How to Be Friends With
Someone Who Has Borderline Personality Disorder
by
Fiona Kennedy:
Sunny Spells and Scattered Showers
Borderline personality disorder is a monumental pain to live with,
both for those of us diagnosed, and those trying to support us. The diagnostic criteria are absolutely huge, and if
you were to sit 10 people with borderline in the same room, chances
are symptoms would manifest differently for all of them. We can be
delightful, engaging, calm and compassionate one minute, and then
for reasons which may seem completely inconsequential or even
invisible to an onlooker, we can flip in seconds to the exact
opposite. Borderline is all about extremes, and this can make us
challenging to be around. Understanding what’s going on is crucial
to getting a handle on it, for us and for those around us. In no
particular order of preference, here are a few things I would like
people to know:
Be honest with me. If I have said or done something to upset you,
please let me know. The conversation might not be pleasant, but
avoiding it just makes things worse
Sometimes I won’t be able to talk to you. It’s nothing personal,
it’s just that sometimes I feel so awkward and out of place that I
can’t actually string a sentence together.
Similarly, sometimes you won’t be able to talk to me because I will
frustrate the hell out of you. That’s ok.
If you need some space, just tell me. It’s up to me to manage my
response to that.
If I don’t make eye contact, that’s a pretty strong indicator that
I’m not doing well You are not responsible for making me better.
If you can, listening on a bad day would be awesome, but I
understand that won’t always be possible. You’re not my therapist!
I want to know what’s going on with you - never, ever feel like you
can’t talk to me. There are two of us in this relationship I’m
really good at picking up on your moods, good, bad, or otherwise.
Unfortunately I also have a tendency to assume it’s my fault if
there’s something wrong, so if you’re able, talk to me. Chances are
I’ll understand
Sometimes my reactions to seemingly minor events will be epic. Nine
times out of ten, it’s nothing to do with the actual event, but
rather what it has triggered in me.
For me, finally getting a diagnosis, while horrifying, was also a
relief because it meant I knew what I was dealing with. It meant I
could learn more about why I think and act as I do, and how this has
impacted on my life over the years (clue - a lot). It has also made
it possible to access the right treatment, and start to gain control
over symptoms. Part of that gaining control has meant having to have
some really difficult conversations with people - my husband, my
family, my friends, even my employer. Borderline is so hard to
understand, even for those of us living with it, so I can only
imagine how challenging it must be at times to be on the outside
looking in. There have been times when my behavior has been way out
of line, and while borderline may be a reason, it’s not an excuse.
It’s my responsibility to learn as much about it as I can, and
then do as much as I can to keep symptoms under control. So far this
has taken the form of long term psychotherapy, medication under
supervision of a psychiatrist, and more recently, compassion
focused therapy and dialectical
behavior therapy. I know more
about my triggers and how I’m likely to react when I encounter them,
but despite this, I also need to be willing to admit to the times
when I’m struggling to keep things under control, and seek extra
help as and when necessary. I don’t have many close friends, but
those I do I really, really value, and they’ve gotten me through
some incredibly tough times. It’s so hard to admit to some of the
crappy and occasionally full on crazy thoughts that borderline makes
me think, and I really struggle at times with the impact this has on
those around me, but as I’m writing this, I’m noticing a running
theme. Talking. It makes all the difference. As often as I can, I’ll
tell you what’s going on. Will you tell me?
Yes, it does/can get better. No, things do not always have to be
this way. This is based entirely on the individual though. I’ve
received correspondence from many people in their 40’s, 50’s, and
60’s that still suffer with the more intense problems of Borderline
Personality Disorder. These are often people that haven’t received
any help, sufficient treatment, or had trouble acquiring any kind of
treatment or support at all.
From my experience I can’t say that Borderline Personality Disorder
will just spontaneously get better on its own. Over time the
severity of symptoms is likely to diminish but they may not go away
entirely. I think this is due, in part, to life experience. When a
person reaches a certain age, by virtue of experience and having
lived through so many situations they can recognize that all the
traumatic feelings that they experience are feelings they’ve had
before, and despite how they feel, see the pattern that things don’t
turn out as terribly as they feared, or that they are in fact,
capable of coping with the results of what do happen.
Then there’s also the fact that the human body and psyche can only
handle so much. It can only deal with so much constant bombardment
of adrenaline boosting anxiety and pain before it starts to wear
down. Or build up a tolerance. When you’ve been exposed to something
for so long, the body adapts. It’s a basic principle of existence.
Adapt or die.
Constantly fighting the pain, tears, and trauma is exhausting.
Eventually the body builds up a little tolerance to all the things
that create such distress and while things may still cause anxiety
and panic, the intensity of those emotions no longer reaches the
same heights. The body, the mind, the spirit… gets tired. And
tougher.
