Borderline personality disorder and institutionalised discrimination
When, aged 17, I found myself at rock bottom and in a fit of absolute despair was admitted to a psychiatric unit. I saw a string of doctors during my time there and various diagnoses were discussed. Bipolar seemed to be the most likely conclusion but, during a particularly erratic and incoherent period in my illness, the term ‘borderline personality disorder’ was mentioned. That scared me. Not in and of itself but because by that point I’d seen how nursing staff had responded to the girls on the unit labelled ‘borderlines’.
The staff seemed to project different meanings onto the behaviours of those with borderline personality disorder. Self harm, for example, was treated with sympathy in people with depression but the girls with borderline personality disorder were often castigated for using it to ‘manipulate’ staff. It also seemed like there was a reluctance to move these girls over from the day unit to inpatient in a crisis situation – a general perception that they were ‘trying it on’. The list could go on; I had a general impression that they were seen as second class patients.
my condition improved and the possibility of me having borderline personality disorder was dismissed
Time went on, my condition improved and the possibility of me having borderline personality disorder was dismissed. I was still left feeling uneasy about the way those girls were viewed but perhaps I’d been imagining it? The girls in question were the only other adolescent girls on the unit so it’s perhaps unsurprising that I paid particular attention to the way they were treated. Yes, perhaps that was it, the nursing staff were professionals after all!
Fast forward ten years and I’ve stayed well enough to finish college and university and to start my career. One afternoon at work was set aside for ‘Mental Health Awareness’ training. I’d silently giggled at the title as for much of my life I’ve been painfully ‘aware’ of mental health!
It seemed a lot like any other training session. Two trainers clicked through a series of slides and delivered basic but reasonably solid information on common mental illnesses. Then a slide came up labelled ‘personality disorders (borderline)’. The trainer looked somewhat disgruntled, ‘Well, we’ve got to talk about this’ she sighed ‘but I’m not sure we should have deal with these people as mental health professionals, we should leave them to the social workers really. I mean, they call it a mental illness but they’re really just being a pain in the arse sometimes’.
The slide remained up and she managed to list a whole host of other prejudicial generalisations
What’s appalling is that my first response wasn’t anger, but shame; was that what a doctor had once considered was the problem with me? Not ill, just a ‘pain in the arse’? The slide remained up and she managed to list a whole host of other prejudicial generalisations ‘They’re the kind of people who turn up pestering the doctor a lot…. You can often tell someone’s borderline because their speech or their clothing will be very weird… when you see ‘bag ladies’ around town a lot of them will be borderline’.
I couldn’t believe what I was hearing! I’d known girls with borderline personality disorder well and none of them were trying to be a pain in the arse, from what they told me they were struggling with extremes of emotion that I can’t even imagine. Their realities were often terrifying with a heightened threat perception or permanent fear of abandonment and they found themselves carried along by extremes of mood that left them feeling powerless and frustrated. None of the things the trainer was telling us rang true. I had no idea of the extent of the prejudice against borderline personality disorder and certainly wouldn’t expect it from mental health professionals who presumably know better.
To my shame I didn’t say anything during the session
To my shame I didn’t say anything during the session. I struck dumb by incredulity and self-consciousness but when I’d had time to gather my thoughts I put in an official complaint. To my even greater shame it may be the case that the staff on the psych unit all those years ago were indeed treating the girls on the unit prejudicially and I looked on and said nothing.
What I find shocking is that, ten years on, the prejudice seems more entrenched than ever and it’s entirely self-perpetuating. People with borderline personality disorder fear speaking out because they’re aware that expressing hurt, anger or indignation can be interpreted as simply ‘being borderline’ and that being labelled non-compliant can affect their treatment. What seems clear is that this attitude is institutionalised, these attitudes have no hope of changing if they are not challenged first from within the professional community. Borderline personality disorder is one of the least visible mental illnesses but one of the most – if not the most - in need of anti-stigma message.
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Hi. I have just come to
Hi. I have just come to realise on my own I have BPD. After wracking my brains into my past I know I definitely have it. My first thoughts were getting help but now after reading all these comments I'm not so sure anymore. I don't want to be labled. Everything I go through I have been through on my own. I dispise attention. I was actually thinking about telling my mum so she could understand but after reading this it seems telling someone will just make matters worse? If I have will, and change myself, and try to face up to the problems, would I be able to beat this? I'm so scared if I tell anyone the will see me different and make me worse. I just came to grips with having anxiety and dyslexia, and finally got some confidence I can feel better , until I discovered I have BPD. I'm not so sure confidence will get me through it. I'm not manipulative or attention seeking at ball. But all other symptoms are there. Thanks for your time.
