Borderline personality disorder: recognition and management

What should happen in a crisis?

If you are having a crisis and you go to see your GP, they should assess whether there is a risk to yourself or others. They should ask about similar crises in the past and what has helped you to cope with them. Your GP should help you to cope with your anxious feelings, for example by focusing on the immediate problem. They can encourage you to look at any changes you can make in your thinking or behaviour that will help you to deal with the immediate problem. You should be offered another appointment with your GP at a time that is suitable for you.

Your GP may offer you an appointment with your community mental health service if you are getting more distressed or if there is a risk to yourself or others, or if you would prefer to see your community mental health team.

If you see your community mental health service in a crisis, they should follow your care plan (see What happens when I first see a healthcare professional?). They should try to understand the crisis from your point of view, and explore with you why you are distressed. They should be sensitive about why you are having a crisis and encourage you to think about solutions for your problems. They should try to help you to work through your problems rather than immediately offering you a place in a crisis unit or hospital. You should be offered another appointment with your community mental health service at a time that is suitable for you.

You may be offered medication to help you in a crisis for short periods. You should usually be offered only one medicine at a time. Your healthcare professional should explain what the medication is for, how often they should see you while you are taking the medication and how long the treatment should last (usually no longer than a week). They should also discuss with you how to take the medication as prescribed. If the medication does not appear to be helping you, then it should be stopped. You may be offered a psychological treatment if you do not feel better.

Once the crisis has passed you should be offered an appointment to look over your care plan to make sure it is right for you. Your healthcare professional should update your plan with you and your family or carers (if you agree to them being involved) as soon as possible to record any concerns and any treatments that have been helpful or unhelpful.

If during a crisis you need to take medication for longer than a week, your healthcare professional should see you regularly at times that suit you.