Getting a BPD diagnosis

[OddCat]

My dd and I strongly suspect she has Bpd. Just been to the gp for a private referral to a psychiatrist for an assessment and she has suggested anger management therapy and said that we can self refer to the priory- you can't self refer .
I forwarded gp the email I received from the Priory saying they need a gp referral.

Gp also said there's no treatment for BPD but there is ( DBT which is proven to be successful.)

Just fed up with battling against the tide.

How did others manage to get a diagnosis?

The Priory may ask for a referral letter but the GP may charge to provide it. Not all private services require a letter. Have you chosen there because it's your local hospital, or is there a particular specialist you have chosen?

DBT will not cure BPD. In many cases it can provide helpful tools to manage the condition.

Most people that are diagnosed with BPD will go through the NHS, but you'll be aware how long the waiting lists are, if she's even seen at all. Be aware that DBT is a long term programme, the costs of doing it privately will be high, but very much worthwhile if it helps your daughter.

I've researched this until I am blue in the face, it's just so frustrating trying to get help- the gp was very patronising when I told her about DBT ' oh I think you mean CBT' no I mean DBT .

The Priory is the nearest place for dd - might have to have a look elsewhere.

How old is your daughter? They are very reluctant to diagnose teens and even people in thier early twenties, with BPD. Because a lot of symptoms of what you might want to call BPD can improve so much in your late twenties that it would no longer merit a diagnosis at all.
BPD tends to be diagnosed as a lifelong personality disorder in the sense that flare ups would be a lifelong reaction to certain triggers and would need a patient to be in constant treatment..... that's what your doctor may mean when he refers to their being 'no treatment'... that's why they are reluctant to diagnose it too early.
Of course your dd would probably benefit from DBT and/or CBT and things like mindfulness, even yoga could be helpful, certainly anger management... the thing is if she is very young she may improve dramatically over the next few years and the diagnosis would become a burden instead of a help

I was finally diagnosed about 18 months ago. I'm on meds and have done STEPPS and then privately arranged CAT which I'm finishing this week. When I lived in Brighton I was told that mental health services were moving away from diagnosing BPD because it was an 'umbrella' term and not overly useful. However when I moved to West Sussex I got the diagnosis. So it can depend on where you live.

I spent 20+ years misdiagnosed as having depression, I hope your daughter gets answers sooner than me.

Dd is 21 and hasn't been 'right' for many years- I'm just desperate for her to get help.
She is utterly miserable , extremely difficult to deal with and is fixated on getting a diagnosis.

I do understand about ending up with a lifelong label (and the bloody stigma attached to it ) but I don't know where else to turn.

Dd doesn't want to 'just have counselling ' - I'm torn between being so frustrated with her and feeling heartbroken for her.

Did you manage to get a diagnosis for your daughter? all sounds very similar to what were are dealing with now 😣

I was diagnosed officially during an inpatient stay, but it was in my notes for nearly 10 years prior and I had no idea. Everyone's journey to a diagnosis is different though.
DBT is the gold standard treatment though, but it is not available everywhere... is a bit of a postcode lottery. Local IAPT services may do courses in parts picked from it. My local one ran an 'emotion regulation' course. It might be worth seeing what is local to you.

OP I would be wary of a borderline diagnosis or EUPD (Emotionally Unstable Personality Disorder) because of the stigma. I don't think you realise how much stigma there is around this diagnosis, especially given how some therapists won't touch it. It's now been changed to EUPD because of this as it's been reframed as a mood disorder. You can read more about that here.

I wouldn't be so fixated on that particular diagnosis, personality disorder diagnosis are pretty contentious for a start and one therapist may disagree with another on the diagnosis. They don't take environmental factors into account. It's difficult to diagnose and women are often diagnosed with it more so than men. It's very easy to say that an angry, traumatised woman is 'borderline', rather than reacting with rage to trauma or other events in her life.

Others are correct in that the brain hasn't really settled until late 20s and to stigmatise a person with this for the rest of their lives, when they could change and settle down, is not the best idea. Also, Borderline is often misdiagnosed like I said above, for various reasons, one of them is trauma. If you look up C-PTSD, this is often misdiagnosed as borderline.

These rages, since you talk about anger management could be hormonal. Did they start around puberty? Some women are completely enraged around the time of their period and that settles down. Since it's hormonal, there's nothing they can do about it but there are supplements such as Primrose Oil, that can help. Rage isn't the only factor in a diagnosis, identity diffusion is a huge component of this, which is unstable self image ie the person doesn't know who they are as a person and their identity is constantly shifting.

Finally it's easy to look for a diagnosis in order to take away responsibility for your behaviour. Even if she does have a personality disorder, she'll have to learn to manage it for the rest of her life and will have to take responsibility for her behaviour. Good therapists won't treat a 'diagnosis', as it's easy to frame a person within the diagnosis, which isn't helpful. You might find this helpful to further understand that.

DBT is available privately and it is possible to recover, or at least recover enough not to be beholden to the disorder. There are specialist clinics for personality disorders and these are available on the NHS as well as privately. There are also forums, online groups and she may find some medication helpful.

@greycloudysky great post.

I completely agree. It is not often someone seeks out this diagnosis. More people work to try and get it taken off their records, due to the stigma, not just from general people, but the health professionals themselves.
What symptoms does she display? Self harm, unstable relationships, fear of abandonment? What was her childhood like as BPD can be linked to childhood abuse etc.

I hope the OP is still lurking this is a really interesting discussion. My DD is 19 and has a chronic depression / traits of BPD formal diagnosis from the Priory. She’s done a DBT group therapy course for a year ...very useful skills which she is continually trying to apply in her life. She can struggle with a sudden on-set of chronic depression with self harm and suicidal thoughts. DBT has helped her to manage these episodes more independently and responsibly. With regards to stigma, I don’t know what to say really other than you don’t announce it publicly..we are very wary I suppose but educated to recognise that it is a transient condition that she is actively working on and need not define her as a person.
BPD can be linked to abuse but trauma of any kind...ours was linked to two terrible traumas in early teens. I think the suggestion of abuse makes a lot of parents recoil but eyes turn to them and wonder if in some way they must be responsible. This isn’t always the case so people should try and talk about this complex condition and support for carers and family more openly.

I would say look at Dr Jessica Taylor about BPD diagnosis. It is eye opening and makes me look at psychiatry and 'diagnosis' in a whole new light.