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Borderline personality disorder

Helping someone with borderline personality disorder

Supporting someone with BPD can, at times, be distressing and difficult. It can seem like nothing is changing.

If you are the family, friend or carer of someone with BPD, there are some things you can do to help.

Is it an emergency?

Get help immediately if the person:

  • has deliberately injured themselves
  • is acting out in a highly aggressive or abusive manner
  • is expressing thoughts of suicide or of killing someone else
  • is disorientated (does not know who they are, where there are, or what time of day it is)
  • has delusions (strange beliefs) or hallucinations (hearing or seeing things that are not real)
  • is confused or not making sense
  • is badly affected by drugs and or alcohol and acting in an abnormal manner.

If the person has any of these symptoms, call 000 in Australia or 111 in New Zealand, or visit the emergency department at your nearest hospital.

More about helping a suicidal person 

How to help someone with borderline personality disorder

  • Offer ongoing support to the person, including listening, comfort and assistance to get help.
  • Validate their experience and distress. Tell them you know that, for them, the experience is real.
  • If you think you understand why they feel the way they do, tell them this. But if you can’t make sense of their feelings, try to find out more from them. Tell them that you really want to understand, and ask if they can say more about what they are feeling and why.
  • Give the person hope for recovery by reassuring them that people with BPD can and do get better.
  • Accept that the person is struggling and that life goals might need to be broken down into smaller steps. 
  • Have realistic expectations. Setbacks can and do happen. Help them to remain positive. If the person has not responded to treatment for BPD, reassure them that this does not mean that they will not succeed in the future.
  • Where appropriate, find out about their management plan and what role you can play in supporting this. You could also ask to see their safety plan.
  • Clearly tell the person what you are not prepared to accept (e.g. abusive language, threats, violence of any kind).
  • If they are agitated, be calm. Leave the situation if you feel in danger and call 000 in Australia and 111 in New Zealand.
  • Find strategies to decrease your own emotional reactivity. For example, consider learning mindfulness.

Things that do not help

  • Do not take over control of their life. Support them to make their own choices. Avoid conflict or arguments over these.
  • Avoid the temptation to try to rescue the person from a particular situation. Don’t imagine that you can fix their life for them.
  • Avoid being drawn into their conflicts with other people, including their psychiatrist (e.g. cancelling appointments on their behalf instead of expecting them to do so themselves, or being drawn into one side of a family conflict).
  • Don’t try to be their therapist. Instead, help them find the right treatment and support them to follow their treatment.
  • Try not to get defensive in the face of accusations and criticism. When they get emotional or angry, it is not just about you or about the situation – they are trying to deal with BPD at the same time.  Try to distinguish the person from the illness.

What if the person doesn’t want help?

Generally, an adult has the right to refuse treatment. But they can be treated without their consent if their life is in danger or if they lack the capacity to consent.

If the situation is not an emergency, tell the person that you are concerned. Let them know that you care about them getting effective treatment.

Keep giving support and acknowledging their point of view. Be open, approachable and non-judgmental.

Sometimes a person with BPD doesn’t want to attend their appointment with their psychiatrist or other therapist, even though they have previously committed to their treatment. If this happens:

  • ask them what is worrying them and let them talk about it
  • keep giving them emotional support and encouragement
  • talk about what kind of practical help they need to keep going with their treatment
  • contact the health-care team for advice.

Looking after yourself

Caring for someone with BPD can be emotionally and physically exhausting.

If someone close to you has BPD, this does not mean that you are a ‘bad’ parent, partner, brother, sister, child or friend.

You will feel pain, suffering, sadness, guilt or despair of your own. Being a support person can be hard work and it may sometimes feel that you are getting nowhere.

Never blame yourself. You are not alone.

More about caring for someone with a mental illness

Support and information for families

Australia

Australian BPD Foundation

BPD Community Victoria

Mind Australia Borderline Personality Disorder Family and Carer Group

NEA.BPDAust – Family connections
Email: bpdfamilyconnections@gmail.com

Mental health Carers Helpline
1300 554 660

SANE Helpline
1800 187 263

New Zealand

Supporting Families in Mental Illness
0800 732 825

Page last reviewed Apr 2017 | C1038V1

This is a general guide only, and does not replace individual medical advice. Please speak to your doctor for advice about your situation. The RANZCP is not liable for any consequences arising from relying on this information. Subject matter experts, people with lived experience of mental illness and carers all contributed to this fact sheet.