Seek a comprehensive evaluation by a licensed mental health professional
Start evidence-based psychotherapy, especially dialectical behavior therapy
Consider mentalization-based therapy, schema therapy, or transference-focused psychotherapy
Treat co-occurring conditions such as depression, anxiety, PTSD, or substance use
Use medications only for specific symptoms or comorbid disorders, as prescribed by a clinician
Build a consistent routine for sleep, meals, exercise, and daily structure
Learn and practice distress tolerance skills
Learn and practice emotion regulation skills
Learn and practice interpersonal effectiveness skills
Learn and practice mindfulness skills
Create a crisis plan for self-harm urges or suicidal thoughts
Reduce alcohol and drug use
Identify and avoid major triggers when possible
Strengthen supportive relationships and boundaries
Attend therapy consistently and complete homework or skills practice
Use peer support or family education when appropriate
Seek urgent help immediately if there is risk of self-harm or suicide