Tips for Interacting with Someone with Borderline Personality Disorder

Clinically reviewed by Kimberly D. Gray, LCSW, Behavioral Health Services Manager

Borderline personality disorder (BPD) is a mental health disorder that causes trouble with interpersonal relationships, extreme mood swings, fear of abandonment, impulsive behaviors, and problems with self-esteem and self-image. 

Along with a tendency to exhibit suicidal behaviors, these characteristics can make communicating with someone with BPD challenging. However, there are actions you can take to make conversations more productive. 

Borderline Personality Disorder Symptoms and Diagnosis

People with BPD tend to have periods where they don’t show any signs of the condition. However, they can be triggered by trauma, criticism, and perceived or actual rejection or abandonment, which cause them to experience symptomatic episodes.  

During episodes, they may exhibit some or all of the following:

• Impulsive or reckless behavior
• Paranoia
• Mood swings
• Risk-taking
• Self-mutilation
• Eating disorders
• Substance abuse
• Avoidance of personal interactions
• Suicidal thoughts or actions
• Self-loathing
• Distorted self-image
• Euphoria
• Depression
• Excessive and impulsive spending
• Intense anger
• Feelings of emptiness or hopelessness
• Disconnection between identity, thoughts, actions, and surroundings
• Risky sexual behavior

BPD is typically first identified in young adulthood. A diagnosis, which is the first step toward recovery, is based on the persistence of the symptoms listed above. It should be noted that many victims of childhood trauma exhibit traits of BPD but do not meet criteria for the diagnosis. Talk to a professional for a proper evaluation and treatment plan. 

How to Help Someone with Borderline Personality Disorder

When trying to support and communicate with someone with BPD, it’s essential to understand that it’s a clinical disorder driving behaviors that can be frustrating, hurtful, or frightening to you. How much you engage and support the person, will depend heavily on your relationship with them, but here are some tips to keep in mind:

• Learn about the disorder. Knowing the symptoms can make it easier to avoid being upset when the person exhibits them.
• Listen actively and sympathetically. When they speak to you, it’s important to be engaged. 
• Validate their feelings. Acknowledge their emotions even if you disagree with them. 
• Be patient. People with BPD may be “all over the map” during a conversation, but urging them to get to the point quickly can be counterproductive.
• Try to help them separate facts and emotions. For example, their anger at someone they believe wronged them doesn’t prove the person intended to hurt them.
• Use constructive criticism. Pointing out areas for improvement is received best when paired with realistic suggestions for improvement. 
• Set healthy boundaries. The person must understand there are behaviors you won’t tolerate and that boundaries are vital to your self-care.
• Learn their triggers. You probably can’t protect them from everything they find triggering, but minimizing their exposure to negative stimuli can be helpful.
• Check in regularly. Fear of abandonment is a major BPD trigger, so letting someone know you’re thinking about them can be helpful.
• Distract them when you see their emotions rising. Drawing their attention to something positive can be effective if their feelings start to spiral out of control.
• Don’t let yourself be the focus of their anger. If you can diffuse their emotion, do so. But in some instances, you may simply have to walk away.
• Encourage them to get treatment. While you don’t want to be perceived as forcing them to take action, you can help them see that recovery is possible. 
• Familiarize yourself with dialectical behavior therapy (DBT). It’s an effective treatment for BPD that involves mindfulness, learning to regulate emotions and guidance in tolerating stress.
• Attend therapy with them if they’ll allow it. Your presence can help them feel safe, and you can also reiterate advice provided by the therapist between sessions.  

The list above is long, and not everything will necessarily apply to the relationship you have with your friend or family member. The best course of action is to educate yourself about borderline personality disorder and have open communication with them on how you could help. 

Get Help with Borderline Personality Disorder from Baptist Health

Borderline personality disorder can be a severe mental health disorder. However, our behavioral health experts can help people navigate it together. 

Learn about behavioral health services at Baptist Health.