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Warning-sign checks

Borderline personality disorder: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    A treatment plan should explain who to contact during office hours, what to do outside those hours, and when emergency services are needed.

    After a crisis or emergency visit, timely follow-up can help review the trigger, update the safety plan, and reconnect the person with ongoing treatment.

    Immediate danger, a suicide attempt, a severe injury, or an inability to stay safe requires urgent or emergency help rather than waiting for a routine visit.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Does any of this apply?

    Book an appointment

    Routine follow-up allows the person and clinician to review symptoms, safety, relationships, daily functioning, and progress toward treatment goals.

    Visits may also address physical health, substance use, sleep, and any medicine side effects.

    Routine concerns to raise at an appointment include increasing emotional instability, more frequent self-harm urges, medication problems, substance use, worsening relationships, or difficulty attending therapy.

The article also says

If therapy does not feel helpful, discuss the reasons before stopping when possible.

The approach may need to change, goals may need to become clearer, or a different therapist may be a better fit.

Medicines should not be stopped suddenly without speaking to the prescriber, because some can cause withdrawal symptoms or a return of the condition they were treating.

Every sign above is quoted from the sofidex article on Borderline personality disorder. If you are not sure, err upward — it is always reasonable to be checked.