Borderline Personality Disorder: Symptoms, Causes & Treatment

What Is Borderline Personality Disorder?

Borderline Personality Disorder (BPD) is a mental health condition characterized by persistent patterns of emotional instability, impulsive behavior, distorted self-image, and unstable relationships. People with BPD experience emotions more intensely and for longer periods than others, and they often struggle with a chronic fear of abandonment. BPD affects approximately 1.6-5.9% of the general population and is equally common across all genders.

Borderline Personality Disorder, also known as Emotionally Unstable Personality Disorder (EUPD) in the ICD classification system, is one of the most studied personality disorders in psychiatry. The term "borderline" was historically used because clinicians observed that patients seemed to be on the "border" between neurosis and psychosis. While this conceptualization is now considered outdated, the name has persisted in diagnostic manuals like the DSM-5.

At its core, BPD is a disorder of emotional regulation. People with BPD experience emotions with an intensity that can feel overwhelming. A minor disappointment might feel like a catastrophe, a small criticism might trigger intense shame, and a perceived rejection might lead to profound despair. These emotional responses are not chosen or exaggerated - they reflect genuine differences in how the brain processes and regulates emotional experiences.

The condition typically emerges during adolescence or early adulthood, though some symptoms may be present earlier. Research has shown that BPD is not a lifelong sentence - with appropriate treatment, many people experience significant improvement. Longitudinal studies have demonstrated that up to 85% of people with BPD no longer meet the diagnostic criteria after 10 years, though some symptoms may persist.

Understanding BPD requires recognizing that it exists on a spectrum. Some people have mild symptoms that primarily affect close relationships, while others experience severe symptoms that impact every aspect of daily life. The condition also frequently co-occurs with other mental health conditions, including depression, anxiety disorders, eating disorders, and substance use disorders.

How BPD Differs From Normal Emotional Experiences

Everyone experiences intense emotions at times, and many people have occasional relationship difficulties or moments of uncertainty about their identity. What distinguishes BPD is the persistence, intensity, and pattern of these experiences. While a person without BPD might feel hurt after a disagreement with a friend, someone with BPD might experience this as evidence of complete rejection, triggering intense fear, anger, or a desire to end the relationship entirely.

The emotional instability in BPD is often described as a "emotional rollercoaster" - moods can shift dramatically within hours, sometimes in response to interpersonal events and sometimes seemingly without cause. This instability makes it difficult to maintain a consistent sense of self, leading to chronic feelings of emptiness and identity confusion.

The Biology Behind BPD

Brain imaging studies have revealed that people with BPD show differences in areas involved in emotion regulation, impulse control, and social cognition. The amygdala, which processes emotional responses, tends to be more reactive in people with BPD. Meanwhile, the prefrontal cortex, which helps regulate emotions and impulses, may show reduced activity. These neurobiological differences help explain why people with BPD experience emotions so intensely and struggle to modulate their responses.

What Are the Symptoms of Borderline Personality Disorder?

The main symptoms of BPD include intense fear of abandonment, unstable and intense relationships, identity disturbance, impulsivity, recurrent suicidal behavior or self-harm, emotional instability, chronic feelings of emptiness, inappropriate intense anger, and transient paranoia or dissociation. To be diagnosed with BPD, a person must have at least five of these nine symptoms persistently over time.

The symptoms of Borderline Personality Disorder are organized into nine criteria in the DSM-5 diagnostic manual. To receive a diagnosis, a person must exhibit at least five of these nine symptoms in a persistent pattern that causes significant distress or impairment in functioning. It's important to understand that these symptoms exist on a continuum - some people experience them mildly while others experience them severely.

Fear of Abandonment

People with BPD often experience an intense, sometimes desperate fear of being abandoned by people they care about. This fear can be triggered by seemingly minor events - a friend being late to meet, a partner not responding to a text immediately, or a therapist going on vacation. The fear is often so overwhelming that it drives behaviors aimed at preventing abandonment, which can paradoxically push people away.

This abandonment sensitivity means that people with BPD are constantly scanning their environment for signs that someone might leave them. A neutral facial expression might be interpreted as displeasure, a brief silence as rejection. This hypervigilance is exhausting and often leads to misinterpretations of others' intentions.

