Is Medication the Best Solution for BPD?

In this episode, I sit down with Professor Joanna Moncrieff, Professor of Critical and Social Psychiatry at University College London and practising consultant psychiatrist, for a conversation that challenges some of the assumptions about mental health, psychiatric diagnosis and medication.

Joanna's work has challenged the idea that psychiatric drugs work by correcting an underlying “chemical imbalance” in the brain. So what does that mean for people with BPD?

Content note: This episode discusses psychiatric medication, depression, suicide, trauma and mental health diagnoses.

⚠️ This episode is for education and discussion, not medical advice. Please don't stop or change any medication without talking to your prescriber. Some medications can cause withdrawal effects if stopped suddenly.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at bpddiariespodcast@gmail.com and let’s keep the conversation going.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT, Schema Therapy, and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

References

Moncrieff, J. (2025). Chemically imbalanced: The making and unmaking of the serotonin myth. The History Press.

Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2023). The serotonin theory of depression: A systematic umbrella review of the evidence. Molecular Psychiatry, 28(8), 3243–3256. https://doi.org/10.1038/s41380-022-01661-0

Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2024). Difficult lives explain depression better than broken brains. Molecular Psychiatry, 29(1), 206–209. https://doi.org/10.1038/s41380-024-02462-3

Stoffers-Winterling, J. M., Storebø, O. J., Pereira Ribeiro, J., Kongerslev, M. T., Völlm, B. A., Mattivi, J. T., Faltinsen, E., Todorovac, A., Jørgensen, M. S., Callesen, H. E., Sales, C. P., Schaug, J. P., Simonsen, E., & Lieb, K. (2022). Pharmacological interventions for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 2022(11), Article CD012956. https://doi.org/10.1002/14651858.CD012956.pub2

Streit, F., Awasthi, S., Hall, A. S. M., Braun, A., Niarchou, M., Marouli, E., Babajide, O., Frank, J., Zillich, L., Callies, C. M., Avetyan, D., Zillich, E., Naamanka, J., Gonzalez, J., Harder, A., Lu, Y., Aherrahrou, Z., Ahmad, Z.-U.-A., Ask, H., ... Witt, S. H. (2026). Genome-wide association analyses of borderline personality disorder identify 11 loci and highlight shared risk with mental and somatic disorders. Nature Genetics, 58(8), 1831–1844. https://doi.org/10.1038/s41588-026-02654-3

I Was Hospitalised Again and Again. Then I Discovered DBT

What does recovery from BPD actually look like?

In this deeply honest conversation, Debbie DeMarco Bennett, better known as Debbie Corso, author of Stronger Than BPD and founder of DBT Path, takes us back to the years when her life was dominated by intense emotions, chaotic relationships, suicidal thoughts and repeated psychiatric hospitalizations.

Debbie talks openly about being misunderstood and misdiagnosed, the stigma surrounding BPD, her eventual diagnosis, and the moment DBT began to change the course of her life.

Debbie also talks about her concerns about the potential risks of the growing reliance on AI for emotional support and why she wants to be part of shaping how we use it safely.

This is a conversation about BPD, DBT, recovery, hope, lived experience, stigma, relationships, AI and what it means to build a life worth living.

Resources & Links

DBT Path
The DBT program offers a 9-month DBT skills class and is designed to make DBT accessible to people worldwide .

Website with Blog: https://emotionallysensitive.com/

Debbie's books (written under her pen name, Debbie Corso):

• Stronger Than BPD: The Girl's Guide to Taking Control of Intense Emotions, Drama, and Chaos Using DBT
• The Stronger Than BPD Journal: DBT Activities to Help You Manage Emotions, Heal from Borderline Personality Disorder, and Discover the Wise Woman Within (co-written with Kathryn C. Holt, LCSW

Other Books Mentioned:

• Self-Compassion Workbook for BPD: Dialectical Behavior Therapy Skills to Find Self-Forgiveness, Healing, and Self-Love with Borderline Personality Disorder by Amanda Smith

• The Deepest Well: Healing the Long-Term Effects of Childhood Adversity by Dr. Nadine Burke Harris, MD

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at bpddiariespodcast@gmail.com and let’s keep the conversation going.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT, Schema Therapy, and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

What if the label everyone's afraid to give a teenager is the one thing that could save their future?

