How to Deal with Borderline Personality Disorder

Happiness as in “feeling present and fully engaged” requires many skills and an open-hearted way of life, which is quite the challenge for most people. Many people are lonely and our culture often fails us in our pursuit of happiness. For those who suffer from Borderline Personality Disorder (BPD), the challenge is even greater. The good news is, usually the symptoms of BPD lessen over time, especially when the person is supported in psychotherapy and psychiatry.

In all honesty, I do believe that we can be too unhappy to be happy, even though it is astounding how suffering changes once we take an honest look at ourselves. Acknowledging our rigidities allows us to face and embrace our suffering, do what we can, and surrender when there is nothing further to be done. With kind attention, we are likely to allow happiness into our lives despite intense, inner obstacles.

While this blog post is foremost for those who are connected with someone who suffers from BPD, I must mention here how important it is to diagnose this disorder accurately. It is notoriously difficult to differentiate between BPD and Bipolar disorders.¹ I highly recommend reading the excellent article I have included in the references below. For example, the authors of this article, Robert S. Biskin and Joel Paris, remind everybody that the erratic behavior in BDP is not as much tied to ongoing and longer mood swings, but to problems occurring in relationships.

Recognizing the Symptoms of BPD

People who have BPD often suffer, but so do the people around them. It is hard to be present-minded when one is barraged by another person’s aggressive, impulsive, and/or chaotic behavior. It is easy to get hurt by someone who explodes in anger and contempt. Let us look at the symptoms of BPD before I make suggestions for how to respond to or become proactive with someone who is borderline.

Those with BPD have a pervasive pattern of instability in three main areas of life: interpersonal relationships, self-image, and affect. They act impulsively from a young age, even though we can only diagnose this disorder once the person is 18 years old. According to the DSM-5², the manual used to help diagnose psychiatric disorders, a person with BPD must meet at least five of the following criteria:

1. Frantic efforts to avoid real or imagined abandonment (other than covered by criterion 5).
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging, for example, spending, sex, substance abuse, reckless driving, binge eating (other than behavior covered in criterion 5).
5. Recurrent suicidal behavior, gestures or threats, or self-mutilating behavior.
6. Affective instability due to a marked reactivity of mood, for intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days.
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger, for example frequent displays of temper, constant anger, and recurrent physical fights.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

It is often exhausting having to prove to someone who suffers from these symptoms that they are worthy and wanted. Young adults who feel empty and scared of becoming abandoned by their parents, for example, tend to test and provoke their parents to find out if they are truly valued. The testing period seems to never end, albeit there could be brief periods of peace after an aggressive outburst. Females tend to act out the aggression against themselves with self-harm and suicidal ideation; males are more likely to externalize and act out the aggression against others or things.

When there is the slightest suspicion that the person with BPD is not valued, the borderline person quickly falls to intense reactivity, accusing the other of intentionally undermining him or her. He or she might try to punish the other to make him or her stop the alleged neglect or hostility. Without even noticing, the person with BPD might successfully transfer his or her chaotic state to the other, meaning that suddenly the other might feel even worse than the one who has this disorder. This can be very painful, where it is hard to function and enjoy life.

Your borderline son or daughter might say hateful things. A borderline husband might break things, become physically abusive and/or threaten with dire consequences if the other is perceived as being disloyal or dismissive. A borderline wife might lose her temper in a split second when she feels disappointed, screaming loudly or threatening to hurt herself or others. What is there to do?

Personality Essential Reads

We Are All a Mixture of Opposites

Why Antagonistic People Think They’re So Perfect

How to Navigate Relationships with People with BPD

1: Leave the abuser. When there is physical abuse of any kind and/or ongoing emotional abuse, one should not stay in a relationship. However, this is not always possible when the person with BDP is a close family member or an affiliate on a job site. Be deliberate about any steps you consider. Your safety comes first.

2: Do not try to endure your suffering alone. Seek support. It is important to seek help to stop the abuse and the chaos. Your own happiness and the happiness of the one who suffers from BPD are at stake. It is our sacred duty to interrupt abusive patterns, to act and detach. We might have to consult with a psychotherapist or make contact with a treatment center.

Don’t let certain ideas stop you, such as thoughts about being a failure or “One should not air dirty laundry in public.” Shame can be a huge obstacle to reaching out and confiding in others who are in the position to help. In the name of happiness and your right to be happy, do not let shame stop you.

3: Set boundaries. There is hardly anything as effective as setting crystal clear, hard boundaries with a person who suffers from BPD. Instead of reacting emotionally, maybe by increasing the volume of your voice or crying, calm yourself. Allow yourself to become all reason, cold and collected, stating that the behavior of the other will not be tolerated. This is especially the case when it comes to your child. Saying “No” and stating your expectations is of the utmost importance.

4: Help address “emptiness.” Without becoming the therapist of the one with borderline symptoms, talk about the underlying feelings that so often throw him or her into darkness. Discuss what is but a feeling of emptiness and look at the feeling together. This discussion must happen when all is calm. Thinking about feelings helps put distance between the experience, which is helpful when negative experiences seem to override every other part of consciousness.

5: Offer reading materials about BPD. The person who has BPD is much better off being informed of the diagnosis and what treatment interventions exist. Usually things do not get worse when one is in the “know” but the search for coping skills can begin.

6: Practice extreme self-care. People with BPD are exhausting as they tend to cross your boundaries. Make sure you nourish yourself and eat healthily. Take meaningful breaks (probably not online). Talk to your friends. Go for extra walks with your dog. Join a gym. Live a little! Take the time to strengthen yourself with meditation and focus on your breath or healing sounds. Notice where you begin and the other ends. Learn to notice when you identify with the “bad person” you are alleged to be. Learn to reject the identification, using affirmations, for example.

It is never too late to be kind to yourself and refocus your attention. Do not let anybody rob you of the space needed to participate fully in your life. Your happiness matters.

© 2021 Andrea F. Polard, PsyD. All Rights Reserved.