Supporting Someone with Borderline Personality Disorder

Supporting someone with Borderline Personality Disorder requires understanding the condition's impact on relationships while establishing healthy boundaries, and professional therapy guidance helps loved ones navigate these complex dynamics while protecting their own mental well-being.

Loving someone feels impossible when every conversation becomes a minefield? Borderline Personality Disorder creates unique challenges for families and friends, but understanding the condition can transform how you support your loved one while protecting your own mental health.

Supporting Someone Close to You with Borderline Personality Disorder

Borderline personality disorder (BPD) can significantly impact not only the individual experiencing it but also those in their support network. Friends, family members, colleagues, and others may face unique challenges when maintaining relationships with someone living with BPD. Understanding these dynamics can help you navigate these relationships while protecting your own mental well-being.

To better comprehend how BPD affects broader social connections, let’s explore the challenges people may face, the causes of BPD, and how to find support as someone who cares about a person with BPD.

Understanding the Origins of Borderline Personality Disorder

According to the National Alliance on Mental Illness (NAMI) California chapter, approximately 3.5 million adults live with borderline personality disorder in the United States. While researchers haven’t identified a single definitive cause of BPD, they generally believe that multiple factors contribute to its development, including genetic predisposition, environmental influences, and social circumstances.

Research indicates that individuals with histories of abuse or neglect may have an increased risk of developing BPD, as may those whose parents faced mental health or substance use challenges. However, it’s important to note that experiencing adverse childhood events doesn’t mean someone will inevitably develop BPD or any other mental health condition.

Some research suggests that individuals with BPD may have functional and structural changes in brain regions associated with emotion regulation and impulse control. However, it remains unclear whether these changes cause the disorder or result from it. Regardless of the cause, it’s crucial to understand that people living with BPD are not at fault for their condition and may not even be aware they have it.

Recognizing the Signs of Borderline Personality Disorder

While the term “borderline” is sometimes used casually in everyday conversation, only licensed clinical social workers and other mental health professionals can diagnose BPD or other mental health conditions.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a person must exhibit at least five of these nine criteria to receive a BPD diagnosis:

• Desperate efforts to avoid real or imagined abandonment
• A pattern of unstable, intense relationships alternating between idealization and devaluation
• Persistent identity disturbances and unstable self-image
• Impulsivity in potentially self-damaging areas (spending, substance use, reckless behavior, etc.)
• Recurrent suicidal behavior, threats, or self-harming behaviors
• Emotional instability due to intense mood reactivity
• Chronic feelings of emptiness
• Inappropriate anger or difficulty controlling anger
• Stress-related paranoid thoughts or severe dissociative symptoms

It’s important to note that BPD typically manifests as a persistent pattern beginning in early adulthood and appearing across various contexts. If someone in your life shows some of these traits only in specific situations, they may not necessarily have BPD.

BPD symptoms typically occur independently of substance use. Additionally, symptoms of autism spectrum disorder (ASD) in women and complex post-traumatic stress disorder (C-PTSD) can sometimes resemble BPD, potentially leading to misdiagnosis if not carefully evaluated.

Licensed clinical social workers and other mental health professionals take care when diagnosing BPD since its symptoms can overlap with other conditions. For example, both BPD and separation anxiety disorder involve fear of abandonment, but individuals with separation anxiety disorder typically don’t experience the identity issues, impulsivity, and interpersonal difficulties common in BPD.

Challenges When Interacting with Someone Who Has Borderline Personality Disorder

If someone close to you lives with BPD, you may experience significant fluctuations in your relationship. They might seem deeply connected to you one moment and distant the next without apparent reason. For instance, if you’re a few minutes late to meet them, they might react with disproportionate anger and suddenly change their opinion of you. This reaction often stems from abandonment fears, which can trigger attention-seeking behaviors. In some cases, people with BPD may resort to self-harm, creating intense pressure on those who care about them.

These relationship dynamics can be extremely difficult for friends, loved ones, and colleagues of people with BPD, especially if they don’t understand that the person has a personality disorder. Even those aware of the diagnosis may struggle to handle mood swings and angry outbursts. They often face uncertainty about how to support the person while maintaining boundaries that protect their own mental health.

Romantic relationships with someone who has BPD can be particularly confusing. The person might idealize you immediately after meeting, make significant demands on your time, and share intimate details prematurely. However, they may abruptly change their opinion if they perceive you don’t care enough about them. Some people with BPD may suddenly end relationships when they fear abandonment.

Challenges for Mental Health Professionals

Licensed clinical social workers who provide therapy to clients with BPD also face unique challenges. Given the fear of abandonment characteristic of BPD, therapists may encounter anger or frustration when ending a session, even though this represents a normal, time-limited separation. Social workers may also worry about clients with BPD, especially if there’s a risk of self-harm, wondering if they’ve done everything possible to ensure safety after sessions.

Research published by Forbes indicates that people with BPD often have a “favorite person” they idealize and depend on for emotional support—sometimes this person is their therapist. This dynamic creates challenges for mental health professionals as they try to help clients with emotion regulation difficulties while maintaining appropriate professional boundaries. Licensed clinical social workers may benefit from their own therapy to develop strategies for effectively working with BPD clients while protecting their own well-being.

Finding Support When Someone Close to You Has BPD

If someone important in your life has BPD, you may find it difficult to manage the relational challenges that often arise. Speaking with a licensed clinical social worker who understands BPD and its impact on relationships can be invaluable.

If your relationship with the person makes it difficult to attend traditional in-person therapy, consider telehealth therapy through ReachLink. With ReachLink’s video-based therapy services, you can connect with a licensed clinical social worker from wherever you have an internet connection. This approach offers greater flexibility and accessibility than traditional therapy models.

Research demonstrates that telehealth therapy can be as effective as in-person therapy. A 2020 study found that digital cognitive-behavioral therapy (CBT) effectively reduced stress and anxiety—common experiences among those supporting someone with BPD. A ReachLink licensed clinical social worker can provide personalized guidance for handling the emotional challenges that arise when caring for someone with BPD.

Takeaway

Relationships with people who have borderline personality disorder can present significant challenges. Friends, family members, colleagues, and even therapists may struggle to support the person while managing their own emotional well-being. If you’re experiencing difficulties related to your interactions with someone who has BPD, remember that you don’t have to face these challenges alone. Speaking with a licensed clinical social worker through ReachLink’s telehealth platform can provide valuable guidance on self-care strategies and effective ways to cope with challenging situations while maintaining your own mental health.