Borderline Personality Disorder: Understanding Self-harm and Suicidal Thoughts

When someone we care about is struggling with borderline personality disorder (BPD) as well as self-harm or suicidal thoughts*, it’s easy to feel confused or even judgmental. But understanding these behaviors is the first step toward offering real help and support to your friend or family member with BPD.

The links between BPD, self-harm and suicide

BPD Basics.

Borderline Personality Disorder is a mental health condition where people struggle with intense emotions, unstable relationships and impulsive behaviors.

<< Read more about BPD: A Deeper Look Into Borderline Personality Disorders.>>

Increased Risk.

People with BPD are at a much higher risk for both self-harm and suicide attempts. This is understandable given the extreme emotional pain they often experience.

What is self-harm?

Self-harm (also called Non-Suicidal Self-Injury, or NSSI) is when someone intentionally hurts themselves without the goal of ending their life. Examples include cutting, burning or hitting themselves.

What are suicidal behaviors?

These include thoughts about suicide, making plans, researching methods, or attempting to end one’s life.

“Why would someone do that?”

It’s normal to have strong reactions to these behaviors. But comments like “How can you do that to yourself?” or “Just stop it!” can increase the person’s shame and make things worse.

The truth is, people struggling with BPD are often in unbearable emotional pain. As Marsha Linehan, a leading expert on BPD and developer of Dialectical Behavior Therapy, said, “The lives of suicidal BPD patients are unbearable as they are currently being lived.”

Why people self-harm.

There are a multitude of reasons someone self-harms. Below are some of the most common reasons my clients have reported.

Cope with overwhelming emotion.

Life with BPD can feel like an emotional rollercoaster. Self-harm is often a desperate attempt to manage these intense feelings, much like how we might turn to comfort food or mindless scrolling when stressed.

Feel something.

Sometimes, emotional pain is so great that people become numb. Self-harm can bring on physical pain, which is easier to handle.

Distract from emotional pain.

Individuals with BPD are often likened to an emotional third-degree burn victim, walking through life in constant discomfort or even agony. To find relief from this pain, people sometimes engage in self-harm to shift their focus to physical pain.

It works (temporarily).

Our bodies are wired to release feel-good chemicals (endorphins) to combat pain. Unfortunately, this reinforces self-harm, making it harder to stop.

The role of suicide.

For someone in constant emotional turmoil, the idea of suicide can feel both terrifying and comforting. It’s not necessarily about wanting to die, but rather about wanting an end to the suffering.

The path to healing.

There IS hope! Treatments like Dialectical Behavior Therapy (DBT) teach people with BPD how to manage their emotions, build healthier coping skills and create a life worth living.

If you’re concerned.

  • If someone is in immediate danger, call 911 or a crisis hotline such as 988.
  • Don’t be afraid to talk to a loved one struggling with self-harm or suicidal thoughts. Let them know you care and are there to listen without judgment.
  • Resources are available! Pine Rest offers a comprehensive DBT program.

Let’s break the stigma and offer support to those who need it most.

<<Learn More about DBT Programs at Pine Rest >>

<<Friends & Family of BPD Class >>


*Important Note: Not everyone with BPD engages in self-harm or has suicidal thoughts, and not everyone who self-harms has BPD.

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