What To Expect When Living With Someone With Borderline Personality Disorder
People with borderline personality disorder (BPD) often experience unstable moods, desires, relationships, and self-worth. They may have a sense of emptiness, fear abandonment, and experience thoughts of self-harm or suicide. Many people with borderline personality disorder have other mental health concerns as well, such as anxiety, depression, or an eating disorder. For these reasons, living with a person who has borderline personality disorder can seem unpredictable as their behavior can be inconsistent.
However, living with someone who has borderline personality disorder might not match up with the portrayals of mental illness seen in the media. The depictions of personality disorders in the media may give the impression that anyone with a personality disorder is erratic, unsafe, violent, or incapable of holding down a job or maintaining relationships.
While these media portrayals can make for dramatic storytelling or further the story arcs of other characters, they usually aren’t accurate. The common popular culture media portrayal of people with mental illness frequently lacks empathy and can lead to negative stigma and stereotypes that often harm both those with mental health conditions and their friends and family members.
While being close to someone with BPD can have its challenges, it is a situation that many people successfully navigate. The more you learn about the symptoms of BPD, the better equipped you may be when you experience them in someone you love. Individuals with BPD can often manage symptoms with therapy, and those who live with people who have BPD may also benefit from the support of a licensed mental health professional.
Mood swings
People with borderline personality disorder tend to have very intense emotions. Their emotions may overwhelm or consume them, making it difficult for them to focus on anything else. An event that may mildly upset most people could prompt a person with BPD to fly into a rage or cry uncontrollably.
Sometimes, people with BPD engage in "emotional hypochondriasis," in which they exaggerate the intensity of their emotions to get others to understand how they feel. Experts think this tendency may arise from a painful and traumatic childhood that involved being neglected, ignored, or deeply misunderstood. For example, when a person with BPD feels sad, they may claim they are more depressed than anyone has ever been before, and that no one can understand the depth of their sadness.
Whether you are a housemate, significant other, or family member of someone with BPD, these mood swings and exaggerated emotional descriptions might catch you off-guard or leave you feeling unsure of how to react. If your words or actions have set off a person with BPD before, you might find yourself walking on eggshells in hopes of avoiding an emotional outburst. While it can be important to respect and validate a person's emotions, it can also be important to continue being honest and genuine instead of allowing another person's emotions to manipulate you.
Fear of abandonment and poor boundaries
People who have BPD usually have a core fear of being abandoned. To assuage that fear, they may act in ways that others find intrusive or uncomfortable. For example, they may want to continually text you throughout the day to reassure themselves that your relationship is healthy and intact. They may also want to spend excessive amounts of time with you or learn your innermost thoughts and feelings to promote a sense of closeness.
All that said, it will likely be important for you to set explicit boundaries while you live with someone who has BPD, since they most likely will not. While some people with BPD may fear your boundaries signal an impending abandonment, you can provide reassurance that they do not, while also being firm about them. Your wants and needs matter, too. Thinking and communicating about how often you want to spend time together and how emotionally close you want to be might be difficult in the moment, but it may ultimately preserve the relationship.
Splitting or black-and-white thinking
A difficult aspect of borderline personality disorder can be the tendency to engage in a form of thinking called “splitting.” When people have the tendency to split, they generally view things as black or white, all or nothing. They may struggle to hold complexity, nuances, and contradictions in their mind.
If you're living with someone who has BPD, this type of dichotomous thinking may mean that when you do something that upsets them, they quickly view you as all bad instead of recognizing that you are generally good but made a mistake, like all humans tend to do.
When someone with BPD splits and views someone as bad, they may name-call, say very rude or insulting things, or even make untrue accusations. However, after the issue has been resolved and the person with BPD has gone back to viewing a person as good, they may idealize them and talk about them as if they are perfect.
These abrupt and dramatic changes of opinion can catch people off-guard, especially if they don't understand what is happening. If a person is splitting and viewing you as bad, it's probably best not to argue with them at that moment, as it will likely not be easy for them to think rationally. If a person with BPD is in therapy and aware of their tendency to engage in splitting, it may be helpful to wait until a calm moment, then point out that you think they were splitting. However, if they aren't aware of splitting, pointing it out may lead to further conflict.
Impulsive behavior
People with borderline personality disorder may suddenly engage in impulsive behavior that seems unusual for them. The impulsive behavior could include spending large amounts of money or buying things they can't afford, abruptly changing their sexual habits and having sex with people they barely know, gambling, drinking and driving, using substances, binge eating, or making a snap decision to quit a good job or end a healthy relationship.
Someone living with a person who has BPD may be surprised by this sudden impulsive behavior, and they may not know how to respond to it. In general, it isn't your job to police the behavior of someone with BPD or determine what is healthiest for them. However, keep in mind that your own tastes, preferences, and comfort levels are important, and it's up to you to set and maintain boundaries. For example, if you don't want someone using recreational substances or bringing a string of casual sexual partners into your home, that's valid and worth communicating to the person with BPD.
Self-destructive behavior
Many people with borderline personality disorder engage in self-harm and have suicidal thoughts. Self-harm can be seen as a coping mechanism that involves any attempt to hurt oneself physically, such as self-destructive behaviors like cutting or burning one's skin. When a person engages in self-harm, they normally aren't trying to kill themselves. However, self-harm can precede suicidal thoughts or suicide attempts, and treatment may prevent that progression.
If a person with whom you’re living says they are suicidal or shows signs of self-harm, take it seriously. Suicide attempts and suicide tend to be greater risks for people with borderline personality disorder than for the general public.
If you believe that you or anyone else is in danger or is facing a medical emergency, immediately seek help and contact relevant authorities. 988 is a suicide and crisis lifeline. A person can call or text 988 in a moment of distress or crisis. Similarly, 911 is an emergency number that can connect you with local emergency services.
Remote therapy for borderline personality disorder
Research shows that multiple types of therapy can help people with borderline personality disorder. Studies have found that dialectical behavior therapy (DBT), transference-focused psychotherapy (TFP), mentalization-based treatment (MBT), and schema-focused therapy (SFT) may improve symptoms of borderline personality disorder.
According to an article in the BMC Psychiatry journal, dialectical behavior therapy (DBT) appears to be the BPD treatment with the most evidence. DBT generally focuses on improving a person's quality of life, addressing any co-occurring mental illnesses, increasing self-worth, and finding a sense of purpose and fulfillment in life.
A qualitative research study looked at nine people with a history of BPD who had been recovered for at least two years after having received DBT treatment. The study authors found that the longer a person was in treatment, the fewer symptoms they typically experienced and the more they believed life was worth living.
As people with borderline personality disorder consider treatment, they might want to think about remote therapy specifically. Remote therapy can offer more flexibility in terms of both the time and place sessions are held. BetterHelp is a remote therapy platform that can connect you with the therapist best suited to meet your needs.
According to a 2022 study, online therapy appears to be effective in treating borderline personality disorder.
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