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Dear Sia, Please Don’t Use 'Borderline' as an Insult

Singer, songwriter and director Sia Kate Isobelle Furler, more commonly known as Sia, recently posted a tweet that the borderline personality disorder (BPD) community has been rightfully calling out.

As Sia publicly supported Johnny Depp during his legal battle with ex-wife Amber Heard, unfortunately, the tweet refers to Heard’s abusive behavior as “classic borderline behavior on her part.”

While I am not bashing Sia and will not be making claims about the Amber Heard and Johnny Depp case, we need to address the stigma and usage of borderline personality disorder as a synonym with being an abuser.

The comment is especially hurtful to the BPD community considering Sia is frequently outspoken about her own mental health struggles, including complex post-traumatic stress disorder, anxiety, depression and addiction. She also recurrently connects with fans in her music, which often reflects themes of mental illness.

Sadly, those of us with BPD may face stigma and ableist comments from people who have other types of mental illnesses themselves.

BPD has long been associated with severe stigma, and comments such as these perpetuate it. Although all mental illnesses are stigmatized, BPD tends to have a surplus stigma. The symptoms tend to be incredibly intense, chronic and interpersonal. Historically, some professionals used BPD as a synonym for pejorative terms and adopted the term “borderline” to stigmatize patients they stereotyped as “difficult/manipulative/crazy” when they may not even have the condition at all.

Stigma does not go without consequences. Thankfully, these myths and biases have improved over time, but they can impact public outlooks and the quality of care someone receives. We may struggle to feel comfortable reaching out for help or support. Another study showed BPD stigma is a common “crisis trigger.”

We may also feel alienated and demonized. As someone with BPD, I have often felt rejected and unwelcomed in mental health spaces, given the frequent stigmatizing comments and the tendency to try to separate “us” from “them.” Comments such as, “I’m not crazy or violent or anything — it’s not like I am borderline or schizophrenic!” unfortunately are not unheard of within the mental health community.

Even more, BPD is the mental illness with the highest suicide rate. One review estimated up to 80% of people with BPD attempt suicide an average of three times.

It is important to realize while the “borderline” comment is wrong, and many people with BPD understandably want the tweet deleted, that does not mean we are criticizing her for supporting Johnny Depp. These are not mutually exclusive viewpoints. In fact, many people with BPD, although not all, have experienced abuse themselves as one possible contributing factor for developing the condition in the first place. Additionally, we may be at greater risk for abuse or remarks towards our symptoms.

Rather, we are emphasizing that a mental illness should not be incorrectly used as a synonym for abusive behavior. If we replace the condition BPD in this example with another mental health condition such as “classic depressive behavior,” “classic bipolar behavior” or “classic PTSD behavior,” hopefully people can understand why it is wrong. The statement is a generalization and a stigmatizing reference. Likewise, exclaiming someone is abusive because of a mental illness overly simplifies abuse.

BPD does not technically make someone abusive (and statistics do not support this), nor does it excuse abusive behavior like anyone else. However, remember it is not our responsibility or authority to make an “armchair diagnosis,” and it is definitely not OK to simplify and sum up the complexities of abusive behavior to just being a “classic borderline.” It is harmful to weaponize a mental illness.

Back in the summer, Johnny Depp mixed together multiple terms by stating, “She is a calculating, diagnosed borderline personality; she is sociopathic; she is a narcissist; and she is completely emotionally dishonest,” but as far as we know, Heard has not been confirmed to be diagnosed with BPD. BPD? Sociopath? Narcissistic? None of these are the same. This claim may have unfortunately given the impression that it is acceptable to misuse the term.

BPD is really a severe and treatable mental illness. It is characterized by emotion dysregulation and extreme emotional hypersensitivity. People with BPD tend to experience intense emotional reactivity for long periods of time, with a slow return to a stable emotional baseline.

Just a few of the main symptoms include chronic emptiness, an unstable self-image and sense of self, mood reactivity and instability (for example, intense anger to depression, idealization, and anxiety, all within a few hours), recurring self-injury, suicidal ideation and impulsivity (e.g., drug use). Other main symptoms include stress-induced dissociation, paranoid ideation and hallucinations.

One of the most notable symptoms of BPD are the extreme reactions to and preoccupations with abandonment or rejection. Someone with BPD may have abandonment-themed nightmares, and mundane events, such as brief separations, may trigger panic or paranoia. Overall, the symptoms impact major areas of functioning, including emotion, behavior, interpersonal, cognitive and sense of self/identity.

If “borderline” is an insult and used synonymously with abusive behavior, what exactly do you think of people who actually live with the pain of borderline personality disorder?

We are not stating Sia should not have publicly shown support for an abuse survivor. We are not agreeing with or defending Amber Heard’s abusive behavior. We are emphasizing that anyone, especially people in her position with a large platform that may influence the perceptions and words of other people, should not stigmatize a severe mental illness and default us to abusers.

People with BPD are not inherently abusers, and it is not “classic” of people with BPD to be abusive.

For further reading about the stigma of BPD, check out the following articles from The Mighty.

Flickr via Tolbxela