Hi Gary, you should only talk
Hi Gary, you should only talk to someone if you feel comfortable doing so but talking to someone you trust can really help: this could be your local gp, a family member or friend. You can also talk to the infolines run by Mind and Rethink Mental Illness and they will be able to offer practical advice and info - their contact details are here: http://www.time-to-change.org.uk/what-are-mental-health-problems/help-su... And there are some tips on talking about your experiences that you might find helpful: http://www.time-to-change.org.uk/talk-about-mental-health/tips
During my nurse training I
During my nurse training I was diagnosed with BPD after a quick in you and and out again hospitalisation and later changed to Bipolar, why? Because they didnt know what 'triggered' my impulsive behaviours it was considered 'unpredictable', upon further observation (after 5 years) discovered it was episodic and linked to mood. Interestingly they had consistently placed me on anti-depressants which was inducing mixed episodes and mimicking BPD and claiming that if this were pure depression the medication would be working - so be aware of this.It seems when they dont know the problem it must be BPD!
From working within MH i believe the BPD stigma comes from the minority. There are few people with BPD I monitor who are very needy and are reliant upon the services HOWEVER there are many more that are kicked out of the loop who are left to manage on their own and ignored, you need to make a noise to gain help. I really wonder if the majority of BPD's are given this diagnosis because they have no clue on what else to diagnose, just listening to the person maybe a step forward!
speechless
reading your post breaks my heart and makes me so angry at the same time, i want to scream in that girls face (who held the presentation) my whole body tensed reading this. although im aware of what people think i try to ignore it, i get on extremely well with my gp, ive seen her for three years and find it easy to talk about anything but if i let myself even consider the thought that she might have the same thoughts as some things mentioned by you all by other mental health professionals i just crumble, i get paranoid and upset and end up thinking shes just being nice to me because she has to... am i right?
all of you have gave examples of when doctors or other mental health professionals have "slagged" people with BPD off, can anyone give me an example of when they have recieved sympathy, compassion, anything remotely positive????
please reply, keep my hopes alive.
PD personality disorder
I believe that GPs and Psychiatrists find it difficult to comprehend PD because sometimes, PD patients do not respond to medication and this is a bit contradictory to their perspective. DBT is a form of CBT and has been very successful in the US. It treats the patients as the experts and looks at how and when an incident has occurred instead of why. This helps better understand the psychosocial factors that can impact on peoples emotions and inevitably their lives and those around them. Subsequently, DBT acknowledges that some people are aroused more rapidly in certain situations and their reactions can be more intense and more informed by emotions.
Unfortunately, GPs are not specialised to deal with mental health problems. You could ask your GP to direct you toward a service that provides DBT or even pay for this form of psychotherapy privately if you feel it could help you.
Regards
BPD
The stigma against BPD and the wealth of inaccurate information on the subject available on the web makes me feel physically sick at times. I am afraid to discuss my diagnosis or come forward with it because I am well aware that people already have a preconception of what BPD entails, and that it will be hugely negative and unhelpful to me.
People do not seem to realise that Borderlines are dealing with frightening levels of insecurity and extremes of emotion and often have absolutely no idea how to cope, which is why so many turn to self-medicating with drugs or alcohol or to self-harm or both.
I think proper awareness of the illness and the removal of professional stigma against it would go a long way in helping those affected by BPD, sufferers and the friends and family of sufferers. I too would love to see the illness given as much helpful and positive press as other mental health problems have in recent years. People with BPD CAN go on to lead fulfilling lives and can also make very compassionate friends and partners.
I married someone who i discovered had BPD
Until i married someone with mental illness (i think he has BPD), i had very little knowledge of mental illness!! the marriage was a disaster from the start. (he changed over night), I dont think my husband had knowledge of his mental illness either. Unfortunately the marriage didn't last and i think its natural for human beings to feel they are understood by others and to for them to understand themselves. without this knowledge of self you cant have a relationship with someone, and its very difficult for someone with mental illness to explain themselves unless they have the help they need to work through it. I unfortunately lived through an extremely traumatic couple of years of my life where the man i had married couldn't trust me and so i became the enemy. He took on a different persona and could switch back to normal if other people were around. It was so scarey. Jackle and Hyde at the flip of a switch.