Unstable and Intense Relationships

Relationships in BPD are often characterized by a pattern of idealization and devaluation, sometimes called "splitting." In the idealization phase, a new friend or romantic partner might be seen as perfect, amazing, and the answer to all problems. However, when disappointment inevitably occurs, the person may be rapidly devalued - seen as cruel, uncaring, or even evil.

This black-and-white thinking makes it difficult to maintain stable, long-term relationships. Partners and friends may feel confused by the rapid shifts in how they're perceived. The intense emotional investment in relationships, combined with the fear of abandonment, creates a volatile dynamic that can be challenging for everyone involved.

Identity Disturbance

Many people with BPD describe not knowing who they really are. Their sense of self may shift based on who they're with, what they're doing, or how they're feeling. Values, goals, career aspirations, and even sexual identity may seem unstable or unclear. This identity confusion often contributes to the chronic feelings of emptiness that many people with BPD experience.

Without a stable sense of self, people with BPD may adopt the interests, opinions, and even mannerisms of those around them. They might drastically change their appearance, career path, or friend groups. This chameleon-like adaptation can make it difficult to develop a consistent life narrative or long-term goals.

Impulsivity

Impulsive behaviors in BPD often serve as attempts to cope with intense emotional pain. These might include reckless spending, substance abuse, binge eating, unsafe sexual behavior, or reckless driving. While these behaviors may provide temporary relief, they often create additional problems and can be dangerous.

The impulsivity in BPD is different from the impulsivity seen in conditions like ADHD. In BPD, impulsive acts are often triggered by emotional distress and represent an attempt to escape unbearable feelings. Understanding this connection between emotions and impulsivity is crucial for effective treatment.

Self-Harm and Suicidal Behavior

Self-harm, such as cutting, burning, or hitting oneself, is common in BPD. These behaviors often serve to regulate overwhelming emotions - physical pain can temporarily distract from emotional pain, provide a sense of control, or help the person feel something when they're experiencing emotional numbness. Suicidal thoughts and behaviors are also common, with research suggesting that 60-70% of people with BPD attempt suicide at some point, though completed suicide occurs in approximately 10%.

Emotional Instability

The emotional instability in BPD is characterized by rapid shifts in mood, often within hours. A person might go from feeling relatively calm to intensely anxious, irritable, or depressed in response to an interpersonal trigger. These mood shifts typically last a few hours but can sometimes persist for days. The intensity of these emotions can be overwhelming, making it difficult to function in daily life.

Chronic Feelings of Emptiness

Many people with BPD describe a persistent sense of inner emptiness - a feeling of being hollow, bored, or that nothing really matters. This emptiness is different from depression; it's more of a fundamental sense that something is missing inside. People may try to fill this emptiness through relationships, substances, or activities, but relief is usually temporary.

Intense Anger

Difficulty controlling anger is common in BPD. A person might experience intense rage that seems disproportionate to the situation, have frequent angry outbursts, or feel constantly irritable. This anger is often related to perceived rejection or abandonment. After an angry episode, people with BPD typically experience intense shame and self-criticism.

Paranoid Thoughts and Dissociation

During times of stress, people with BPD may experience transient paranoid thoughts or dissociative symptoms. Paranoid thoughts might include suspicions that others are plotting against them or are not to be trusted. Dissociation involves feeling detached from oneself or one's surroundings, as if watching life from outside one's body or feeling that things aren't real.

What Causes Borderline Personality Disorder?

BPD develops from a complex interaction of genetic factors (accounting for 40-60% of risk), neurobiological differences in brain structure and function, and environmental factors such as childhood trauma, neglect, or invalidating family environments. Most experts believe BPD results from a combination of inherited emotional sensitivity and environments that fail to teach healthy emotional regulation skills.

Understanding the causes of Borderline Personality Disorder requires recognizing that no single factor is responsible. Instead, BPD emerges from the interplay of biological vulnerabilities and environmental experiences. This "biopsychosocial" model helps explain why some people develop BPD while others with similar backgrounds do not.

Genetic and Hereditary Factors

Twin studies have shown that genetic factors account for approximately 40-60% of the risk for developing BPD. If you have a close family member with BPD, you're about five times more likely to develop the condition yourself. However, genetics don't determine destiny - they create a vulnerability that may or may not be expressed depending on other factors.

