How is the family affected by borderline personality disorder symptoms? Borderline personality disorder (BPD) is a devastating mental health condition that doesn’t just impact the person with BPD, it also impacts everyone they share relationships with, including friends, family and romantic partners. Since there are so many family issues that are directly impacted by borderline personality symptoms and behaviors, the entire family of a person with borderline personality may suffer. This article covers some of the most common effects of BPD on the family and how to find help as a family.
Stress in the BPD Family
Watching a loved one with BPD suffer, and dealing with very difficult relationship symptoms of BPD, are extraordinarily stressful for family members. Family members often feel helpless while watching their loved one with BPD engage in self-destructive behaviors. This may be particularly true for parents or caregivers of adolescents with BPD, who may seem out of control.
In addition to the chronic stress of caring for a loved one with BPD, many members of the BPD family will experience very severe psychological trauma due to some of the high-risk behaviors associated with BPD. For example, many people with BPD engage in self-harm behaviors, such as cutting or burning. These behaviors can become so severe that they can lead to accidental death. In addition, people with BPD have a very high rate of suicide. Family members are often the ones to manage these high-risk behaviors (e.g., driving their loved one to the emergency room after a suicide attempt) and may experience psychological trauma (which can, in severe cases, lead to problems such as post-traumatic stress disorder).
Guilt and Responsibility in the BPD Family
Many family members of people with BPD describe very difficult struggles with feelings of guilt. Research on the causes of BPD suggests that childhood maltreatment in the form of abuse or neglect may be related to the development of BPD. There is also evidence of a strong genetic component. These findings lead many family members, especially parents, to blame themselves or feel guilty, even if the development of their loved one’s BPD was outside of their control.
Along with the internal struggles about responsibility for the development of BPD, many family members have a hard time figuring out what responsibility they have for their loved ones’ recovery from BPD. Some families try to be supportive but are concerned that if they are too supportive they will reward some of the BPD-related behavior, such as self-harm. Others want to be supportive but feel angry at the person with BPD about their behavior. Finally, some have difficulty being supportive because of their own psychiatric issues. For example, because BPD does tend to run in families, other people in the family may also have BPD.
Struggles Between the BPD Family and the Mental Health System
The stress of dealing with a loved one’s BPD symptoms is compounded by the stress of managing their treatment. Often, clinicians rely on the BPD family to help organize the family member’s treatment, which can involve multiple providers and teams and many different levels of care (including outpatient treatment and occasional partial or inpatient hospitalization).
Family members may be called upon to notice changes in their loved one’s status (e.g., is their mood lower than usual or have they stopped taking their medications as prescribed?), provide transportation between appointments or coordinate searches for new treatment options. Negotiating these details, and the larger mental health system, is no easy task and can place another burden on an already stressed BPD family system.
Broader Effects of BPD on the BPD Family
Unfortunately, the stress, struggles and support issues involved with having a person with BPD in the family can have consequences on both the immediate and extended family. Parents of adolescents and adults with BPD describe the intense stress that caring for a child with BPD can introduce in to the marriage relationship. It is not uncommon for this level of stress to lead to strain in the marriage and even separation or divorce.
In addition, siblings are affected in many ways. Some siblings may also be pulled in to a caregiving role, while others may distance themselves from the family in order to protect themselves (or their own marriages, children, etc.) or to avoid the emotional distress involved in being in a close relationship with someone with BPD.
Extended family may also be affected; grandparents, aunts, uncles and other relatives are part of the BPD family support network, and they can also feel the strain of caring for a person with BPD.
Help for the BPD Family
It is not always easy for loved one’s to find the help and support they need to care for their family member with BPD. If you are committed to getting help, though, there are options and resources available.
First, if you suspect that your loved one has BPD and they are not yet in treatment, you can encourage them to get the help they need. BPD is a very serious mental illness that requires professional help; you cannot help your loved one alone. For tips on how you can find treatment for your loved one, read this article on getting help for BPD:
There are also resources specifically available for family members. For example, the National Alliance for Borderline Personality Disorder (NEA-BPD) offers the Family Connections Program throughout the United States. This program is a 12-week class designed to offer education, skills training and support to family members of people with BPD. To learn more about the program, visit the Family Connections page of the NEA-BPD website.
There are other programs, books, workshops and groups that focus on helping families of people with BPD. Below, find a link to a comprehensive list of resources for families:
Giffin J. Family Experience of Borderline Personality Disorder. Australian and New Zealand Journal of Family Therapy. 29:133-138, 2008.