Asking for therapy today for borderline.

[selfdestructivelady]

I hope he gives me some I'm worried he will say no. But I desperately need it. I'm bipolar as we'll and while that is managed by meds my borderline is currently untreated.

[NanaNina]

Am assuming you mean borderline personality disorder? I keep hearing about this on the MH threads. How exactly is this condition diagnosed I wonder. I can't help thinking it could be a "catch all" for issues that don't seem to fit with other types of mental illness. Is it related to trauma in the past at all - if so how is it distinguishable from PTSD.

Hope you get the help you need.

[SaucyJack]

Whereabouts in the country are you?

STEPPS and dialectical behaviour therapy are both Borderline PD specific therapies that are available on the NHS in some parts of the UK.

(Have done STEPPS myself and it's fantastic)

And no, BPD isn't a catch-all for other issues. It's a very real and very distinct mental disorder in its own right- with very clear symptoms and behaviours and diagnostic procedures.

[selfdestructivelady]

I'm in South Wales.

[Messupmum]

How is any mental illness diagnosed? BPD is horrible to live with, no worse or easier than any other mental illness. I want to ask about dbt too as it's never been suggested to me.

[KeepNaanAndCurryOn]

I'm with you NanaNina. I have friends diagnosed with BPD who absolutely fit the diagnostic criteria and have benefitted greatly from DBT in particular. However, pretty much everyone I've met through voluntary work has has it mooted as a co-morbid disorder and I can't believe its that prevalent.

Sorry OP, I'm not suggesting for a moment that it's not the case with you and I hope you get the help you need. I just have concerns that people are being diagnosed with BPD when they don't quite fit the boxes properly.

[SilverStars]

BPD has an official diagnostic test called a SCID-D. It is a long questionnaire that has 119 questions that has to be filled in over several sessions with a qualified professional. Those answers are then scored and the official personality disorders are then diagnosed - such as schizo, borderline and so on. There is a strict diagnostic criteria for BPD.

Without this diagnostic tool being used the diagnosis has the danger of being used in appropriately for people, often women who self harm and attempt suicide. Those behaviours are not necessarily meaning someone has BPD.

DBT is group therapy that looks at 4 key skills: interpersonal effectiveness is one of them as people with BPD struggle with this skill. Mindfulness is another as it helps reduce intrusive thoughts etc.

To participate in DBT most courses insist that you are not self harming and do not participate in life threatening behaviours. People under crisis teams or presenting at a and e generally need other treatment and to be more stable first. That is why not everyone is offered it straight away.

[Messupmum]

I never had a test done, makes me wonder whether they've got it all wrong. Is there an online version of that test?

[KeepNaanAndCurryOn]

The on-line tests aren't worth much as the questions they ask don't go into the detail required IMO. For example, when I was seriously depressed I made lots of suicidal gestures and as I went manic, I lost my temper a lot. Those are also two of the diagnostic criteria for BPD, but when my bipolar is stable, I don't meet any of them IYSWIM.
If you've been diagnosed and are unsure, I'd certainly ask for the proper test.

[Messupmum]

I could ask for the proper test, I don't get told a lot really. Just get shifted about and not listened to. Be nice if there was a therapy that worked for bpd, but how do you get better ie not sh'ing or feeling desperately suicidal without the therapy? Maybe meds or CBT, I don't know.

Have you tried other therapies op?

[fluffydressinggown]

Sorry to contradict you silver but dbt is specifically designed for people who are actively self harming or suicidal. Risky behaviour is not a reason to be excluded from dbt if anything it is a reason to start dbt! It is also not just group work it is 1 to 1 therapy and group.

[SilverStars]

Yes I forgot it has a 1:1 element as well as the group work. Regarding risky behaviour the groups know of ask people to sign no harm contracts so that demonstrates again the variety of different provision across the UK.

[SilverStars]

The official test is not an online test as it has to be carried out, usually over several sessions, by a trained professional. Many people are diagnosed without this though, perhaps due to a variety of reasons. It also assesses for all the other personality disorders which can aid treatment choices.

[thedyingswan]

I started dbt as an inpatient. I was transferred to outpatient group after discharged.

[selfdestructivelady]

I was offered a mindfulness course.

[SilverStars]

That sounds encouraging. Mindfulness is one of the 4 units of DBT.

[selfdestructivelady]

Oh good at least he is trying to help.