The genetic contribution to BPD likely involves many genes, each with small effects. These genes appear to influence traits like emotional reactivity, impulsivity, and stress responsiveness rather than causing BPD directly. A person might inherit a tendency toward intense emotional reactions, but whether this develops into BPD depends on their experiences and environment.

Neurobiological Differences

Research has identified several brain differences in people with BPD. The amygdala, which processes fear and emotional reactions, tends to be smaller and more reactive. The prefrontal cortex, responsible for impulse control and emotional regulation, often shows reduced activity and weaker connections to the amygdala. The hippocampus, important for memory and contextualizing experiences, may also be smaller.

Additionally, differences have been found in neurotransmitter systems, particularly serotonin (involved in mood regulation), dopamine (involved in reward and impulsivity), and the stress hormone cortisol. These biological differences don't mean BPD is purely biological - the brain is shaped by experience, and many of these differences may result from early trauma or stress.

Childhood Experiences and Trauma

Environmental factors, particularly early childhood experiences, play a crucial role in the development of BPD. Studies consistently show that 40-70% of people with BPD report childhood abuse - physical, sexual, or emotional. Neglect, early separation from caregivers, and parental mental illness or substance abuse also increase risk.

However, it's essential to recognize that many people with BPD do not have histories of severe trauma, and many trauma survivors do not develop BPD. What seems particularly important is growing up in an "invalidating environment" - one where a child's emotional experiences are dismissed, criticized, or punished rather than acknowledged and supported. This can occur even in families without overt abuse.

The Biosocial Theory

The most widely accepted model for understanding BPD development is Marsha Linehan's biosocial theory. According to this theory, BPD develops when a person with biological vulnerability to intense emotions (the "bio" part) grows up in an environment that invalidates or fails to adequately respond to their emotional needs (the "social" part).

An emotionally sensitive child in an invalidating environment never learns how to understand, label, or regulate their emotions. They may be told their feelings are wrong, exaggerated, or unacceptable. Over time, they internalize these messages, developing shame about their emotional experiences and lacking the skills to manage them effectively. This creates a cycle of emotional dysregulation, impulsive attempts to cope, and further invalidation.

How Is Borderline Personality Disorder Diagnosed?

BPD is diagnosed through a comprehensive clinical evaluation that includes a detailed interview about symptoms, history, and functioning. Mental health professionals use criteria from the DSM-5 or ICD-11, requiring five or more of nine specific symptoms. Diagnosis typically involves ruling out other conditions that can cause similar symptoms. Structured interviews like the SCID-II or DIB-R may be used to ensure accurate diagnosis.

Diagnosing Borderline Personality Disorder requires careful clinical evaluation by a qualified mental health professional, typically a psychiatrist or clinical psychologist. The process involves understanding not just current symptoms, but patterns of thinking, feeling, and behaving that have persisted over time and across different situations.

The Diagnostic Process

A thorough BPD assessment typically includes several components. The clinician will conduct a detailed clinical interview, asking about current symptoms, their history and development, relationships, work or school functioning, and any previous treatment. They'll explore specific experiences related to the nine BPD criteria, such as fear of abandonment, relationship patterns, and self-harm behaviors.

The clinician will also gather information about early life experiences, family history of mental illness, and any history of trauma. Collateral information from family members or previous treatment providers can be valuable, though not always necessary or appropriate. Psychological testing, including standardized personality questionnaires and structured diagnostic interviews, may be used to support the diagnosis.

Diagnostic Criteria

According to the DSM-5, BPD is diagnosed when a person shows a pervasive pattern of instability in interpersonal relationships, self-image, and affects, along with marked impulsivity, beginning by early adulthood and present in various contexts, as indicated by five or more of the nine criteria: fear of abandonment, unstable relationships, identity disturbance, impulsivity, suicidal behavior or self-harm, emotional instability, chronic emptiness, inappropriate anger, and transient paranoia or dissociation.

The ICD-11, used internationally, takes a different approach. It diagnoses "personality disorder with borderline pattern" based on meeting general criteria for personality disorder plus specific borderline features including emotional instability, negative self-image, interpersonal dysfunction, and behavioral dysregulation.

