For most people, an unreturned text is a minor frustration—a sign that a friend or partner is busy and will respond eventually. For someone living with borderline personality disorder (BPD), that same silence can feel like evidence that something is terribly wrong.

“Your perceptions are off, and as a result of that you read signals in ways that are incorrect,” says Rebbie Ratner, who has BPD and directed the documentary Borderline, along with running the YouTube channel BorderlinerNotes. “And based on those incorrect reads, you react.”

That reaction might be a furious message—Why aren’t you texting me back? It’s so rude that you don’t think about me enough to respond—or a less-obvious freeze-out: pulling away, keeping score, deciding not to respond the next time the other person reaches out. “Not only am I not going to answer, I’m going to make them pay next time,” Ratner says, describing the pattern she lived inside for years. That might mean “sending zingers their way to try to wound them because they've wounded me.”

It’s the kind of pattern that gets misread constantly—written off as manipulation, drama, or someone being “too much.” Over time, it can wreck the very thing the person is trying to protect. “Do it enough, and you blow your relationships,” Ratner says. “You blow your ability to build connections. You get lonely. You lose your ties to people.”

BPD affects an estimated 2.4% of people globally. The condition is marked by intense emotional swings, a chronic feeling of emptiness, and a deep fear of abandonment. It's also one of the most misunderstood diagnoses in mental health—often confused with bipolar disorder, dismissed as a character flaw, or thought of as untreatable. 

None of that is accurate. We asked experts and people with BPD to break down the most common myths about the condition—and what they wish more people understood.

Myth: People with BPD lack empathy

If anything, the opposite tends to be true. People with borderline personality disorder often feel other people’s emotions so deeply that those feelings become indistinguishable from their own.

“They are deep, deep feelers,” says Lauren Hunter, a psychotherapist in New York who treats BPD and whose father has the condition. “If somebody shared a devastating scenario, they would almost take on those feelings.”

That sensitivity may help explain why so many people with BPD are drawn to caregiving roles. “I see so many people in helping professions who have BPD,” says Sara Rose Masland, an associate professor of psychological science at Pomona College in Claremont, Calif., who specializes in BPD. “Nurses, vets, vet techs—professions where they're trying to help others.”

Part of why this myth persists, Masland says, is that the hardest moments are the most visible ones. Someone in the grip of intense emotion might lash out or say something cutting, and that can be mistaken for not caring. “It’s not coming from a place of actually trying to hurt anyone else,” she says. “It’s coming from this place of dysregulation.”

Myth: People with BPD are manipulative or attention-seeking

The phrase “attention-seeking” gets thrown around constantly in discussions about borderline personality disorder—but experts say it obscures what’s actually happening.

“Something that may seem like attention-seeking might actually be help-seeking,” says Priscilla María Gutiérrez, a mental-health advocate in Sarasota, Fla., who was diagnosed with BPD in 2018. “Safety-seeking. Connection-seeking. Relief-from-pain seeking.”

Behaviors that look dramatic from the outside—late-night texts, over-the-top exits, even self-harm—are often attempts to manage emotions that feel intolerable. “Self-harm actually has a function for that person to decrease that painful emotional intensity,” Masland says. The person might be trying to stop someone from leaving, distract themselves from overwhelming panic, or make their pain visible enough that someone finally responds.

The cycles Ratner fell into with romantic partners—lashing out, then apologizing, then resenting herself for apologizing—often looked, from the outside, like calculated efforts to manipulate. “I don’t think that’s what was going on,” she says. “It was much more about doing behaviors to assist in regulating and managing my feelings.”

Myth: Everyone with BPD acts the same

The cultural image of borderline personality disorder—loud, volatile, Winona Ryder in Girl, Interrupted—captures only one possible presentation of a much more varied condition. According to the Diagnostic and Statistical Manual of Mental Disorders, a person needs to meet at least five of nine criteria to receive a diagnosis, which means there are hundreds of possible symptom combinations. The criteria include frantic efforts to avoid abandonment, having unstable relationships, identity disturbance, impulsive behavior, chronic feelings of emptiness, intense anger, emotional instability, paranoia or dissociation under stress, and recurrent suicidal behavior or self-harm.

“Not everyone is going to have the same five out of nine,” Gutiérrez says. Her own presentation was what some clinicians informally call “quiet BPD”—the volatility turned inward rather than outward. “My outbursts were kind of rare but very intense,” she says. “A lot of it was internal. I took it out on myself.” She has never attempted suicide, she notes, though suicidal ideation and self-harm are common among people with the condition.

