Tips for Friends and Family Members of Persons with Borderline Personality Disorder
If your friend or family member has been diagnosed with borderline personality disorder, here are some tips to help you cope and maintain the relationship.
Tip #1: Knowing the symptoms and possible causes of Borderline Personality Disorder (BPD) can help you better understand your loved one.
First, learn to spot the symptoms. Those diagnosed with Borderline Personality Disorder (BPD) meet five or more out of nine diagnostic criteria and tend to have problems in five main areas.
Emotion regulation
Emotion regulation is challenging as individuals vacillate between intense highs and lows, depressed mood, heightened anxiety, and anger.
Interpersonal Dysregulation:
Interpersonal relationships may suffer because BPD patients sometimes fear real or imagined abandonment by loved ones and fluctuate between idealizing or devaluing friends and family.
Self-Dysregulation:
Negative or unstable self-image may lead to reports of identity disturbance or distorted sense of self.
Behavioral Dysregulation:
Risky behavior such as self-harming and threats or attempts of suicide by those diagnosed with BPD can be scary for loved ones to experience. Additionally, individuals may engage in risky behaviors related to sex, stealing, reckless driving, etc.
Cognitive Dysregulation:
At times, interpersonal paranoia or dissociative symptoms such as reports of feeling detached from one’s body or emotions can occur.
Next, while the exact cause of BPD is unknown, research suggests that certain factors may increase risks for individuals.
Biological factors such as having a close family member with BPD may increase the likelihood that an individual may develop it, too. Some research shows that sensitivity, reactivity, slower return to baseline, and impulsivity found in individuals diagnosed with BPD may have biological bases as well.
Environmental factors such as childhood trauma, physical or sexual abuse, or separation from parents at a young age may also contribute to developing the disorder.
Tip #2: Living with someone diagnosed with BPD may bring about challenging feelings and questions for you.
For example, you may experience one or more of these commonly reported feelings and accompanying thoughts or questions:
Guilt: Perhaps you feel like “I’m not doing enough” or “My loved one’s behavior is my fault” and feel like it is up to you to care exclusively for your loved one.
Shame: You may worry about how others view you and/or your loved one diagnosed with BPD and feel embarrassment, which may lead to isolation. “No one can find out what’s really going on at home” or “People are judging me for my loved one’s behavior” might be messages playing in your mind.
Fear and worry: Those diagnosed with BPD may self-mutilate and threaten or attempt suicide. “What if they hurt or kill themselves?” or “What happens to him/her if symptoms get worse?” are normal concerns due to the unpredictable nature of self-harming attempts.
Anger: Sometimes, patients diagnosed with BPD have angry outbursts directed towards loved ones. In response, you may ask “How can s/he treat me this way?” or feel like retaliating “One more outburst and I’ll lash out too!” Anger may also prompt urges to avoid your loved one, which could elicit even stronger reactions.
Tip #3: Building support for yourself can help you cope more effectively and provide better support for your loved one diagnosed with BPD.
Keep these three ideas in mind:
Tap into your community. While it may be tempting to isolate yourself due to some of the painful feelings and thoughts mentioned above, try building a support system by reaching out to friends, hobby/interest groups, volunteer organizations, or local churches and synagogues to build and maintain meaningful connections with other people.
Invest in self-care. You may find it challenging to care for your loved one if you are feeling run down or tired. Try to be well-rested, eat a balanced diet, exercise, and set aside time for leisure. It is also a good idea to seek therapy for yourself in order to acquire skills to manage your own reactions and to be more effective in the relationship. For example, it can be extremely difficult to set limits with your loved one.
Try DBT skills training group for friends and family. DBT (Dialectical Behavioral Therapy) is an evidence-based therapy specifically designed to treat individuals diagnosed with BPD. DBT Skills training walks participants through four modules of Emotion Regulation, Interpersonal Effectiveness, Distress Tolerance, and Mindfulness with targeted exercises to help increase day-to-day coping skills. Joining a Friends and Family DBT Skills Group can help you learn the skills your loved one is learning in a safe and supportive environment.
At FRTC, our “friends and family” group (for those who love someone with BPD) starts in January. If you are interested, contact us today and we will get you more information.