Conditions That May Look Like BPD

Several other mental health conditions can present with symptoms similar to BPD, making differential diagnosis important. These include:

• Bipolar Disorder: Both involve mood instability, but bipolar mood episodes last longer and include distinct periods of elevated mood
• Complex PTSD: Shares many features with BPD and often co-occurs; trauma history and specific PTSD symptoms help distinguish
• ADHD: Both involve impulsivity, but ADHD impulsivity is not specifically linked to emotional triggers
• Depression: Both involve mood disturbance, but BPD mood changes are more rapid and often interpersonally triggered
• Other Personality Disorders: Features may overlap with narcissistic, histrionic, or dependent personality disorders

It's also important to note that BPD frequently co-occurs with other conditions. Studies show that up to 96% of people with BPD meet criteria for at least one other psychiatric diagnosis, with depression, anxiety disorders, PTSD, eating disorders, and substance use disorders being most common.

Challenges in Diagnosis

BPD diagnosis can be challenging for several reasons. Symptoms fluctuate over time and may be more apparent during crises. People with BPD may have difficulty accurately reporting their experiences, particularly regarding relationship patterns. There's also historical stigma around personality disorder diagnoses that may make some clinicians reluctant to assign the label.

Diagnosis in adolescents is particularly complex. While symptoms often emerge during teenage years, normal adolescent development includes some identity exploration and emotional volatility. Most guidelines recommend caution in diagnosing BPD before age 18, though early identification can lead to early treatment.

When Should You See a Doctor About BPD?

You should seek professional help if you're experiencing persistent emotional instability, difficulty maintaining relationships, self-harm or suicidal thoughts, or if symptoms are significantly impacting your work, relationships, or quality of life. Early treatment leads to better outcomes. Seek immediate help if you're in crisis, having thoughts of suicide, or have harmed yourself.

Deciding to seek help for mental health concerns can be difficult, especially given the stigma that still surrounds conditions like BPD. However, getting an accurate diagnosis and appropriate treatment can be life-changing. Here are signs that it's time to consult a mental health professional:

Consider seeking help if your emotions feel consistently overwhelming or out of control. If you find yourself cycling rapidly through intense emotional states, or if your emotional reactions seem disproportionate to the situations triggering them, this may indicate a need for professional support. Similarly, if relationship patterns keep repeating despite your best efforts - perhaps you consistently idealize people initially only to feel betrayed later, or you push people away when they get too close - a mental health professional can help you understand and change these patterns.

Self-harm or suicidal thoughts are always reasons to seek help. Even if these seem like your only ways to cope with emotional pain, effective treatments can teach you new skills. You don't have to wait until things are "bad enough" - early intervention generally leads to better outcomes.

If symptoms are interfering with your daily life - your ability to maintain employment, pursue education, or have meaningful relationships - professional help can make a significant difference. Many people with BPD struggle for years before getting proper treatment, but recovery is possible at any stage.

How Is Borderline Personality Disorder Treated?

BPD is primarily treated with specialized psychotherapy, particularly Dialectical Behavior Therapy (DBT) and Mentalization-Based Treatment (MBT). These therapies typically last 1-2 years and involve both individual and group sessions. Medications may help manage specific symptoms but are not the primary treatment. With appropriate treatment, most people with BPD experience significant improvement.

The treatment of Borderline Personality Disorder has advanced significantly over the past few decades. What was once considered an untreatable condition now has several evidence-based treatments that produce meaningful, lasting improvement. The key to successful treatment is accessing therapies specifically designed for BPD - standard talk therapy alone is usually not sufficient.

Dialectical Behavior Therapy (DBT)

DBT is the most researched and widely available treatment for BPD. Developed by Dr. Marsha Linehan, who herself has lived experience of BPD, DBT combines cognitive-behavioral techniques with mindfulness practices derived from Zen Buddhism. The "dialectical" part refers to balancing acceptance (acknowledging reality as it is) with change (working to improve).

A comprehensive DBT program includes four components: individual therapy (typically weekly, focusing on problems in daily life), skills training group (usually weekly for two hours, teaching new coping strategies), phone coaching (brief calls between sessions for crisis support), and a therapist consultation team (ensuring therapists remain effective and motivated).

DBT teaches four sets of skills: mindfulness (being present and aware), distress tolerance (surviving crises without making things worse), emotion regulation (understanding and managing emotions), and interpersonal effectiveness (communicating needs and maintaining relationships). These skills, practiced over approximately one to two years, help people build a life worth living.