That variation is part of why the diagnosis is often missed. Someone whose symptoms don’t match the popular image—throwing things during arguments, screaming at partners, storming out of rooms—may go years without anyone recognizing what they’re experiencing. “From different people that I’ve met,” Gutiérrez says, “none of us are the same.”

Myth: BPD is just another name for bipolar disorder

The two conditions get confused all the time—partly because of the similar acronyms, and partly because both involve intense mood shifts. But they’re fundamentally different, and the distinction matters because the treatments aren’t the same.

“Bipolar disorder is a disorder of mood regulation, and borderline personality disorder is a disorder of personality,” Hunter says. People with bipolar disorder cycle through extended periods of mania and depression, often accompanied by grandiosity or elevated self-esteem during manic phases. People with BPD, by contrast, often struggle with a persistent sense of emptiness and low self-worth, she says. And their emotional swings are more likely to be set off by something that happens—a perceived rejection, a fight, an unanswered text—than by an internal mood cycle. 

Myth: BPD is always caused by childhood trauma

Trauma is a major risk factor for BPD; many people with the condition have experienced physical, sexual, or emotional abuse. But it doesn’t apply to everyone, and assuming it does can create problems of its own. 

“This is not necessarily a trauma disorder,” Masland says. What’s more consistent, she explains, is a pattern of chronic emotional invalidation—growing up in an environment where big feelings were dismissed, minimized, or punished rather than helped. “You can imagine a child who has baseline high emotional intensity,” she says, “and the parent is not equipped to help with that emotional intensity. They may do things that are well-meaning, but still invalidate the child.”

The messages aren't always intentionally cruel. Sometimes they sound like attempts to calm a child down: It's not a big deal. Don't make such a fuss. But over time, they teach kids that their emotions aren’t legitimate, Masland says, and as a result, they never develop the tools to manage what they’re feeling.

That nuance also matters for how families approach treatment. If clinicians assume abuse where there wasn't any, it can derail recovery and falsely indict parents who were trying their best. “Symptoms make sense even without a significant trauma,” Masland says. “Even that well-meaning chronic invalidation can create these kinds of problems.”

Myth: People with BPD can’t have healthy relationships

Relationships can be especially challenging for people with BPD; the fear of abandonment runs so deep that even small ruptures can feel catastrophic. But the idea that healthy connection is off the table is wrong.

“These are people who deeply care about relationships,” Masland says. “That fear of abandonment comes from a place of really caring about interpersonal connections.” With the right treatment, she adds, many people with BPD build meaningful relationships—and developing the skills to maintain them is often a central piece of recovery.

Gutiérrez, who has done years of dialectical behavior therapy (DBT, the most effective treatment for the disorder), says she had to work hard at the relationship skills most people absorb in childhood. “We feel things deeply, and so it’s not that we’re incapable of loving or learning boundaries or learning how to regulate our emotions,” she says. “It’s just that we didn’t really have that foundation growing up. But we’re more than capable of growing and learning and healing.”

Myth: BPD only affects women

About 75% of people diagnosed with borderline personality disorder are women, but research suggests the condition actually affects men and women at roughly the same rates.

“When we look at good epidemiological studies, it actually turns out that the prevalence is equal for men and women,” Masland says. “It’s just that men are not getting the diagnosis.” Men, she explains, are less likely to seek treatment in the first place—and when they do, clinicians often default to other diagnoses because the cultural image of BPD is so heavily gendered. Pete Davidson and former NFL player Brandon Marshall are two of the few male public figures who have spoken openly about having the condition.

Myth: BPD can’t be treated

DBT is the gold-standard treatment for borderline personality disorder. The approach was developed by psychologist Marsha Linehan (who has publicly disclosed her own BPD diagnosis). It’s intensive—typically at least 24 weeks—but the results are striking. Research has found that after a year of DBT, the majority of patients no longer meet the criteria for a BPD diagnosis.

At its core, DBT teaches skills that many people with BPD never had the chance to learn. It’s “a whole curriculum of distress tolerance, of coping skills, of how to talk to people—just really foundational human skills,” says Gutiérrez, who began DBT shortly after her diagnosis. Combined with medication and ongoing therapy, she says, the work has been transformative. “I would describe my BPD as in remission. If a psychiatrist were to analyze me, I wouldn’t meet the criteria.”