Professor Joost Hutsebaut has spent a career working with young people on the edge of a diagnosis most clinicians won't touch: borderline personality disorder (BPD).

In this episode, Joost explains why he wrote a paper called The Diagnosis That Should Speak Its Name, arguing it's ethically right to diagnose personality disorders in teens. We dig into where a "difficult personality" ends and a disorder begins, the real risks of stigma versus the risks of staying silent, and how his own philosophy - "make therapy simple again" - reshaped the way he practices. He also honestly answers some of the internet's most asked questions.

Whether you're a clinician, a parent, or someone who's ever been told to "wait and see," this conversation reframes early diagnosis as an act of hope, not a life sentence.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at bpddiariespodcast@gmail.com and let’s keep the conversation going.

🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out Empowered Heroes Meditations on ⁠⁠⁠⁠Spotify.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT, Schema Therapy, and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

📚 Referenced Research Includes:

Bomhof, C., Löffler, J. P., Brugman, S., Lodder, P., van den End, A., van Dijk, M. K., ... & Hutsebaut, J. (2025). The effectiveness of generalist (GIT-PD) versus specialist treatment (MBT/ST) for severe personality disorders (Personality Disorders Access to Effective Treatment, P-DAET): study protocol of a pragmatic randomised controlled non-inferiority multicentre trial. BMC psychiatry, 25(1), 1107. https://doi.org/10.1186/s12888-025-07550-4

Clarke, S. L., Soons, N., Videler, A. C., van Alphen, S. P., Van, H., Dil, L., ... & Hutsebaut, J. (2025). The progress in the field of clinical staging for mental disorders within the last decade: an updated systematic review. Frontiers in psychiatry, 15, 1473051.https://doi.org/10.3389/fpsyt.2024.1473051

Hutsebaut, J. (2020). Make therapy simple again. Tijdschrift voor Psychotherapie, 46(2), 96-106.

Hutsebaut, J., Clarke, S. L., & Chanen, A. M. (2023). The diagnosis that should speak its name: why it is ethically right to diagnose and treat personality disorder during adolescence. Frontiers in Psychiatry, 14, 1130417. https://doi.org/10.3389/fpsyt.2023.1130417

Hutsebaut, J., Willemsen, E., Bachrach, N., & Van, R. (2020). Improving access to and effectiveness of mental health care for personality disorders: the guideline-informed treatment for personality disorders (GIT-PD) initiative in the Netherlands. Borderline Personality Disorder and Emotion Dysregulation, 7(1), 16. https://doi.org/10.1186/s40479-020-00133-7

Remeeus, M. G., Clarke, S. L., Feenstra, D. J., Van Eeren, H., Smits, M. L., Debruyne, S., ... & Hutsebaut, J. (2024). The (cost-) effectiveness of early intervention (MBT-early) versus standard protocolized treatment (CBT) for emerging borderline personality disorder in adolescents (the EARLY study): a study protocol for a randomized controlled trial. Trials, 25(1), 261.https://doi.org/10.1186/s13063-024-08095-9

Renneberg, B., Hutsebaut, J., Berens, A., De Panfilis, C., Bertsch, K., Kaera, A., ... & 30 experts with lived experience–clients, relatives, significant others-from 10 European countries. (2024). Towards an informed research agenda for the field of personality disorders by experts with lived and living experience and researchers. Borderline personality disorder and emotion dysregulation, 11(1), 14. https://doi.org/10.1186/s40479-024-00257-0

Whether you've just been diagnosed with BPD or have been living with the diagnosis for years, deciding whether to disclose it can feel overwhelming. Should you tell your partner? Your family? Friends? Your employer? Or is it safer to keep it private?

In this episode, I explore one of the most common and emotionally difficult questions people with BPD ask.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at bpddiariespodcast@gmail.com and let’s keep the conversation going.

🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out Empowered Heroes Meditations on ⁠⁠⁠⁠Spotify.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT, Schema Therapy, and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

📚 Referenced Research Includes:

Brohan, E., Henderson, C., Wheat, K., Malcolm, E., Clement, S., Barley, E. A., ... & Thornicroft, G. (2012). Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace. BMC psychiatry, 12(1), https://doi.org/10.1186/1471-244X-12-11

De Picker, L. (2021). To diagnose or not to diagnose your BPD patient. European Psychiatry, 64(S1), S55-S55.

