Living with and Knowing Someone with Borderline Personality Disorder; Understanding BPD and Tools to Cope.
By Jessica Anne Pressler, LCSW
Borderline Personality Disorder (BPD) exists at the intersection of intense emotional experience and interpersonal struggle. For those living with the condition and those who love them, each day can bring remarkable challenges—and opportunities for profound connection. This blog explores BPD with compassion for all involved in its complex emotional landscape.
Understanding Borderline Personality Disorder
Borderline Personality Disorder is characterized by a pattern of instability in emotions, self-image, interpersonal relationships, and impulsivity. The emotional experience of someone with BPD can be likened to living without an emotional skin—feeling everything with an intensity that others might struggle to comprehend.
Dr. Marsha Linehan, a pioneering researcher in BPD treatment who later revealed her own diagnosis with the condition, describes it as "living in hell without knowing how not to." This captures the profound emotional suffering that often accompanies the disorder, as well as the confusion about how to regulate these overwhelming feelings.
The condition affects approximately 1.4% of the adult population, though many believe it to be underdiagnosed, particularly in men. It typically emerges in early adulthood, though its roots often trace back to childhood experiences.
The Lived Experience of BPD
To understand BPD means acknowledging that behind the diagnosis are people experiencing life through a unique emotional lens:
Someone may describe their experience: "It's like my emotions are always at a 15 on a scale of 1 to 10. When I'm happy, I'm ecstatic. When I'm sad, I'm devastated. And these feelings can switch in moments. Most people don't understand that I don't choose this rollercoaster—I'm strapped to it."
The core experiences for many with BPD include:
Intense fear of abandonment that can lead to frantic efforts to avoid real or imagined rejection
Unstable and intense relationships that can rapidly shift between idealization and devaluation
Disturbances in self-image and sense of identity
Impulsive behaviors that may be self-damaging
Recurrent suicidal thoughts or self-harming behaviors
Intense emotional reactivity and difficulty regulating emotions
Chronic feelings of emptiness
Intense anger or difficulty controlling anger
Transient stress-related paranoia or dissociative symptoms
The Path to Diagnosis
Recognizing BPD can be challenging, as many of its symptoms overlap with other conditions. The diagnosis process typically involves:
A comprehensive psychological evaluation by a mental health professional
Discussion of symptoms, personal history, and family medical history
Evaluation against the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
For some, receiving a diagnosis brings relief and understanding. Someone may say: "After years of being called 'too emotional' or 'attention-seeking,' having a name for what I was experiencing meant I wasn't just broken—there was a reason, and more importantly, there was help."
If you suspect you or someone you love may have BPD, consider these questions:
Do emotions seem to overwhelm daily life?
Is there a pattern of unstable relationships marked by extreme shifts in perception of others?
Are there persistent feelings of emptiness or identity confusion?
Is there a history of self-harm or suicidal thoughts as ways to manage emotional pain?
Do fears of abandonment drive relationship behaviors?
While these questions cannot diagnose BPD, they may indicate the need for professional evaluation.
BPD and Relationships
The impact of BPD on relationships can be profound for all involved. For the person with BPD, relationships are often characterized by intense attachment, fear of abandonment, and emotional volatility.
A loved one whose partner has BPD, may share: "There are days when I'm her hero, and hours later, I'm her villain—without having done anything differently. Understanding that this isn't manipulation but her genuine experience has been crucial to maintaining our relationship."
For loved ones, the experience can be confusing and emotionally draining. They may feel they're walking on eggshells, never knowing what might trigger an emotional shift. They may struggle with setting healthy boundaries while showing compassion.
Yet, relationships with someone who has BPD can also be characterized by deep emotional connection, passionate engagement, and profound empathy when the condition is understood, and proper support is in place.
Effective Communication Strategies for BPD Relationships
When communicating with someone who has BPD, thoughtful approaches can help navigate emotional intensity while fostering connection. These strategies benefit both the person with BPD and those in relationship with them.
Validation-Based Communication
Validation is perhaps the most powerful tool in BPD-affected relationships. It acknowledges the person's emotional experience without necessarily agreeing with their interpretation or actions.
