To think people with EUPD/BPD get a tough time on here?

[FFSOMG]

I have been diagnosed with bipolar for 12 years. Two months ago my diagnosis changed to EUPD, and a month ago (different psychiatrist) it changed again to both.

I was so, so upset when I received the EUPD diagnosis because of just how stigmatised it is. If a person is behaving horribly you can guarantee that along with narcissistic personality disorder, some poster will suggest EUPD.

People with EUPD are described as manipulative and controlling. Two things I’m definitely not. I’ve been with my DH for nearly 12 years, married for 6, I have good friendships and don’t struggle with relationships. I ‘just’ suffer with extreme low/mixed moods that cause me to self harm and attempt suicide... what I’m try to say is that I am genuine in my attempts, I don’t ‘cry suicide’ as a way of manipulating those around me like some on here accuse people with EUPD of doing. paragraph edited by MNHQ

Personality disorders are so far behind in terms of being understood and accepted by the general public. It seems if I said that I struggle with depression and anxiety that would be ok, but because my diagnosis is emotional unstable personality disorder that people think we are vile monsters.

I’ve had psychiatrists tell me that CPTSD is diagnosed instead of EUPD purely because of the stigma attached to the latter (from the medical profession included).

Someone with CPTSD will be treated with compassion and offered support - someone with EUPD are too often condemned to a lifetime of little to no support, little to no treatment options (because they aren’t funded not because they don’t work), very limited compassion from professionals involved in their care.

It’s is a two tier system and those with EUPD are firmly buried at the bottom of a shitty barrel.

@Rinoachicken that's why it's really important to keep talking about these things, for awareness and information.

The one person I knew with BPD may have 'only been one person' but it was the most significant one person - my DM who caused a great deal of trauma and abuse so hopefully you can see why I'd have such a deep rooted wariness by me explaining that.

But from this thread it seems like my DM was an extreme case, and the majority are not like this.

I'd be your friend, you sound incredibly self aware and like you couldn't be trying any harder to feel better, and that's really inspiring

Oh and if you try to make a complaint against a medical professional who has treated you poorly, forget it. You have EUPD. Anything you say will be disregarded as manipulative or lies.

Like the time I presented at A&E with self inflicted wounds that required stitches. I didn’t want to go, I was taken there by someone else. A nurse refused to treat me because of my diagnosis, she ‘didn’t believe in playing along with other people’s mind games’. Another nurse had to be found. This is the prevailing attitude amongst many medical professionals.

@HungryHiker thank you, for at least taking the time to listen and to maybe think again

@Rinoachicken you're very welcome. You deserve support and to feel better, I hope you keep going and I'm glad you posted on the thread :)

A lot of people previously diagnosed with rapid cycling bipolar are now re-diagnosed with EUPD.

EUPD doesn't mean you are manipulative or controlling, it means you have severe mood swings and struggle to regulate your moods and behaviour (e.g. self harm as a means to coping with emotions).

Most people with bipolar experience manic phases sometimes with psychosis, that last months and usually need hospitalisation, followed by clinical depressions that last months (often with agitation and suicidal intent). ECT is commonly used to treat bipolar depression. SSRIs are contraindicated as they can trigger mania.
Bipolar is treated differently to EUPD; drugs like lithium and antipsychotics can be harmful if taken long term, so you wouldn't be on them with an EUPD diagnosis.

Group therapy and DBT has been proven to be most effective for EUPD, along with medication (but not the type given for bipolar, more along the lines of SSRIs, mild mood stabilisers, anxiety meds etc.

I’m currently inpatient. There’s a woman who has bipolar is being absolutely horrible. Swearing and abusing staff with the most horrific offensive and derogatory verbal abuse. But I wouldn’t say I wouldn’t be friends with other people with bipolar- I have two very good friends who have bipolar who are lovely.

What about the fact I was diagnosed with bipolar for 12 years then in the space of one appointment that label changed, would you suddenly stop being my friend because my label had changed, despite 12 years of a bipolar diagnosis?

