Borderline personality disorder involves intense, rapidly shifting emotions, unstable relationships, fear of abandonment, impulsivity and often self-harm. The primary treatment is structured psychotherapy, especially dialectical behavior therapy (DBT), with medication used to target specific symptoms such as mood instability or impulsivity. Most people improve substantially, and the majority achieve remission over time. Stedfast Psychiatry treats borderline personality disorder at 25 Clarks Summit Drive in Bluffton and by video across South Carolina; new patients call (561) 234-4547.
Borderline Personality Disorder at our Bluffton office
Patients come to the Bluffton office for borderline personality disorder treatment from Old Town Bluffton, Sun City Hilton Head, Hampton Lake, Palmetto Bluff and Rose Hill, and from nearby Hilton Head Island, Okatie, Hardeeville and Ridgeland. The office is at 25 Clarks Summit Drive, Suite F201, close to Tanger Outlets Hilton Head.
New-patient scheduling for Bluffton runs through (561) 234-4547. Existing patients reach the office directly at (854) 800-2740. Free surface parking is available at the building, with accessible spaces near the entrance. If a same-week in-person slot is not open, a video visit with the same provider usually is.
Stedfast Psychiatry's Deep TMS and Spravato programs are open to South Carolina patients: the evaluation, screening scales and insurance authorization are done at the Bluffton office or by video, and treatment sessions are scheduled at our Florida treatment centers. Your Bluffton provider will tell you plainly whether a treatment course is practical for you.
Who you will see in Bluffton
The Bluffton team includes psychiatrist Dr. Josh Walters and physician assistant Amanda Skipworth. Children and teens are seen by Savanna Smallwood-Corcoran and Josh Walters.
Savanna Smallwood-Corcoran
Clinician · Ages 5 to 64
Amanda Skipworth, PA-C
Physician Assistant · All ages
Dr. Josh Walters, MD
Psychiatrist · Adolescents through older adults
Signs of borderline personality disorder
- Frantic efforts to avoid real or imagined abandonment
- Intense, unstable relationships that alternate between idealizing and devaluing
- Unstable self-image or sense of who you are
- Impulsive behavior in areas like spending, sex, substance use, driving or eating
- Recurrent self-harm, suicidal threats or attempts
- Intense mood shifts lasting hours to a day
- Chronic feelings of emptiness
- Intense anger that is hard to control
How we diagnose it
We diagnose BPD through a careful clinical interview focused on long-standing patterns rather than the current crisis: how relationships typically go, how you react to perceived rejection, how quickly moods change and what triggers them, impulsivity, self-harm and suicidal behavior, and your sense of identity. The McLean Screening Instrument for BPD is a useful screen, and we may use the structured interview for personality disorders. Distinguishing BPD from bipolar disorder is central: BPD mood shifts last hours and are triggered by interpersonal events, while bipolar episodes last days to weeks and arise more autonomously; the two can coexist. We also assess for PTSD and complex trauma, depression, ADHD, eating disorders and substance use, all of which are common companions and change the plan. A safety assessment is part of every visit.
About 1.4 percent of US adults have borderline personality disorder in a given year.
Source: NIMH, National Comorbidity Survey Replication
Roughly 75 percent of people diagnosed with BPD are women, though community studies suggest the true gender gap is smaller.
Source: American Psychiatric Association, DSM-5-TR
In long-term follow-up studies, about 85 percent of people with BPD achieved remission within 10 years, and most did not relapse.
Source: McLean Study of Adult Development (Zanarini et al., 2012)
Dialectical behavior therapy reduces suicide attempts, self-harm and psychiatric hospitalizations compared with treatment by community experts.
Source: Linehan et al., Archives of General Psychiatry, 2006
Treatment for borderline personality disorder in Bluffton
Medication management
No medication is FDA-approved for BPD, and medication does not treat the disorder itself, but it can reduce specific symptoms while therapy does the core work. SSRIs such as sertraline or fluoxetine help when depression or anxiety is present. Low doses of atypical antipsychotics such as aripiprazole or quetiapine can reduce anger, impulsivity and stress-related paranoia. Lamotrigine or topiramate are sometimes used for mood instability and impulsivity, with mixed evidence. We avoid benzodiazepines, which worsen impulsivity and disinhibition, and we keep regimens simple because polypharmacy is a common problem in BPD and increases overdose risk. We prescribe limited quantities when safety is a concern and review each medication's usefulness regularly, stopping what is not clearly helping.
