Supporting Someone with Borderline Personality Disorder

By Laura Greenstein | Jun. 23, 2017

 

“The things I struggle with the most are the feelings of abandonment, feeling like people are always mad at me, the self-hatred and self-harm.” says Katie, who lives with Borderline Personality Disorder (BPD). You might notice these symptoms are all related to relationships—with others and herself. This is not a coincidence.

Intense relationships, fraught with conflict, are the hallmark of BPD. And while it’s difficult for someone with BPD to develop, manage and keep meaningful relationships, it’s essential for them to have support and encouragement for recovery.

So, for those helping a loved one manage their BPD: Yes, their symptoms will most likely affect you and your relationship won’t always be easy. However, it’s important to keep in mind that BPD is not an easy mental illness to experience either. Your stable, reassuring presence in the life of someone experiencing BPD can help them get better. Here are some suggestions on how to further provide effective support, straight from people who live with BPD.

Encourage and Understand Treatment

BPD is not an easy condition to treat, but it is treatable. There are specific options designed for this condition, such as Dialectical Behavior Therapy (DBT). Help your loved one enter and/or stay in treatment. Once they are in treatment, learn the language of that program and use it to offer support in times of need. For example: Learn the basics of the four skills of DBT—mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation—and how you can help your loved one practice them.

Show You Appreciate Your Loved One

Someone with BPD may go out of their way to do things for you and make you happy because they want to receive love and affirmation in return. Relationships can become turbulent when a person with BPD feels unappreciated: “If we don’t get the recognition we think we deserve, then we’ll start to feel like we hate [the people we love], because they didn’t give you that feeling that you had helped them or did what they wanted,” says Katie. You can combat this by showing your loved one you appreciate them and the things they do to make you happy. Individuals living with BPD are often looking for honest validation and love—so if you feel it, be open about it.

Be Prepared for Mixed Messages

A person with BPD can go from loving and adoring you (idealization) to being furious and “hating” you (devaluation) in a matter of hours. Even when they do “hate” you, they will still carry an overwhelming fear that you will abandon them. “My relationships were very volatile…I was terrified people wouldn’t listen to me, or understand me, or that they would just leave me,” says Robert about his onset of BPD.

When these fears arise, be ready to offer comfort with a meaningful reassurance: “I understand that your feelings are overwhelming right now; I understand that you feel afraid that I will leave you. But I won’t. We will get through this and I support you.”

Be Responsive

When a person with BPD is trying to reach out or contact you, it’s helpful to be as responsive as possible. If a friend or loved one doesn’t respond, a person with BPD can feel rejected and internalize that as something being “wrong” with them. As Katie describes it, “Everybody needs to be there for you and everybody needs to love you. And if they don’t, then you start blaming them, but you also start hating yourself. You start thinking, ‘What did I do to keep them from liking me?’”

This can lead to self-hatred and destructive behaviors. It’s very difficult for a person with BPD to handle conflict or rejection because they blame and punish themselves. This is one of the reasons why self-harm is often associated with BPD; 75% of people with BPD will cut, burn, bruise, bite or hurt themselves in some way. This is not to say it’s your fault if a person self-harms, but being responsive and kind can make all the difference.

Understand It’s Not Their Fault

BPD is known to add immense stress to relationships. It can be challenging—even impossible—for a person to manage their symptoms in a way that doesn’t affect the people close to them. So when symptoms do flare, remember that they don’t have control—literally. This condition is defined by its lack of regulation, or control, over emotions, thoughts and behavior. You wouldn’t blame a loved one for having cancer symptoms that might spill into everyday life, so don’t blame someone for having a mental illness with active symptoms.

 

Laura Greenstein is communications coordinator at NAMI.

Comments
Mary
I think my daughter-in-law may have this and I'd like to know better how to help her. Thanks.
9/28/2017 7:40:04 PM

Judy Bou Kheir
I am a mother of a 28 year-old female who shows symptoms in all diagnostic criteria for Borderline Personality Disorder. When my youngest when to college 4 years ago, I went to graduate school for a Masters in counseling. Little did I know then that I would spend the last two years of my graduate program, diagnosing my own daughter. It's heartbreaking for families to see their loved one suffer, and yet that loved one attacks the very people who care and are trying to help. Through my short time understanding this illness, I believe if I want to help my daughter, I better get a clear understanding of what's going on with her, and arm myself with tools that help me! My counseling skills have helped a great deal in relating to her, but I'm still human. My three courses of action right now are to communicate with her more clearly, avoid my own reactionary behaviors to her mood swings and outbursts, and set clear and defined limits with her to keep me sane. I would love to have any information someone has about family support groups for this illness. I think it's paramount for the loved ones to have support.
9/23/2017 6:59:11 AM