The behavioral symptoms—like self-harm, impulsivity, and extreme mood swings—tend to improve first, Masland says. More internal symptoms, like chronic emptiness and an unstable sense of self, take longer to shift. “It can take ongoing work for years, because this is a really severe mental illness,” she says. “But there are people who make really fantastic recoveries from BPD. It’s definitely treatable.”

Ratner especially appreciates learning how to question her initial reactions. “One of the core capacities that’s brought forth when one gets treatment is learning how to cast doubt into your perceptions,” she says. The unreturned text she once read as rejection? Now she can pause to consider other possibilities—her friend was busy, didn’t see the message as urgent, or simply didn’t get to it yet.

And she refuses to let stigma slow her recovery down. “It is really not my business what other people think about [BPD] or me,” she says. “I will be damned if I am to be distracted by their opinion of it to the extent that it in any way impacts my efforts at recovery.”

The secret to everlasting love and happiness might be fighting—but only if you do it the right way. Most people don’t, couples therapists say.

The trouble is that almost no one is ever taught how to fight in a healthy way, leaving many of us to improvise difficult conversations. If the way you and your partner argue feels like a script you can't escape, though, experts say it isn't a life sentence—it's a set of habits, and habits can change.

Learning to fight well is "like a new muscle," says Linda Engelman, a licensed marriage and family therapist in San Ramon, Calif. It’s awkward and uncomfortable at first, but more natural every time you use it. "You're just rewiring the circuit,” she says. Here are 15 rules therapists use to help couples fight more fairly. 

Schedule the fight

Most blowups happen when one person is already activated and the other gets caught off guard and slips into defense mode—which means no one is actually listening. Putting a hard conversation on the calendar removes the ambush. It doesn't need to be formal, says Ilana Grines, a licensed marriage and family therapist in Los Angeles: "Tonight after the kids are in bed, can we talk?" is plenty. 

"It's one of the most unromantic things, just like scheduling sex," she says, "but it works incredibly well." The message it sends: “I respect this conversation enough to give it a real shot, and not just come into it hot.”

Check the conditions before you start

The body has an enormous impact on how you handle conflict, so before you wade in, make sure you're both in shape for it. "Adding conflict on top of hunger, exhaustion, hormonal shifts—you're basically asking to be running on empty and having the worst fight of your life," Grines says. Many of the most vicious arguments happen late at night simply because everyone is depleted, which is a reflection of capacity, not of the relationship.

Take stock of your partner's state, too. Jenny Mahlum, a couples therapist in Manhattan, suggests asking how wide their window is that day, on a scale of 1 to 10, borrowing from psychiatrist Dr. Dan Siegel's "window of tolerance." An 8 means there's room to get into something difficult; a 3 means even a small thing might land hard. If their window is narrow, the best move is to delay, not abandon, she says; agree on a better time rather than forcing a conversation neither of you can do well.

Set the ground rules before you need them

Therapists call this meta-communication: communicating about how you communicate. Tina Shrader, a licensed marriage and family therapist in Oak Park, Ill., recommends agreeing in advance on what's off-limits when things get heated. No name-calling, no cursing, no belittling or dismissing each other's feelings ("you always feel that way" or "why would you take it that way?") is a good place to start. The more specific these rules are to your relationship, the better, she says.

Give yourselves a designated spot

Pick one place to have hard conversations—ideally somewhere you don't otherwise spend much time, so it carries no baggage. Mahlum calls it a "talking spot" (inspired, she says, by Winnie the Pooh’s "thoughtful spot"). Over time, settling into that spot becomes its own signal that you're there to work something out.

Another option is to switch up the location occasionally. If you always fight in the bedroom with the door shut, Shrader says, try the kitchen instead. Changing one element of the pattern often shows couples they're "actually not stuck" and can do things differently.

Slow down

Most couples fight at "rapid ping-pong velocity," Engelman says—volleying so fast that neither person is really listening. The speed comes from anxiety, and assuming you won't be heard, so you talk over each other and race to make your point. The first step is simply noticing it: Is your heart pounding? Is your face hot? Then say it out loud: "Hang on, I hear myself, and I want to slow down." Lowering your pace and softening your voice keeps the conversation from spiraling.

Be a detective, not a lawyer

Couples tend to fight like they're in a courtroom, building a case to prove who's right. It works far better to behave like detectives on the same team, trying to solve the same mystery, Mahlum says. That approach uses curiosity, which is usually the first thing couples abandon mid-fight. Instead of accusing, ask: "Help me understand what was going on for you." "Help me walk through how you made that decision." It signals that you're trying to understand your partner, not judge them. As Grines puts it, "Curiosity leads to intimacy,” and it can change the entire temperature of a fight.