I had to flee from my house, i thought he was going to kill me.
Education in the UK will help those who suffer from Mental illness and those who are trying to live with it, or even without that person, and the after affects are still with me.
Keep up the good work.
Doesn't surprise me unfortunately
My diagnosis used to be reactive depression and bulimia. Lots of sympathetic doctors and therapists. Acknowledgement that my childhood had caused trauma. Now I have a diagnosis of BPD, although I only found out when it was written on my discharge form on leaving hospital. Now my depressive moods are no longer seen as real, my self harm manipulative, my agitated states and my anxiety just bad behaviour. My friend took me to a&e last month because she was so concerned I wouldn't stay safe. The psych consult said he agreed that I was suicidal but thought my chances of committing suicide successfully were low, so he sent me home with an urgent referrel to the CMHT. Two days later I overdosed and didn't seek help. Fortunately/Unfortunately it didnt' work. Had my assessment with the CMHT. A week later they have yet to tell me their decision. So not so urgent after all I guess. But it looks like the doctor was right. Doesn't make me feel any better though.
Disgrace
I do not understand where this stigma has come from? I have worked with BDP clients and i can assure you it is VERY VERY real! Though i know of many clients who are called liars about their phobias too which i will be looking into, yet when i called the Psychiatrist he scoffed at me and asked how dare i question him and scoffed some more! Rude over educated idiot if you ask me. No wonder he has blood on his hands!
Anyone out there with BDP/PD/MHI'S please never feel ashamed, it can happent to anyone xxxx
Thank you
'Anyone out there with BDP/PD/MHI'S please never feel ashamed, it can happent to anyone xxxx'
Hey anonymous : ). Just reading through posts of peoples experiences of stigmatization in regards to mental health professionals- touching, relevant but altogether very gloomy reading. Especially when you can empathize with so much of it. Your last comment helped me to feel unexpextedly better though, so thankyou! x.
BPD Relapse
I was diagnosed with "Emotionally Unstable Personality Disorder" (Impulsive Type) 3 years ago during a relationship break up. I was hospitalised and was taking Chlorpromazine and some other stuff (i cant rememeber the name) I was discharged to CMHT and swiftly got my life back on track moved in with my sister who helped me get back on my feet and re establish contact with my children (who i had not seen for 2 years)
I stopped all medication on my own and stopped going to my GP etc because I felt better. I also stayed single (and plan on staying single)
BUT recently I have been having awful feelings about bad things happening to my children. I visualise things (like them being hit by a bus I am travelling on and other freaky stuff. I worry constantly about it and people I have spoken to tell me to go see my GP, but I am actually scared of being relabelled (after working so hard to shake it) I find it embarrassing because all I ever read about BPD are negative comments about being attention seekers and the like.
...
This is so very, very true (unfortunately). I'm a student mental health nurse and I met a few PD patients in my first year. Staff on the ward weren't overly concerned when they were sat crying, or threatening to hurt themselves. They said it was just what PD patients were like and there was no real point in treating them because they can't be helped. I'm in second year now and was diagnosed with BPD in November. At least I know what to expect from the "professionals".
BPD and Institutionalised discrimination
I have learnt such alot by all of you that have taken the courage to write about your experiences. I just wanted to say Thank You, because it really is only by sharing , that those of us that have no experience of BPD or PD can learn the truth. Big hugs to you all. x
Disgust
I can't believe it!! People cant go around saying things like that its belittling to who ever it affects and the family, and i like many of you i have BPD and other MHI's and just reading that story fills me up with hate and anger and disgust. People are missing the point by a long shot and i have already tried to raise awareness for MHI within the children in care community because ths social services and foster carers are just as uneducated as the majority of the world all ready is. People are scared to learn about something they know nothing about and who have only heard bad things about what it is and therefore don't want to know due to not wanting to know any different!! :@
Time to Change and BPD
I did email Time to Change much earlier in their campaign and said that I thought the issue of BPD/PD needed special attention. However, while Time to Change have featured celebrities endorsing speaking out about diagnoses such as bipolar and depression, there has been an absence of work on PD. This is a great shortcoming given that it is PD diagnoses which attract the greater stigma.
