BPD diagnosis rescinded

[Worried74]

My son (21) had an assessment recently where the clinician said he suspected he had BPD and in an initial letter lists his impression as AUdhd (existing diagnosis) and BPD. They discussed what the diagnosis meant, a treatment plan and what happens next only to then get a call to say the multidisciplinary team have said all his symptoms are down to ASD and ADHD and he does not have BPD, the sign off is pretty much dismissive of all of his symptoms and feelings.
How do we go about challenging this correctly? My gut feeling is locally other diagnosis except ASD and ADHD are down played due to resources and whilst I am aware there is a cross over in symptoms the issues can exist co-morbidly. Here if your issues are ND based you get fobbed off as the local mental health teams are not commissioned to undertake work with the ND. My son struggles massively and he firmly believes that what he experiences is BPD. I would be very grateful for any advice.

You might want to clarify whether you are using the abbreviation to mean borderline personality disorder or bipolar disorder

Totally agree. Need to clarify the abbreviation to be able to advise accordingly.

This is a tricky dilemma for MH services at the moment. There is an overlap in symptoms and there's been a big push from autism charities and action groups to re-diagnose a lot of people who had EUPD diagnoses with just ASD. The argument is that it is validating to be just ASD, rather than being told that you're mentally unwell.

In both cases, treatment is limited. There's increasing evidence that DBT helps with PD, and psychoanalytic psychotherapy has always been the main treatment, but very few adult metal health team have psychoanalytically trained therapists, so support options are probably limited either way.

If you want to challenge, you can ask for a second opinion. You should be able to see a different psychiatrist and review the formulation. If not, you contact PALS.

I’m assuming borderline personality, they seem to be diagnosing everyone with that nowadays, and bipolar is usually considered a more obvious condition.

Bi-polar disorder or Borderline Personality Disorder.

Treatments and presentations are vastly different depending on which.

Frankly I’d take the ND diagnosis over a personality disorder one anyday because it’s a highly stigmatised diagnosis (seen ans histrionic, difficult and manipulative) and very much affects how healthcare and mental health care professionals will treat you.

There are a huge amount of women saddled with BPD diagnosis who are in fact undiagnosed AuDHD because there is a big cross over of ‘symptoms’

Borderline Personality Disorder is usually stemming from childhood trauma/experiences. Audhd is a neurotype that may have been masked for many years but has always been part of how the person experiences the world and handles living in it.

If it's borderline personality disorder he's maybe better off without the diagnosis tbf, sadly there is so so much judgement and exclusion from therapy etc. It doesn't usually open many doors to help sadly. He may find DBT helpful the my DBT website is a great one.

If it's borderline, what would be the purpose of the diagnosis? If it's to access a PD clinic to get treatment, then I might push for it.

PD are pretty contentious, especially borderline. Many women (it's mostly women) diagnosed are suffering from trauma or are autistic. People with the disorder aren't treated very well, so I wouldn't persue it.

I was diagnosed BPD at a similar age and honestly, you don't want that diagnosis on his record. I had a traumatic childhood and think I am autistic but with added PTSD on top. They won't remove the BPD diagnosis and I get turned down for referrals to support groups and specific therapies because of it. It's just a nightmare.

Honestly if your DS doesnt have bipolar you want not want it on record.

Comorbidities are very complex and difficult. Essentially we’re trying to fix a hammer with a hammer and it’s not working. The DSM changes all the time, many signs and symptoms overlap, treatment is poor and so on. For example, rejection sensitivity s common to all three (BPD, autism and ADHD). A team is left trying to work out if it presents this way, that way, too much and take into account environment as well.

If he can get DBT, I would. Otherwise, I’m not sure I’d be chasing a BPD diagnosis. It has even more stigma than AuDHD.

Thank you everyone for coming back to me, I meant borderline personality disorder. The reason for the diagnosis would be to get him the help he needs to function but I understand exactly what is being said.
I did question his plan in pursuing this form of diagnosis as I have read about the stigma attached when trying to research the illness.
This is all very new to me, I am well versed in dealing with SEN and neuro divergence but with children, now he is older the world seems bleaker and he struggles more. He has experienced childhood trauma and I suspect possible PTSD but I truly don't know how to help him.

If you live within the M25 and he gets the PD diagnosis back, there's a brilliant treatment facility, on the NHS, at Cassel Hospital. It's specifically designed for people with PD.