Instead of: "You're overreacting again. I was only 10 minutes late."
Try: "I see you're really upset right now. Being late must have felt like I don't value our time together. I do care about you, and I'm sorry I was late."
Validation communicates: "Your feelings make sense given your experience," which can help de-escalate emotional intensity.
Non-Judgmental Listening
When someone with BPD is expressing intense emotions, avoid dismissing their feelings or immediately trying to solve the problem.
Instead of: "You shouldn't feel that way" or "Just calm down"
Try: "I'm here to listen. Can you tell me more about what you're experiencing?"
Clear, Consistent Boundaries
Establishing and maintaining boundaries is essential for healthy relationships involving BPD.
Instead of: Inconsistent limits that change based on your emotional state
Try: "I care about you, but I need to end this conversation if there's yelling. We can talk again when we're both calmer."
When setting boundaries:
Use "I" statements to express your needs
Be specific about acceptable and unacceptable behaviors
State consequences clearly but without threats
Follow through consistently
De-escalation Techniques
When emotions are heightening:
Maintain a calm tone and body language Even if the person is escalating, keeping your voice steady and posture open can prevent further escalation.
Redirect to crisis skills "Would it help to take a few deep breaths together?" or "Maybe we could use that grounding technique your therapist suggested?"
Create space when needed "I want to have this conversation, but I think we both need a short break to collect our thoughts. Can we pause for 20 minutes and then continue?"
Avoid defensive responses When accused or criticized harshly, resist the urge to counterattack.
Instead of: "You're being completely irrational right now!"
Try: "I understand you're upset with me. When you're ready, I'd like to hear more about what's bothering you."
Navigating "Splitting" Behavior
"Splitting" refers to the tendency to view people as all good or all bad. When you notice someone shifting from idealizing to devaluing you:
Instead of: "Last week you said I was the best partner ever, and now you're saying I'm the worst. You're so inconsistent!"
Try: "I notice things feel different between us right now. I'm still the same person who cares about you. Can we talk about what's changed?"
Managing Crisis Situations
Have a crisis plan developed in calmer moments that includes:
Warning signs that emotions are intensifying
Specific grounding techniques that have worked before
Agreed-upon steps each person will take
Emergency contacts and resources
Someone, whose partner has BPD, shares their experience: "During a crisis, I used to try logical arguments or would withdraw completely—both made things worse. Now I say something like, 'I can see you're in tremendous pain right now. I'm not going anywhere. Let's just sit together for a bit.' That simple acknowledgment often helps more than any advice I could give."
Supporting Treatment Without Becoming the Therapist
Express support for their therapy while maintaining appropriate relationship boundaries:
Instead of: "Let me analyze why you might be feeling this way..."
Try: "I'm here to support you through this process. How did your therapy session go today?"
Remember that consistent application of these communication strategies, combined with your own self-care practices, creates the foundation for healthier interactions. With practice and patience, many relationships affected by BPD can develop new patterns of communication that foster connection rather than conflict.
Finding Support and Healing
For those with BPD, recovery is not only possible—it's happening every day. Effective treatments include:
Dialectical Behavior Therapy (DBT)
Developed specifically for BPD by Dr. Linehan, DBT combines cognitive-behavioral techniques with concepts of mindfulness and acceptance. It focuses on four key areas:
Mindfulness: Being present in the moment
Distress tolerance: Handling crisis situations without making them worse
Emotion regulation: Understanding and managing intense emotions
Interpersonal effectiveness: Communicating needs effectively while maintaining relationships
Schema Therapy
This approach addresses deeply held negative beliefs about oneself and others that formed in childhood and reinforced throughout life.
Mentalization-Based Therapy (MBT)
MBT helps individuals understand their own mental states and those of others, improving interpersonal relationships and emotional regulation.
Medication
While there is no specific medication for BPD, certain medications may help manage specific symptoms like depression, anxiety, or mood instability.
Carlos, who was diagnosed with BPD five years ago, shares his recovery journey: "DBT changed my life. I learned that my emotions are valid, but they aren't always accurate reflections of reality. I've developed skills to pause between feeling and acting, which has transformed my relationships."