Mentalization-Based Treatment (MBT)

MBT, developed by Drs. Anthony Bateman and Peter Fonagy, focuses on improving the capacity for mentalization - the ability to understand behavior in terms of underlying mental states (thoughts, feelings, intentions) in both oneself and others. People with BPD often struggle with mentalization, particularly during emotional arousal.

MBT helps people slow down and reflect on mental states rather than reacting automatically. It typically involves individual and group therapy over 18 months to three years. The therapist maintains a curious, non-knowing stance, helping the patient explore their own and others' minds without jumping to conclusions. Research shows MBT is as effective as DBT, though it may take longer to show results.

Other Evidence-Based Psychotherapies

Several other therapies have demonstrated effectiveness for BPD:

• Schema-Focused Therapy: Addresses maladaptive patterns (schemas) developed in childhood, using cognitive, behavioral, and experiential techniques
• Transference-Focused Psychotherapy: A psychodynamic approach focusing on the patient-therapist relationship to identify and change problematic patterns
• STEPPS (Systems Training for Emotional Predictability and Problem Solving): A shorter-term group program that can supplement other treatments
• Good Psychiatric Management: A more generalist approach that can be used by clinicians without specialized BPD training

Medication in BPD Treatment

There is no medication specifically approved for BPD, and medications are not the primary treatment. However, they may help manage specific symptoms or co-occurring conditions. Mood stabilizers may reduce emotional instability and impulsivity. Antidepressants may help with depression and anxiety symptoms. Low-dose antipsychotics may help with cognitive-perceptual symptoms like paranoia or dissociation.

It's important to approach medication cautiously in BPD. People with BPD may be more sensitive to side effects and may have impulsive tendencies that make certain medications risky. Benzodiazepines (anti-anxiety medications) are generally avoided due to the risk of dependence and potential for disinhibition. Any medication should be prescribed by a psychiatrist familiar with BPD and closely monitored.

What to Expect From Treatment

Effective BPD treatment is typically long-term, often 1-2 years or more. Progress is rarely linear - there will be setbacks and crises along the way. The early stages of treatment often focus on reducing self-harm and other dangerous behaviors, building basic emotional regulation skills, and establishing a stable therapeutic relationship.

As treatment progresses, the focus shifts to addressing underlying patterns in relationships and self-image, processing past trauma when appropriate, and building a meaningful life. Many people continue with less intensive therapy or periodic "booster" sessions after completing primary treatment.

What Can You Do Yourself to Manage BPD?

Self-help strategies for BPD include maintaining regular routines (sleep, meals, exercise), avoiding alcohol and drugs, practicing mindfulness and distress tolerance skills, building a support network, identifying triggers, and creating a crisis plan. While these strategies don't replace professional treatment, they can significantly improve daily functioning and quality of life.

While professional treatment is essential for BPD, there's much you can do yourself to support your recovery and improve your quality of life. These self-help strategies are most effective when used alongside professional treatment, but they can make a meaningful difference regardless of your treatment status.

Establish Regular Routines

The brain and body thrive on predictability. Maintaining regular routines for sleep, meals, and activities creates a foundation of stability that can help regulate emotions. Try to go to bed and wake up at consistent times, even on weekends. Eat regular, balanced meals - blood sugar fluctuations can affect mood. Build in time for activities you enjoy, even when you don't feel like it.

Physical Health Matters

Regular physical activity is one of the most effective natural mood regulators. Exercise releases endorphins, reduces stress hormones, and can provide a healthy outlet for intense emotions. You don't need to become an athlete - even a daily 30-minute walk can make a significant difference. The key is consistency rather than intensity.

Avoid alcohol and recreational drugs. While these may provide temporary relief from emotional pain, they ultimately worsen emotional instability, impair judgment, and interfere with treatment. Similarly, be cautious with caffeine, which can increase anxiety and sleep problems.

Practice Mindfulness

Mindfulness - paying attention to the present moment without judgment - is a core component of DBT and can be practiced independently. Regular mindfulness practice helps you observe your thoughts and emotions without being swept away by them. Start with short practices (even 5 minutes) and gradually build up. Many apps and online resources offer guided meditations specifically for emotional regulation.

