To think the stigmatisation of borderline personality disorder is awful

[PonderingBPD]

Most people with BPD have experienced alot of trauma, typically during childhood, hence the disorder which has alot of parallels to complex PTSD. It's not something people choose to have and is actually soul destroying to live with.

Why are people with the condition spoken of and thought of so negatively? It's essentially victim blaming.

AIBU?

Below is a questionnaire from the NHS website, so I'll use that for sake of ease. The answer to every question for me is yes.

Be careful with this though, OP. It seems from your most recent comments that you have answered these questions based on past behaviour.

Some people who have been diagnosed with BPD no longer meet the criteria for a BPD diagnosis 5 - 10 years down the line. Studies are ongoing in relation to this spontaneous remission of symptoms.

You really need to be answering the questionnaire based on your current symptoms/behaviours.

I was training to be a doctor a few years ago. I often witnessed patients with BPD treated with contempt. Only recently did the RCP release advertisement for an upcoming event describing patients with BPD as the thorn in the Docs side. I feel the stigma runs much deeper though. This was one of the main reasons I left medicine and am a year a way from qualifying as a psychotherapist.

You ask why BPD is 'stigmatised' and you say that your behaviour doesn't affect anyone else negatively. But then you've answered 'yes' to a lot of behaviours that would certainly have a negative effect on others in a lot of situations. You say that you just withdraw into yourself and feel everything deeply and so on - well, that does affect other people. Intensity and mood-swings and difficulty with self-control and all those things that you mention, even if you are not aggressive or cruel, do affect other people and the relationships you have with them. I'm sorry, but they just do. And part of understanding your own condition is accepting that.

Mood swings, overly-intense relationships, difficulty in controlling temper, self-harm, being overly impulsive - yes, these are things that affect you very badly, and I sympathise greatly. But they do also affect others. This is not just about you.

BPD behaviours aren't necessarily violent or deliberately cruel, but they are, by definition, traits that can make people very difficult to be around and many of those traits are specifically about relationships with/to others. And knowing that they are symptoms of a disorder doesn't make those behaviours any less impactful or difficult for other people.

I don't think you can have it both ways. If you don't ever display those negative behaviours, you don't have BPD. You can't reasonably say 'I behave in these negative ways because I have BPD' but then complain about your condition being viewed negatively. You are the one who has chosen to make the link between your difficult behaviours and BPD.

Thank you for highlighting this

@10HailMarys I would tend to agree with you - it’s perfectly common to have difficulties around emotional regulations that do not meet the threshold for BPD.

Also the PP who said about answering the questionnaire retrospectively. It’s supposed to be within the last 6mnths I believe.

Of course, BPD never ‘goes away’ - even someone who is in recovery and ‘well managed’ - still experiences all the emotions, negative and distorted thinking etc - they’ve just learned how to manage that to the point that the symptoms/traits are much much less apparent to an outside observer - and if they turned up in a Drs office now, they would not fit the criteria for BPD anymore. Doesn’t mean they don’t have it anymore, just that it’s clinically managed successfully.

Incedentally, the ICD11 (or whatever it’s called) is moving away from the model of ‘9 traits and you have to have 5 and if yes you do have BPD and if no then you don’t’ and instead moving towards a sliding scale model - where you have people with no difficulties, people with some difficulties but not clinically enough to have met the old threshold, then clearly BPD and severe BPD. They are also recognising that people can and will move around on that scale as they move through recovery.

Im a good example of this - in my 20s (when diagnosed) I would have been classed as severe - multiple hospital stays, in and out of A&E, self harming etc et. - textbook. But now I’m nearly 40, and been in recovery for coming up to 10 years, I would be classed as mild - no longer self harming, self aware, well managed symptoms. Doesn’t mean I no longer have BPD - just that I am making HUGE daily effort to manage it.

My older sister was diagnosed with BPD not too long ago and I can confirm nothing traumatising happened during her childhood.

However, something traumatising did happen during my childhood. I grew up with an older sister who would scream, shout, throw things, push furniture and full display cabinets over, lash out, run away from home and threaten to kill themselves etc all very unpredictably and without warning. Going from playing nicely to literally trying to strangle me or throw plates and knives at me in the blink of an eye. Smashing up the house was a regular occurrence with no specific reason other than not getting her own way or feeling like someone had offended her. "Can I go out?" "It's 10pm you have school tomorrow" smash up house. "Can I have £20 for xyz?" "No I don't have £20" smash up house. Repeat for every scenario.