Cynthia McKinnon
My 40 yo stepson has dx of BPD, PTSD, and now BPD.
He has a lengthy criminal record, participates in therapy and takes medications only when court mandated.
We support him completely . He lives in a building at my husban's workplace .
Over the last year my husband decided to help him realize his dreams of having a small farm and has purchased 3 vehicles , 3 pieces of land and ? $20K of various building materials etc.
If anything behavioral issues are worse and include daily rages , loud crying , screaming and threatening himself and others .
We are physically and emotionally exhausted by this unrelenting stress , unbridled emotion and inability to have any real impact.
We attempted to get court ordered treatment but after ( court mandated ...after ? 5 th domestic violence , threatening , burglary , disturbing the peace charge) that was denied we met with the Public Fiduciary and Social worker as well as a counselor who saw him 13 years ago.
They all suggested we give him one week to move out in order that he :
1. Be forced to seek psychiatric help
2. Be forced to seek regular employment ( he only works when he wants something .. a new truck now ...but will NOT seek out regular employment as he will not work for less than $20/hr ..!!!).
3. Allow him to experience real life consequences for his actions/ lack of actions.

He IS capable of controlling the tantrumming as I forbade him this behavior 15+ years ago assuring him I would immediately call the police and bring charges.

Does anyone have experience with these disorders in co existence ?
And experience of in stopping support ?
We will of course continue to communicate but immediately leave or hang up when he begins his behavior.

Thank you for any response .
Cynthia
9/20/2017 10:10:52 AM

Diane Howard
Hello, I didn't realize comments were necessary to be approved for subscription. I have a 18yo son who just recently came home from 17mo RTC. He has slipped off his meds (since he was better didn't seem to see the need) and his BPD is back in full force! I am walking on eggshells! I am providing love and support, but not sure how to initiate conversations. I hope this blog will help me feel less isolated and maybe a bit more empowered
8/26/2017 11:00:16 AM

Diane Howard
Hi
8/26/2017 10:56:02 AM

Anita
After plowing into a brick wall, my daughter finally realized she needed help. She was sexually assaulted in her 1st semester of college last fall. She spiraled into major depression. I didn't know how bad as she was living on campus 2 hrs away. She ended up drinking a lot and getting an underage drinking citation. After that I really tried to get her to agree to get help. She transferred schools for spring and when she came home in may, we had her set up to go to a Psychiatrist. I researched things and sent a letter with traits I've seen to point the Dr in a direction. She was diagnosed with PTSD from the assault and in addition, BPD and Episodic Mood Disorder. I was so mad at myself for not realizing the trauma from the assault. She's on medication and will be starting treatment for the BPD. I have found these comments about helping very helpful because she isn't able to tell me what she needs from me. I am going to access some of the suggestions here and I am grateful I found these comments. Positive thoughts to everyone here!
7/31/2017 2:35:12 PM

John Mader
Kimberly and others interested in DBT Programs for Teens, please go to http://www.practiceground.org/dbt-therapist-wiki/
You will find a table of information. Scroll down until you see the heading "
DBT ADHERENCE, CASE FORMULATION, SKILLS, MODELING CLIPS, HANDOUTS & MORE" and look for "DBT Teen Residential Programs List" that links to a 4-page document - a compiled list of DBT residential programs for teen patients which are adherent to the Linehan Model. Unfortunately not all BPD programs offer DBT and some that do lack key elements necessary to gain the results achieved by programs that are adherent with the Linehan Model.
7/15/2017 1:45:57 PM

Kimberly
The article on this post was very informative and touching it brought tears to my eyes. My daughter started to exhibit these signs early adolescence the age of 13. She has gone through so much bullying, onset of a broken family plagued by divorce, and hidden trauma at the hands of her half brother. It's by the Grace of Our Havenly Father she is still alive, and in long term residential treatment. I read an article on NAMI website, depicting the Stigmatization of the Mental Health Community treating cases of BPD. My daughter they would not diagnose her at that early age, and still will not; even, when she is about to turn 18 in the next 4 months. I agree with the research done in that articles, stating some clinicians look at BPD as hopeless because their symptoms are extreme emotional instability, and other underlying symptoms attached with BPD. Also, less not forget that their illness is among the highest in suicide fatalites. There bais toward BPD patient makes them feel patient can control their symptoms, unlike other mental illnesses. Moreover, the issues from that article are the problems my daughter is having in her current treatment. After three months of treatment they want to discharge my daughter. On 7-6-17 she experienced both visual and auditory hallucinations associate with BPD. Please respond!
7-11-17 @ 5:00am
7/11/2017 5:01:03 AM

B.
I'm 38 years old and just now realizing this may be my disorder. My actions and reactions indicate that. I have been to therapy, I have had traumatic experiences in my past I believe are contributors along with genetic pre-disposition.