Like scar tissue for the mind. It’s not to say that the pain won’t
eventually come through, but it doesn’t penetrate quite as easily.
Which still doesn’t sound incredibly encouraging.
However! That’s the theory for those with BPD that have never
accepted or found support or tried to work through the disordered
thinking that we have to deal with. The odds of having your
Borderline Personality Disorder improve rises drastically and
dramatically when you are able to admit there is a problem, seek
help, support, and/or therapy, and actively work to tame the wild
beast that is the Borderline Personality.
You don’t have to tell me that this is easier said than done. You
don’t have to tell me that there are times when therapy feels futile
and it seems like nothing will ever improve. Trust me, I’ve been
there. I still have those days. But those feelings pass. You’re kind
of on this journey with me. I still have my bad days. I have a lot
of my bad days. But I have many more good days as well. Days without
panic, without anxiety, without depression. Days with happiness! Or
just contentment. Those feelings are so foreign to me that it’s hard
for me to recognize them at first. By the simple fact that I have
had days like that, days where my world wasn’t shrouded in darkness,
proves to me that even though things may not be perfect, things most
certainly can get better.
The choice is yours. That’s the important thing to remember. Blaming
our parents, blaming our exes, blaming the world around us,
regardless of whether or not our circumstances are our fault, does
not help. I certainly blamed my Evil-Ex for the years of trauma and
unhappiness I had to deal with when I was with him. But blaming him
isn’t going to make my situation better. Blaming him isn’t going to
suddenly make him take it all back and try to fix my life for me.
That’s never going to happen. It wasn’t fair, but life usually
isn’t. The only one that can decide to make my life better, is me.
It sucks that things have to be so hard. It’s a shitty hand to be
dealt, but it’s the only hand we have. We can let the murk mire us
in thoughts of self-pity, blame, and loathing… perpetuating a cycle
of dismal depression and anxiety, or we can decide to make a change.
In time, things may get a little better on their own, but frankly,
I’m sick of waiting, and I don’t have a lot of faith that the world
is suddenly going to smile on me and decide that I’ve dealt with
enough shit for one person already. Borderline Personality Disorder
can absolutely improve with age, but the amount of improvement is
directly proportional to the amount of effort you are willing to put
forth.
I’ve seen a lot of “studies” and read a lot of testimony from
therapists and social workers that say in X amount of years they’ve
never seen improvement for BPD. There are a lot of reasons for this,
including the fact that these people probably were not skilled or
trained in the very recent developments that create real change for
those with Borderline Personality Disorder. Therapists/clinicians
are people too, and certain types of people are simply not equipped
to deal with someone that can be more difficult to pinpoint their
problems. That’s why we have specialized therapy now. Major, MAJOR,
strides have been made in therapy specifically meant for us. Don’t
let these limited perspectives discourage you. They usually don’t
have the kind of knowledge or experience to give an inclusive
opinion.
The other thing that I’ve noticed people focus on is the distinction
between what improves. Many say the ‘symptoms’ of BPD often improve;
the self-harm, the suicidal ideation, the paranoia, impulsivity… but
how about the instability in relationships? That’s a different kind
of symptom. That first group of symptoms are internal to the one
person suffering with BPD. However, relationships take two. It seems
more broadly agreed upon while the individuals symptoms may improve,
things like abandonment and dependency issues are longer lasting.
Again, this is all dependent on the individual, what kind of help
they seek, and how much effort they put into their own recovery.
I
can’t promise that all symptoms of BPD will eventually go away. I
can’t promise that everything will one day be healed and no longer
any issue at all, even with therapy and dedication. I can say that I
am entirely optimistic that these things can all become manageable
and not the monsters we know them to be.
BPD is not something that is going to get better in days, weeks or
months. Hell, even years may be an estimate that is too
conservative. I’m going on a year and a half of intense therapy and
medication and I’m far from ‘recovered’, but my Therapist tells me
every week that she can see improvements. What’s more though, is I
FEEL better.
Without acknowledging the issue that is BPD there may be little to
no improvement for decades. Even with active acknowledgement and
intense effort improvement can take years. I don’t mean to be
discouraging, but I do mean to be realistic. You know me. I don’t
sugar coat anything. That’s not why I do this. Think about this: In
a world where it is now common to live into our 80’s and 90’s, isn’t
taking a year or two to really focus on ourselves, worth it? If we
can have 40, 50, 60 years of living that is more content and happy
than what we currently know, isn’t the long term pay off worth the
struggle and introspection?
Taking care of our mental health is no different than taking care of
our physical health. If you eat nothing but junk food, load up on
soda, and smoke 2 packs of cigarettes a day your body is going to be
pissed and reward you with a heart attack by the time you’re 40. If
you eat healthy, exercise, get a good amount of sleep and don’t
abuse your body… in other words; work on taking care of yourself,
your odds of living a long and productive life vastly improve.
