality disorder is usually over a longer period of months to years, a large part of the treatment or the entire therapy usually takes place in the outpatient area.

This is also useful because the treatment is mainly about coping with problems in everyday life and practicing the theoretically learned under normal conditions. In a stationary context, this is only possible to a limited extent.

Therefore, outpatient care is generally preferable and stays in psychiatric institutions should be kept as short as possible.

In case of suicidality always stationary

Sometimes they can not be avoided. In the case of imminent suicidality or other, uncontrollable crises that can lead to self-harm to the person concerned, inpatient treatment is inevitable. It may also be useful to temporarily use medication for relief. This too is easier in a stationary setting and can be better controlled.

Finally, additional comorbidities such as alcohol or drug addiction or an eating disorder may require hospitalization.

The advantage of inpatient care is not only the better opportunities for crisis intervention but also the multimodal treatment concepts and the highly specialized treatment teams. In a psychiatric clinic affected people are treated promptly, receive regular therapeutic discussions and have a diverse selection of sports activities and artistic offerings. A social worker is available for professional and other matters in the environment of those affected.

You can also talk to other people who have the same or another condition. This can be very relieving. Often, contacts develop in a clinic that persist beyond their inpatient stay.

Outpatient care often inadequate

If a person with a borderline disorder has stabilized after a crisis intervention in the inpatient environment, a possible outpatient continuation of the treatment is planned.

Unfortunately, however, the current outpatient care situation is not entirely satisfactory because care structures for "Borderliner" are not available nationwide and nationwide. To date, too few of the outpatient therapists specialize in offering a professional care. There are good concepts that have been developed specifically for the disorder and can also be implemented very well on an outpatient basis.

However, there is still a bit of luck in finding the right therapist to accompany you over a longer period of time and to help you cope with everyday problems.

Authors: Dr. med. Julia Hofmann, Eva Bauer (doctor)