My advice to people dealing with those of us suffering from this disorder is patience over all other options. Listening without judgment and not interrupting with "solutions" in some way. If others are like me, I am infuriated by the suggestions because I have contemplated every solution and nothing seems to help in moments of confusion. I completely shut down and stop communicating if I am feeling "judged" or like I haven't tried to do everything in my power NOT to feel the way I am feeling. Counseling does help. For me, anti-depressants have helped but I struggle with keeping on them when I start to feel better, which I think is common.

"Silent Treatment" I can understand. When I'm in the depressive mode, I don't want to talk to anyone. It feels like I can't say anything right. I have an extremely hard time verbalizing anything clearly, so for me...writing is best. Be open to communicating in that fashion and let them know it is acceptable to communicate that way.

Just my humble opinion and feelings from someone beginning to realize that this might be my struggle to overcome in life, if that is possible. I am working on it.
7/6/2017 3:45:05 AM

Peg Morrison
Great information. Thank you.
7/5/2017 10:07:33 AM

Traci
Much appreciated!
7/5/2017 3:43:41 AM

John Mader
Along with the tremendous resources to be found at www.borderlinepersonalitydisorder.com/family-connections/ and other pages on the NEABPD website, we use Shari Manning's book, Loving Someone with BPD. She addresses several of the questions posted here by helping to sort out where behaviors like "silent treatment" are coming from. DBT emphasizes the importance of understanding the function of behavior to begin to know how to more effectively respond.
7/2/2017 5:10:02 PM

Donna Marie
This article holds much truth to how we with BPD internalize rejection and abandonment. This explains very clearly the reasons for our suicidal ideation or tendencies. It's not always that we feel we must be bad people or that we are unlovable... but we have hearts so huge and such a strong desire to not only give love and affection, but also to receive it...and when we dont, the feelings of loss and loneliness are too strong to accept being able to live in a world where everyone walks away from us. I hope to see many other writings explaining this to those we love so dearly.
7/1/2017 4:38:40 AM

Donna Neuman
Hi! Thank you so much for your comments. I was diagnosed with Bipolar Disorder at age 26. I remained in denial until 46. Even with treatment though, both individual and group therapy, staying on my meds and living an honest program, my emotions continued to be all over. It was exhausting!! I remained consumed with suicidal ideation. It was awful. My psychiatrist added Borderline Personality to my diagnosis and sent me to a DBT group.....it is literally saving my life! It is intense, but worth it! I also have been blessed with a family and friends who have never forgotten about me or stopped supporting me no matter how often I went off the grid!!! Good luck and peace to all!! You are NOT alone!!
6/30/2017 12:26:35 PM

Libby
How do I ask my niece to be more open and specific about her diagnosis when she hasn't told her family more than that she struggles with a chemical imbalance depression and drug/alcohol addiction. I want to be more supportive but its difficult to know how to react to her anger when I/we don't know her diagnosis. I am researching BPD and Bipolar disorder and she is possibly suffering from either of these. HELP
6/29/2017 3:43:35 PM

MaryJo
All great information but what if your family member has no income and the only health insurance is state provided medical? All the in-patient programs are either private pay or don't accept the state insurance. So I either need to find $30,000 to cover the first 30 days of treatment. Issue has never been will she accept treatment it has ALWAYS been ACCESSING treatment. Why is this okay. Would you deny someone suffering with cancer, heart condition or diabetes from medical care???
6/28/2017 4:01:53 PM

Kate
Also, check out the family connections page of NEABPD. It reduced our anguish significantly. That, in turn, helped our BPD daughter improve. There is hope! http://www.borderlinepersonalitydisorder.com/family-connections/
6/28/2017 6:56:45 AM

Ryan Robinson
The information is very helpful. Now I can take the next step to help others. Thank you!
6/27/2017 7:27:07 PM

Meredith
This post really redonated with my current situation at home. I feel helpless and lost.
6/27/2017 5:11:16 AM

Adele Kaber
Would like to know more -if I read this my eldest daugter surely jave this
6/26/2017 7:04:02 PM

Stacey M.
Good read. Life is extremely difficult for me and a never ending nightmare for my husband who most certainly has BPD (previously diagnosed with MDD and PTSD) Best we can do is sliding scale clinics with PAs that can't do much to help in 10-15 mins. I get to my wits end with the situations that we end up in and then I read an article like this one and I remember that it's not his fault and he needs my support. Thanks!
6/26/2017 6:46:45 PM

Tammy Wilson
I want to thank you from my entire heart, I have been assuming I understood what my daughter has been going through I had my guard up thinking she was manipulating me I wish i had information long ago I am ashamed she is in the hospital now getting help so I want to get help to be the better mom she needs. Thank you
6/24/2017 11:49:57 AM

John
What about the silent treatment as a sign or behavior? It is extremely painful and we are trying our vest to stay with our adult child. We have no idea whether she is even reading our e-mails to her, so what is your insight about the silent treatment? Please elaborate.
6/23/2017 1:41:59 PM

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