Personality disorder: discrimination by diagnosis
"What are you doing now?"
"I’m in this clinic here."
"Why, are you a Doctor?"
"No, I’m a psychiatric patient."
"Shit, you’re not going to knife me are you?"
This is how a short conversation started between 2 former Cambridge University students on Borough High Street, London in the early summer of 1994. We had been at the same college. He had studied law and I had studied history. We had graduated together 3 years before and not met since. He had gone on to be a lawyer and I had gone on to be incarcerated in a Victoria Asylum after a catastrophic breakdown.
By the time we met again I was 3 years into treatment for a mental illness that was proving intractable. I use the term treatment loosely as none of the many anti depressants I had taken, nor the 18 months of psychotherapy, had made any difference. That summer I was once again in hospital, which was clearly the last chance saloon.
the real discrimination came from the professionals.
I expected discrimination from the public: why should they know about mental illness? For the first 2 years I had told people I had ME (Myalgic Encephalopathy), which sounded better than depression. But the real discrimination came from the professionals.
I was diagnosed with a personality disorder. No one wanted to know me after that. In my experience, few professionals then or now regard personality disorder as a mental illness. They seem to see it as more of a problem than a biological disorder such as depression or schizophrenia.
the way in which one was treated was entirely down to diagnosis
I learned very early in my psychiatric career that the way in which one was treated was entirely down to diagnosis. People were taken far more seriously if they had a label of schizophrenia or manic depression (as we called it then). Professionals took little interest in those with depression, anxiety or personality disorder.
Almost exactly 7 years after that fateful conversation on Borough High Street I was still battling with wild mood problems, voices and an overwhelming desire to kill myself. Yet then my life changed. I finally met a psychiatrist who listened to me. She dismissed any notion of personality disorder and suggested I go on risperidone to stabilise my mood and stop my psychosis. A very strange thing happened then, it worked.
I also became a mental health practitioner
The following year I started to write the book that I swore I would always write. I was driven by vengeance on those who had wronged me, judged me, and lied to me. I also became a mental health practitioner. What I had said all along about discrimination by diagnosis sadly was proved right.
Fast forward my life to 2012, I am about to enter my 6th year as a Mental Wellbeing Advisor at the University of Hertfordshire. My book A Pillar of Impotence has been out in paperback since January 2011 and is on the essential reading list for mental health nursing students for at least 2 universities. I’m no longer motivated by vengeance. What it did do for me was exorcise many of my demons - the story no longer flies round my mind perpetually. In that respect it was hugely cathartic. The sequel, Charon’s Ferry, about my life as a professional is written and will soon be submitted for publication.
professionals treat people with personality disorders differently
I hope the wider world has moved on but I somewhat doubt it. There are exceptions of course such as the Haven Project in Colchester, Essex. It does still seem to me that professionals treat people with personality disorders differently. It is time to end discrimination by diagnosis.
And what of that conversation of Borough High Street? It had ended with him asking if I was about to commit an armed robbery on a newsagent shop. What was I doing really? Waiting to use a phone box. If we struggle to educate the professionals what hope do we have with ending discrimination by the public?