Diagnosing Borderline

I was not officially diagnosed with Borderline Personality Disorder until very recently.

The thing that I must emphasise about being diagnosed with any mental health disorder is that it is meant to aid the direction of treatment, not be a constricting box that you can't move outside of, and not a life-sentencing label that will damn you for the rest of your life. The likelihood is that someone with a mental illness will have aspects of more than one illness, and there are some illnesses that are very often concurrent because they feed off each other.

Also a mental illness, unlike a physical illness, is not consistent from person to person. The differences in each individual's brain is enormous, and it's important to remember that the same illness can present differently in those individuals.

Borderline Personality Disorder is diagnosed when a person has shown consistent and repeated behavioural patterns in at least 5 of the following ways:

1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in (5).
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. This is called "splitting."
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in (5).
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
   
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
   
7. Chronic feelings of emptiness.
   
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
   
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

The fact that only 5 out of the 9 criteria need to be met for diagnosis is very important as it can mean a significant variation in the presentation of BPD in each individual. In fact, there are 256 different variations.

There is a great deal of negative stigma attached to BPD. Here is a website dispelling some of the most dangerous myths about Borderline sufferers.

My first diagnosis from a Clinical Psychologist was Major Depressive Disorder and General Anxiety Disorder. I was 17. For several years this seemed accurate, and medication helped me to retain a sense of functionality.

Last year though things appeared to be getting worse rather than better. Then earlier this year my psychologist said that I should look up BPD and see if I felt that I fit into the criteria, and that we would discuss in the following session how to go about treatment if we both agreed that BPD was a more accurate diagnosis.

After a great deal of research I felt certain that BPD made a great deal more sense than depression and anxiety. After talking to my psychologist, we decided that my treatment needed to move in a different direction to be more effective.

I really struggled once I came to terms with being someone with BPD. I had thought of myself as someone with depression and anxiety for so long, and had become to accustomed to seeing myself that way that I had to change my perception of how my illness affected me. Depression and anxiety symptoms are very common in BPD however, and once I realised this was the case, I started to tell people.

While BPD is relatively common, most people didn't seem to actually know much about it, and honestly to begin with, neither did I. So instead of just saying "So hey I have BPD" I included information on the disorder and types of treatment. I also made sure that I had enough of my own information to dispel any misconceptions people had about the illness, and emphasised the individuality of presentation.

I am now comfortable with my diagnosis, and am not ashamed of it. I answer people's questions with frank honesty and am constantly keeping updated with information on research and treatment. I stand up for my rights with the way that I am treated by professionals and keep my supports close and informed.