Learn and Use Distress Tolerance Skills

When emotions become overwhelming, having practiced skills to survive the crisis without making things worse is invaluable. The TIPP skills from DBT are particularly useful for intense distress:

• Temperature: Apply cold to your face (cold water, ice pack) to activate the dive reflex and calm your nervous system
• Intense exercise: Use physical activity to release emotional energy
• Paced breathing: Slow your exhale to longer than your inhale to activate the parasympathetic nervous system
• Progressive muscle relaxation: Systematically tense and release muscle groups

Build Your Support Network

Recovery from BPD is not a solo journey. Identify people in your life who are supportive and understanding. This might include family members, friends, peer support groups, or online communities of people with similar experiences. Be thoughtful about who you turn to for support - not everyone will understand, and that's okay.

Consider joining a peer support group specifically for people with BPD or personality disorders. Connecting with others who truly understand your experiences can reduce isolation and provide practical coping strategies. Organizations focused on BPD often offer resources and support groups.

Create a Crisis Plan

When you're in a calm state, develop a plan for managing crises. This should include early warning signs that a crisis is developing, coping strategies to try, people you can call for support, and clear guidelines for when to seek professional help or emergency services. Share this plan with trusted people in your life so they know how to help.

What Is It Like Living With Borderline Personality Disorder?

Living with BPD involves navigating intense emotional experiences, relationship challenges, and often a fluctuating sense of identity. While difficult, many people with BPD lead fulfilling lives, especially with appropriate treatment. Recovery is a journey that involves developing emotional regulation skills, building stable relationships, and creating a meaningful life aligned with personal values.

Living with Borderline Personality Disorder is often described as experiencing emotions without the "emotional skin" that protects others from the full intensity of feelings. Events that others might brush off can feel devastating. This emotional sensitivity can be both a burden and, in some contexts, a gift - many people with BPD are highly empathic and attuned to others' emotions.

The journey of living with BPD varies greatly from person to person. For some, symptoms improve significantly in early adulthood, even without treatment. For others, symptoms persist but become more manageable with age and life experience. With appropriate treatment, the prognosis is generally positive - research shows that most people who engage in evidence-based treatment show meaningful improvement.

Recovery Is Possible

Perhaps the most important message for anyone living with BPD is that recovery is possible. This doesn't necessarily mean becoming symptom-free - some degree of emotional sensitivity may persist. But it does mean building a life where symptoms no longer dominate, where relationships are more stable, and where there's a clear sense of identity and purpose.

Recovery typically involves learning to understand and manage intense emotions, developing healthier relationship patterns, building a stable sense of self, reducing or eliminating self-harm and other dangerous behaviors, and creating a life that feels meaningful and worth living. This process takes time and effort, but countless people with BPD have achieved it.

How Can You Support Someone With BPD?

Supporting someone with BPD involves validating their emotional experiences, maintaining consistent boundaries, encouraging treatment, taking care of your own mental health, and learning about the condition. Avoid dismissing their feelings, trying to "fix" them, or sacrificing your own wellbeing. Family therapy or education programs can be helpful for loved ones.

Being close to someone with BPD can be emotionally demanding. The intense emotional expressions, relationship instability, and potential for crisis can leave loved ones feeling confused, frustrated, and exhausted. However, your support can make a meaningful difference in their recovery journey.

Validate Without Necessarily Agreeing

Validation means communicating that you understand someone's emotional experience makes sense given their perspective. You can validate feelings without agreeing with the thoughts or actions that accompany them. For example: "I can see you're really hurt by what happened. That sounds painful" validates the emotion without endorsing any particular interpretation of events.

Set and Maintain Clear Boundaries

Boundaries are essential for both your wellbeing and the relationship. Be clear about what behaviors you can and cannot accept, and follow through consistently. Boundaries are not punishments - they're guidelines for sustainable relationships. When setting boundaries, focus on your own needs rather than trying to control the other person's behavior.

Encourage Treatment

Gently but persistently encourage your loved one to engage in evidence-based treatment. You might help research treatment options, offer to accompany them to initial appointments, or support their treatment in practical ways. However, remember that you cannot force someone to seek help - ultimately, it's their decision.

Take Care of Yourself

You cannot pour from an empty cup. Make sure you're meeting your own needs for rest, social connection, and enjoyable activities. Consider seeking your own therapy or joining a support group for families affected by BPD. It's okay to have complicated feelings about your loved one - frustration, fear, and grief are all normal responses.

Learn About BPD

Education is powerful. The more you understand about BPD, the less you'll take symptoms personally and the better equipped you'll be to respond helpfully. Many organizations offer family education programs that can provide both information and support.