Do I think of her negatively now? Sometimes. She has children now and one has to live with a family member. I try and help her as much as I can but from a distance. She still flys off the handle at anything and everything - the latest incident was her phoning me to complain about her job to which I gave her advice which she somehow took offence at. Past incidents include me having to collect her kids because she'd smashed the house up in an argument with her boyfriend, going no contact because I couldn't babysit when I was working, having to listen to her screaming at neighbours etc it's never ending. My mum is a nervous wreck but won't say anything. I lived round the corner from her for a year when I moved back home and very nearly had a mental breakdown because the anxiety from constantly anticipating what was next was draining. I avoid her now and live three hours away.

Would I avoid other people if I knew they had BPD? Only if they behaved the same way as my sister. As in, if they directed their bad moods, anger and shouting towards me then I would obviously not be friends with them. If they are nice to me then I would be friends with them. I've heard bpd be spoken about but only sympathetically.

The key for diagnosis is ‘the three Ps’.

Symptoms must be:

Persistent - starting in adolescence and continuing into adulthood (this is where a key differentiator is with ASD, as ASD is from birth).

Pervasive - affecting a number of different areas of a persons life, not just only work life, or only home life etc.

Problematic - the symptoms are unusual and causing distress/harm to self and/or others.

That's amazing you've worked so hard to manage your symptoms @Rinoachicken, it must take a huge amount of strength and courage to be so self-aware, really hope you're living a great life!

@PonderingBPD I fully agree with you that the stigmatization of BPD is appalling. One of my best friends has BPD and is one of the sweetest people you could hope to meet.

Unfortunately its a vicious cycle that most people who have BPD will not disclose it due to the stigma, so many people will have friends, colleagues, neighbors etc. who have BPD but would never share that fact.

That means that the only experience they have of it is of the far end of the spectrum - those who can't hide it or those who use it as an excuse and that just serves to reinforce the negative stereotypes

Honestly you don't sound like you have BPD OP. It sounds much more like C-PTSD and depression like another poster said. You are able to regulate your emotions and put your dc first. It really doesn't sound from what you've said, that you have BPD.

BPD and other PDs are on their way out. It's trauma and reactions to trauma in the majority of cases.

I hear what you are saying but I have to point out that you cannot confirm that your sister did not experience trauma during her childhood. You cannot possibly know the details of her every waking move. Children experience all sorts of things that they do not necessarily share.

It is much more likely that your sister has an undiagnosed condition that was overlooked and that has become more entrenched. Children don’t scream and trash houses regularly unless there is something significantly wrong.

NB my posts aren’t saying they’re exactly the same. Mine are staying where there can be symptom overlap & misdiagnosis can & does occur.

Children don’t scream and trash houses regularly unless there is something significantly wrong.

Yes that was me unfortunately. I'm ashamed to admit it and never want my children to know I behaved like that. With the benefit of hindsight as an adult I can see that I was lashing out due to S.A, neglect and emotional abuse. I was just labelled a "problem child" though and I'm sure of my mother read this thread she would enjoy telling everybody "see, told you she was a bad egg"

I know it’s difficult to offload shame but you were just a child trying to manage the unmanageable. You were failed by those who were supposed to look after you.

Is your mother’s voice constantly in your head?

If you think you have BPD, then please don't self diagnose. There is a huge overlap with other conditions such as ADHD and autism, especially in women. It is vital you get assessed, diagnosed and treated for the correct one.

Yes, there is huge stigma surrounding it too, sadly amongst healthcare workers. I did that that thing where you misjudge the bottom step and have a mini heart attack. I ended up breaking my foot, but the triage nurse was convinced I had tried to throw myself down the stairs and was faking limping.
Another time, I attended a walk in centre, and when the nurse was out the room, I took a peek at the computer screen. It had a section in big text saying "Patient Alert - Personality Disorder". Not even a mention of which one.

Unfortunately yes she is. I'm NC now and have been for a few months but the woman is still living rent free in my head.

Ugh I can relate. Sorry if I have overlooked this but do you have a therapist?

I was seriously considering going private through psychiatryUK for an assessment / diagnosis. I contacted them and asked them to clarify whether I could keep any potential diagnosis off my medical record and was told yes I could.