I have children, and a loving partner. What happened to me earlier in my life to upset my brain wiring, that wasn’t my fault, but it wasn’t my families fault either. It is my responsibility to make sure I take my medication as prescribed, engage with the professionals who are trying to help and teach, to practice what I am taught and also accept that I will always have need to be alert and aware of what I am feeling at all times, no matter how exhausting, in order to be able to live the life I want to life, have meaningful and mutually beneficial relationships with those around me.

It helps massively that my partner is a forensic social worker specialising in mental health. So he understands what’s going on most of the time and he can help me ‘sound things out’ when I’m not sure what I’m feeling or why. He also adds a much needed touch of humour to the situation, “yeah honey, that’s a bit too BPD” when gently telling me that no, I really can’t send the 200 word rants text I’ve just composed to my best friend because she cancelled on me the day before for a perfectly valid reason! 😂 he’s like a backup system of checks and balances.

When someone does have the self-awareness, and is really trying, it is so invaluable to have someone you can trust, who gets it, who can approach you and say those important printing words in a safe and loving way - “do you think you are reacting reasonable to what has happened or do you think this might be triggering something” - that’s all it take for me for the wind to be blown out my sails, it’s like an “Ohhhh!” moment, and it means I can then unpick what is REALLY happening, separate the reality NOW from the crisis my brain THINKS it’s in based on something from my past that has been triggered.

Reading with interest as one of my nieces has just been diagnosed with BPD, but I didn't realise that there was such a stigma attached to it to be honest. I would in fact say the diagnosis might be helpful to her and those around her as there is now a valid reason for her, at times, very poor behaviour. Surely if you're not displaying the traits associated with the disorder you don't have much to worry about? Actions speak louder than words and all that or am I being incredibly naive here?

Prior to 2005 there was officially (NHS) no treatment path for people with BPD/EUPD - we were seen as untreatable, high maintenance, problematic. We were left to rot as long term inpatients, drugged to the eyeballs to keep us ‘easy’ to manage. No hope of improving, recovery, no hope of a life.

Medical professionals who have been in practice before 2005, still hold these beliefs - though they may say different to your face. That has been my experience.

2005 is not that long ago

The trouble with mn is that many users just can’t accept that some people are just not nice. They feel the need to diagnose any arsehole in question with some form of mental health issue without any experience in the field of psychology.

Just to clarify, having a personality disorder/ mh issue does not make you an arsehole.

@Rinoachicken can You clone him please?!?!

Treesandrocks- One factor in the increase in diagnosing personality disorders is that the Original 1983 Mental Health Act excluded personality disorders, this was amended in 2007 (think that's the right year) . I can remember as a student mental health nurse in the late 1980s being taught that ' nothing could be done' for personality disorders. Plus (and this is controversial) society since the 1970s has adopted policies of keeping children with their parents no matter how dysfunctional the home life is, exposure to childhood trauma and abuse affects development of personality, then a few years on the consequences are evident. I see young people aged 16 with first presentations to adult mental health services and they have often been exposed to horrific experiences growing up, by 18 they will have a diagnosis of personality disorder. In my experience the people with a personality disorder who do best are those that manage to access psychological therapies with a psychologist and Emdr therapy. There is a massive deficit in the Nhs in the availability of psychological therapies which need to be regular and consistent. I think the current management by health services of personality disorders is flawed but what is really needed is very costly.

Rinochicken, I don't as detailed above!

To the OP and the poster with EUPD upthread. My mum is 72, undiagnosed and in complete crisis. She has been all of the awful things said on here and then some. I’ve been emotionally and physically abused all my life. I’m the last person left. After much resistance, we’ve had intervention and I’m told this is the likely diagnosis.

Despite all this I’d certainly be friends with you both. Each person is so different and recognising and being consistent with how you can manage it is so key. This is your trump card so you don’t waste your lives like my mum. I’d like to meet someone managing it as I know their are some fabulous and inspiring individuals who deal with the frightening effects of EUPD as their day to day.

I completely understand just how worried, frightened, scared and miserable it can make you. At the end of the day we’ve walked the walk, know the deal and everyone else who knew someone’s sister’s boyfriend who may or may not have had EUPD can fuck off and then fuck off some more. Xx

OP if you're an inpatient, are you on the EUPD pathway? There's new research to suggest that a hospital environment can make EUPD worse, so many wards aim for a 3-day stay then discharge. Then community group therapy.