Whether Borderline Personality Disorder improves or worsens with
age, is up to you.
Top
Recovery probabilities in varying
degrees from BPD.
Top
Roller-Coaster
Relationship: Your Partner with Borderline Personality Disorder
By Kate Thieda
If you have a partner with
borderline personality disorder (BPD), your relationship may look
something like this:
•Yesterday, in the eyes of
your partner, you could do no wrong. Today, everything you do is
wrong.
•Ten minutes ago, your partner was smiling and happy. Now, they are
screaming at the top of their lungs about a perceived snarky comment
from you, which was not meant in the way it was interpreted, and
household objects are being thrown. You hastily leave to go to work.
•By the end of today, you will get 15 text messages, eight phone
calls, and 10 emails from your partner that ask if you still love
them, and threatening suicide if you end the relationship.
According to the National Institute for Mental Health, two percent
of Americans are diagnosed with BPD, which equates to about six
million people, although some estimates are as high as six percent,
or eighteen million people. Women are more frequently given the
diagnosis, but that may be because they present for psychiatric
services more often than men, or because of provider bias, with men
being diagnosed with antisocial personality disorder instead of BPD.
Obviously, having a
relationship with someone who experiences BPD is a challenge. At the
beginning of your relationship, there may have been a honeymoon
period where you were idealized by your partner. But now you may be
experiencing the darker side of BPD: fears of abandonment, impulsive
behaviors (gambling, unsafe sex, spending sprees, binge eating, drug
use), emotional instability, and suicidal gestures or attempts.
What does the partner of
someone with BPD do?
Helping your partner find the
right treatment is crucial. Convincing them to first try treatment,
and then stick with it, however, is a whole other issue. BPD clients
are frequently considered the “toughest to treat” by mental health
professionals because of the instability they present. Remember,
what happens in the “real world” also happens in therapy offices:
the same patterns your partner with BPD does at home happen with the
therapist, too.
But there is hope. Dialectical
behavioral therapy (DBT) is considered the most effective treatment
for BPD. There are a ton of resources online about DBT, including
the blog Dialectical Behavior Therapy Understood here on
PsychCentral, so I invite you to check them out to learn more. There
are other treatments that are beginning to receive more attention as
well, such as mentalization-based therapy (MBT),
transference-focused psychotherapy (TFP), schema therapy (ST), and
cognitive behavioral therapy (CBT) tailored specifically to BPD.
Next, finding a therapist to
help you is vitally important as well. Even if your partner is in
treatment, the instability and uncertainty around their mood and
behavior will not resolve overnight. Treatment for BPD is a long
process, and if you and your partner are going to get to the other
side with your relationship intact, you are going to need
professional support.
It is important for you to
learn about DBT as well so that you can participate in your
partner’s recovery. One way to do this is through DBT Family Skills
training.
As for day-to-day ways to
support your partner during the recovery process, some tips include:
•Do not ignore your partner’s
threats to harm themselves. After a while, family and friends can
become desensitized to the threats of the person with BPD. However,
it is common, especially when someone is in treatment, for things to
actually get worse before they get better. Statistically, around
9-10% of people with BPD complete suicide, and it is often by
accident. Don’t take chances: call 911 or bring your partner to the
emergency room if they are threatening suicide. Let the mental
health professionals decide the level of actual threat.
•Learn how to validate your partner’s experience. One of the
theories behind DBT is that the person with BPD grew up in an
invalidating environment, which means they were consistently told
that their feelings were bad or wrong, or may have even been
physically punished for showing emotion, even if their reaction to
the situation was perfectly appropriate.
•Use good communication skills to set boundaries with your partner.
Another hallmark of the experience of people who have BPD is that
their lives have always been unstable. Having boundaries in place in
their adult relationship, and especially having those boundaries
remain in place when tested, helps to provide your partner with a
safe environment that they know will not fail them.
•Take care of yourself. I say this in practically every post: if you
are not caring for yourself, you are not in a position to help your
partner get better.
Top
What is the prognosis of
people with borderline personality disorder?
from MedicineNet.com website
As with any illness, an
appropriate question about BPD is if it is curable. While
improvement in any personality disorder is not synonymous with being
cured, the symptoms of BPD do tend to diminish with time. How well
or poorly people with BPD progress over time seems to be influenced
by how severe the disorder is at the time that treatment starts, the
state of the individual's current personal relationships, whether or
not the sufferer has a history of being abused as a child, as well
as whether or not the person receives appropriate treatment.
Simultaneously suffering from depression, other emotional problems,
or a low level of conscientiousness have been found to be associated
with a greater likelihood of symptoms of BPD returning (relapse).
Conversely, having steady employment or school status once symptoms
of BPD subside (remit) tends to protect BPD sufferers from
experiencing a future relapse.
|