I Think My Friend may have BPD and I want to help him.

[Frank123]

In recent months I've become very close friends with a guy I work with, who has had a very tumultuous couple of months.

He's only 22 and lost his job, and home, so when I met him he was couch surfing and had just started working with the same company as me. We work in a sales environment, in which I'm one of his supervisors, and we quickly bonded as he felt I helped him improve in work to keep his job and we both happen to be the only two gay people in our office.

During this time he was in quite an intense relationship, which he talked about frequently, that seemed to be the main focal point of his life. I always put it down to him being in a bad place and having someone who made him feel slightly better and not wanting to lose that.

However, as the months progressed and the relationship became on again and off again, I noticed the progressively more upset he was (for him losing the guy was the end of the world), and the greater and greater lengths he would go to keep him - e.g. suicide threats. Anything involving his ex either caused extreme frustration or serious melancholic episodes.

I'd seem glimpses of his rage, and he also honestly told me some of the more extreme episodes, but i saw it in full force a week ago. He had invited me and his ex (with whom he'd been working on a friendly relationship) to his new place for drinks.

His ex and I (in our minds anyway) gently made fun of him a couple of times and he told us angrily to stop, we did, but 15 minutes later he erupted into a rage that saw him punch me and smash plates, cups and furniture. When he was angry he said some really nasty things and started begging his on again off again boyfriend not to leave him. Anger turned into despair.

Eventually, after he calmed down, a couple of hours later we went on a night out without further incident, but the next day when the guy brought up what had happened the same.rage saw more damage done along with self harming.

The next day his ex told him he needed space, and not to call or text him. I consoled him the next day, calmed him down and helped him clean up the mess.

He talked frankly and honestly about how thisis a regular pattern in his life, whic h isone of the reasons he doesn't have close bonds with his parents, and he didn't know why he always reacted to things so strongly. He became in his mind the worst person in the world. Even though he admitted it was "mainly" his fault, he still maintained we were partly responsible for chiding him.

Even though he had been asked to give his ex space, he insisted on going to wait outside his place of workfor 3 hours until the guy finished for "one last" chat to convince him not to leave him.

I was so worried about my friend, who is actually a really decent (if somewhat self centred), nice, caring and funny person when hes not angry. Although we haven't been friends for a huge amount of time, I really helped him during his homeless phase, I helped him budget, Ilet him sleep in my house and spent a lotof my time and energy helping him - he became somewhat ofa little brother figure to me and I know he did appreciate it and feel the same close friendship - he'd made a point of saying so.

Being so worried I googled "extreme rage" and came upon BPD. I'm no psychiatrist, so I'm NOT trying to diagnose him, but he fit into so many of the criteria: extreme fear of being alone, extreme anger and rage to feelin he's losing the most important person in his life, "splitting" and even the mimicking of other people's ways of speaking/acting. If nothing else i feel it bears checking out.

His ex and he are still meeting up, although there has been an argument since, and as his confidante whom he talks to everyday hes told me he wants to get better and stop reacting like that, he's just not sure why he does.

In another brief flarevup recently, he told me he was horrible, he deserved to lose everyone and nobody couldcare for him. He told me never to message him again (along with messaging me another 5 times after that) and having spent the entire weekend before reading about BPD, I was able to calm him down and tell him that no matter what i would always be his friend and I wouldn't leave him which seemed to hit a nerve and caused him to call me on the spot where I tried to validate how he feels and empathise, without neccessarily agreeing with him.

Things have calmed down and, even though he apologised for all his behaviour, I asked him if we could meet up tomorrow to talk about it and he agreed.

The reason I'm posting here is to get advise on how to best approach the chat. The goal is to get him to agree to go to the doctor with me (if he wants) and, hopefully, get referred to a psychiatrist if needed.

I've read articles on how to approach it, the dangers, the pitfalls, etc, but i think it's the right time and I'm a person he trusts enough that he.might listen.

He's been so upset recently trying to figure out why he acts up so much, he wants to stop reacting like that and get better and he even wants to get prescribed antidepressants so getting him to the doctor might not be that hard. Of course he wants to do this to stand a chance of getting his ex back, who he regards as the most amazing person in the world.

I've talked to my friend whose aunt is a psychiatrist and who is studying post-grad counselling, so i know not to go in with a stupid: "I think you are x" and using any sort of label, my plan is to make him feel at ease, assure him I'm always gonna be his friend and won't leave him if he needs me, and gently bring up the incidents, asking him why he thinks they happen. When he's not sure why they happen, Im going to offer an opinion that when we react in that kind of way that sometimes there can be reasons for why we do things like that  and that he might need to talk to someone to figure out why.

I know some say NEVER approach someone with BPD like this  but I think he's in a place where he wants answers and trusts me enough to listen to me and not get angry. He knows id never judge him.

