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Friends and family members of those who suffer from BPD often feel overwhelmed, divided, exhausted, or traumatized due to their loved one's behavior. Depression, feelings of grief or isolation, and feelings of guilt are also common among people who have a loved one with BPD. It can be helpful to know that these feelings are common, and aren't because you are a bad or uncaring person. Although BPD is as real and debilitating as a physical illness. The disorder is not your loved one's “fault." Your love one may feel intense shame and guilt about his or her behavior, but feel unable to change. Knowing more about BPD will enable you to give your loved one the best support possible. Conduct research to learn more about what BPD is and how you can help.  The National Institute of Mental Health has a wealth of information on BPD.  There are also many online programs, blogs, and other resources that can help you understand what it is like to suffer from BPD. For example, the National Education Alliance for Borderline Personality Disorder has a list of family guidelines. The Borderline Personality Disorder Resource Center offers videos, book recommendations, and other advice for loved ones. Understand, however, that therapy may take some time to work, and some people with BPD do not respond well to therapy.  Try not to approach your loved one from an attitude of judgment. For example, it is unhelpful to say something like “You're worrying me” or “You're making me weird.” Instead, use “I”-statements of care and concern: “I am concerned about some things I've seen in your behavior” or “I love you and want to help you get help.” A person with BPD is more likely to find help from therapy if s/he trusts and gets along with the therapist. However, the unstable way that people with BPD relate to others can make finding and maintaining a healthy therapeutic relationship difficult.  Consider seeking family therapy. Some treatments for BPD can include family treatments with the person and his/her loved ones. Even if you don't understand why your loved one feels the way s/he does, try to offer support and compassion. For example, you can say things such as “It sounds like that is very hard for you” or “I can see why that would be upsetting.” Remember: you don't have to agree with your loved one to show him/her that you are listening and compassionate. Try making eye contact as you listen, and using phrases such as “mm-hmm” or “yes” as the other person is speaking. Because people who suffer from BPD are often wildly inconsistent, it's important for you to be consistent and reliable as an “anchor.” If you have told your loved one that you will be home at 5, try to do so. However, you should not respond to threats, demands, or manipulations. Make sure your actions are consistent with your own needs and values.  This also means that you maintain healthy boundaries. For example, you may tell your loved one that if s/he screams at you, you will leave the room. This is fair. If your loved one does start screaming, make sure to follow through on what you have promised to do.  It's important to decide on a plan of action for what to do if your loved one begins to behave destructively or threatens to self-harm. You may find it helpful to work on this plan with your loved one, possibly in conjunction with his/her therapist. Whatever you decide in this plan, follow through. People with BPD can be difficult to live with because they often cannot regulate their emotions effectively. They may try to manipulate their loved ones to meet their own needs. They may not even be aware of others' personal boundaries, and are often unskilled at setting them or understanding them. Setting your own personal boundaries, based on your own needs and level of comfort, can help keep you safe and calm as you interact with your loved one.  For example, you may tell your loved one that you will not answer phone calls after 10 PM because you need adequate sleep. If your loved one calls you after that time, it's important to enforce your boundary and not answer. If you do answer, remind your loved one of the boundary while validating his/her emotions: “I care about you and I know you're having a hard time, but it is 11:30 and I've requested that you not call me after 10PM. This is important to me. You can call me tomorrow at 4:30. I'm going to get off the phone now. Goodbye.” If your loved one accuses you of not caring because you do not answer these calls, remind him/her that you set this boundary. Offer an appropriate time when s/he could call you instead. You will often have to assert your boundaries many times before your loved one understands that these boundaries are genuine. You should expect your loved one to respond to these assertions of your own needs with anger, bitterness, or other intense reactions. Do not respond to these reactions, or get angry yourself. Continue to reinforce and assert your boundaries. Remember that saying “no” is not a sign of being a bad or uncaring person. You must take care of your own physical and emotional health to properly care for your loved one. It's very important to reinforce appropriate behaviors with positive reactions and praise. This can encourage your loved one to believe s/he can handle her emotions. It can also encourage him/her to keep going. For example, if your loved one begins to yell at you and then stops to think, say thank you. Acknowledge that you know it took effort for her/him to stop the harmful action, and that you appreciate it. Caring for and supporting a loved one with BPD can be emotionally draining. It's important to provide yourself with sources of self-care and support as you navigate the balance between being emotionally supportive and setting personal boundaries.  The National Alliance on Mental Illness (NAMI) and the National Education Alliance for Borderline Personality Disorder (NEA-BPD) offer resources to help you find support near you.  You may also find it helpful to see your own therapist or counselor. S/he can help you process your emotions and learn healthy coping skills. NAMI offers family education programs called “Family-to-Family,” where families can receive support from other families who are dealing with similar issues. This program is free.  Family therapy may also be helpful. DBT-FST (family skills training) can help teach family members how to understand and deal with their loved one's experience. A therapist offers support and training in specific skills to help you support your loved one. Family Connections therapy focuses on the needs of family members separately. It focuses on helping family members strengthen their skills, develop coping strategies, and learn resources that help promote a healthy balance between their own needs and the needs of their loved one with BPD. It can be easy to get so involved in caring for your loved one that you forget to care for yourself. It's important to stay healthy and well-rested. If you are sleep-deprived, anxious, or not caring for yourself, you may be more likely to respond to your loved one with irritation or anger.  Get exercise. Exercise relieves feelings of stress and anxiety. It also promotes feelings of well-being and is a healthy coping technique.  Eat well. Eat at regular mealtimes. Eat a well-balanced diet that incorporates protein, complex carbohydrates, and fruits and vegetables. Avoid junk food, and limit caffeine and alcohol.  Get enough  sleep. Try to go to bed and get up at the same time each day, even on weekends. Don't do other activities in bed, such as computer work or watching TV. Avoid caffeine before bedtime.  Relax. Try meditation, yoga, or other relaxing activities such as bubble baths or nature walks. Having a loved one with BPD can be stressful, so it's important to take time to care for yourself. Even if you have heard your loved one threaten suicide or self-harm before, it is important to always take these threats seriously. 60-70% of people with BPD will attempt suicide at least once in their lives, and 8-10% of them will be successful. If your loved one threatens suicide, call 911 or take him/her to the nearest emergency room. You can also call the National Suicide Prevention Lifeline at 1-800-273-8255. Make sure your loved one has this number as well, so s/he can use it if necessary.

Summary:
Understand that your feelings are normal. Learn about BPD. Encourage your loved one to seek therapy. Validate your loved one's feelings. Be consistent. Set personal boundaries and assert them. Respond positively to appropriate behaviors. Get support for yourself. Take care of yourself. Take threats of self-harm seriously.