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How do you deal with a person with Borderline Personality Disorder?

Posted in Babysitting on 6th August 2011

How do you deal with a person with Borderline Personality Disorder?
My best friend has been diagnosed with BPD. She has tried commiting suicide 3-4 times in the last 5 months. She is getting help, has been hospitalized several times, is heavily medicated, and has even gone through a course of ECT treatments. My problem is this…’s getting old….I know that part of her problem is she can’t be left alone, but I have a fiancee and a 2 year old to worry about as well…..I just found out that she tried again last night and is sitting in the psych ward again! I can’t “babysit” her 24/7 because her negative view on life is starting to bring me down. Is it time for tuff love? How do I try to make her understand that she has to make a conscious decision to make her self better?

Best answer(s):

Answer by mlady_in_virginia
Unfortunately the symptoms you are describing are very common and are very difficult to treat. She needs to continue to receive professional treatment. You have to do what’s best for you – Put yourself first and when you start to feel like a babysitter, encourage her to see her therapist. I would recommend not trying to help her solve her problems, because she will become very dependent on you and pull you into her issues. Be supportive, but don’t enable her – keep referring her to her therapist.

Answer by Tracey B
You need to explain to her that you have a family and life that doesn’t only pertain around her. That is the tough love part. Also learning to say no, because if you keep running every time she calls, then it will continue to go on. You then need to learn about the disorder so you can have a better understanding of where she is coming from.

Answer by Anonymous61245
You can’t help her. Now before people think I’m cruel and uncaring, I have BPD and have done everything this friend has been done (except the ECT). It is not your job to babysit her. That is her therapists job (sort of). I would recommend telling her that you still care for her and want to be her friend, but you can’t sit by and watch her do this to herself. If she’s having a hard time, you should recommend that she talk to her therapists. Make sure to reassure her that you are not abandoning her, make time to do things together that you can both enjoy, but ensure that her illness is taken care of by the professionals.

Answer by psychgrad
She is doing what people with Borderline Personality Disorder do best. Depending on someone else to “maintain” her mental health and using self-harm as a means to grab attention. I’ve worked with a few Borderlines and I’ve known therapists and case managers who have worked with more. Some of these patients would call 20 times a day, usually with a crisis…they got into a fight with their boyfriend, they just drank a beer, they’re cutting…..And if the therapist (or I) did not return the phone call right away, they would call back, this time, threatening suicide. So, of course, a lot of therapists would then panic and run to the rescue (fearing malpractice), but this is the worst thing you can do. It reinforces their behavior and next time the patient wants attention, they know exactly what to do.
That is what your friend is doing. When she is feeling alone or sad, when she feels like no one loves her, she needs proof that someone loves her, so she will call you, in a crisis, hoping you will come to the rescue and show that you care about her.

Unfortunately, research has shown that medication and multiple hospitalizations do not help much with BPD (I’m not sure about ECT). Personality disorders are largely behavioral and cognitive, rather than chemical. There may be a chemical component, but the cognition is a huge piece. Marsha Linehan created Dialectical Behavioral Therapy (DBT) specifically for people with BPD.
Dialectical Behavioral Therapy (DBT) works best for Borderline Personality Disorder. DBT is a treatment designed specifically for people with self-harm behaviors and parasuicidal (like cutting) and suicidal behavior. It involves individual therapy, a skills group, and phone coaching.
“Clients receiving DBT, compared to TAU (Treatment as usual), were significantly less likely to drop out of therapy, were significantly less likely to engage in parasuicide, reported significantly fewer parasuicial behaviors and, when engaging in parasuicidal behaviors, had less medically severe behaviors. Further, clients receiving DBT were less likely to be hospitalized, had fewer days in hospital, and had higher scores on global and social adjustment.”
Here are some links on finding a DBT program and more info on DBT. The Dialectical Behavior Therapy Frequently Asked Questions section of the last link is very informative.

Maybe you should look into this and suggest it to her.
I would not recommend that you tell her that you can no longer be her friend because she is being an emotional parasite (which, in fact, she is). That will probably send her off the deep end and she will end up back in the hospital. Explain to her that you are concerned about her and you did some research and found a therapy she has not tried that may work. Tell her that you are still her friend, but believe that she needs more help than you can provide and that you are feeling terribly overwhelmed.

Good luck!

Answer by sashali