How to deal with someone who has borderline personality disorder?

How to Cope When a Partner or Spouse Has Borderline Personality Disorder

Finding Relief if You’re Facing Relationship Problems Due to Borderline Personality Disorder

Gerry Surrency, a board-certified advanced practice psychiatric mental health nurse practitioner with North Florida Medical Associates in Orange Park, Florida, who provided therapy for the couple, says identifying Stephanie’s symptoms, validating them with Jerome, and then deciding on the best intervention was key in helping them improve their relationship.

Surrency and other experts say that despite the challenges BPD can bring to a relationship, communication skills and self-care are important for both partners. Here are some other tips for partners dealing with BPD:

Seek out information. Learning as much as possible about BPD can increase empathy in a partnership. If you’re the partner affected by BPD, educating yourself about the disorder can help give an explanation for your feelings and behaviors and help ease your shame. Education can help the spouse without BPD understand that it’s an illness, not a choice. “When the person is responding out of fear, shame, or lack of self-worth, this is not the whole person, this is a moment in time that will pass,” Dr. Ochoa says.

Get help. Seeking support from a mental health counselor or therapist — separately or as a couple — can help people affected by BPD gain insight, communicate more effectively, resolve conflict, and strengthen their relationships.

Because someone with BPD can also experience other conditions, such as anxiety disorders, post-traumatic stress disorder (PTSD), bipolar disorder, depression, eating disorders, and substance abuse, it’s important for both partners to keep their provider informed about changes in mood and behavior, Surrency says.

Practice healthy communication. When you communicate, don’t say anything that could make the person with BPD feel slighted or uncared for. Actively listen and do your best to respond in a positive way. “Always do it in love as opposed to attacking or putting the person down,” Surrency says.

Ask open-ended questions. If you’re a partner to someone with the disorder, it’s important to speak objectively and keep in mind that BPD can cause people to misconstrue what others say to them. Asking open-ended questions can also help them feel that they’re being heard, such as “I think….”

“You may need to use your words in places where you would assume that your facial expression or the nuance in the room would make it clear,” Saltz says. “You may really need to spell it out.”

Talk only when your partner is calm. A severe episode of BPD is not the time to tackle potentially sensitive topics, like the cleanliness of your living room or your family budget. Doing so may lead your partner with BPD to make irrational decisions. He or she is also more likely to be defensive, pull away, or turn to self-harming behaviors when their symptoms are uncontrolled.

Offer support. Partners should provide the person with BPD understanding and emotional support and encourage and support their treatment. “I think it’s important for the partner to tell the person that they are there, that they understand it’s hard, and they want to help them in any way they can whether or not it’s rejected,” Ochoa says.

Avoid labeling or blaming. It’s important to be careful not to blame everything the person with BPD says or does on their mental illness because “then it starts to become sort of an insult or a put-down,” Saltz says.

Take threats seriously. Threats of self-harm or suicide should never become a form of blackmail in the relationship, but they must be taken seriously regardless of whether you believe the person plans to follow through. Call your spouse’s therapist, the National Suicide Prevention Hotline (1-800-273-8255), or 911. This isn’t only to protect them. “You also have to maintain your own sanity and safety,” Saltz says.

Prioritize self-care. Likewise, being in a relationship with someone who has BPD can feel all-consuming, but it’s important to seek out your own support system and have a healthy outlet to deal with stress.

Make healthy eating, fitness, and sleep a priority, and carve out time for friends, a hobby or enjoyable activities. Although a glass of wine for example, can help you relax, be aware that you can get drawn into substance abuse if your partner is abusing too, Saltz says.

Know that you can live a normal life with BPD. People with BPD often have risk-taking behaviors, such as overspending, drug use, reckless driving, or self-harm due to a lack of inhibition. Although these behaviors can be dangerous, and potentially life-threatening, many people with BPD are high-functioning individuals. “There are definitely different degrees of severity of BPD,” Saltz says.

Mental illness is incredibly hard to live with as it causes a great deal of pain not just to the person who has it but also to their loved ones. On this blog we wrote about many mental illnesses and their effect on interpersonal relationships, including narcissism, sociopathy, psychopathy and pathological lying (here and here). However there is another disorder not any less debilitating and dangerous — Borderline Personality Disorder or BPD.

