Encourage them to seek help

Encouraging your loved one to seek support is a good place to start. If you feel comfortable expressing your concerns in a non-judgemental and supportive conversation, this is a good starting point.

Be there to support them

The power of emotional support is underestimated. It’s one of the most powerful things you can provide to your loved one during challenging times. Providing non-judgemental support and understanding, as well as patience during those challenging times can be really helpful.

Listen with empathy

When someone is upset or angry, it's easy to be angry and emotional back at them. It’s a natural, understandable reaction, but not very helpful. A slower, calmer approach works better in general, but especially with people with BPD.

• Even when you don’t agree with everything that’s being said, give the person time to speak, and listen without expressing personal judgement or blame

• Empathise with the person, and imagine how distressed they must be feeling in order to be talking in that way

• Avoid sarcasm or other tones that can be misunderstood, and talk calmly, reflecting back their own words, to demonstrate that you have been listening

Express yourself

Communicating calmly with someone doesn't mean you can't say how you feel. If you’re angry or frustrated by something, it doesn’t help to suppress it. Let the person know how you feel, but do so in a calm, matter-of-fact manner. Explain that this is how you are feeling and the reasons for it, so there is a better chance of resolving the issue.

Families affected by BPD explain how emotions can be contagious. While this often works in a negative way, you can turn it around to create an atmosphere of calm, setting the tone for everyone. 'Contagious calm' can be a surprisingly effective way of helping everyone feel they have had their turn and been heard, so you can move on to resolving disagreements.

It can be easier to talk about something while walking or doing something together outside, rather than staring at each other across a table. Suggest going for a walk together or doing something else outside that the person with BPD finds relaxing. Sometimes it can help to have a neutral third-party there too, as a kind of mediator.

As well as giving the person with BPD respect, you have a right to expect it too. If you need to set boundaries for what is acceptable behaviour, explain these clearly and calmly, giving your reasons. 

Encourage independence

It can be tempting to feel responsible for fixing the problems and difficulties of a loved one with BPD. This is a natural instinct, but it can be counter-productive, especially if they have BPD.

Offer support, but encourage self-care and independence. This will not only help them become more self-reliant, but also promote a better sense of self-respect and a stronger sense of existing as an independent being, less vulnerable to other people's attitudes and actions.

Remind them of their positive traits

When someone you care about is finding it hard to believe anything good about themselves, it can be reassuring to hear all the positive things you see in them. Remind them of what they bring to the world and to the people around them.

Learn their triggers

Talk to your loved one and try to find out what sort of situations or conversations might trigger negative thoughts and emotions. Understanding their triggers could help you avoid difficult situations, and feel more prepared when they have strong reactions to certain things.

Set clear boundaries

Practising good boundaries and expectations can make a big difference. If your loved one is feeling insecure about being rejected or abandoned, or seems worried about being left alone, it can help to clarify what you can expect from each other and to communicate about this calmly and patiently if things become unclear.

Look after yourself

Caring can be hard and carers often put their needs last, but it doesn’t have to be that way. Carers deserve care. Also, if your mental or physical health suffers as a result of being a carer, you are less able to help.

You can't directly make someone with BPD get better. It's not your 'fault' they have the condition, and not your responsibility to 'cure' them. Recovery is something that people with BPD choose for themselves. Your contribution to this process is to be supportive while looking after your own health and wellbeing too.

So whenever you can, take time to prioritise your own needs: eat healthily, get regular sleep, exercise and fresh air, keep your alcohol consumption down and do things that calm you — listen to music, do yoga, mindfulness exercises or anything else that helps. It's the calming effect that matters, not the method, so choose whatever works for you.

This might seem like obvious advice, and it's easier said than done. But self-care has a powerful effect on people’s capacity to cope, and it's doubly important to look after yourself when you look after someone else too.

When someone has experiences BPD, it's easy for the condition to become the focus of the family's concern, with everyone else coming second or expected to look after themselves. So it’s important that everyone feels their needs are met.

Safety in a crisis

People with BPD have higher rates of self-harm and suicide than the general population. It can be really upsetting to know that someone is suicidal. If this is a concern in your family, it’s a good idea to develop a safety plan that includes strategies to delay, divert and distract from self-harm, and also the numbers of people and help services to call in times of high distress.

Discuss this with the person with BPD, who can develop a plan with support from their therapist.

When the person with BPD has their safety plan, ask for a simple summary of what to do that helps them to keep safe and where to call for help if needed — in your phone, for example.