Caring about someone with borderline personality disorder (BPD) can be difficult. At any given time, your loved one may struggle with emotional regulation, low self-esteem, intense mood swings, and a persistent fear of abandonment. They also might react to stress impulsively, causing you to feel worried about their well-being.
It’s important for you to understand BPD and recognize how this condition affects relationships. Let’s get into what you need to know.
What Are the Signs and Symptoms of BPD?
BPD is a personality disorder that affects mood, behavior, and self-image. In America, the lifetime prevalence of this condition is about 1.4%. Nearly 85% of people with BPD also meet the criteria for another mental health diagnosis, such as a mood, anxiety, substance, or impulse control disorder.
Like all personality disorders, BPD exists on a large spectrum. Milder diagnoses can be harder to detect, whereas more severe conditions may seem apparent very quickly. It’s not uncommon for people to sometimes confuse BPD with other mental health conditions.
That said, the common signs and symptoms of BPD include:
Relationship problems: People with BPD often have intense, tumultuous relationships with others. They may “fall hard” when they meet new people, putting them on pedestals. Their loved ones may describe them as overly needy or clingy. They often seek intense attention from others and may become furious and self-destructive when that need isn’t met.
Impulsivity: BPD often coincides with risky, dangerous behaviors, including substance use, self-harm, disordered eating, compulsive shopping or gambling, and risky sexual behaviors. Many times, this impulsivity occurs during heightened emotional states.
Erratic and intense moods: BPD emotions often feel larger-than-life, and regulation can feel impossible. Someone with BPD may seem content and pleased in one moment, only to become spiteful or enraged soon after.
Chronic feelings of numbness or emptiness: People with BPD often describe feeling a deep void within themselves. This feeling may come from childhood trauma, particularly with early experiences of real or perceived abandonment. They may try to fill that “void” with risky behaviors or intense relationships.
Difficulty with work or school: Because people with BPD often experience difficulties in interpersonal dynamics, they may face issues with teachers, colleagues, and bosses. As a result, they may struggle with their classes or with holding down a job.
Dissociation: Many people with BPD feel out of touch with reality, particularly when they feel triggered. This dissociation can feel like being spaced out or numb. Some people describe it as seeing themselves outside of themselves.
A qualified mental health professional diagnoses BPD. Usually, the provider will conduct a series of assessments to rule out other conditions.
While adolescents can have BPD, most therapists avoid diagnosing personality disorders in people under the age of 18. That’s because teenagers can exhibit developmental traits that mimic BPD.
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What Challenges Do Loved Ones Experience?
Loved ones may experience a combination of frustration, sadness, fear, and confusion over BPD behaviors. The phrase ‘walking on eggshells has become synonymous with loving someone with BPD. In fact, Stop Walking on Eggshells, written twenty years ago, is still one of the most popular books on the topic.
You may relate to this infamous eggshell effect by feeling like you’re always tiptoeing around, trying to avoid rage or confrontation. You might not know what mood your loved one will be in on a given day. You may second-guess what you say or worry that doing the wrong thing will trigger an emotional backlash.
Here are some other challenges you might encounter:
Feeling either loved or hated: People with BPD often cycle through idolizing their loved ones and then devaluing them. During the idolizing phase, it may seem like you are invincible or like you two are soul mates. But the change often happens quickly, and then it can suddenly seem like you do nothing right. If you ask them what happened, they may become defensive or deny it outright.
Needing to provide ongoing reassurance: BPD can coincide with trust issues and paranoia. People with BPD often have histories of betrayal, infidelity, and abandonment, and they may project these fears of repeat offenses onto you. Unfortunately, it may seem like no amount of reassurance you provide is enough.
Having safety concerns: People with BPD often struggle with impulsive or self-destructive behavior. They might threaten suicide, for example, if you leave the relationship. These intense concerns may cause loved ones to feel hopeless or even trapped in challenging dynamics.
Blame and guilt: You may blame yourself for causing or exacerbating distress in your loved one’s life. Sometimes this comes from a place of low self-esteem. Other times, it’s a reaction to being gaslit into believing you legitimately did something wrong. Unfortunately, this mindset often perpetuates more relationship problems.
Making excuses: You might find yourself justifying your loved one’s behavior. For example, you may defend their choices and get upset at other people who confront them. Or, you might reason that they can’t “help themselves.”
How Can You Have a Healthy Relationship With Someone Who Has BPD?
Borderline personality disorder doesn’t mean your relationship is doomed. However, it also doesn’t mean that your loved one has the right to mistreat or take advantage of you. Here are some important tips to keep in mind.
Educate Yourself on the Disorder
BPD is a chronic and pervasive personality disorder. There is no cure, but people can learn to manage their symptoms and live fulfilling lives.
As a loved one, it’s important for you to be informed about the condition. Read up on the signs and symptoms. You may start to notice patterns after a while, and having this insight can help you interact with your loved one in healthier ways.
