Mental illnesses affect the entire family unit. For personality disorders this effect is especially acute, due to the inherent impairments in interpersonal relationships. Family members are typically the most affected people in the lives of those with borderline personality disorder (BPD). They therefore impact the individual suffering from the disorder in return.
Commonly, family members, often parents or spouses, must often take charge when their loved one has a crisis, often requiring trips to the emergency room or brief psychiatric hospitalizations. Suicidal behaviors must be dealt with by family members.
Close family members often feel the brunt of an ill person’s frequent mood cycling and expressions of anger and rage targeted to those close to them.
Family members may witness the ill person seemingly burn bridges with supportive resources . Those with BPD run the risk that those around them who have been supportive, concerned, and protective will pull away, leaving the person to fend for herself in the world. Thus, they fear abandonment. Their response to the fear is a relapse. They may not make a conscious decision to relapse, but fear and anxiety can drive them to use old coping methods.
Family members often feel helpless while watching their loved one with BPD engage in self-destructive behaviors. This may be particularly true for parents or caregivers of adolescents with BPD who may seem out of control.
Given the high propensity of persons with BPD to have frequent and recurrent crises, family members often are prone to “compassion fatigue,” where sympathy for their loved one becomes blunted, simply as a coping mechanism.