Just like many other mental illnesses, BPD is a mystery in a sense that its causes are not completely understood. It is believed that certain traumatic events during childhood (physical, emotional or sexual abuse) may play a role in this, however the research is still in its early stages as BPD was officially recognized only in 1980. With 5.9 percent of adult population affected, we certainly hope for more research and solutions in the near future .

Having a BPD feels awful: There is a very real fear of abandonment, conflicted feelings about relationships with friends, partners and relatives, a certain degree of identity crisis, mood swings, impulsive behavior, self-harm and suicidal thoughts, inappropriate and intense anger and chronic feeling of emptiness among other symptoms. BPD often goes undiagnosed, and people with this mental illness have no idea that their intense and contradicting feelings aren’t a part of normal human experience.

Relationships with people who have Borderline Personality Disorder can be very chaotic, intense and full of conflict. When the disorder goes undiagnosed, as it’s often the case, healthy partners and family members may begin to question their own sanity. You may feel trapped, manipulated, used and abused. Although people with BPD don’t necessarily lie, they may see things very differently under different circumstances; they may misrepresent things and accuse you of crimes you didn’t commit.

What makes you the way you are? Take THIS TEST to discover your personality type.

Even if all borderline personality traits are present, BPD should be diagnosed by a mental health professional experienced in treating mental health disorders, such as a psychiatrist or a psychologist. It is not something that can be diagnosed by a general practitioner and certainly not something we can diagnose ourselves by reading articles on the Internet. Yet, it all begins with awareness — if you don’t know that BPD exists, chances of you or your loved one getting professional help are pretty slim. The following questions are signs your loved one might have BPD. Put a check next to statements that describe your relationship. The more “yes” answers, the higher the likelihood.

Your relationship feels very intense.
Your loved one causes you a great deal of pain.
You feel as if you are being held a hostage.
You find it necessary to conceal your true feelings and thoughts because you are afraid of how your loved one might react.
Your loved one often switches between intense irrational rages and perfectly normal behavior.
Your needs aren’t satisfied but you avoid mentioning it because you are afraid to provoke your loved one.
Anything you say or do may be twisted and used against you.
You can’t leave the relationship because your partner threatens to harm himself or herself.
Your partner constantly changes his or her expectations of you so you can never do anything right.
Your loved one thinks in terms of black and white: They either love you or hate you. It’s either all good or all bad, with nothing in between.
You feel controlled and manipulated.
They act like your feelings aren’t important.
They accuse you of things you didn’t do or didn’t say.
Their moods change by the second.
They get mad at you even when you do everything exactly as they ask.
They constantly criticize you.
You aren’t the only person they have a problem with.
Your partner is irrationally jealous.

You should only click the button once or else the result will be inaccurate.

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Your result will appear here.

If you answered “yes” to many of these questions, it is likely that your loved one suffers from BPD or another personality disorder. You may want to talk about your experience of living with someone with mental illness with a professional therapist — not only for the sake of your loved one, but also for your own sake. At this point you must be exhausted, suffering from low self-esteem, feeling trapped and possibly questioning your own sanity. A counselor can help you understand what you are dealing with, provide you with a necessary emotional and professional support, as well as advise you on how to talk to your partner or family member about possible diagnosis.

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Personality disorders are a unique category in the world of mental illness. While someone with depression or anxiety may feel that they are experiencing symptoms that are different from their normal state, people with personality disorders often fail to realize that their emotions and reactions depart from the typical human experience. People with borderline personality disorder (BPD) struggle to understand how wives, husbands, friends, and other family members experience their intense reactions, mood swings, and risky behavior.

Needless to say, if you have a loved one with BPD, life can be fraught with crises and conflict. You might feel like you’re being held hostage, worrying that your family member will injure themselves if you don’t appease them. You may wonder whether you should let them borrow money again or answer the dozens of voicemails they left on your phone. Dealing with borderline personality disorder requires skills for deescalating crises and fostering independence in your loved one. With the right tools and community strategies, it is possible to help your loved one towards recovery.