I used to work on a psychiatric ward and sometimes half the beds were taken up by patients with EUPD in crisis, due to lack of community support. An acute ward is a very stressful place, with patients experiencing psychosis, or bipolar mania, or other illnesses where they have little insight or control over their behaviour. Hence why the nurses tolerate derogatory comments and abuse when somebody is unable to rationalise or lacks capacity for their actions, yet may seem frustrated when somebody who does have insight self harms in front of others or behaves in an aggressive or upsetting manner that takes staff attention away from those who are acutely unwell.

When I was younger (2005-2007) I was diagnosed with BPD. I found the medical professionals were against getting involved or offering any support. The hospital stays I had lasted days, and I was given no support. I was too unwell to engage in therapy as I was in extreme crisis, yet not unwell enough for hospital. So I lived a miserable life with extreme self harm (causing myself to have seizures and requiring tendon repair surgery) and no support apart from a useless crisis team who obviously resented me. I wasn’t allowed medication in case I overdosed on it.
Then I was diagnosed with bipolar disorder and put on lithium and anti depressants and my life changed. I was stable for years until I had to come off lithium as I had a baby and was breastfeeding. I was given a CPN, medication, support and compassion. I had three hospital stays with my two baby’s in total, for about 3 months each time. Totally the opposite to the treatment I had when I was diagnosed with BPD and denied therapy, medication, hospital or community support.

My current CPN says when she graduated (around the same time as I had the BPD diagnosis) people with BPD were seen as not requiring hospitalisation, weren’t accepted on the books for community support. But now 75% of her patients have that diagnosis.

My diagnosis has changed back to EUPD, but I am being granted medication, therapy and treatment in hospital.

If I had have been left to go home after 3 days I would have been dead. I was off my medication and seriously unwell and unstable. I needed longer to re titrate and stabilise on the medication I was on. I trust the judgment of the ward team and my CPN more than you.

I trust the judgment of the ward team and my CPN more than you.

OP the poster above was just offering their experience and knowledge, there was no judgement there.

@CandyLeBonBon 😁😁😁

I trust the judgment of the ward team and my CPN more than you

No judgement intended OP. Your team know what is best for you. I hope you get well soon.

I was just pointing out why the lady with bipolar (who was being derogatory to staff) may have been treated with more tolerance, as bipolar is often accompanied by psychosis, disinhibition and lack of capacity.

EUPD is a serious mh disorder too (and the cause of a lot of deaths through suicide or misadventure/impulsive behaviours). Professionals do take it seriously nowadays. At least that's my experience.

Unfortunately it's often confused with other personality disorders e.g. narcissistic PD, antisocial PD etc so has a negative press. If somebody with EUPD is violent to others on the ward, abuses staff or has a history of GBH the diagnosis is sometimes changed to antisocial PD. If they repeatedly take overdoses or self harm in public places to seek admission, or do repeated serious harm to themselves, Munchausens is sometimes added to the diagnosis.

I've met some lovely, kind, empathetic people with EUPD. But also a few who attack others or self harm in front of others eg secreting a razor blade then slashing their wrists in front of the entire dining room. They usually get sent to Psychiatric Intensive Care or discharged to a community team.

If you feel you have bipolar not EUPD then challenge the diagnosis.
It's not set in stone.

IME a key difference between EUPD and bipolar is self harm. People with bipolar rarely cut, head bang or ligature, and if they do they tend to do it secretly or as part of a serious suicide attempt, rather than as a coping strategy. Therapy for EUPD focuses on regulating emotions and changing behaviours, and learning positive coping skills. Plus medication. Therapy for bipolar is mostly lithium, strong antipsychotics and ECT to try and regulate brain chemistry.

See MN deleted my paragraph where I explained how my suicide attempts have been secretive and genuine. Unfortunately I’m not allowed to explain how as method sharing. But there is a reason I have been kept in hospital since October last year, and yesterday both my CPN and my ward psychologist referred to my “serious attempts” at taking my own life. I have made myself very poorly (physically) because of them.