Ma, R., & Else-Quest, N. M. (2025). Destigmatizing borderline personality disorder with social justice and intersectional cultural humility: How researchers can construct and deconstruct stigma. Feminism & Psychology, 35(1), 3-21. https://doi.org/10.1177/09593535241278213

Masland, S. R., Victor, S. E., Peters, J. R., Fitzpatrick, S., Dixon-Gordon, K. L., Bettis, A. H., ... & Rizvi, S. L. (2023). Destigmatizing borderline personality disorder: A call to action for psychological science. Perspectives on Psychological Science, 18(2), 445-460. https://doi.org/10.1177/17456916221100464

Nault, E. (2025). The Moderating Effects of Disclosure on Bpd Personality Pathology Severity and Workplace Interpersonal Mistreatment (Doctoral dissertation).

Navarre, K. M. (2025). “You sure she's not making this up?”: A qualitative investigation of stigma toward adults with borderline personality disorder in physical healthcare settings. Personality and Mental Health, 19(1), e1646. https://doi.org/10.1002/pmh.1646

Stricker, J., Jakob, L., & Pietrowsky, R. (2024). Associations of continuum beliefs with personality disorder stigma: Correlational and experimental evidence. Social psychiatry and psychiatric epidemiology, 59(9), 1629-1637. https://doi.org/10.1007/s00127-023-02543-8

van Schie, C. C., Lewis, K., Barr, K. R., Jewell, M., Malcolmson, N., Townsend, M. L., & Grenyer, B. F. (2024). Borderline personality disorder and stigma: Lived experience perspectives on helpful and hurtful language. Personality and mental health, 18(3), 216-226. https://doi.org/10.1002/pmh.1609

Villet, L., Madjlessi, A., Revah-Levy, A., Speranza, M., Younes, N., & Sibéoni, J. (2024). The lived experience of French parents concerning the diagnosis of their children with borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 11(1), 13. https://doi.org/10.1186/s40479-024-00258-z

Volkov, I., Sheppard, D. M., Kirk-Brown, A., & Van Dijk, P. (2025). Workplace outcomes after mental health disclosure: the critical influence of supervisor reactions. Journal of Occupational Rehabilitation, 1-12. https://doi.org/10.1007/s10926-025-10352-w

Watts, J. (2024). The epistemic injustice of borderline personality disorder. BJPsych International, 21(4), 78-82. doi:10.1192/bji.2024.16

business.com/articles/disclosing-mental-health-at-work

pursuit.unimelb.edu.au — source for BPD stigma exceeding schizophrenia in healthcare settings.

Helping young people with BPD is 'sexy.' Helping older adults? Not so much. That's the ageism we need to talk about.

In this episode, I'm joined by Professor Arjan Videler - Professor of Psychotherapy in Older Adults at Tilburg University, senior researcher at PersonaCura in the Netherlands, and one of the world's leading voices on BPD across the lifespan.

We cover:
• The 19-year life expectancy gap for people with BPD
• What BPD actually looks like at 70
• The advantage older adults have for recovery
• The ageism in mental health
• How schema therapy and STEPPS are being adapted for older adults
• What 'positive schemas' are and why they matter

And somewhere in the middle, there's a story about a glass of expensive wine in Central Park, a psychologist named Theodore Millen, and how the DSM ended up categorical instead of dimensional.

This is a quiet, profound episode about a population that has been largely invisible in BPD research and public conversation.

If you're 40 or 70, it doesn't really make a difference. It's never too late to heal.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at bpddiariespodcast@gmail.com and let’s keep the conversation going.

🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out Empowered Heroes Meditations on ⁠⁠⁠⁠Spotify.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT, Schema Therapy, and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

📚 Referenced Research Includes:

Conjaerts, J. A., Videler, A. C., Schepman, R., Elfeddali, I., Rosowsky, E., & van Alphen, S. P. (2025). Clinical staging for personality disorders in older adults. Journal of Geriatric Psychiatry and Neurology, 38(1), 32-43. https://doi.org/10.1177/08919887241254467

Ekiz, E., van Alphen, S. P., Ouwens, M. A., Van de Paar, J., & Videler, A. C. (2023). Systems Training for Emotional Predictability and Problem Solving for borderline personality disorder: A systematic review. Personality and Mental Health, 17(1), 20-39.

https://doi.org/10.1002/pmh.1558

Khasho, D. A., Van Alphen, S. P. J., Heijnen-Kohl, S. M. J., Ouwens, M. A., Arntz, A., & Videler, A. C. (2019). The effectiveness of individual schema therapy in older adults with borderline personality disorder: Protocol of a multiple-baseline study. Contemporary clinical trials communications, 14, 100330. https://doi.org/10.1016/j.conctc.2019.100330

van Donzel, L., Ouwens, M. A., van Alphen, S. P., Bouwmeester, S., Bachrach, N., & Videler, A. C. (2025). Integrating positive schemas in schema therapy for Cluster C personality disorders in older adults: A multiple baseline study. Clinical Psychology & Psychotherapy, 32(4), e70121.

https://doi.org/10.1002/cpp.70121

Videler, A. C., Hutsebaut, J., Schulkens, J. E., Sobczak, S., & Van Alphen, S. P. (2019). A life span perspective on borderline personality disorder. Current psychiatry reports, 21(7), 51. https://doi.org/10.1007/s11920-019-1040-1

Videler, A. A., van Royen, R. R., & van Alphen, S. B. (2012). Schema therapy with older adults: call for evidence. International Psychogeriatrics, 24(7), 1186-1187. Doi:10.1017/S1041610211002638

PersonaCura: https://ggzbreburg.nl/over-ggz-breburg/voorloper-in-de-ggz/topklinische-ggz/personacura

Make Therapy Simple Again Article: https://www.researchgate.net/publication/340081785_Make_therapy_simple_again

What if the most effective framework for BPD recovery was written by a former slave and a Roman emperor over 2,000 years ago?

This episode is about Stoicism. Not the pop culture version that means suppressing your feelings and pretending nothing hurts, but the real thing. A practical, rigorous system of thought that maps onto what people with BPD struggle with most.

The impulsivity. The fear of abandonment. The catastrophic interpretations. The feeling of being a slave to your emotions.

I go through ten Stoic principles, each one mapped directly to the BPD experience, grounded in neuroscience. Because this isn't just philosophy. CBT was directly influenced by Stoic thought. DBT was built on CBT. Which means there's a direct line from Epictetus in the first century AD to the skills your therapist may have walked you through last week.

🌱 Have questions, stories, or something you’d like us to cover? We’d love to hear from you. Email us at bpddiariespodcast@gmail.com and let’s keep the conversation going.

🎧 Looking for meditations made for emotional regulation, BPD, and more? Check out Empowered Heroes Meditations on ⁠⁠⁠⁠Spotify.

If you’d like more support in your journey toward BPD recovery, Steff offers 1:1 sessions using evidence-based tools from DBT, Schema Therapy, and Mindfulness to help you heal. Email for a free 30-Minute Consultation:

📩 steff@bpdsupport.org or check out the website: www.bpdsupport.org

📚 Referenced Research Includes:

Aziz, A. (2025). The Application of Stoic Philosophy to Modern Emotional Regulation.

Denny, B. T., Lopez, R. B., Wu-Chung, E. L., Dicker, E. E., Goodson, P. N., Fan, J., ... & Koenigsberg, H. W. (2024). Training in cognitive reappraisal normalizes whole-brain indices of emotion regulation in borderline personality disorder. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 9(8), 819-826. https://doi.org/10.1016/j.bpsc.2024.03.007

Zetsche, U., Bürkner, P. C., Bohländer, J., Renneberg, B., Roepke, S., & Schulze, L. (2024). Daily emotion regulation in major depression and borderline personality disorder. Clinical Psychological Science, 12(1), 161-170. https://doi.org/10.1177/2167702623116070

Stoic Primary Texts (all public domain)

Epictetus. The Enchiridion.

Marcus Aurelius. Meditations.

Seneca. Letters from a Stoic.

Further Reading

Robertson, D. How to Think Like a Roman Emperor: The Stoic Philosophy of Marcus Aurelius.

Robertson, D. Stoicism and the Art of Happiness.

Holiday, R. The Obstacle is the Way.

Waltman, S. The Stoicism Workbook.