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Signs and Symptoms

Only a doctor or mental health professional can officially provide an official diagnosis of a personality disorder, but there are several key symptoms you can observe that might indicate a person has BPD. These include:

  • Intense fear of rejection, separation, or abandonment
  • Rapid changes between thinking someone is perfect to believing they are evil
  • Risky behaviors including unsafe sex, gambling, drug use, or accumulating credit card debt
  • Threats of suicide or self-harm
  • Difficulty empathizing with other people
  • Mood swings from euphoria to intense shame or self-criticism
  • Frequently losing one’s temper

Origins and Treatments

Like many other mental illnesses, researchers don’t fully understand the origins of the disorder. Some studies suggest that there is a genetic component, meaning the disorder can be hereditary. Hostile family environments, childhood abuse and neglect, and separation from caregivers can also increase the risk. Some research indicates BPD can emerge when parts of the brain that help regulate emotions and aggressive impulses are not functioning well.

Psychotherapy, otherwise known as talk therapy, can be incredibly valuable for treating BPD. In addition to learning about the signs and symptoms of the disorder, individuals can gain skills for managing difficult emotions, developing and maintaining relationships, reducing impulsive decision-making, and improving daily functioning.

The most common typed of psychotherapy used to treat BPD is known as dialectical behavior therapy, or DBT. The therapy helps people change unhealthy patterns of behavior by becoming more mindful about the emotions and reactions they are experiencing in the moment.

To date there are no drugs approved by the FDA that have been specifically created to treat personality disorders. However, some people find that medications can help reduce anxiety or impulsivity in individuals. These might include antidepressants, mood-stabilizers, and antipsychotic medications.

If an individual with BPD experience intense symptoms, such as self-injury or physically harming others, they may be in need of inpatient treatment at a hospital or other residential program.

How should I structure the home environment?

People with BPD benefit from a home environment that is calm and relaxed. All involved family members (including a boyfriend or girlfriend) should know not to discuss important issues when the individual is in crisis mode. Stop to take a breath yourself when they do become emotionally reactive. It’s also important to not center all discussions around the disorder and setbacks. Conversely, it’s important not to place too much emphasis or praise on progress, or an individual may begin to self-sabotage. People with BPD should have opportunities to talk about their interests and thoughts about the news, family events, and other leisure activities. Take the time to laugh at a funny joke or eat dinner together several times a week. The less an individual feels like his or her mental illness is under the spotlight, the more opportunity they have to explore other aspects of themselves.

How can I communicate effectively during a crisis?

When a loved one becomes reactive, they may become to insult you or make unfair accusations. The natural response is to become defensive and to match the level of reactivity. You have to remind yourself that an individual with BPD struggles to place themselves in a different person’s perspective. They struggle to gauge what is a minor issue and what is a full blown catastrophe. They interpret your defensiveness as not being valued.

Instead, when they become reactive, take the time to listen without pointing out the flaws in their argument. Try not to take it personally. If the person does point out something you could improve or have done wrong, acknowledge their point, apologize, and suggest a way you can improve on the matter in the future. If the individual feels like they’re being heard, the crisis is less likely to escalate. However, if the conflict rises to the level where an individual is throwing a full-on tantrum or threatening you, it’s best to walk away and resume the conversation when they are calmer.

What if they threaten to hurt themselves?

A crisis is escalating if a person with BPD begins to threaten to harm themselves. Sometimes self-harm signs may be less overt, such as scratching the skin, eating less, coloring or shaving off hair, or isolating from others. These actions represent the person’s inability to express their emotions verbally. Recognizing early signs can help prevent an emotional crisis from becoming more serious or requiring medical or psychiatric attention.

Be aware that you don’t put the idea into someone’s head by asking about self-harm or suicide. Instead, you invite the individual to talk about their emotions and allow yourself to gauge whether professional assistance is necessary. All threats of suicide should be taken seriously. Even if the behavior is attention-seeking, it can result in seriously harm or even death. However, that doesn’t mean you have to call 911 every time an individual speaks about hurting themselves. This sends the message that they have an enormous amount of power over all arguments. Instead, ask your family member what they would feel most comfortable doing when they threaten injury. They might want to speak with their therapist, call a hotline, or walk with you into an emergency room. Allowing them some amount of agency in of deescalating a crisis can help calm out of control emotions.

