Borderline personality disorder can be a confusing diagnosis, and there are many misconceptions about what people with BPD experience. Educating yourself about the condition, its symptoms, and prognosis can help you gain a clearer understanding of what your loved one is going through. You can read about the illness online from reliable sources such as the National Institute on Mental Health (NIMH) or the National Alliance on Mental Illness (NAMI), or you can contact a mental health care professional directly for a more personal conversation. Demystifying borderline personality disorder can help you cut through the confusion, more deeply appreciate your loved one’s struggle, and feel better equipped to support them through their healing journey.

People with BPD experience reactions and an intensity of emotion that people without the disorder can often not relate to. It can be tempting to try to talk them out of what they are feeling or write them off as simply irrational. However, those feelings are very real to the person with the disorder. Therefore, dismissing their emotions is not only profoundly painful, it is counterproductive.

You can provide validation without agreeing with them. Often, simply mirroring back what they are telling you can be highly effective. For example, you can say, “I can see that you are hurting, it must be terrible to feel that way,” instead of, “There’s no reason for you to feel this way.” Listen with empathy, compassion, and respect. Validation is so critical for people with BPD that it has become one of the most central components of treatment. Ensuring that your loved one feels heard can go a long way toward helping both your loved one and your relationship.

Depending on their current state, people borderline personality disorder may distort what you are saying in order to confirm their own worst suspicions of you or of themselves. A seemingly innocuous statement can easily be twisted into an attack, even if it is the furthest thing from what you meant. It can feel as if you cannot get through to your loved one because the illness stands between you, filtering out your true intentions and making communication impossible. To minimize the risk of this happening, Randi Kreger, author of the renowned Stop Walking on Eggshells, suggests:

When speaking with [a person who has BPD], especially about sensitive issues, remember emotion is likely to be so strong that neither of you can do high-level thinking. Make each sentence short, simple, and direct. Leave no room for misinterpretation.

Of course, this doesn’t guarantee that misinterpretation won’t happen, but it can facilitate communication to help you avoid it as much as possible.

When someone you love has BPD, it can be easy to fall into a caretaking role. After all, it’s natural to want to help someone you care deeply about and restore normalcy as soon as possible. However, encouraging responsibility is sometimes the most loving thing you can do. This doesn’t mean leaving them alone to cope with their illness without support, but it does mean resisting the urge to rescue them from the consequences of their actions.

If they break something while angry, don’t jump in to fix it for them. If they get into credit card debt, don’t bail them out. Allowing them to experience natural consequences can help them understand that they need help. It also allows you to more effectively cope by stepping back and not taking responsibility for things that are not your fault. As counterintuitive as it may initially seem, this can be a deeply empowering experience for both of you.

Just as encouraging responsibility can initially feel wrong, like you are betraying your loved one in some way, so too can setting boundaries. However, setting and sticking to boundaries can give you both a much-needed sense of structure and agency. It encourages your loved one to be accountable for their choices, keeps you from enduring unacceptable behavior, and can ultimately strengthen your relationship.

When setting boundaries, think about what will be both helpful and realistic. Introduce new ideas calmly and with love rather than accusations and shaming. Don’t be surprised if your loved on initially takes the establishment of boundaries as a sign of rejection and things may get worse before they get better. Stick it out through this difficult time; boundaries can be profoundly beneficial to both of you.

Threats of suicide or self-harm are common amongst people with BPD and many people see these threats as attention-seeking and manipulative, particularly if their loved one has yet to follow through. However, actual suicide and self-harm are also common amongst people with BPD and threats should never be ignored. About 10% of those living with BPD die by suicide and, contrary to popular belief, 80% of people who plan to attempt suicide signal their intentions to others, including by talking about it.

If your loved one is threatening to take their own life or hurt themselves, don’t argue with them. Don’t accuse them of being manipulative or just wanting attention. Instead, recognize that they are in deep pain and express your concern while maintaining your boundaries. Call their doctor, 911, or the National Suicide Prevention Lifeline (1-800-273-TALK) and stay with them until they are in the care of a professional. While it is never your fault if a loved one attempts suicide or self-harms, it is vitally important to do what you can to keep them safe.

People with BPD are often reluctant to seek treatment for a wide variety of reasons, including believing that their feelings are justified or having had negative experiences with mental health care professionals in the past. However, professional mental health treatment is necessary in order to restore emotional harmony and ensure your loved one has the support they need to make meaningful changes. It may fall to you to find that treatment.

For many people with BPD, residential mental health treatment programs offer the best environments in which to begin the healing process. The immersive milieu and intensity of therapy made possible by these programs allow your loved one to be continuously monitored and make rapid progress toward wellness. Using a personalized curriculum of individual, group, and holistic therapies, they can begin to deeply explore their illness and develop concrete strategies for making emotional and behavioral change. If your loved one has experienced trauma, connecting with a program that offers specialized trauma-focused therapies can be paramount to the healing process.

However, all residential treatment programs are not created equal. Finding a program staffed by compassionate, highly-trained clinicians with extensive experience treating people with BPD is vital to ensuring your loved one receives the best possible treatment.

Learning how to cope with borderline personality disorder is not easy, either for you or your loved one. Many family members of people with BPD experience profound isolation, fear, and shame as they struggle to navigate the illness and it is important to make sure your own needs and feelings do not get lost in your quest to support your loved one. Remember to take time for yourself and nourish yourself, mind, body, and spirit. By seeking your own individual therapy and/or connecting with support groups for loved ones of people with BPD, you can get the guidance you need to cope. The family programming offered by some residential mental health treatment programs is often an invaluable source of support and designed specifically for people like you.