How Digital Tools Are Changing the Way We Treat Borderline Personality Disorder (BPD)

Borderline Personality Disorder (BPD) is a mental health condition that affects emotions, relationships, and behaviors. It often makes managing daily life and interpersonal connections a challenge. While therapies like Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) are effective, they’re not always accessible. High costs, long waitlists, and the lack of specialized therapists can create barriers for people seeking help.

Digital tools—like apps, online programs, and websites—are offering new ways to manage BPD symptoms. These tools are designed to be more accessible and affordable, making treatment possible for people who might otherwise go without help. A 2024 study published in the Journal of Medical Internet Research reviewed multiple studies to examine how effective these tools are for individuals with BPD. This article explores the findings and offers practical advice for those living with BPD and their loved ones.

What Are Digital Interventions?

Digital interventions are mental health tools delivered through apps, websites, or online platforms. These tools are designed to teach skills for managing emotions, improving relationships, and reducing stress. They may include:

• Guided Exercises: Activities that teach users to handle intense emotions or manage stress.
• Lessons on Key Skills: Programs that focus on communication, mindfulness, or distress tolerance.
• Access to Therapists: Some tools connect users with licensed professionals through chat, video, or phone sessions.
• Support Groups: Digital communities where users can share experiences and advice.

Some tools are completely self-guided, while others include professional support. They aim to make therapy more accessible and flexible, particularly for people who can’t attend in-person sessions.

Key Findings from the Study

Digital Tools Reduce Symptoms

The study found that digital tools can significantly reduce symptoms of BPD, particularly emotional instability, impulsivity, and difficulties in relationships. For instance:

• Apps that teach mindfulness exercises help users calm their minds during emotional episodes.
• Guided programs encourage users to pause and think before making impulsive decisions.
• Communication-focused tools improve relationship dynamics by teaching healthy ways to express feelings.

These tools are especially helpful for people who need extra support managing their emotions but can’t access traditional therapy.

Therapist-Supported Tools Work Better

Digital tools that involve therapists or coaches tend to work better than self-guided ones. Regular check-ins with professionals provide accountability, personalized feedback, and encouragement, making it easier for users to stick with the program. For example, some apps offer messaging features that allow users to ask therapists for advice or share progress.

Accessibility Makes a Difference

One of the biggest advantages of digital tools is their accessibility. These programs can reach people who:

• Live in rural or underserved areas with few mental health resources.
• Have limited financial means to pay for traditional therapy.
• Need flexible schedules to fit around work, school, or caregiving responsibilities.

Digital tools remove many of the barriers that prevent people from seeking help, offering a convenient and cost-effective alternative.

Examples of Digital Tools for BPD

If you or a loved one is interested in using digital tools, here are some effective options that can help manage BPD symptoms. Each tool is designed to focus on different aspects of emotional regulation, impulsivity, and relationship challenges:

1. DBT Coach
   • What it does: Offers DBT-based exercises, mindfulness practices, and distress tolerance tools.
   • Where to find it: Available on iOS and Android.
2. Calm Harm
   • What it does: Helps users manage urges to self-harm through distraction techniques and calming activities.
   • Where to find it: Free on iOS and Android.
3. Woebot
   • What it does: A chatbot offering emotional support and evidence-based techniques for managing stress and emotions.
   • Where to find it: Free on iOS, Android, and online.
4. DBT Self-Help
   • What it does: Provides lessons and exercises based on DBT skills, including mindfulness and emotion regulation.
   • Where to find it: Available on Android.
5. BetterHelp
   • What it does: Matches users with licensed therapists for online sessions via chat, video, or phone.
   • Where to find it: Accessible worldwide through its website.

How to Use Digital Tools Effectively

If you’re considering a digital tool, here’s how to make the most of it:

Start Small

Begin with one tool that feels manageable and relevant to your needs. For instance, if you’re struggling with emotional episodes, try an app like DBT Coach or Calm Harm. If you want professional guidance, consider BetterHelp.

Set a Routine

Consistency is key to seeing results. Dedicate 10–15 minutes daily to using the tool. Set reminders or notifications to help you stay on track.

Track Your Progress

Many apps include features to monitor your mood, behaviors, or progress over time. Use these tools to identify patterns and celebrate improvements, no matter how small.

Combine with Traditional Therapy

Digital tools can complement in-person therapy by helping you practice skills between sessions. If you’re not in therapy, these tools can still provide meaningful support while you work toward accessing professional care.

Advice for Loved Ones

If someone you care about has BPD, digital tools can also be beneficial for you. Here’s how you can help:

• Explore Options Together: Research tools with your loved one to find something that fits their preferences and needs. Apps like Woebot or DBT Coach can be great starting points.
• Encourage Regular Use: Gently remind them to use the tool and celebrate their progress. Positive reinforcement can make a big difference in motivation.
• Participate in Activities: Some tools include exercises for loved ones, such as communication or mindfulness practices. Doing these together can strengthen your bond and show your support.

Challenges and Areas for Improvement

While digital tools are promising, they’re not perfect. The study identified some common challenges:

• Dropout Rates: Many users stop using the tools after a few weeks, often due to lack of motivation or feeling overwhelmed. Choosing a simple, easy-to-use tool can help maintain engagement.
• Variety in Quality: Some tools are well-designed and evidence-based, while others lack proper research backing. It’s essential to choose tools recommended by trusted sources.
• Short-Term Focus: Most studies only track users for a few months, so it’s unclear how effective these tools are in the long term.

Why Digital Tools Are Worth Trying

For individuals with BPD, digital tools offer a way to take control of symptoms and start improving daily life. They’re not a replacement for therapy, but they can be a valuable addition, especially when in-person options aren’t available. Their flexibility, affordability, and accessibility make them a practical option for many people.

Loved ones can also benefit by using these tools to better understand BPD and learn how to provide effective support. Whether you’re living with BPD or supporting someone who is, digital tools can help bridge the gap between challenges and meaningful progress.

Reference:
Lindsay, J. A. B., McGowan, N. M., Henning, T., Harriss, E., & Saunders, K. E. A. (2024). Digital Interventions for Symptoms of Borderline Personality Disorder: Systematic Review and Meta-Analysis. Journal of Medical Internet Research, 26, e54941. https://www.jmir.org/2024/1/e54941

‍