What other strategies can reduce conflict?

Listening and reflecting can be the most effective strategy in communicating with someone with BPD. Though you might disagree with every word that is spoken, listening is not the same as agreeing. It is simply acknowledging a person’s emotions and perspective. Ask open-ended questions that encourage them to share, such as “What happened today that caused you to feel this way?” or “Tell me about how your week is going.”

Statements of reflection and summarizing can also help an individual feel heard. For example, if your son shares that he thinks you value his sister more than him, you can say, “You feel that we don’t love you as much as your sister.” The temptation to argue and point out their bias will be present, but just remind yourself that reflecting is not agreeing. This type of communication is not about winning an argument or being right. It’s about helping your family member feel heard and deescalating conflict.

What can I do when I feel overwhelmed?

Because a family member with BPD may not be able to provide the empathy and self-awareness necessary for a relationship, it’s vital to have other supports in your life. Carve out time to spend with friends and engage in leisure activities. If you need to talk about the experience of living with someone with a mental illness, support groups, mental health professionals, religious leaders, and your doctor can be excellent resources. You also should consider how to involve other family members in the care and support of someone with BPD. No single person should be responsible for communicating calmly and responding to crisis situations. The more people who know effective strategies for responding to the individual, the less often crises will erupt.

Will they ever completely recover?

Unlike with physical illness, recovery has a different meaning when it comes to mental health. Recovery does not imply the total elimination of symptoms, the lack of need for medication or therapy, and functioning comparable to persons without the disorder. Recovery from Borderline personality disorder looks like fewer threats of self-harm, reduction of frequency of emotional outbursts, and a decrease in the intensity of reactivity. Relapse may occur, but crises will resolve quickly and you will feel more prepared to handle the situation. In turn, your loved one will feel encouraged to take small but steady steps towards a fuller and healthier life.

Last Updated: Apr 29, 2019

Loving Someone with Borderline Personality Disorder

The person with BPD may appear to be the underdog in the relationship, while his or her partner is the steady, needless and caretaking top dog. In fact, both are codependent and it’s hard for either of them to leave. They each exercise control in different ways.

The non-BPD may do it through caretaking. A codependent who also yearns for love and fears abandonment can become the perfect caretaker for someone with BPD (whom they sense won’t leave). The codependent is easily seduced and carried away by romance and the person with BPD’s extreme openness and vulnerability. Passion and intense emotions are enlivening to the person without BPD, who finds being alone depressing or experiences healthy people as boring.

Codependents already have low self-esteem and poor boundaries, so they placate, accommodate, and apologize when attacked in order to maintain the emotional connection in the relationship. In the process, they give over more and more control to the borderline and further seal their low self-esteem and the couple’s codependency.

Borderlines need boundaries. Setting a boundary can sometimes snap them out of their delusional thinking. Calling their bluff also is helpful. Both strategies require that you build his or her self-esteem, learn to be assertive, and derive outside emotional support. Giving in to them and giving them control does not make them feel more safe, but the opposite. See also my blog on manipulation.

BPD affects women more than men and about two percent of the U.S. population. BPD usually is diagnosed in young adulthood when there has been a pattern of impulsivity and instability in relationships, self-image, and emotions. They may use alcohol, food, or drugs or other addiction to try to self-medicate their pain, but it only exacerbates it.

Like all personality disorders, BPD exists on a continuum, from mild to severe. To diagnose BPD, at least five of the following symptoms must be enduring and present in a variety of areas:

  1. Frantic efforts to avoid real or imagined abandonment.
  2. Unstable and intense personal relationships, marked by alternating idealization and devaluation.
  3. Persistently unstable sense of self.
  4. Risky, potentially self-damaging impulsivity in at least two areas (e.g., substance abuse, reckless behavior, sex, spending)
  5. Recurrent self-mutilation or suicidal threats or behavior. (This doesn’t qualify for nos. 1 or 4.) Around eight to 10 percent actually commit suicide.
  6. Mood swings (e.g. depressed, irritable, or anxious) mood, not lasting more than a few days.
  7. Chronic feelings of emptiness.
  8. Frequent, intense, inappropriate temper or anger.
  9. Transient, stress-related paranoid thoughts or severe dissociative symptoms.

