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When Your Mental Health Diagnosis Shifts Over Time

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If you’ve read any of my articles before, you’ll know I often write about my perspectives on life with borderline personality disorder (BPD). I have had that diagnosis nearing on ten years. It originated after a particularly rough breakup, but stood the test of time for a long time thereafter.

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It was a psychiatrist who diagnosed me with BPD in my early 20s. As they are seen as authorities on mental illness, I believed him and dedicated myself to learning and healing through that lens. BPD has become part of my identity in many ways — I’ve made friends because of it, I have been prescribed medications because of it, and so on.

Because the availability of psychiatrists and their evaluations, I haven’t properly been assessed in years. Fast forward to last week. I had asked my GP for a referral for a medication review, as his knowledge around mental health is less than stellar.

An hour and a half after the session began, the doctor was prepared to give me her “findings.” She didn’t believe I had BPD — just some symptoms of it. Rather, her diagnosis included: generalized anxiety disordersocial anxiety disorder and persistent depressive disorder.

WTF? Questions began to swirl in my head. What about BPD? I thought that was a “forever” disorder. How can it not be part of me anymore? And adding social anxiety? The thought of that increased said anxiety tenfold.

Luckily, I saw my therapist a couple days later and relayed this new information to her. We talked about the fact that the psychiatrist didn’t even ask anything about my childhood or past experiences. So now, in addition, we have added complex post-traumatic stress disorder (C-PTSD) to that list given by the psychiatrist.

My therapist explained her view of this to me. She said that diagnostic labels according to the DSM may shift over time, even the “extreme” ones — and that the one common denominator, in my situation anyways, is trauma.

The good news is, I believe I am in recovery from BPD, a thing I didn’t believe was possible. The bad news is I have an ever growing list of terms to learn about in order to continue with my progress. I guess I naively thought if I were ever to be lucky enough to not struggle as much with BPD, I wouldn’t have to find myself at the bottom of another mountain to overcome. Instead I have found social anxiety pass and depression hill, all part of the big Mount Trauma.

Needless to say, this is all unexpected. I have to build a new path and need to find my way up this foreboding peak.

If the end goal is recovery, does it really matter the words we place on ourselves? What do these labels mean? Why do we assign ourselves to them? In doing so, I feel like we are giving our power up by self-shaming and stigmatizing ourselves. Each one of those diagnoses are loaded terms.

I am currently left in a state of confusion. On one hand, I want to digest all the information I can about these new names. On the other, I want to throw them and the DSM in the garbage.

One thing is for certain: I will keep documenting my journey. If you’re in a similar boat as me (I haven’t seen a lot of findings or readings about evolving mental illnesses) — feel free to reach out so we can navigate this together.

Getty image by Sasha_astra

Originally published: July 23, 2020
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