If anyone has any advice/thoughts id really appreciate some insight. I've read some really horrible things about people with BPD (which seem very bias) but I can safely say that, despite his flare ups and self destructive impulses, he's a really, really good kid with the capacity to be a very empathetic and caring person. I just want to make sure he's gonna be okay.

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[Mutt]

Hi Frank123,



BPD carries a hefty stigma. You have the right idea with depression, often there's an underlying clinical depression with BPD. Anxiety and depression is quite the opposite with BPD and stigma, it's more accepted in society and easier to talk about and share with others, you could say that you think that he may show signs of depression and you'd like to support him if he chooses to see a professional, that way it guides him in the right direction.

What do you think?

[Frank123]

Hi Mutt,

Thanks so much for the reply!

The stigma is exactly why I'm here, I know I'm gonna have to be very, very careful in how to approach this.

He is very depressed, and he does want to talk to someone already. The issue is work have told him they'll pay for six sessions with a counsellor (non psychiatrist) for him.

In Ireland, to see a psychiatrist affordably, you need to be referred by your GP (every day doctor). My worries are twofold: if he goes to the doctor and just says he's depressed that they'll just give him antidepressants and leave it at that (as I know from experience they often do).  To get referred the doctor is gonna have to hear about the severity of his rage/self harming, etc.  The other worry is that he just uses the counsellor who isn't qualified to diagnose anything.

I think he wants answers, I think he knows there's something at play but he's confused as to what. He always rationalizes that he shouldn't react that way and he knows he was wrong and takes (in his words 80 per cent) responsibility.

Do you think if I talk about depression but also try get HIM to say there might be something else that that'd be an idea?

The furthest I was ever gonna imply is something along the lines of: "when we feel this way sometime there can be reasons for it we don't understand" and maybe he might bite and I can get him to say it might be something deeper? I know I'm not gonna use the words personality disorder, bipolar or anything like that at all and the goal is get him to the doctor and to tell the doctor the full story to get referred.

Hes told me he feels were close friends, I know he trusts me and i think the timing might be just right.

You guys' thoughts on the matter are based on experience so I think your opinions on the matter are what  I'll go with! I just wanna get it right.

[Mutt]

Do you think if I talk about depression but also try get HIM to say there might be something else that that'd be an idea?

Does he have anxiety and depression? The GP should be able to refer him to a P if he has anxiety.

[Frank123]

He can be quite anxious but he hides it quite well, I don't think he regards it as as much of an issue as his depression.

Doctors in Ireland can be quite quick to tell someone to take pills or get counselling. From what I've heard (and experienced) they only refer to a psychiatrist in extreme situations. Mental health services here are almost non-existent.

That's my worry, that nobody will look into it deep enough for him.

[Mutt]

It can be like that in Canada too. Don't get disappointed. Many mentally ill people don't believe that they are mentally, some believe that they are and want to help themselves. That's another reality too, you may have to radically accept him for who he is.

[livednlearned]

It might work to wait until he is in a moment of self-reflection, like the ones you describe. "I don't know what is wrong with me."

You can let him know that you have heard DBT (dialectical behavior therapy) can really help with distress tolerance. It was initially developed for BPD, and now people with anxiety/depression and PTSD use it, among others, like bipolar.

And then perhaps let it go. It's up to him to figure things out. If he asks for help, that's different.

Something else: He punched you and then later you all went out together -- this is a good sign that he is eroding your boundaries. People with BPD tend to have no boundaries, so it's our job to provide them. It can feel very scary and out of control to have emotional dysregulations, and blowing up at you can end up making him feel bad about feeling bad that he was able to hurt you, and you weren't emotionally strong enough to stop him.

He won't like the boundary in the moment. He will respect you, though, and that is essential in a BPD relationship.

[Notwendy]

Hi Frank,

I think it is good of you to want to help your friend. I also want to caution you about the danger in helping "too much".  What I see is a workplace relationship that has crossed the line to personal. I hope that is not a problem in your career, but it is something that has caused problems in the workplace- especially when one person is in a supervisory position for the other.

One of my favorite models is the Karpman drama triangle. Before I was aware of that, I tended to help too much ( rescue). It was how I grew up with BPD mom. Since that was the "normal" I was familiar with, I tended to take this role in other relationships.

I still want to help people, but I have to stay conscious about when I am helping, and when I am helping too much ( rescuing). I think it is good that you are helping someone who is depressed seek medical care and are a supportive friend. But I also think that there are actions that we think are helping that are not helping- they are rescuing- and actions that don't feel good  or helpful to us - like setting limits and boundaries- that are actually helpful in the long run.

The old saying is " bring a horse to water but you can't make him drink". Once in medical care- it is between your friend and the doctor. Be careful about getting into a triangle situation with these two parties. I also agree with livedandlearn about keeping the boundary about not hitting you. It is important that you maintain good boundaries- as pwBPD have weak ones. Boundaries are a help to us and also to them.