Psychotherapy
Psychotherapy is the primary treatment for BPD. Dialectical behavior therapy (DBT) has the strongest evidence and teaches four skill sets: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness, typically through weekly individual therapy plus a skills group over six to twelve months. Mentalization-based treatment, schema therapy, transference-focused psychotherapy and good psychiatric management are also effective. Our therapists provide DBT-informed individual therapy and we refer to full DBT programs with skills groups and phone coaching when that level of care is needed. Therapy is where the reduction in self-harm, hospitalization and relationship chaos happens, and medication is the support, not the reverse.
What to expect
The first visit is a 60-minute evaluation, in person or by video, that focuses on long-term patterns as well as current symptoms. You leave with a diagnosis explained in plain terms, a therapy plan, a safety plan, and medication if a specific symptom warrants it. Psychiatric follow-ups are every four to eight weeks; therapy is weekly. We coordinate closely between prescriber and therapist, because consistency between providers is itself part of effective BPD care. Telehealth is available across Florida and South Carolina for both medication visits and therapy.
The complete guide, including causes, subtypes and research, is on our Borderline Personality Disorder page.
Emergency and crisis resources near Bluffton
In an emergency, call 911 or go to Coastal Carolina Hospital Emergency Department (1000 Medical Center Dr, Hardeeville). The 988 Suicide and Crisis Lifeline is available by call or text 24 hours a day. Hilton Head Hospital Emergency Department and 988 Suicide and Crisis Lifeline are also listed on the Bluffton office page.
Frequently asked questions
Who provides borderline personality disorder treatment at the Bluffton office?
The Bluffton team includes psychiatrist Dr. Josh Walters and physician assistant Amanda Skipworth. Every provider works under psychiatrist oversight and the same evaluation standard: about an hour for a first visit, validated screening scales, and a written plan.
Can I be seen by video instead of coming to Bluffton?
Yes. Stedfast Psychiatry providers are licensed in South Carolina and offer video visits for evaluations and follow-ups. Some situations, including certain controlled-substance prescriptions and first visits for young children, require an in-person appointment at 25 Clarks Summit Drive.
Does the Bluffton office take my insurance?
We accept most major commercial plans and Medicare. Call (561) 234-4547 with your member ID and we will verify benefits before the visit. Self-pay new-patient evaluations are $185.
How soon can a new patient be seen in Bluffton?
Most new patients are scheduled within one to two weeks. If you need to be seen sooner, ask about a video visit; those often open up within days. If you are in crisis, call or text 988 or go to the nearest emergency room rather than waiting.
Can I get Deep TMS or Spravato as a Bluffton patient?
Yes. Stedfast Psychiatry is licensed for both. Your Bluffton provider does the evaluation and the prior authorization; treatment sessions are scheduled at our Palm Beach Gardens TMS center and the Palm Beach Gardens Spravato rooms.
Is BPD the same as bipolar disorder?
No, although they are often confused. Bipolar disorder involves mood episodes lasting days to weeks that come on largely independent of events. BPD involves mood shifts lasting hours to a day, usually triggered by interpersonal events like perceived rejection, along with unstable relationships, identity disturbance and fear of abandonment. Bipolar disorder responds to mood stabilizers; BPD responds to structured therapy. About 10 to 20 percent of people have both, and a careful history sorts it out.
Is borderline personality disorder treatable?
Yes, and the outcomes are better than most people, including some clinicians, believe. In the largest long-term study, 85 percent of patients reached remission within 10 years and most stayed there. DBT and other structured therapies substantially reduce self-harm, hospitalization and emotional chaos within a year. The 'untreatable' reputation comes from an era before these therapies existed.
Nearby Stedfast offices
If you are in crisis, call or text 988 or go to the nearest emergency room. Educational content; individual results vary. Reviewed by Dr. David Husted, board-certified psychiatrist.