I had a post about it in mental health a few months ago actually. Some MNers suggested I try to access DBT therapy privately, and forget trying to get a diagnosis and just treat the symptoms as the stigma will follow me around forever.

I'm so sorry you had those experiences, I'm so angry for you. The people saying there's no stigma need to read things like this. It's exactly the sort of thing I was worried about. What on earth is "ALERT: PERSONALITY DISORDER" about? That makes you sound like a threat. Just horrible.

Not at the moment no.

I've been through IAPT before, for EMDR and CBT. I contacted them when I was last pregnant (baby now 7 months) and asked if i could see the same therapist as I had alot of childhood related things I needed to work through. I'd done alot of work with her on a few unrelated traumatic experiences (birth trauma and DV)

She is happy to see me but suggested I waited until after baby as it was so late on in my pregnancy to be opening Pandoras box, so to speak, and she'd be concerned it might set a predecent for postnatal depression.

It's the same therapist who said she doesn't think I have BPD because I don't turn up at A&E threatening to kill myself 🤔but she practically saved my life when I was in the grips of PTSD after my birth trauma, so she's great with trauma work.

I should really arrange to go back, they won't go into the BPD but I'd definitely benefit from going through the childhood / mother stuff.

I'm really sorry you can relate 😔

I encounter a number of people with eupd/bpd at work
the only thing they have all had in common is that they believe they are the victims and it’s everyone else who is the problem. Even if they admit they have done wrong they were pushed or provoked or defending themselves or sick.
your post pretty much says you’re not at all bad to others, only yourself yet made a post essentially saying that your autistic son and husband have it easier than you…

This thread makes me so sad.

BPD is a horrible diagnosis to have. Very few people know my actual diagnosis and I think some of the responses on here show I'm right not to tell them. I mask incredibly well and except for those who are very close to me, people tell me that they would never have guessed I have MH issues as allegedly I come across as very serene and sorted (I'm actually disocciating) and I'm the 'go-to' person for all my friends when they need a shoulder to cry on (which actually heaps a lot of pressure on me that I can't always handle).

I've never smashed anything up in my life or had an angry tirade at anyone except myself. I don't deny that it is hard for my husband as he's been there through all my depressive episodes.

The latest thinking is that BPD and c-PTSD are very similar and BPD can indeed be caused by childhood trauma. So it's extra upsetting to be defective as a result of being abused and to then be stigmatised for it too. Like with anything, BPD is not an excuse to treat people badly and I can hand on heart say I have never used it as one.

No I didn't. Please don't put words in my mouth.

I said autism isn't stigmatised in the way BPD is, and that my husband having emotional responses / meltdowns to things is viewed as more understandably than when I do, because autism is more socially acceptable than BPD.

When posters pointed out that I was being ignorant and was wrong I reassessed what I'd said and apologised.

There's nothing 'easy' about having autism and I've never suggested there is. My point was about how society is more forgiving of autistic meltdowns than they are of BPD episodes.

@PonderingBPD
I think you rightly realise (from your own experience of the system) that nhs services are just not designed nor equipped to treat mh difficulties adequately - even for you to be able to get an accurate diagnosis - whatever that may be sadly. So many people are lumped under a blanket anxiety & depression category when there can be far more nuanced & complex aspects at play, where good assessment & diagnostic expertise can be severely lacking. Too often people are quickly labelled with a “treatment resistant” label (or worse still personality disorder) to excuse inappropriate or non existent “treatment” & ineffective medication (often not even designed for the condition being presented). Most services are completely stretched & firefighting at the more severe end of the spectrum when ironically any therapy tends to have better outcomes with people like yourself, with insight, & a willingness/ability to engage to manage symptoms better.

Of course I’m not advocating you not to seek help via your GP or a crisis team if you find yourself in a position where you struggling to cope or if your condition changes. This is just my observation.

I think the stigma is very alive & real hence why it’s so critical services & practises change so as not to deter people from seeking help. That doesn’t leave you anywhere however as you say.

You shouldn’t be forced down that route & I don’t know what service provision for DBT is like privately, but it may be the best option? Whether you need a BPD label per se in order to qualify for DBT is something I do not know. Many therapies are practised integretively because people are not walking diagnostic entities & mh constructs. If they have any expertise, they will be able to assess you properly & listen to your concerns & intervene accordingly? At least that’s what we’d hope. 🍀

Fair dues