Unstable Interpersonal Relationships and Borderline Personality

Borderline Personality Disorder Can Make Relationships More Difficult

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Many people with borderline personality disorder (BPD) have intense and unstable relationships with others. Their relationships tend to fluctuate between being all good or all bad and they can be unable to experience contradictory feelings when relating to the world or others. This black and white thinking, or splitting, can spill over into all relationships including those at school or work with peers, professors and instructors, managers and supervisors.

Idealization and Devaluation

If you have BPD, you may initially idealize a person or situation, throwing yourself into a relationship fully and without reservation. However, soon something may occur that conflicts with this idealized view, such as a harsh comment from a supervisor, a poor grade on a paper or a fight with your partner. This can cause you to switch from an idealized view to one of devaluation. You may think that there is suddenly nothing good about the person or situation and there never was.

A heightened sensitivity to rejection may trigger your devaluing reaction. This sensitivity can cause you to overreact to real or perceived rejections. The feeling of rejection is overpowering and consuming and can feel very real, regardless of whether it was truly meant or unintended.

In response to devaluation, you may erupt in anger, quit the related task, become aggressive or just give up.

It is possible that the person, relationship or task will again be seen as ideal, but it is also possible that the negative view will remain constant or that the damage that occurred will be irreversible. Friendships can be destroyed, jobs quit or classes dropped. It can be a debilitating experience with significant consequences.


Treating Borderline Personality Disorder and Managing Relationships

Borderline personality disorder can have a significant impact on your relationships. Even with your family members, you may be sensitive to rejection, changes in plans or feelings of being slighted. These distortions in thinking can make you feel isolated, lonely and helpless. 

In the past few years, significant progress has been made in understanding and treating BPD. There are many treatment options that have been proven to be effective, including dialectal behavior therapy (DBT), and mentalization therapy (MBT). In some cases, inpatient and outpatient treatments are necessary. 

While there are no medications currently approved to treat BPD, medication is sometimes prescribed by doctors to help manage BPD symptoms and improve your interpersonal relationships. Some studies have shown that certain medications approved for other mental disorders are effective in controlling symptoms like anger, impulsivity, depression and feelings of isolation.

Results can vary greatly and it is unlikely that medication will completely eliminate these feelings; you can most likely expect modest results. 

While medication may be a useful tool for managing your symptoms while undergoing therapy, many of the medications used have significant side effects. Before taking any pills, talk to your doctor and your therapist about potential side effects and if the advantages of medications outweigh the drawbacks. For some people, the risk is not worth the modest improvements in symptoms. 

Regardless if you take medication or not, therapy is essential for improving your relationships with others and managing your other symptoms. Talk to your doctor about your specific needs and concerns to come up with a strategy to meet your unique needs. 


"What is Borderline Personality Disorder?" National Education Alliance: Borderline Personality Disorder, 2015. 

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