The cause of BPD is not clearly known, but often there has been neglect, abandonment, or abuse in childhood and possibly genetic factors. People who have a first-degree relative with BPD are five times more likely to develop BPD themselves. Research has shown brain changes in the ability to regulate emotions. For more, read here and here.

Unlike narcissists, who often avoid therapy, borderlines usually welcome it; however, before recent treatment innovations, its effectiveness had been questioned. Use of medication and DBT, CBT, and some other modalities have proven helpful. Borderlines need structure, and a combination of knowing that they’re cared about and firm boundaries communicated calmly.

Today, BPD is no longer a life sentence. Studies have shown that some people recover on their own, some improve with weekly therapy, and some require hospitalization. Long-term treatment is required for maximum results, with symptom relief increasingly improving. A 10-year study showed substantial remission after 10 years.

Use of medication and DBT, CBT, schema therapy and some other modalities have proven helpful. Most individuals with BPD have another co-occurring diagnosis, such as addiction or depression. Acute symptoms diminish more readily than temperamental ones, such as anger, loneliness, and emptiness and abandonment or dependency issues.

Borderlines need structure, and a combination of knowing that they’re cared about plus boundaries that are communicated calmly and firmly. For partners, it’s also important to seek therapy in order to raise your self-esteem, learn to be assertive, and set boundaries. See my blog on “How to Spot Manipulation” and my books and e-workbooks for helpful exercises.

©Darlene Lancer, LMFT

Loving Someone with Borderline Personality Disorder

Caring for a spouse with BPD

Fred: This might sound strange, but in some ways, it has helped our relationship. I’m not the easiest person to live with, and I have my own issues with major depression. The treatment helped Cathy have the confidence to say to me, “Hey, pull your head in.”

Cathy: Before I got treatment, I wouldn’t say anything. I was too shy, terribly shy. Fred is quite a large person, and he used to scare the living daylights out of me. My first marriage was very abusive. It took a long time for me to realise that just because he is big doesn’t mean he is going to be bashing me.

We have had to work together at the marriage.

Fred: And we still do. I grew up in a domestic violence household. And I came out of that declaring that I would never be physically abusive, and I’m not. But I’m verbally abusive. My hearing is not so great, so I’m loud which doesn’t help either.

But confronting this mental illness has brought us close together. When something happens to either of us, it brings out the best in us.

I’ve had people say to me that I’m a hero. Cathy is the hero, I’ve just been here for the journey.

Cathy: My five kids are from my previous marriage. I got unwell not long after we got married, so they blamed him, which I think is a normal thing for them to do.

Fred: And I handled it badly.

Cathy: It’s taken a long time for it to all settle down, but now they’ve left home, gotten married, with kids of their own. It’s all fine now.

Fred: We’re both very black in our humour. If we said things out in public that we say to each other, we’d be crucified. Black humour has played a big part in getting through a lot of the journey.

Cathy: We have learnt to laugh at the silly childish things that we do, which I suppose is just being human.

You can learn more about Borderline Personality Disorder in SANE’s BPD Factsheet.

What You Need to Know When Dating Someone With Borderline Personality Disorder

Borderline Personality Disorder is a chronic and complex mental health disorder marked by instability, and interpersonal relationships are often the stage on which this instability plays out. Dr. Barbara Greenberg, a clinical psychologist who treats patients with BPD, explains:

People with borderline feel empty, and they are always trying to fight off what they perceive as rejection and abandonment, so they see abandonment and rejection where it doesn’t necessarily exist. They’re so afraid of being alone, abandoned, or left, or people breaking up with them, that they sense it where it doesn’t exist and they need tons of reassurance.

Often, this emptiness and intense fear of abandonment are the result of early childhood trauma and the absence of secure, healthy attachments in the vital formative years. Paradoxically, the overwhelming fear manifests in behaviors that deeply disrupt the relationship and pushes partners away rather than pulls them closer, resulting in a stormy and tumultuous dynamic that typically emerges in the early days of dating.

