How to Help Someone With Borderline Personality Disorder (BPD)
Key takeaways:
To help a person with borderline personality disorder (BPD), always try to approach them with empathy, validation, and understanding.
Learning about BPD, developing healthy communication skills, and getting your own support are all beneficial when someone you love has BPD.
If a person with BPD is experiencing a crisis, try to remain calm and take appropriate action. If they are at risk of hurting themselves or others, are unable to care for themselves, or are severely injured, seek emergency care.
Borderline personality disorder (BPD) is a type of personality disorder in which a person has difficulty regulating their emotions. People with BPD often experience instability in their mood, relationships, and sense of self. Often these symptoms are related to past trauma or painful childhood experiences.
If someone you know has BPD, you may be wondering how to help. Read on to learn more about what you can do.
What are the best ways to help someone with BPD?
Learning about BPD can help you better understand what your loved one is going through. And seeking out support for yourself can make it easier to provide for your loved one. Read on to learn five additional ways to help a person with BPD.
1. Maintain a calm and supportive environment
A person with BPD often feels like their internal world is chaotic. Maintaining a calm environment can help provide stability and reduce stress.
You can do this by establishing habits and routines at home, such as consistent meals and bedtimes. You can also make sure fun family activities and vacations are balanced with times reserved for rest. Reducing extra stimulation — like loud noises or bright lights — can also be beneficial.
2. Manage your expectations
BPD can be a serious mental health condition. Even after a person gets help, it can take time for them to increase their ability to cope with intense emotions, manage interpersonal communication, and maintain safety.
Ask yourself if you are expecting too much of your loved one. If so, consider managing your expectations or helping them set smaller goals for recovery. Rather than taking a “tough love” approach, encourage them by praising their progress.
And don’t work harder than your loved one. They need to commit to their treatment progress and move at their own pace.
3. Set healthy limits and boundaries
Limits and boundaries are important components of all healthy relationships. People with BPD may struggle with boundaries, pushing against them or experiencing them as rejection.
When setting a boundary, state your limit clearly and firmly. Then be prepared to follow through with it. You can explain why the boundary is necessary. Express care and warmth, and emphasize that the boundary is meant to protect you and your loved one.
Be careful not to enable or protect a person from experiencing the consequences of their actions.
4. Keep an eye on anger
If your loved one directs anger toward you, it can be hard to not feel defensive. But reacting with your own anger will probably make the situation worse.
Instead, try to remain calm, listen, and validate what they are experiencing. Try to remember that the person’s emotions and behaviors have a cause. For example, their anger may be linked to traumatic or invalidating experiences in their past.
Validation does not mean that you have to agree. You can acknowledge the pain your loved one may be feeling even if you don’t think they are seeing things accurately. Encourage your loved one to use coping skills to deal with anger — and you can do the same.
5. Encourage and support treatment
You can also support your loved one by encouraging their treatment journey. Individual, group, and family/couples therapy, along with medication, may all be used to treat BPD.
Dialectical behavior therapy (DBT) is often the first-choice therapy option for BPD. It focuses on developing skills in four key areas:
Mindfulness
Distress tolerance
Emotion regulation
Interpersonal effectiveness
Full DBT involves weekly group and individual therapy sessions. It also includes phone contact with a therapist in between sessions. Your loved one can also elect to just attend weekly DBT skills groups. This can be a good way to develop effective skills while seeing their own individual therapist separately.
Other types of therapy that are evidence-backed to help BPD include:
Mentalization-based therapy
Transference-focused psychotherapy
Schema-focused therapy
There are currently no FDA-approved medications for BPD. But people with BPD who have other mental health conditions, such as anxiety or depression, may benefit from:
Antidepressants
Anti-anxiety medications
Mood stabilizers
What should you not say to someone with BPD?
When communicating with a person who has borderline personality disorder, be clear and direct. But it’s also important to convey empathy and acceptance.
With that in mind, avoid the following:
Taking a harsh or “tough love” approach
Making empty threats
Name-calling
Blaming or shaming the person for their symptoms
Dismissing how they feel
When should you seek emergency care for someone with BPD?
In some cases, people with BPD may require emergency care. The following situations may warrant emergency help:
A person says they have a specific plan for ending their life that they intend to act on within 48 hours.
A person says they want to harm another person and have a plan to do so.
A person has self-harmed and caused serious injury.
A person is unable to care for their basic needs.
When you encounter someone having a mental health crisis, encourage the person to seek help on their own. Suggest they call or text the 988 Suicide & Crisis Lifeline. Or you can offer to take them to the nearest psychiatric emergency room.
If they refuse, call 988 or 911 and explain that the person is having a mental health crisis. If you contact 911, you can request that a crisis intervention training officer (CIT) or another officer trained in mental health be dispatched. Emergency responders will evaluate your loved one and determine whether they need to be hospitalized.
What resources are available for someone with BPD?
More information on BPD and how to get help is available from the following organizations:
National Alliance on Mental Illness (NAMI):NAMI publishes information on mental illness and offers in-person and online support groups. Call their hotline at 1-800-950-NAMI (6264) or text 62640 for help finding treatment or a support group in your area.
National Education Alliance for Borderline Personality Disorder (NEABPD): NEABPD provides information about BPD. The organization also offers a Family Connections program. This free online course teaches family members about BPD and evidence-based practices to support their loved ones.
Mental Health America (MHA): MHA publishes information on BPD and guidance on navigating the treatment process.
Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA’s online treatment locator tool allows you to search for local treatment centers and providers. You can also call the National Helpline at 1-800-662-HELP (4357) to speak to someone about a referral for treatment.
Dialectical Behavior Therapy Providers Directory: The DBT providers directory allows you to search for trained DBT providers and facilities in your area.
The bottom line
Supporting a person with BPD can be challenging, especially because those with BPD may experience interpersonal problems because of their symptoms. When a loved one has BPD, it is helpful to learn more about the condition and about how to communicate effectively. Additionally, maintaining realistic expectations, keeping the environment calm, setting boundaries, and understanding how to handle a crisis are all important.
Why trust our experts?
References
Choi-Kain, L. W., et al. (2017). What works in the treatment of borderline personality disorder. Current Behavioral Neuroscience Reports.
Gunderson, J. G., et al. (2006). Family guidelines.
National Alliance on Mental Illness. (2018). Navigating a mental health crisis.
National Institute of Mental Health. (n.d.). Borderline personality disorder.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