Furthermore, education helps you recognize that your loved one isn’t intending to act maliciously toward you. Instead, they are struggling with a mental health issue and likely need support.
Learn Their Triggers
It may seem like your loved one becomes reactive to anything. But if you pay close attention, you’ll likely notice certain trends. The most common triggers are related to separation, rejection, and conflict. People with BPD tend to be extremely sensitive to anything that might resemble feeling unloved.
It’s not your job to shield your loved one from all of these triggers. But knowing what might provoke an outburst can help you prepare yourself and ensure that your boundaries are in place.
Honor Your Own Self-Care
BPD can feel tumultuous, and it may seem like there isn’t any space for your needs. At times, a person with BPD might also make you feel guilty for looking after yourself. But your own well-being is paramount, and you can’t sacrifice all your values for your loved one.
Make sure you take time to prioritize engaging in activities that feel meaningful for you. Be aware that your loved one may give you pushback- or act out in a way that makes you feel like they desperately need you. Often, this defensiveness comes from a place of jealousy or fear.
Model Healthy Communication Yourself
It may feel tempting to yell at your loved one after they yell at you. Or, you might feel pressured to respond to their demanding texts right now, even when you’re busy with an important task.
But engaging in toxic or ineffective patterns only reinforces communication problems. Instead, try your best to remain calm even when your loved one acts out. If you need to cool down, walk away for a few moments.
Instead of making accusations, use I-statements to articulate your emotions and needs. For example, I felt hurt when you accused me of cheating on you.
Emphasize Your Desire to Understand
Many people with BPD feel painfully isolated within themselves. They often go through life feeling misunderstood, and that chronic feeling can trigger unhealthy coping mechanisms.
Aim to be clear with your loved one in letting them know that you want to understand their experiences and emotions. Do not make assumptions about how they feel. Let them speak openly and validate their feelings as much as possible. Consider saying, That does sound hard. It makes sense why you feel angry.
Maintain Clear Boundaries
Boundaries are the foundation of any healthy relationship. But they’re especially important when you love someone with BPD. Your boundaries honor your integrity and demonstrate what you will and will not tolerate from others.
Some common boundaries to consider include:
- Not allowing your loved one to criticize or threaten you
- Calling 911 if they make a suicidal gesture
- Taking a walk or pausing before you speak if you feel agitated yourself
- Insisting that your loved one seek treatment if they want to continue living with you
- Refusing to provide financial assistance
- Refraining from allowing them to gossip about other people to you
- Setting limits around how frequently you will communicate with them
- Refusing to lie about their behavior to other people
Keep in mind that boundaries can be challenging to set with BPD. Your loved one may feel like they’re getting punished. They might continue trying to push your limits, and they will likely “split” other loved ones or family members to get someone on their side.
Boundaries are not a singular event. They are a continuous process, and you may need to remind your loved one of them regularly.
Do not set a boundary or initiate an ultimatum that you can’t keep. If you’re unable to maintain consequences, your loved one learns that your boundary is flexible. Therefore, they will likely continue pushing that limit, causing you to feel even more resentful.
Stay Connected to Your Other Loved Ones
Caring about someone with BPD can, at times, feel isolating. When things aren’t going well, you may feel emotionally exhausted. Furthermore, some people with BPD may actually isolate their loved ones due to jealousy or fear of abandonment.
However, it’s important to keep your other relationships intact. Regardless of your relationship- or its current status- you need to have your own support system.
Be Optimistic (And Realistic)
Treatment can be invaluable for someone experiencing BPD. If your loved one is willing to work on their condition and improve how they cope, they may have a great prognosis.
Unfortunately, the opposite can also be true. If your loved one refuses treatment or continues to abuse you emotionally, things may not get better on their own. In fact, they may worsen progressively.
Therefore, like with any mental health condition, it’s important to balance optimism with realism. Support efforts towards change, and try to avoid enabling problematic symptoms when they arise.
Consider Getting Your Own Therapy
If you feel angry, confused, or hopeless about your relationship, you may benefit from talking to a therapist. Loving someone with BPD can be taxing, and it’s important to have a space to process your feelings.
A therapist can help you understand your relationship goals and teach you healthy coping skills for managing your stress. Likewise, they may be able to provide you with specific resources for providing BPD support.
Be an Ally In Their Treatment
You may feel relieved and hopeful if your loved one develops insight into their BPD or decides to get help. Aligning with their treatment plan can keep you both moving forward.
Being an ally for their recovery may mean:
- Driving them to and from therapy sessions
- Helping with medication (if needed)
- Encouraging them to complete any assigned homework
- Reminding them of their coping strategies
- Engaging in couples or family therapy if recommended
Be mindful of the tendency to try to fix, control, or rescue their treatment. You want to support your loved one’s autonomy and avoid doing the work for them.
If you love someone with borderline personality disorder, you might sometimes feel like you’re riding a rollercoaster. Remember that your needs matter and that recovery is possible. Aim to be supportive without enabling problematic behavior.