When they are in relationships they get very intensely involved way too quickly. tend to really like at first, because they are very intense, and very passionate. But then what comes along with it, a couple of weeks later, is: “Why didn’t you call me back immediately?” “Are you out with somebody else?” So get attached very quickly, give their all, but then get disappointed very quickly. They start out thinking, “I love this guy, he’s the greatest,” but if he does a minor thing that disappoints them, they get deeply disturbed. Everything is done with passion, but it goes from being very happy and passionate to very disappointed and rageful.

For Karla, a 29-year old woman recently diagnosed with BPD, Dr. Greenberg’s description is right on point. “When I feel as though someone is secretly attacking me, I will get on the defense, become overly emotional, moody, and dramatic, and perhaps will call them out on it. In reality, may have just not been aware whatsoever,” she says. Prior to her diagnosis, her boyfriend, Thomas, used to blame himself for her hot and cold behavior. “Many of her mood swings (which of course I can now link and identify with her BPD) before the diagnosis were difficult for me to understand,” he says. “I assumed it was something to do with me being difficult for her to be with.” When Karla was diagnosed with Borderline Personality Disorder, however, things began making sense, and as Thomas began learning more about the disorder, he began to reconceptualize his own role in their relationship; many of their conflicts weren’t about him, but about Karla’s struggle to deal with an intense internal struggle that affected not only her understanding of herself, but her ability to interact with other people.

My girlfriend has Borderline Personality Disorder

My girlfriend is incredible. She is sexy, funny, smart – everything you could want. She loves my friends, they love her. Perfect.

But sometimes I get worried that I will lose her. Why? Not because of any normal, irrational student related relationship drama. It’s because she’s a little nutty.

Now, she gets all stroppy when I jokingly call her crazy, but the truth of it is just that. She suffers from Borderline Personality Disorder (BPD), a mental illness that effects your mood and results in (according to the NHS Online):

  • feelings of distress, anxiety, worthlessness or anger
  • difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses
  • difficulty maintaining stable and close relationships
  • sometimes, periods of loss of contact with reality
  • in some cases, threats of harm to others

luckily, I had my trusty idiots guide to make everything okay

I had no idea when I met her. Nobody does. I cannot stress enough how upon meeting her, you would never guess that there was anything wrong. Our relationship had such a normal start, and our everyday life is just like any other student couple. I forget most days that she is unwell.

She often says she feels bad that she “tricked me into thinking she was normal” but by the time I found out, I loved her – and it was too late to back out. Can you really leave someone because of something they can’t help? Would it have changed anything if I had known from the start? Probably not, because she handles it so well.

She had scars everywhere, but in my sex filled loved up haze I didn’t second guess about their origin when she lied at first. When she told me the truth, before she was diagnosed with BPD, I actually wasn’t fazed at all. I knew self harm was surprisingly common. It seemed like the past.

But when you’re running home from a club on a Wednesday night because she is drunk and has sliced herself open with a razor, and you arrive to see what the person you love has done to themselves – the reality hits you like a smack in the face.

I sat in the ambulance whilst she drunkenly made friends with the paramedics, and seriously considered whether or not I could carry on in this relationship. I am so young I told myself. I am a student who is meant to be living some kind of crazy drug and booze filled carefree existence for 3 years. Can I keep doing this?

I could, I can and I have.

In reality, apart from a few down days and a small amount of panicking when she looks twice at a bottle of rum, I love my relationship. She makes me happy. And as long as she does her best to help herself, why shouldn’t I stay with her? (And she’s great in bed – crucial factor).

We run away from mental illness and fear what we don’t understand. I am proud to be with someone who has been through so much and still comes out the other side a pretty amazing person. She inspires me.

People don’t usually announce their mental illness on a first date. Maybe match.com should provide a tick box to confirm that you are mentally sound. But seeing as I have learnt that it changes very little, I think not.

I love someone with BPD – could you?

The identities in this article have been protected, not out of shame, but out of a need for privacy. Email [email protected] to for the chance to give your opinion.

When a partner, spouse or girlfriend has Borderline Personality Disorder

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