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How I Really Feel About Borderline Personality Disorder Awareness Month

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This year’s mental health awareness week has just past and this May has been heralded as borderline personality disorder awareness month.

In all honesty, these things leave me somewhat conflicted. By the fact that a need exists to have awareness weeks and months, there is the implicit acceptance that it’s OK to remain unaware the rest of the year. Should we in this day and age still be at a point at which we need to have a designated week to bring to our attention the fact that a huge proportion of our population live with mental health difficulties? I say a huge proportion rather than stating the one in four figure because the one in four is the figure of those who we know about, those who present themselves to mental health services and so are on the radar — there are so many more that live in silence. If we were to have a week dubbed “Physical health awareness week” I wonder what the public’s feeling about it would be… that it seems too broad? That there are so very many things that can affect physical health? So many complaints that can afflict it, that it seems an arbitrary label because of its crude depiction of something so very complex?

That said, can a week where the fact that mental illness is acknowledged in the public arena actually be anything other than a step forward from not talking about it at all? Such awareness landmarks mean that some, albeit perhaps ignorantly undefined, acknowledgement is given to something which desperately needs to be addressed. There are those who feel mental illness has been medicalized, localized within the individual and the societal aspects of these “conditions” roots ignored. It is the view that an awareness week leads back to this idea of pointing to the individuals themselves as having problems and thus creating a them vs us culture. Whether you have a diagnosed mental health condition or not, I think anybody would find it hard to deny, no matter what you think of those of us who carry these labels, that society at large has huge issues and they cannot be ignored as factors in its inhabitants psychological well-being. Of course no condition of mind or body is ever born out of a singular factor, I believe firmly it is a combination of our genes, our society and our life experiences that make us who we are but the fact that other factors go toward the development of an individuals’ mental health doesn’t negate the imperative of addressing those issues that are collective and can be thought about and changed.

To address the topic of May being BPD awareness week means I must also address the controversy of the diagnosis. An awareness week is generally lobbied at the general public rather than professionals who work in the field and yet BPD I’d argue is perhaps one of the most stigmatized diagnoses that exist inside of institutions and psychological services from a staff perspective. There are swathes of psychiatrists, CPN’s, psychologists and care coordinators that bulk at the idea of taking on a “patient” with the diagnosis. By many, we are still viewed as clinician drains that suck the life out of the professionals who dare to work with us “difficult cases.”  I’ve discussed in previous posts how being openly labeled as BPD meant that time dedicated, working for a voluntary cause I believed in, was pathologized into a symptom of my illness. My dedication was seen as obsession and over-involvement. This is just one example of how a diagnosis can lead your professional and even lay people down a path that doesn’t exist. If you look for something hard enough then you will
find it. How do we re-educate those who have already been in the profession decades and as such think they know it all? Knowledge and practice is evolving but inside the walls of universities in undergraduates who won’t have influence over the system for many years to come when change is needed now.

Then of course there are those who professionals who profess to have a “special interest in people with personality disorder” which is perhaps just as insulting when (as I have experienced) it is used as a pitch to curry personal favor — Maybe we could spread the word about your brave forward thinking passion at the next collective meeting with us “BPD patients?!” The idea we are all the same is implicit within this innocuous statement. Many people I’ve met and myself included have been brought this diagnosis almost as an explanation for why we aren’t getting better, an excuse on a silver platter — sorry we don’t help you, but you are of the sort that is almost impossible to help. With this in mind, having collected several other labels over several years and having swallowed any number of combinations of pills to treat what the system told us was “wrong with us,” you can see how anger can bubble up against the diagnostic system.

All of that said, I can’t deny that several aspects of the diagnostic criteria simply fit who I am and in some small way validate my experience by virtue of acknowledging that it isn’t purely a difficulty I alone have. Also in this way, awareness of the broadly defined “symptoms” of the illness, do in a sense prime the general public with a more empathetic stance towards what would most likely otherwise be viewed as grossly irrational behavior on my part. The flip side of this is that naturally a study of such “symptoms” of any illness will inevitably lead to the expectation that you may very well exhibit all of them (watch out for the BPD’ers “murderous rage”).This is exasperated by the way in which they are portrayed by the media which can inflate our diagnosis into an expectation that we are all raging, obsessive stalkers. Ultimately I think providing and platform for discussion, despite my conflicting feelings, may be the best hope we have of airing subjects otherwise undiscussed. I can use media platforms to openly discuss my BPD more readily under a banner of announcing it is a “BPD awareness month.”

Regardless of when I raise the topic though, society still has a tendency to turn those who discuss their mental health difficulties into these “brave” individuals. In the same way that the use of peer workers has in many cases become a “tokenistic” pat on the head with a metaphorical cookie, with thankfulness that we be bold enough to share our stories. This is aside from the often objectification of peer workers and service user activists whereby we become a trusts currency with the Quality care commission – a badge of honor for “involving the patient” where parity of esteem quite often is overlooked by all concerned. I’d like to get one thing straight – speaking out about my mental health difficulties should not be brave, it shouldn’t have to be brave, it should be normal.

This year’s mental health awareness month focussed on “thriving and not just surviving” and that is an important discourse to have but at the same time it doesn’t marry up with the system in which we live. The NHS is not set up to assist people to restoring their lives to the point of thriving, the NHS is financially breaking and constrained to remaining satisfied with simply keeping the most severely affected alive. There are long waiting lists on which those who can’t afford to use to private sector, sit and decline in health. When decline has reached the point of lethal physical danger the individual is then hospitalized, given medication and when sedated adequately enough, returned to the community, no longer qualifying for therapy because they are considered “too fragile” now to “do the work” and so they begin waiting to go on a waiting list, as if time could heal them by magic.

A question that perhaps needs to be asked is can a person thrive and not just survive in a system that is doing just that – just surviving.

Services are not expanding and growing, they are shrinking, making cut backs, working with minimal staff and minimal resources, with higher numbers of people than ever seeking out support. I think that is the final question I want to leave on the table this awareness week/month.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741.

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Originally published: May 20, 2017
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