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How to support someone with borderline personality disorder

Alanoud AlturkiMedical review: Tatmeen team10 min read
شرائط ورقية متشابكة تصل بين مشهد مشمس أخضر ودوامات زرقاء داكنة.
Article contents
  1. If someone's life is in danger now
  2. Everyday conversations: acknowledge the hurt and explain your position
  3. Agree on support you can sustain
  4. Make support part of a wider care plan
  5. Keep room in your lives for things beyond the problem
  6. Frequently Asked Questions
  7. Sources and references
  8. Writer and reviewer

A message saying “I need you now” may arrive while you are at work or trying to sleep. Before finding the right words, you need to understand what is happening: does the person need someone to listen, or are they in danger and need urgent help? You can listen, offer support you can sustain and help them reach professional care1. You do not have to become the only person responsible for their treatment or safety.

This guide is for someone supporting a family member or friend with a professional diagnosis. A diagnosis does not explain every disagreement or reduce a person to one way of behaving. The communication examples can also help without assuming a diagnosis for someone who has not been assessed. For an explanation of the condition and assessment, read the guide to borderline personality disorder.

If someone's life is in danger now

If the person has harmed themselves, has taken something that could harm them, says they will hurt themselves now, or you fear they may act on suicidal thoughts soon, call an ambulance on 997 in Saudi Arabia. Do not wait for a therapy appointment or for an argument to end. Give the location4 and explain what happened, then follow the dispatcher's instructions. Outside Saudi Arabia, use the emergency number3 in the person's country.

After taking a potentially poisonous substance, do not wait for symptoms5 or try to make the person vomit. If you cannot reach the ambulance service, get help reaching the nearest emergency department with another driver who can drive safely. The person at risk must not drive themselves.

If you are elsewhere, try to establish their location and contact emergency help in the country where they are, as well as someone trusted who can reach them. Waiting for a reply to messages must not be your only action when danger is imminent.

Talk about suicidal thoughts3 or wanting to self-harm needs prompt contact with a professional or the treating team1, even without a stated immediate intention. Help the person seek support today.

If the person is having thoughts of killing themselves right now, seek an urgent mental health assessment immediately. Stay with them if it is safe for you, or ask someone trusted to stay with them while help is being sought. Do not delay seeking help while waiting for someone to arrive. If an immediate assessment is unavailable, seek help at an emergency department9.

In Saudi Arabia, 937 offers medical consultation around the clock; if you fear immediate danger, call 997. You do not have to determine a “risk level” yourself before seeking help7.

Everyday conversations: acknowledge the hurt and explain your position

When it is safe to talk, begin with what the person says about their experience. If they say, “You replied late because you don't care about me,” you could respond: “It sounds like my late reply hurt you. I was in a meeting and couldn't answer. I'd like us to agree on what to expect when one of us is busy.”

This takes their hurt seriously while explaining what happened on your side. You can understand the feeling2 without agreeing that a late reply means you do not care, or getting drawn into a long series of explanations. If you are unsure what would help, ask: “Would you like me to listen, or shall we look for a next step?” Listening and understanding are useful ways1 to offer support, but no phrase guarantees that distress will disappear.

If you made a mistake, name it clearly. If you promised to call and forgot, you might say: “I said I'd call and didn't. I'm sorry. Next time I'll let you know if the time changes.” Make a promise you can keep. Their diagnosis does not remove your responsibility for your own actions, or mean you have to agree with every accusation.

Avoid calling the person manipulative, difficult or “a borderline.” Discuss a specific behavior rather than bringing the diagnosis into every disagreement. “When voices are raised, I can't keep following the conversation” is clearer than “You're always like this.”

Agree on support you can sustain

You may be able to talk in the evening or help someone get to an appointment, while needing other times for work or rest. Explain this when you are both calmer. An agreement involves both of you2 and can be reviewed when it no longer works. Do not use it as a punishment or a test of love.

The following examples are for ordinary, safe conversations. They do not apply to danger from self-harm or violence.

Situation What you could do or say
Many messages while you are working “I can't keep up with messages while I'm at work. I can talk after six. If you need urgent help, we'll follow the contact plan agreed with your clinician.”
A conversation in which both of you are raising your voices “I'm starting to lose my calm. Let's pause and return to this in half an hour.” Suggest a time you can keep, then return to the conversation or explain if the time changes.
A request your budget cannot cover “I can help with this much, but I can't pay the rest. Let's think about an option we can afford.” Do not withhold a shared essential need to teach the person a lesson.
Different interpretations of an event “I see it differently, and I want to understand what hurt you.” Discuss one issue rather than collecting old disagreements.