For Loved Ones: Nurturing Relationships While Practicing Self-Care
Supporting someone with BPD requires balancing compassion with healthy boundaries:
Educate yourself about BPD: Understanding the condition helps depersonalize difficult interactions.
Practice validation: Acknowledge the person's emotions without necessarily agreeing with their interpretation or actions.
Maintain consistent boundaries: Clear, consistent boundaries provide security for both parties.
Encourage treatment while respecting autonomy: Support their healing journey without making your relationship contingent on it.
Practice self-care: Maintain your own support network, interests, and emotional health.
Consider family therapy or support groups: Organizations like the National Education Alliance for Borderline Personality Disorder offer programs specifically for families.
Someone, whose sibling has BPD, reflects: "Learning about BPD helped me understand that when my sister lashes out, it's her pain speaking, not her heart. I've learned to validate her feelings without taking responsibility for them. Our relationship has grown stronger through this understanding."
The Path Forward: Hope and Healing
Research shows that the prognosis for BPD is much more positive than previously thought. Studies indicate that remission rates are high—approximately 85% of people with BPD experience symptom remission within 10 years of diagnosis with appropriate treatment.
Recovery doesn't necessarily mean freedom from all symptoms but rather developing the skills to manage emotions effectively and build fulfilling relationships. Many individuals with BPD go on to lead rich, meaningful lives with deep connections.
As one recovery advocate with BPD expressed: "Having BPD means I feel everything deeply—both pain and joy. As I've healed, I've learned that this emotional intensity, when channeled, can be my greatest strength rather than my deepest struggle."
Living with BPD—or loving someone who does—presents unique challenges, but with understanding, appropriate treatment, and compassion for all involved, healing and meaningful connections are not only possible but happening every day. The journey may not be linear, but with each step forward in awareness and acceptance, the path becomes clearer for everyone touched by this complex condition.
*The examples I stated to help the reader understand were all hypothetical based on years of experience as a professional.
Resources for Support and Further Information
For Individuals with BPD:
National Suicide Prevention Lifeline: 1-800-273-8255 (24/7 crisis support)
Crisis Text Line: Text HOME to 741741 (24/7 crisis support)
Treatment and Research Advancements Association for Personality Disorder (TARA): www.tara4bpd.org
BPD Resource Center: www.borderlinepersonalitydisorder.org
For Family Members and Loved Ones:
Family Connections Program: Evidence-based program for relatives of people with BPD
National Alliance on Mental Illness (NAMI): www.nami.org
National Education Alliance for Borderline Personality Disorder: www.borderlinepersonalitydisorder.org
Books:
"The Buddha and the Borderline" by Kiera Van Gelder
"I Hate You—Don't Leave Me" by Jerold J. Kreisman and Hal Straus
"Stop Walking on Eggshells" by Paul T. Mason and Randi Kreger
"Loving Someone with Borderline Personality Disorder" by Shari Y. Manning
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Gunderson, J. G., & Links, P. S. (2014). Handbook of good psychiatric management for borderline personality disorder. American Psychiatric Publishing.
Linehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press.
Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and axis II comparison subjects: A 16-year prospective follow-up study. American Journal of Psychiatry, 169(5), 476-483.
National Institute of Mental Health. (2022). Borderline Personality Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/
DISCLAIMER:
The contents of this website; blog, video, articles, media, social media, book, and references, are ONLY for informational and entertainment purposes. It is NOT intended as a psychological service, diagnostic tool, medical treatment, personal advice, counseling, or determination of risk and should not be used as a substitute for treatment by psychological or medical services.
Please seek consultation by an appropriate healthcare provider.
Call 911 if there is an emergency.
Call or text 988, which is the National Suicide and Crisis Lifeline,
Call National Suicidal Prevention Hotline at 1-800-273-8255 to talk to someone 24/7 if needed. Call National Domestic Violence Hotline at 1-800-799-7233 to talk to someone 24/7 if needed.
Looking at, reading, listening to any information on my website, social media, YouTube, or book, and communicating with me by email or any other communication with me, you acknowledge and agree that we do not have a professional/client relationship. Use of this site and information associated with this site is solely at the visitor’s own risk.
