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 11641 Kew Gardens Ave in Palm Beach Gardens and by video across Florida; new patients call (561) 437-2199.
Borderline Personality Disorder at our Palm Beach Gardens office
Patients come to the Palm Beach Gardens office for borderline personality disorder treatment from PGA National, BallenIsles, Mirasol, Frenchman's Creek and Frenchman's Reserve, and from nearby North Palm Beach, Juno Beach, Jupiter and Lake Park. The office is at 11641 Kew Gardens Ave, Suite 209, close to The Gardens Mall.
Free surface parking is available at the building, including accessible spaces near the main entrance. The lot is shared with other medical and professional offices, so arrive a few minutes early for your first visit. Patients coming for Deep TMS or Spravato sessions can park in the same lot. Hours are Monday to Friday, 8:00 AM to 5:00 PM, with weekend appointments by arrangement. New patients call (561) 437-2199; existing patients use (561) 402-3971.
Both Deep TMS and Spravato are delivered on site at this office, so a patient who does not respond to medication can move to an interventional option without changing clinics.
Who you will see in Palm Beach Gardens
The Palm Beach Gardens team includes psychiatrists Dr. Louis Velazquez and Dr. Tanya Peguero Estevez, psychiatric nurse practitioner Sophia Schulman and physician assistant Ellington Curtis. Visits in Spanish are available with Tanya Peguero Estevez. Children and teens are seen by Louis Velazquez, Sophia Schulman, Ellington Curtis and Stephanie Mills.
Dr. Louis Velazquez, MD
Psychiatrist · Ages 4 to 80
Sophia Schulman, PMHNP-BC
Psychiatric Nurse Practitioner · Children 7+, adolescents and adults
Ellington Curtis, PA-C
Physician Assistant · Adults and teens 14+
Dr. Tanya Peguero Estevez, MD
Psychiatrist · Adults 18+ · English, Spanish
Stephanie Mills
Clinician · Adults and teens 13+
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 Palm Beach Gardens
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 Palm Beach Gardens
In an emergency, call 911 or go to Palm Beach Gardens Medical Center Emergency Room (3360 Burns Rd, Palm Beach Gardens). The 988 Suicide and Crisis Lifeline is available by call or text 24 hours a day. Jupiter Medical Center Emergency Department and 988 Suicide and Crisis Lifeline are also listed on the Palm Beach Gardens office page.
Frequently asked questions
Who provides borderline personality disorder treatment at the Palm Beach Gardens office?
The Palm Beach Gardens team includes psychiatrists Dr. Louis Velazquez and Dr. Tanya Peguero Estevez, psychiatric nurse practitioner Sophia Schulman and physician assistant Ellington Curtis. Visits in Spanish are available with Tanya Peguero Estevez. 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 Palm Beach Gardens?
Yes. Stedfast Psychiatry providers are licensed in Florida 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 11641 Kew Gardens Ave.
Does the Palm Beach Gardens office take my insurance?
We accept most major commercial plans and Medicare. Call (561) 437-2199 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 Palm Beach Gardens?
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 Palm Beach Gardens patient?
Yes. Deep TMS is delivered on site in Palm Beach Gardens. Spravato is available at Palm Beach Gardens, Palm Beach Gardens and Royal Palm Beach.
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.