Speak in parts

Try saying "part of me feels angry" instead of "I'm angry." It sounds like a tiny change, Mahlum says, but it softens the standoff, because one feeling rarely tells the whole story. You might be angry and hurt and shut down—and still love your partner and want to figure it out. This strategy slows things down and reminds you both that there's more in the room than anger: "Part of me is feeling this way, and part of me also wants to work this out with you,” she says.

Remember, it's never about the fork

The perpetually unfolded laundry, the never-replaced toilet-paper roll, the forks loaded into the dishwasher the wrong way—these might set off the fight, but they're rarely what it's actually about. As Engelman puts it, "It was never about the fork."

Therapists encourage couples to look past the fight’s trigger and ask what deeper hurt is underneath. A month's worth of arguments can often be traced back to the same core fear: You don't trust me. You don't think I know what I'm doing. You don't value what's important to me. Once you identify that larger theme, the conversation tends to shift. Recurring conflicts are often a "dance" both partners participate in, Shrader says. The goal isn't to keep arguing about the fork—it's to understand the pattern that keeps bringing you back to it. 

Make physical contact

Many people instinctively pull away during conflict, but Grines says couples who can hold hands while disagreeing tend to recover faster. The point isn't romance in the moment—it's co-regulation. Holding hands, sitting close together, or resting a hand on your partner's arm can signal to both of your nervous systems that no one is actually in danger. "It's OK to say: This person is still my safe place, even when it's difficult," Grines says.

Try sitting back to back

There's a reason why it’s easier to have difficult conversations in the car or on a walk: When you don’t have to make direct eye contact, the stakes feel lower, and you're less likely to tailor your words to every flicker of your partner's reaction. Mahlum sometimes has couples sit back to back—ideally still touching, so they don't feel disconnected—and take turns talking. Simply doing something unexpected can defuse tension, she says, while the setup makes it easier for people to say what they actually mean.

Use a fill-in-the-blank template

When people don't know how to start, Shrader hands them a script: "When you [did a specific behavior], it made me feel [a feeling], and I reacted with [a behavior]." It can feel a little robotic, she says—in a good way. The power is that it pairs what happened with how it felt. For example: "When you shut the cabinet door like that, it made me feel scared." That makes it easier for the other person to focus on the feeling being expressed, rather than jumping to their own defense. “Putting it in that framework allows for the response we want, which is to feel heard,” Shrader says.

Agree on a code word

When you're upset, it's hard to find the right words—and even harder to hear them. That's why Shrader suggests agreeing in advance on a nonverbal cue or a silly buzzword, like "banana split," that means: let's take a break. Decide ahead of time when you'll come back to the conversation, whether that's in 30 minutes or a couple of hours. The important part, she says, is actually returning to it. A timeout only works if both people know it's a pause, not a way out.

Listen until they actually feel heard

Here’s a trick to make sure everyone is really listening: One person talks, the other paraphrases what they heard, and the speaker confirms or clarifies it before you switch. It can feel painfully slow, but that's the point. People often fixate on one sentence and miss everything else, Mahlum says. "The sooner you both feel understood, the sooner the conversation can actually go somewhere." 

Keep in mind that validation isn't the same as agreement. "’Agree’ is a dirty word in my office," Shrader says. "I don't have to agree with that to offer you validation, for you to feel seen and heard."

Swap your go-to move for something braver

Under stress, most people default to one of two patterns, Engelman says: pursuing (getting louder, more critical) or withdrawing (shutting down, leaving the room). You can't easily stop getting triggered—but you can choose a different response. 

It’s better to say what's happening inside of you instead of criticizing, stonewalling, or walking away. Someone who tends to withdraw might say, "I'm overwhelmed and my brain is shutting down—can I take 10 minutes and come back?" A pursuer might say, "My heart is racing, but I do want to hear you." It's a circuit you rewire with practice, not a switch you flip.

End on the same team

You can't always resolve everything before sleep, Grines says, and you don't have to. What matters most is reminding each other that you're not enemies. You can always say some version of: "I love you. I'm still upset, and we can figure this out tomorrow," she suggests. The goal isn't to pretend everything's fine. It's to leave the conversation knowing you're still working toward the same thing: a close, connected relationship.