Telling someone you suspect they have borderline personality disorder (BPD) can be an incredibly difficult conversation to have. BPD is a complex mental health condition characterized by struggles with emotion regulation, unstable relationships, impulsivity, and a fragile sense of self. If you have reason to believe someone close to you may have BPD, you likely care deeply about them and want to tread very cautiously. Accusing someone of having BPD or armchair diagnosing can easily backfire and damage your relationship. At the same time, voicing your concerns compassionately and encouraging them to seek professional help could be a lifeline if they are struggling. Here are some tips for having this delicate discussion in a thoughtful, caring way.
Why You Might Suspect BPD
There are many reasons you may suspect someone has BPD. Some common signs and symptoms include:
- Intense but unstable emotions and mood swings
- Explosive anger or feeling easily slighted
- Chronic feelings of emptiness
- Unstable, chaotic interpersonal relationships
- Impulsive or reckless behavior like substance abuse, unsafe sex, or binge eating
- Self-harming behaviors
- Frequent suicidal thoughts or threats
- Intense fear of abandonment
- Unstable self-image or sense of self
- Dissociation or feeling detached from yourself
You may have noticed some of these signs or the person may have even confided that they struggle to control their emotions or behaviors. Whatever your reasons for suspecting BPD, it’s important not to jump to conclusions. Only a mental health professional can make an accurate diagnosis after a thorough evaluation.
Consider Your Motivations
Before deciding to share your suspicions, spend some time soul searching about your motivations and goals for having this discussion. Are you genuinely concerned this person is suffering and wants help? Or could you have ulterior motives like wanting to control them, get revenge, or end the relationship? If your intentions don’t come from a caring place, it’s best not to say anything at all. Focus on your own behaviors rather than trying to diagnose others.
If your aim is to help this person, make sure you’re approaching the conversation from a place of compassion, not judgment or criticism. Keep in mind there’s often stigma associated with BPD. Assure the person you care about them no matter what.
Educate Yourself First
It’s essential to learn more about BPD before talking to the person so you can have an informed, thoughtful discussion. BPD is often misunderstood or portrayed negatively. Educate yourself on the facts from credible sources like mental health organizations, not inaccurate online forums or stereotypes. Some key things to know:
- BPD has biological and environmental roots – it is not anyone’s fault or due to personality flaws.
- Many people with BPD want help but struggle to access and afford proper treatment.
- With professional help like psychotherapy, medication, and support, many people with BPD see great improvement in symptoms.
- Not everyone with BPD experiences the same subset of symptoms.
The more you understand BPD, the more empathy you can have for what this person may be going through.
Choose the Right Time and Place
Carefully consider when and where to have this conversation. Don’t blurt it out in passing or during an argument when emotions are already running high. Instead, set aside dedicated time to talk privately and free from distractions. Make sure the person isn’t already upset or in a vulnerable state when you bring this up.
If meeting in person isn’t feasible, at least have the talk over video chat or phone so you can better connect. Avoid text-based communication which can easily be misconstrued. However, only initiate the conversation if you have an established relationship with the person. Discussing mental health with a stranger or loose acquaintance is inappropriate.
Use “I” Statements
When expressing your concerns, use “I statements” focused on your perceptions and worries rather than accusatory “you statements.” For example:
- I’ve noticed you seem really down lately and talk about hating yourself. I’m worried about you.
- I feel like we fight a lot and have trouble communicating calmly. It’s taking a toll on our relationship.
- I’ve seen you act impulsively in ways that scare me. I care about you and want to understand what’s going on.
This non-judgmental language makes the person less likely to get defensive and more receptive to a caring dialogue. Avoid absolute statements like “you always overreact.”
Acknowledge Their Feelings
Let the person share their perspective and validate their feelings. Don’t lecture or dismiss their experience. Comments like “I’m sure it’s not that bad” shut down conversation. If they deny or downplay the issues, don’t argue. Simply express you want to be a support for them, and revisit the topic another time if needed.
If they admit to symptoms like depression or self-harm, thank them for their honesty and recognize how hard it must be to struggle with those feelings. Assure them you take their pain seriously and only have their best interest at heart.
Share Specific Observations
Give concrete examples of behaviors that led to your concerns. For instance:
- “Remember last week when you yelled at me for being 10 minutes late, then later felt really guilty about overreacting? I could tell you were really upset with yourself.”
- “I’ve noticed you have a lot of falling outs with friends where you feel they’ve abandoned you. I see how much that hurts you each time.”
- “When you call me in the middle of the night talking about wanting to hurt yourself, I feel scared that you might actually try.”
Citing real observations rather than vague criticisms can help them connect the dots about their mood and behavior patterns. Stick to your own first-hand experiences rather than hearsay.
Acknowledge Overlap with Other Conditions
Some BPD symptoms may also be signs of other common mental health issues like depression, anxiety, PTSD, or bipolar disorder. Note any other possibilities you think could be impacting their wellbeing too. For example:
“I notice some of your mood swings seem really severe, I wonder if seeing a doctor about possible bipolar disorder might help.”
This shows you’re not trying to diagnose them yourself but want an expert to properly identify and treat any issues.
