I Knew What Would Happen When I Lost My Borderline Personality Disorder Diagnosis
“You have an anxiety disorder, major depressive disorder, anorexia nervosa and borderline personality disorder,” the psychiatrist explained in a perfectly even-keeled tone. He spoke as if the moment I first received formal mental health diagnoses was nothing, as if it wouldn’t change how anyone would see me.
For the most part, I took the information in stride, mirroring his relaxed demeanor, even as my heart raced and my head span. I wanted to believe that my life would remain the same, but one specific diagnosis haunted me: Borderline personality disorder. BPD. What would those three words, those three letters, mean for my future?
Borderline personality disorder is one of the most highly stigmatized conditions in the DSM-5, the clinical guide to the diagnostic criteria for all formally recognized mental health conditions. It was not lost on me at the time of my diagnosis that people with BPD are often unfairly, inaccurately stereotyped as abusive, manipulative and self-destructive. I knew that I tried wholeheartedly to be none of those things, that I was just a woman who struggled with dark feelings that seemed too large to control. But I was also keenly aware that the stereotypes surrounding BPD could affect both the way loved ones viewed me and the way mental health professionals treated me. I hoped beyond hope that my interactions with professionals wouldn’t change.
Unfortunately, though, the moment I mentioned my BPD diagnosis in a clinical context often turned composed treatment professionals wary of me. Although many reacted the same as they would to any other condition, some treatment providers used my words or actions to fit my behavior into pervasive, inaccurate BPD stereotypes. The moment anyone put the words “borderline personality disorder” on the table, I magically became too “self-destructive” to effectively treat. I was “manipulative” in the ways I succumbed to my suicidal thoughts, even though I genuinely felt desperate to escape the world. I was turned away from treatment I desperately needed, sometimes in ways that bordered on client-rights violations. I was no longer human to these professionals; instead, I was little more than a self-destructive “borderline.”
To my surprise, I recently lost my borderline personality disorder diagnosis. The therapist pulled out the DSM 5, read all nine core criteria with me, and concluded that while I do struggle with suicidal thoughts and empty feelings, I don’t currently have BPD and likely never have had the highly stigmatized mental illness. I was rattled, not because I identified strongly with my prior BPD diagnosis but because I knew that professionals’ clinical perceptions of my thoughts and feelings would likely radically shift. I’d no longer be the “self-destructive girl” no one could treat; I’d be the “sad girl” who needs and deserves effective treatment to manage her depression and build a fulfilling life.
The fact that, in an instant, I gained a tremendous amount of privilege because three words were removed from my psychiatric history doesn’t sit well with me. The loss of my borderline personality disorder diagnosis shouldn’t entitle me to more understanding professionals and greater access to treatment resources, but unfortunately, I may now be treated with more understanding and respect than people who have a BPD diagnosis in their file. The ability to access appropriate treatment from professionals who understand our conditions and don’t reduce us to tired, inaccurate stereotypes should be a given in our mental health system, but it still remains elusive to many people who live with BPD, and I’ve never been more aware of this diagnosis disparity than I am right now.
Unfortunately, the stigma those with borderline personality disorder face unwittingly forces many mental health clients into the same demoralizing experiences I faced as a person with a BPD diagnosis, experiences that may only change when those clients lose their borderline personality diagnoses. It is therefore imperative that professionals educate themselves about the true presentation and nuances of borderline personality disorder and treat their clients with dignity and respect so that all clients, regardless of how long they live with a BPD diagnosis, can access stigma-free, unbiased care for their mental health needs. After all, everyone, regardless of diagnosis, deserves proper mental health treatment, and those with BPD are no exception.
Photo by Jonathan Cosens Photography on Unsplash