A pause can help you return to a safe conversation. If a new danger to the person or others emerges, seek urgent help. If you fear a harmful reaction to explaining what you can offer, seek private, safe support from someone trusted or a professional before a confrontation. Supporting someone in distress does not require you to endure humiliation or violence.

Make support part of a wider care plan

At a calm time, ask what they want from you and what they prefer to keep private. You can offer help arranging or attending an appointment, or joining a session if the person wants it and the treating team agrees. Do not make your support conditional on hearing everything discussed in therapy. Treatment and family support1 do not require you to act as the therapist.

Together with a clinician, you can agree on a clear plan for increasing distress: warning signs the person recognizes in themselves, what helps, whom to contact and when emergency care is needed. Keep the team's numbers and availability to hand. Do not assume a therapist is available day and night. Include more than one person or service rather than making the plan depend on your ability to answer at any time. Planning for help and following up after a crisis6 matter, but a plan does not replace emergency services3 when danger is immediate.

If the person does not want treatment, explain your concern specifically: “I can see that distress is affecting your sleep and work, and I hope you can find help. Would you like me to help you look for a professional?” Avoid threats or arguments aimed at proving a diagnosis. You can seek advice for yourself about the support you provide. When danger is imminent, call emergency services even if the person refuses help.

If they take medication, encourage them to discuss problems with their doctor1. Do not suggest changing a dose or stopping treatment. Structured psychotherapy is the foundation8 of BPD treatment. Good communication between you can support care and does not replace it.

Keep room in your lives for things beyond the problem

Not every meeting needs to focus on symptoms. Ask what the person enjoys and suggest a small activity1 they can choose with you: a short walk, preparing a meal or watching something enjoyable. Talk honestly about qualities you appreciate, without forced praise2 or asking them to be well for your sake.

Care for your own sleep, time and relationships too, and share support where possible while respecting the person's privacy. If worry or exhaustion affects your life, seeking mental health support for yourself1 can be helpful. You can care about and respect the person while making the decisions you need for your own safety and boundaries.

Frequently Asked Questions

How can I support someone with borderline personality disorder?

Listen, offer support you can sustain and help them reach professional care; you do not have to become the only person responsible for their treatment or safety. Begin with what the person says about their experience, and take their hurt seriously while explaining what happened on your side. Discuss a specific behavior rather than bringing the diagnosis into every disagreement. Listening and understanding help, but no phrase guarantees that distress will disappear.

Is suicidal talk in borderline personality disorder just attention-seeking?

Do not promise to keep the danger secret or dismiss suicidal talk as acting or seeking attention, even if it has happened before. You can say: “I take what you're saying seriously. We're going to get help now.” You can also ask directly: “Are you thinking about suicide? Do you intend to hurt yourself now?” Asking does not plant the idea. Listen, and do not treat a denial of suicidal thoughts as proof of safety if you remain concerned. Talk about suicidal thoughts, even without a stated immediate intention, needs prompt contact with a professional or the treating team; help the person seek support today. In Saudi Arabia, if you fear immediate danger, call 997.

When should I call an ambulance for someone with BPD?

Call an ambulance on 997 in Saudi Arabia if the person has harmed themselves, has taken something that could harm them, says they will hurt themselves now, or you fear they may act on suicidal thoughts soon. Do not wait for a therapy appointment or an argument to end. Give the location and explain what happened, then follow the dispatcher's instructions. Outside Saudi Arabia, use the emergency number in the person's country.

If it is safe for you, stay until help arrives and ask someone trusted to help. If they threaten you or stop you leaving, move somewhere safe and call emergency services, or police on 999 in Saudi Arabia; do not use force. Move medicines or items that could cause harm only if it is safe, without confrontation.

How do I set boundaries with someone who has BPD?

Agree on support you can sustain, and explain it when you are both calmer. You might say: “I can't keep up with messages while I'm at work. I can talk after six. If you need urgent help, we'll follow the contact plan agreed with your clinician.” An agreement involves both of you and can be reviewed; do not use it as a punishment or a test of love. Supporting someone in distress does not require you to endure humiliation or violence.

What is the treatment for BPD, and what is my role?

Structured psychotherapy is the foundation of BPD treatment; good communication between you can support care but does not replace it. You can offer help arranging or attending an appointment, or joining a session if the person wants it and the treating team agrees. Do not make your support conditional on hearing everything discussed in therapy. If they take medication, encourage them to discuss problems with their doctor, and do not suggest changing a dose or stopping treatment.

Writing and article review

Alanoud AlturkiWritten byAlanoud Alturki

Content writer and researcher at Tatmeen, writing in Arabic and English on mental health and everyday life topics, including relationships, stress, work, habits, and family.

Tatmeen teamMedical reviewTatmeen team

Every Tatmeen article is reviewed by care providers licensed by the Saudi Commission for Health Specialties, so what you read is accurate and trustworthy.

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