My friend told me they have BPD -- now what?
Since I’ve had several people ask me this question, I thought it warranted its own post.
A lot of you have friends, partners or family members who have either recently been diagnosed or who’ve had a previous diagnosis of BPD and just “came out” to you. You want to help (and that’s awesome!) but you aren’t sure how. As someone who’s diagnosed with BPD (and MDD) here’s my advice:
1. Start with validation.
The most important thing you can do for someone with BPD (or anyone, really) is to validate them. Basically, validating means recognizing what someone is going through in an empathetic way. You’d think that’d be easy to do, but most people screw it up! This video is really helpful in understanding how to be empathetic and validating:
Often, in an effort to let someone know they’re not alone, we try to relate. The impulse comes from a good place, but it usually does more harm than good. Here’s a real-life example: once when I was in high school, I told a friend I was adopted. I just threw it out there because it came up in the conversation somehow and it clearly caught her off-guard. In an effort to bridge the gap she saw between us, she grasped at the first negative “secret” she could think of and blurted out “I had ringworm once!” Bless her heart.
If someone tells you they have BPD and your first response is to say something about yourself and your own suffering… just don’t. They might smile on the outside but on the inside they’re thinking:
Wow dude, way to make it about you.
So you’re saying this huge thing I’m going through isn’t a big deal?
Okay, that thing and my thing are not the SAME thing. You clearly don’t get it and I probably won’t open up to you about this again.
3. Don’t question the diagnosis.
You may want to reassure your friend that they’ll be okay by pointing out that they’re not “that bad.” My dude, do NOT do this. This is a form of invalidation and it’s one of the worst things you can do to someone with BPD. In your head you may be trying to say, “I believe in you because you’re a strong and capable person” but what they’ll hear is “Wow you think you’re such a special snowflake and your problems aren’t even real. PLEASE.”
Also keep in mind that people with BPD are like glaciers. You only see the very tip of their symptoms that break through the surface. They are probably hiding a LOT more that they aren’t telling you about – and for good reason. There are a lot of BPD behaviors that aren’t pleasant and would be easily judged by others. So while your friend may not seem that bad to you, they could be practicing behaviors like:
compulsive gambling or impulsive overspending
drug use, ODing, combining drugs in dangerous ways (like drinking on meds or mixing meds)
risky sexual behavior
self harm (including behaviors that might not leave marks)
disordered eating (they can be doing this even if they’re not severely over or under weight)
etc.
Keep this in mind and don’t assume you know the whole picture.
4. Don’t try to GET the whole picture.
You’re probably curious about exactly why your friend was diagnosed with BPD, but do them a favor and don’t grill them about it or their symptoms. I mean, would you want to talk about the above behaviors over a Grand Slam at Denny’s? Because I sure as fuck don’t. Also, when you start asking for specifics, BPD cats feel like you don’t believe them and that they somehow have to “prove” their illness to you (or to themselves) which could lead them to up the ante on their dangerous behaviors. NOT GOOD.
Also keep in mind that the “why” behind a BPD diagnosis isn’t a simple answer. It may be one they themselves never fully understand, but the big picture can and usually does involve painful memories like instances of sexual or physical abuse. These are issues your friend will probably be more comfortable talking about with their therapist and doctors.
5. Ask open-ended questions.
Instead of focusing in specifics, ask broad questions that allow your friend to open up if they want to. Here are some good ideas:
How do you like your new therapy group?
Have you learned any new DBT skills that you like?
What can I help you with this week?
6. Treat them like a widow.
I know that sounds weird but stick with me. Recently, I had my first bonified lock-up in a psych ward. I reached out to two of my closest friends and they helped me. After I escaped (kidding) they continued to help me. One of those friends had lost both of her parents and said to me, “Look, you were there for me then and I’m here for you now.” And although those two scenarios are very different, it made me realize that the kind of help needed can be similar in a lot of ways.
Here are some things you can do:
Offer to drive them to therapy or doctors visits.
Schedule coffee dates after their appointments so they can relax and have support.
Cook meals together – I think this has been one of the most helpful things for me, not only because it helps me eat well-rounded meals, but also because it’s a fun social activity that’s very low-stress.
Help them care for their pets, buy groceries or even clean up around the house.
Get them out of the house to do fun new things.
By no means should you push these things on people, but it is okay to push a tiny little bit. They will likely feel bad accepting any kind of help because they’ll feel like a burden, so push a little bit but try to be aware and back off if they seem genuinely uncomfortable.
7. Don’t betray their trust.
What your friend tells you about their mental illness stays between you and them. The fact that they told you at all really means they trust you – so don’t betray their trust.
In the event that your friend says or does something that makes you fear for their safety or someone else’s safety – tell them. Ask them to talk to you about it, then consider calling 1 (800) 273-8255. That’s the National Suicide Hotline, and the calls are completely confidential. Explain the scenario to them and they’ll tell you what you should do. This is a much better idea than violating your friend’s trust by disclosing things to other people they know in real life.
This is by no means a complete list of tips. When I first started typing it I had no idea it would be this long! I’d actually like to create a “part 2″ to this when I have time, so if you have questions or tips you think I should add, please message me!