How to Handle Borderline Personality Disorder in Relationships

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Many mental health conditions can add increased stress to a relationship, especially if you don't have tools to help you work through these added challenges. Borderline personality disorder falls under the umbrella of personality disorders for mental health conditions.

People who have borderline personality disorder experience changes in how they perceive relationships based on the severity of their symptoms. This can lead to different challenges in the relationship both for the individual living with this condition and their partner.

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What Is Borderline Personality Disorder?

Borderline personality disorder (BPD) is typically diagnosed during adolescence or early 20s. People who have this condition often experience large changes in their mood and often aren't certain how they see themselves and the world.

Common symptoms of BPD include:

  • Fear of abandonment and difficulty trusting
  • Pattern's of intense unstable relationships
  • Unstable self-image and sense of self
  • Recurring thoughts of suicide and threats of self-harm
  • Self-harming behaviors
  • Intense and varying moods
  • Suspicions of others and fear of their intentions
  • The feeling of emptiness or sadness
  • Intense anger and problems controlling anger
  • Feelings of dissociation from self and disconnected from the world around

The frequency, severity, and how long each symptom lasts varies based on the individual and any other conditions they have.

It’s common for people with BPD to also have a mood disorder, and the most common are:

Effects on Relationships

Research suggests that the attachment style of people with BPD is a common difficulty in relationships. Some issues include:

  • Fear of abandonment: This can lead to them either becoming overly attached in an attempt to prevent their partner from leaving or they could choose to leave first before their partner has the chance to leave. 
  • Difficulty connecting: Communication and connecting are challenged by the shifting views of their identity and place in the world. This can lead to difficulty connecting with one’s partner and leave the relationship chaotic, feeling like a rollercoaster with many highs and lows.
  • Mood swings: People with BPD experience large swings in their mood and tend to view things as all good or all bad. Studies show increases in hostile actions, verbal aggression, and physical aggression in relationships when BPD symptoms begin during adolescents.
  • Distrust: People with BPD tend to be distrusting and suspicious of others. This can cause them to question the intentions of their romantic partner and distrusting their behaviors.

One study compared the relationships of couples where one partner had BPD with relationships where neither partner had BPD. They found that the perception of the relationship for the partner who had BPD was more negative than their partners, demonstrating that BPD symptoms impacted their happiness and trust in their romantic relationships.

Diagnosing and Treating BPD

Diagnosis of BPD is done through an interview and assessment by a trained mental health professional. They will use the assessments to see if they meet the criteria to be diagnosed with BPD and rule out other mental health conditions that have similar symptoms.

Psychotherapy is the primary treatment for BPD. It provides tools and coping mechanisms to help identify and manage thoughts, feelings, and behaviors. The goals of psychotherapy are to help learn to manage emotions, reduce impulsive actions, improve awareness in relationships, and understand borderline personality disorder.

There are no medications that specifically treat borderline personality disorder. In some cases, medications are recommended to help with co-morbid conditions such as anxiety and depression.

Couples Therapy

A properly trained mental health therapist in BPD can provide couples therapy to help identify which feelings are caused by BPD symptoms and improve communication between the couple.

This could help the partner of the person with BPD to better understand the disorder and they can learn techniques of how to best support each other.

Supporting a Partner With BPD

If you have a partner who is living with BPD, it’s important to focus on communication and taking care of yourself.

There are many challenges that can occur, but there are ways you can help to support a partner with BPD. These include:

  • Educating yourself: Learn as much as you can about BPD. Understanding the cause of the behaviors are symptoms of a mental health condition can increase compassion and ease some of the difficulty.
  • Seeking help for yourself: Get help from a trained mental health professional.
  • Practicing clear communication: BPD can cause people to jump to conclusions and misunderstand others meaning, clearly communicating, and expressing fears to each other can help.
  • Knowing how to spot symptoms of a BPD episode: Save important conversations for when the person living with BPD is calm.
  • Asking your partner how you can help them: Knowing how to support them when they are experiencing an episode of symptoms will help.
  • Build your own self-care routine: It can be stressful supporting someone with a mental health condition, so building your own social support systems and coping techniques is important.

What to Do In a Crisis?

If you or a loved one is in crisis, facing mental health or substance abuse issues, call the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-622-HELP (4357). This confidential service is available 24/7 and provides information on resources, treatment facilities, and support groups in your area. View other helplines at this national helpline database.

Take threats of self-harm or aggression to others seriously and don’t hesitate to seek help and take them to the emergency room if you are concerned about their health or the safety of others.

Prognosis

It takes work and presents lifelong challenges, but with a treatment plan and working with therapists, BPD can be managed. People with BPD often are very compassionate to others and can have healthy relationships.

A Word From Verywell

Because of the frequent changes in emotions and mood, BPD has an impact on relationships. Following a treatment plan and consistently working on communication can help with managing the effects BPD has on relationships. Even though BPD can add different challenges to a relationship, people with BPD can still have healthy relationships. 

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