I talk about Borderline Personality Disorder a lot, and there are two reasons for this:
1. It has shaped me in so many ways and explains a lot about me.
2. Not enough people are talking about it.
I’m not here to play the ‘who has it worse?’ game, as each mental illness is a struggle, and each struggle is subjective to the individual. People have it worse than me, others may not have experienced the same difficulties yet, but we all deserve to be recognised in our pain. So I won’t claim that BPD is the worst mental illness, as I can’t know that unless I’ve experienced them all, but even then, it would be dependent on my subjective experience. Instead, I’m telling you why we need BPD Awareness Month and the issues currently at hand. Anything further than that is up to you.
I’d like to think the confusion lies in the lettering, BPD versus BD, but I think that people don’t really care enough to distinguish between the two or that we’re quick to assume well-known disorders like Bipolar. Individuals with BPD are easily misdiagnosed. For years, I was told that I just had depression and an eating disorder, and they never considered the possibility that these were connected. But when seeing the right therapist, it was efficiently discovered that I had BPD, and that this is what spurred my anxiety, depression and struggles with bulimia. Individuals with BPD are often misdiagnosed with substance abuse issues, Bipolar disorder, Antisocial Personality Disorder, PTSD and more.
When an individual with Bipolar disorder is not in their manic or depressive episode, they can demonstrate a level of stability and functioning that someone with BPD struggles heavily with. BPD is highly characterised by the instability it brings to relationships, which isn’t a primary aspect of Bipolar. Furthermore, BPD individuals experience far more erratic, and random mood swings, whilst Bipolar disorder has more extended mood changes. For example, I’ll switch from euphoric to inconsolable within ten minutes, whilst someone with Bipolar would usually experience the elevated or lowered mood for days.
“Those with bipolar might have a hair-trigger kind of response during an episode, whereas the borderline person has a hair-trigger response all of the time.” Dr Frank Yeomans, Health Matters.
When you look up BPD, it’s too easy to slip into the darker side of the results. The ones that tell you that the disorder isn’t real, that you’re just dramatic, that you’re manipulative. You’ll find clinicians who refuse to treat BPD, ex-partners of people with BPD complaining about it and more. This is one of the first things to confront people who are diagnosed with BPD, as despite warnings, we just can’t help but look it up.
I’ve had people tell me that BPD isn’t real, that it’s just a poor excuse for being a crappy person. I’ve had people email me to tell me that they read my articles and don’t believe in BPD. The list goes on, and I’m far from the only one.
I have lost years to my mental illness. I have missed so many beautiful moments because the depression and loneliness pushed me down like an anchor. I have come too close to losing the rest of my life. BPD isn’t fake, it isn’t a label, it’s the struggle I experience on a daily basis and many others too. Don’t undermine our experience unless you’ve been exactly there.
Neither did I! It was first termed in 1938 in the US as ‘borderline schizophrenia’. In the 1970s, more research was done into this disorder, and Otto Kenberg described it as being on the ‘borderline’ between psychosis and neurosis, hence the term. BPD individuals were considered to have ‘primitive’ psychological defences, including splitting and projective identification. Then in 1980, BPD was officially introduced to the Diagnostic and Statistical Manual of Mental Disorders III.
Nowadays, a lot more is known about BPD. We recognise how it’s driven by intense emotional experiences and instability in relationships and behaviour. It begins in early adulthood and includes feelings of emptiness, intense anger, suicidal idealisation and impulsivity. There is also a lot of research suggesting a strong genetic component to BPD.
Many disagree with the term ‘borderline’, and believe it to be outdated and stigmatising. Some clinicians also believe that BPD should be removed from the personality disorder classification and instead viewed as a mood disorder or identity disorder. Names that have been suggested include Emotional Dysregulation Disorder and Emotional Intensity Disorder.
These names certainly would make it far easier to explain my mental illness to people and avoid terrifying them instantly!
I’m not even going to start on the media portrayals of BPD, and the lack of them, for that’s a topic for another day. But even within society, we view BPD in one specific light. We often consider individuals with BPD to be extroverted, impulsive, sexually promiscuous and the life of the party. They live in a big and loud way. Whilst this may relate to some individuals with BPD, it isn’t an accurate representation of others.
My relief of being correctly diagnosed with BPD was quickly diminished when I realised that I didn’t fit in once again. I’m an introvert and quickly classed as ‘high functioning’. I’ve been told more times than I can count that I don’t seem like I have BPD. Perhaps this is intended as a compliment, but it isn’t received as one. Just because my pain is heavily masked, that doesn’t mean it hurts any less. I have just repressed myself to the extent that you overlook my self-sabotage and extreme emotional dysregulation.
I want to fit into the BPD community, because of anywhere, this should be the place that I’m understood. I want people with BPD to be able to be themselves and not limited to a stereotype. The same goes for every mental illness that has been diminished to a single role and nothing else.
The chances are that you’ll meet someone with BPD at some point during your life. It’s estimated that 1.4% of the adult population in the US experiences BPD. And for personality disorders in general, it’s estimated that 10-13% of the world’s population suffer from one. This is too large a portion of the population to ignore it or continue diminishing their experiences. Personality disorders need to be understood as they are affecting people you know.
Individuals with BPD are more likely to complete suicide than individuals with any other psychiatric disorder. Estimates show that 3-10% of individuals with BPD will commit suicide. This is an alarming number, worsened only by the fact that this is 50 times the rate of suicide in the general population. Like many other mental illnesses, BPD is life-threatening, and the stigmatised only renders it more so.
That is why we need BPD Awareness Month, and that is why we need everyone to do their part. Learn about BPD, from the symptoms to the biggest struggles. Learn how people with BPD think and feel, how you can support them best. Share this information, and if nothing else, start the conversation. By discussing your mental health struggles, you give the space for someone else to do the same. By discussing mental illnesses like BPD, you make yourself someone that can be opened up to, someone to trust. In silence, we’re all alone, but in conversation, we’re united.
What will you do today to tackle the stigmatisation of mental illnesses like BPD?
For further reading, check out how I manage my BPD on a daily basis.
Welcome to Symptoms of Living! A place where I like to relieve myself of the barrage of thoughts and ideas filling my mind. Here I'll take a look at various topics, from books to BPD, series to self-harm, there's nothing that we can't, and shouldn't, talk about.
Having struggled with mental illness since the age of 15, one of the hardest parts was how alone I felt in it. While mental illness is beginning to be discussed more openly, and featured in the media, I still think there is room for improvement. So whether it is mental illness or merely mental health, a bad day or a bad year, let's make this a place to approach it and strip it back. Everyone has their own symptoms of living, and you certainly won't be the only one with it.
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