I’m going to hide this thread now as tbh it’s mostly confirmed what I feared and that I indeed WNBU.

OneStep If they repeatedly take overdoses or self harm in public places to seek admission, or do repeated serious harm to themselves, Munchausens is sometimes added to the diagnosis.

This is interesting, and a little disturbing. If a person is struggling with their mental health, the advice is always "seek help" and irl other people seem to expect a much greater response, including hospitalisation (whether suitable or not), from mental health services. So society sets up a certain expectation, then the person suffering in turmoil and struggling to think rationally at all, finds they are getting conflicting messages and can't access support or treatment. In a way, if there is no option to get some help when things are calmer I can sort of see why when deep in emotional turmoil someone might do this - a sort of desperate attempt to get the help they need, driven by a subconscious survival instinct. I mean, there are culture-bound MH syndromes (that only occur in certain cultures), people "express madness" differently... surely it's the same subconscious forces at work in expressing distress and desperation for help, but they're somehow doing it wrong?

I've never done it myself, mind, but certainly I've found it impossible to work out WTF I'm supposed to do between friends' and society's expectations, and MH services expectations. There didn't seem to be a legitimate way to explain or express what was going on for me or what I was struggling with.

Turned out I'm actually autistic, but nobody noticed despite some fairly obvious traits. Worse, their judgement was so clouded by preconceived stereotypes that they actually reported some things as the opposite to what I actually struggle with! (Eg. I was previously described as impulsive, but I actually struggle to do anything impulsively/change plans quickly).

I think there's a lot of people misdiagnosed, and BPD/EUPD covers so many different people and presentations, most of which is related to trauma + understanding of society/MH system. It's basically people expressing distress in vaious ways, and often maladaptive ways of asking for help. People with this label deserve that help.

This is interesting, and a little disturbing. If a person is struggling with their mental health, the advice is always "seek help" and irl other people seem to expect a much greater response, including hospitalisation (whether suitable or not), from mental health services

I've only known a handful of patients diagnosed with munchausens alongside EUPD, and they receive support and therapy in the community as munchausens is in itself a serious illness. I've known women who have swallowed sharp objects, cut themselves so extensively they need transfusions, insert broken glass into their vaginas, set fire to themselves and end up with horrific burns. These women need therapy and community support, after the initial medical care. Long stays on acute psychiatric wards are thought to be detrimental to people with EUPD, they become institutionalised and often their self harm behaviours escalate due to the stressful environment of the ward (noise, disrupted sleep, nurses doing observations, lack of privacy, other patients who are psychotic or aggressive due to being unwell, having personal belongings like phone chargers and mirrors confiscated.) Once the initial crisis has passed, many people with EUPD manage better at home, with community support groups and individual therapy.

Sometimes diagnoses get changed. I remember a male patient who was diagnosed with EUPD then re-assessed and diagnosed with psychotic depression. I've seen people with a diagnosis of 'Bipolar with EUPD traits' or 'adjustment disorder' or 'Complex PTSD'.

Thank you for the clarification, OneStepSideways
I thought you meant they were getting diagnosed with Munchausens for "pretending" to be mentally ill!

I'm still a little confused as I thought Muchausens was about faking illness for some kind of emotional gain - am I correct in thinking they are perceived as harming themselves specifically for the medical attention?

I guess my concern is that whilst these women may require therapy and community care, there doesn't always seem to be a way to obtain it "legitimately" (from POV of services). Like, if they'd calmly gone to the GP and explained their difficulties, would they be receiving the same therapy with community support? From what I've seen, heard, and read about, I can believe some people are - consciously or otherwise - driven to desperate measures to obtain psychological help.

FWIW I'm also very sceptical about the NHS's use of stage one Dialectical Behavioural Therapy without following it with the other stages. Seems to be removing the behaviours that cause others distress without drilling down into the root of the problem.

IDK I just find it all very interesting!

I agree it's very stigmatised. Have you found any support groups?

Also... it changes when people like you speak out and show how you really are :) you're not alone and people will start to realise.