Without intending to be dismissive to any one of these conditions, if depression, alcoholism, anorexia or self-harm can be considered a “can of worms” to deal with, borderline personality disorder (BPD) is like a whole swamp of worms – many of which you’re not even sure ARE worms but you are sure as hell they’re all trying to get a good grip on your neck and strangle you. BPD is one of the most controversial and difficult diagnoses you can receive, and if you’ve recently received it, it can feel like a death sentence – particularly when many health professionals themselves view it as some sort of toxic substance. That’s why I thought I’d start with this post regarding receiving the diagnosis, rather than attempting to define or really go into detail about the disorder itself – it’s just too complicated and I’m pretty confused myself as to what it is, what causes it, etc. But in the meantime, if you’d like a rough definition/list of symptoms to see if you identify, see here.
So. The diagnosis.
First and foremost: I can’t recommend strongly enough that anyone who receives this diagnosis get a second (and/or third, fourth, etc.) opinion, if possible. For obvious reasons, mental health care is, in general, extremely complicated and misdiagnosis is rampant. Doing a bunch of research online might lead you to your own conclusions, but getting at least a couple medical opinions is essential – otherwise you can literally spend years ‘treating’ the wrong illness, which is frustrating and pointless. If both you and your doctor(s) feel BPD is a pretty clear-cut answer in your case, consider the fact that millions of people go undiagnosed or refuse to acknowledge the diagnosis: by pinpointing and facing the problem, you’re already about a hundred steps ahead of that… so take heart (seriously).
In the vast majority of cases, BPD (like so many disorders) overlaps with a ton of other mental disorders and diseases: depression, bulimia, anorexia, anxiety, bipolar disorder, PTSD and many personality disorders like narcissistic personality disorder, multiple personality disorder, etc. For some people, BPD is the nexus of all of these problems and a very useful way to address many, many different issues; for others, certain criteria of BPD just don’t fit, in which case further research should be undertaken before settling on a treatment.
For me, “getting the diagnosis” was mostly a self-driven process. I am still kind of angry and hurt that the healthcare system in my country took almost two years to take my textbook symptoms and turn them into something concrete – which is especially odd given that I am what one could call “classic” BPD: I fit just about every single criteria of it and every single criteria fits me. Is it possible someone with extensive education and experience in mental health could have maybe realized/mentioned that before, in total desperation, I stumbled across it myself on the Internet? Hmph.
ANYway, yes, when I put forth the idea to my therapist at the time, she leapt on it – “Oh I’m SO GLAD you think so; I didn’t want to say it but that’s what I’ve suspected all along.” When I rather testily asked why she couldn’t have given me some clues as to what she had so long “suspected”, she replied matter-of-factly, “Well no one wants to give or get that diagnosis. It’s a last resort. I mean 1 in 10 BPD patients ultimately kill themselves.” WOWZERS what a fun fact to open with.
So right off the bat, I had some rather horrendous associations with BPD. For months I sought out a therapist who would diagnosis me as something – anything – else, and then I decided I didn’t want to think about mental health at all because everything seemed pointless and everyone I talked to seemed useless, so I gave up that too. I didn’t want to admit I had it, and I didn’t want to look into it let alone treat it. It sounded horrible, and the gist of it seemed to be (based on the oh-so-objective and informative Internet world) BPD = childish, whiny, self-centred brat who likes to pretend they have “real” mental problems (more later on why this perception is so rampant – hint: BPDers can hurt people who love them. Badly. There are a LOT of anger-filled people who have been left in the wake of a destructive BPDer and a lot of them love venting on the Internet so take care what you read.). Which is exactly what I felt like so that really just completed a cycle of feeling lower and lower: feel whiny and pointless, attempt to address it, realize many people think you ARE whiny and pointless, feel more whiny and pointless… etc. etc.
So the BPD diagnosis was hard enough to hear, but accepting it was yet another hurdle. Admitting that you have any kind of mental disorder/disease is awful. I felt: a) Guilty, like I didn’t ‘deserve’ to have a problem (everything is fine! I live in a first-world country! I’ve never been raped or abused or starved or beaten, how dare I have the gall to be unhappy?); b) Angry, like it was completely unfair and ridiculous that I should have something so wrong with me; c) Terrified, like I was one step away from the kind of full-on crazy person who people throw change at and look at with something between pity and disgust; d) Isolated, suddenly branded and removed from the herd, cut off from all of the lucky people who get to think of mental patients as totally foreign and something to write horror movies about; and more than anything, e) Utterly bewildered. How could this have happened? This couldn’t happen to someone like me. I was a classic overachiever who had (or liked to think I had) everything together. I had three post-grad degrees, including a masters’ from one of the top schools in the world. I had a big family, dozens of friends, plenty of extra-curricular activities. I’d had boyfriends and best friends and lots of good jobs. I had no problems that anyone would consider out of the ordinary – how could I possibly be this fucked up all of a sudden?
Of course it wasn’t that I was actually fucked up “all of a sudden.” I didn’t like to think about it at first, but behind all the resistance and negative inner reactions listed above, a tiny part of me was actually so relieved to find out YES there was something seriously wrong with me and it had a name. There were certain aspects of my life – aspects I’d always convinced myself were just little things or not that important – that were screamingly wrong, but I’d always downplayed them as “difficulties” or normalized them as “angst” rather than mental problems: relationship difficulties, anger difficulties, self-harm and eating difficulties, drinking and drug difficulties, klepto (petty theft) difficulties, lying difficulties…. suddenly all these “difficulties” rushed to the forefront and gathered under one big bad banner to confront me: BPD. It was terrifying. Well I say was, but it’s more like is. I shouldn’t pretend any of this is past-tense for me, even if I’m writing in the past tense for clarity’s sake. I only got this diagnosis about 6 months ago and I’m still considered to be in the very early stages of treatment. Argh.
I’d like to wrap up this post on a positive note, but the truth is, there’s not a lot of point to ending on a positive note just for the sake of seeming positive. I’d rather this blog be something real, something that others with BPD can read and go “yes, my GOD, yes, I’ve felt exactly like that” than be falsely optimistic. Sometimes I feel optimistic, don’t get me wrong. But most of the time I really really don’t. And that’s one of the many things that dealing with this involves. If I were to aim for an optimistic conclusion, I’d point out that I’ve been experiencing severe and extensive symptoms of BPD for about 25 of my 30 years on earth – and I’m still here. And I still have the drive, some days, to do things like start a blog about it in the hopes of helping/comforting someone, somewhere, at some point (perhaps that someone could even be myself in the process). Does that count as hopeful?