Express Why You Care
Remind the person how much they and your relationship means to you. For example:
“I care about you so much and value our friendship. I can see you’re really hurting, and I want to help in any way I can. I brought this up because I hate seeing you in pain and want you to find some relief and support.”
Knowing your concern comes from a place of kindness can ease any defensiveness and make them more receptive.
Suggest Seeing a Therapist
Gently recommend making an appointment with a licensed mental health professional. You can offer to help them research providers and even attend the first session if they want moral support.
Note that evaluating and accurately diagnosing any mental health condition requires clinical expertise. But a therapist can also simply help with troubling symptoms without putting labels on it. Frame therapy as a useful way to develop coping skills and feel better overall.
Send Resources Afterward
Follow up after your conversation by sending educational resources about BPD and mental health treatment options. Reputable organizations like the National Alliance on Mental Illness or the National Education Alliance for Borderline Personality Disorder have informative websites with guidance that may resonate with them.
Let them explore facts independently and come to terms with everything at their own pace. Don’t overload them in the initial talk.
Set Boundaries If Needed
If certain behaviors have become toxic or abusive in your relationship with this person, you may need to set firmer boundaries temporarily while they seek help. For instance, if their anger outbursts or self-harm threats have become dangerous or emotionally exhausting for you, it’s okay to step back and prioritize your own well-being.
Explain you care about them but cannot continue the status quo for your own health. Stressing that professional treatment will better equip them to manage their reactions can motivate positive change.
Have Realistic Expectations
Keep in mind this conversation may not go smoothly, and the person may react with anger, denial, or by shutting down. Do not take it personally. With BPD, emotional reactions can seem disproportionate due to profound shame, instability, and fear of abandonment. Expect potential defensiveness and be prepared to calmly revisit the issue another time if needed.
Even if the talk does go well, they may still struggle to follow through with therapy or resist the idea they have a mental health condition requiring treatment. Recovery is a gradual process requiring patience and support. Manage your expectations, and focus on expressing concern for their wellbeing above all else.
Navigating the Conversation
Once you’ve laid the groundwork thoughtfully, it’s time to actually speak with the person. Here are some key tips for navigating the sensitive conversation:
Pick a Stable Moment
Wait until the person seems regulated and not already emotionally activated or in distress before initiating the talk. You want them calm enough to have a thoughtful discussion.
Use a Gentle Tone
Keep your volume and tone of voice soft. A confrontational, aggressive approach will make them shut down. Project nothing but kindness and concern.
Let Them Talk
Give them space to share their perspective and feelings instead of lecturing. Listen attentively and reflect back what you hear.
Suggest Not Diagnosing
If they try to diagnose themselves, steer them away from this, as only a professional can accurately assess mental health conditions.
Come from a Place of Support
Stress you believe in their ability to get healthy and are willing to help in any way. Shame or scare tactics will only make matters worse.
Set Another Time to Chat
If emotions start running high, agree to pause and resume the dialogue later when things have calmed down.
Offer to Join a Therapy Session
Offer to attend an initial therapy visit together if it would make them feel more comfortable taking that step.
Help Find Treatment Options
Offer to help research affordable therapists or clinics, enroll in insurance/coverage programs, arrange transportation, etc. Remove obstacles to seeking help.
Check In Without Judgment
In future chats about this issue, simply ask how they’re feeling about things without lecturing or making demands. Let them share at their own pace.
Celebrate Small Steps
If they pursue therapy or start making small positive changes, recognize these successes so they feel proud and motivated.
What Not to Do
There are also some key mistakes to avoid when voicing your concerns:
- Don’t accuse, guess at diagnoses, or label them with illnesses.
- Don’t present their symptoms as toxic behaviors or personality flaws.
- Don’t issue ultimatums or threats if they don’t get help.
- Don’t share your observations with others or spread rumors.
- Don’t bring this up while you or the person is already upset.
- Don’t debate their denials or force them to accept their symptoms.
- Don’t nag, lecture, or convey disappointment if progress is slow.
- Don’t share statistics on BPD risks that provoke fear or hopelessness.
Demonstrating compassion is more constructive than taking an aggressive or coercive stance.
When to Seek Emergency Help
While you want to have sensitive conversations about mental health at appropriate times, certain situations require urgent action:
- If the person is in immediate danger of self-harm or suicide, call emergency services or the National Suicide Prevention Lifeline at 1-800-273-8255.
- If they are having a mental health crisis with severe symptoms like seeing or hearing things that aren’t there, call a crisis hotline or take them to an emergency room.
- If their substance abuse is at a life-threatening level, seek medical intervention. Don’t wait to have a discussion.
- If they are threatening to harm you or others, remove yourself from the dangerous situation and get help from emergency responders if needed.
Prioritize safety in emergency scenarios, and talk about next steps like therapy once the crisis has stabilized.
Conclusions
Suspecting a loved one has BPD can be scary. But voicing your concerns sensitively may motivate them to seek help and find relief from suffering. With compassion, patience and the right professional treatment, individuals with BPD can absolutely better manage symptoms and lead fulfilling lives. Avoid shaming or cornering them. Instead come from a non-judgmental place of caring. Ensure you’re also taking care of your own well-being throughout the process. Addressing mental health issues openly but gently with supportive loved ones makes recovery possible.
