You may be a family member of someone with Borderline Personality Disorder (BPD), and may be wondering how to treat someone with BPD if he or she has an episode. The “episodes” of BPD can be of intense emotions, fear of rejection, anger, anxiety, impulsivity and mood changes. This can be disturbing to all. But there can be reassuring, calm, and caring responses that can minimize the trauma.
At Florida Atlantic Coast Treatment Solutions, we assist people and families to respond more appropriately, to better communicate and to recover from the consequences of having Borderline Personality Disorder.
Don’t be competitive, argumentative, and contradictory; be supportive but not dismissive and trivialising; don’t solve problems; if possible, avoid enabling, and if not, accept professional help. It’s not about winning today’s argument but rather de-escalate and be safe.
Key Takeaways
- Talk firmly, politely and calmly.
- Acknowledge feelings with no reward of behavior.
- Avoid arguing, blaming and escalating the situation.
- Use props or provide negative space.
- Stand up, but gently.
- Staff treatment and aftercare services.
- In the case of a suicide attempt and cut/self-harm.
Understanding a BPD Episode
Borderline episodes (BPD episodes) are temporary, intense periods of emotional dysregulation, distress and impulsive behavior triggered by perceived abandonment (real or perceived) or conflict in people with Borderline Personality Disorder. An episode lasts anywhere between an hour or two and several days and involves extreme fluctuations in mood, explosive anger, paranoia and self-destructive thoughts.
Signs May Include:
- Irresistible or uncontrollable rage and irritability.
- Panic/fear of being rejected.
- Crying, lack of feelings or emptiness.
- Impulsive behavior
- Overly sensitive to criticism.
- You can make statements such as “You don’t love me” or “You are leaving me.
- Self-defeating thoughts or actions.
People will sometimes quickly switch from feeling loved and feeling terribly betrayed or abandoned. This will not be manipulation. This will typically be an emotional management problem.
Stay Calm First
It is important to know that the best way to interact with your loved one, friend or colleague with BPD who is in an episode is to keep calm. It can include anger, scrosso and screaming.
Try to:
- Lower your voice
- Slow your breathing
- Use short sentences.
- Stay emotionally steady
- Emphasize safety.
- Calm and de-escalate.
Validate Feelings Without Fueling Conflict
Validation does not imply agreement to false premises and inappropriate behavior. It means being aware of the person’s hurt.
Helpful Examples:
- You see, I am very much hurt.
- I know you are very cross at this moment.
- But I know this is all so much.
Unhelpful Examples:
- “You’re overreacting.”
- “You’re crazy.”
- It’s all your fault.
- When there’s a strong emotion, you can’t reason with it. After, you can solve problems.
Avoid Arguing Facts in the Heat of the Moment
It is not an effective use of time to discuss facts when somebody can be emotional. It can be dismissive and add to distress.
Instead of Saying:
- “That never happened.”
- “You’re wrong.”
Try Saying:
We don’t remember it the same way. Let’s talk about it later when we are not so angry.
This will preserve the relationship and it will de-escalate the issue.
Use Grounding Techniques
Grounding techniques can be used to remain focused on the present.
Simple Options:
- Inhale and count to 5; Exhale and count to 5
- Name 5 colors you see.
- Make an icy drink or ice cubes.
- Open a new window.
- Take a deep breath.
- These can be used to calm down.
Allow Space When Necessary
To be supportive sometimes is to intrude. Sometimes it means taking some space.
You Can Say:
- I am here; it’s OK to take some space.
- You’ll be fine to take some rest and I’ll see you soon.
- Space is not a Punishment. It should be peaceful, pure and temporary.
- Create Barriers of Love
No enabling manipulations, abuse and threats. Healthy boundaries matter.
Examples:
- I love to talk, but not when yelled at.
- I love you, we will talk tomorrow.
- I can’t today; tomorrow.
- If you’re a friend or a family member of someone with BPD, take care of yourself.
Know When Safety Comes First
Treat them as if they were saying they are suicidal, harming themselves or others or not able to keep themselves safe.
Take Action By:
- Calling emergency services
- Call a suicide hotline.
- Contacting a mental health worker.
- If safe, stay with them.
- Take any threats or warnings seriously.
Encourage Treatment After the Episode
It’s best to delay discussions of change until later, when the crisis has subsided.
Success can come from:
- Individual therapy
- Dialectical Behavior Therapy (DBT)
- Trauma-informed counseling
- Medication when needed.
- Counseling and education for the family.
Florida Atlantic Coast Treatment Solutions works with someone who may need to work on regulating emotions or anxiety and coaches the family.
What Not to Do
- Don’t do this in stressful times:
- Yelling back
- Threatening abandonment
- Mocking emotions
- Holding it against all the errors made.
- Demanding instant calmness
- Threatening or ultimatizing.
- This only makes matters worse.
Healing is Possible
BPD is distressing, but it’s curable. Counseling and support and structure and behaviors may help. Families can work on family skills and boundaries.
Remember, when supporting someone in crisis with BPD, you don’t have to be right. Naivety, servility, limits and firmness will be fine.
Need Guidance for Yourself or a Loved One?
So you’re not alone if you don’t know how to respond to your loved one’s BPD “episode.” Florida Atlantic Coast Treatment Solutions provides empathy, understanding and support. Call us to talk in confidence.
Call Florida Atlantic Coast Treatment Solutions
You may be experiencing a flood of feelings, but you don’t have to do it alone. Florida Atlantic Coast Treatment Solutions is a treatment center offering individual and family personal, confidential counseling. For more information on treatment, call now.
Disclaimer
This content is for educational and informational purposes only and is not a substitute for professional medical, psychological, or psychiatric advice, diagnosis, or treatment. If you or someone you know is experiencing a mental health emergency, suicidal thoughts, or immediate danger, call emergency services or contact a local crisis hotline immediately.
FAQ
How to calm down a BPD episode?
Stay calm, lower stimulation, validate feelings, and encourage slow breathing. Avoid arguing or criticizing. Offer reassurance and space if needed. If safety concerns arise, seek immediate professional or emergency help.
How to comfort someone in a BPD episode?
Use a steady tone, listen without judgment, and acknowledge their pain. Say you care and are present. Keep statements simple and avoid trying to “win” the conversation.
How to help someone in a BPD spiral?
Reduce conflict, focus on grounding, and guide them back to the present moment. Encourage hydration, breathing, and a short pause. Revisit problem-solving after emotions decrease.
How to help someone with BPD whose having an episode M?
Stay patient, validate distress, and maintain boundaries. Do not insult, threaten, or argue facts. If they mention self-harm or danger, contact emergency support immediately.
How long does a BPD episode usually last?
Episodes vary widely. Some last minutes or hours, while others may continue longer depending on triggers, stress, and coping skills. Professional treatment often reduces frequency and intensity.
What are the three C’s in BPD?
A helpful framework is: stay Calm, show Compassion, and keep Consistency. These three habits support healthier communication and reduce escalation during difficult moments.
References
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
- National Institute of Mental Health (NIMH). Borderline Personality Disorder.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Crisis Support Resources.
- Linehan, M. Dialectical Behavior Therapy Skills Training Manual.
- National Education Alliance for Borderline Personality Disorder (NEA-BPD). Family Support Resources.