I have a diagnosis of BPD but have difficulty in disclosing this when it is seen as a less worthwhile diagnosis to help, elsewhere it is not known and is written about in disparaging ways. There are specialist services for PD within the NHS but many of these offer one model of therapy only (group therapy in therapeutic communities). Individual therapy is viewed as dangerous and creating a dependency, there is no choice. I now work full time but couldn't tell my employer about the BPD diagnosis. I hope TTC will do more work on this subject.
Unfortunately true
I have now worked in mental health services for 5 years in both inpatient and outpatient settings. I have to say this is unfortunately very true. However it feels impossible as a member of staff to speak out. The ques"truths" that people with a diagnosis of borderline personality disorder are trying to get a reaction, doing what they do to manipulate others and just want to be in hospital are hard to stand up to and honestly, it feels like you can't have a different opinion or your professional opinion in general will not be taken seriously. As an extreme example, i know of a 17 year old who attempted suicide, survived by chance more than anything else and staff were reassured they had done nothing wrong as she was just doing it for the extra attention she would get from being paralysed afterwards! We really need to develop empathy and a different way of working with people with this diagnosis. The only time I didn't experience institutionalized stigma was during my time volunteering with Mind. It was really refreshing.
BPD discrimination
It seems from the responses here that people are having two main problems caused by the poor attitudes of mental health professionals.
On one hand, people who have been diagnosed are being stigmatised because of the lack of understanding about BPD, leading to difficulty accessing the right support and causing wider social difficulties.
On the other hand, mental health professionals are dismissive of people demonstrating symptoms of BPD and obstruct attempts to access support.
I think that this is a terrible situation and that people will one day look back at this time with shame
I know exactly how you feel.
I know exactly how you feel. This condition has such an awful stigma that is perpetuated by myths and a misunderstanding of the disorder. I for one certainly do not "attention seek" by self harming. I go to every effort to hide my self harming behaviours because I want exactly the opposite: no attention. But all it takes is for one ill informed person (whether that be a medical professional or not) to spread negative words about BPD and the stigma continues to grow.
It's important that sufferers and people with a real understanding of BPD help to change the stereotypes of people suffering with BPD and give the condition the same respect that more well known disorders have. But sometimes, yes, it does feel like we have been short changed with the diagnosis with the worst stigma attached.
I totally agree with you. At
I totally agree with you.
At first thought whilst reading the initial post I assumed I'd been given the wrong diagnoses, as I do not attention seek. But then it occurred to me that most of the other BPD suffers that I know also do not attention seek and it is about real extremes of real emotions. Hearing about this stigma has made me angry, I had no idea of it. I now seek to ensure it will change.
In my opinion the
In my opinion the institutional discrimination of BPD sufferers is THE biggest and most harmful form of stigma.
I've come across the diagnosis of BPD at times (I disagree with the diagnosis). The label and my more BPD-ish symptoms have led me to be treated very nastily by MH professionals.
As someone with BPD I have
As someone with BPD I have seen therapists flinch when my condition is mentioned. I've fell off the waiting list for therapy at least three times and I'm guessing BPD is the cause.
Fantastic post
Thank you so much for sharing your experiences. I am regularly shocked by the way in which my mental health colleagues refer to patients and service users who have been diagnosed as having a borderline personality disorder - not another PD! They seem to forget, as you clearly describe, that the 'symptoms' of BPD are simply ways in which people are trying to manage with emotional extremes, with complex trauma, with really tough things that life can throw at us.
Angry
This makes me so angry, thank you for writing this, and highlighting the struggle people have when they're diagnosed with BPD. I was diagnosed with BPD a few years ago, and I hate the stigma that comes with it. People with BPD, or any type of mental health illness, have enough problems without the stigma that comes with it.
Angry and sad.
This makes me angry and sad too.... while it's true that a lot of borderlines do manipulate, I have always considered ultimatums, suicide threats and ordering partners around to be absolutely abhorrent.
I have borderline personality disorder, depression and anxiety, and the other symptoms of BPD fit well... I can change from bubbly to despairing in seconds, I am terrible at keeping and making relationships, I reject help, I invite rejection of others through my actions, I find it very easy to dismiss people from my life, even those I have been very attached to because I will easily become attached to a new person, I am terrified of rejection, I hallucinate, I have had suicidal episodes and I self harm regularly. So it is possible for someone to be borderline without being manipulative. Even with a diagnosis with several symptoms, people are still different.
Thankyou so much for making an official complaint, and I hope you're doing better now.
Amy
Borderline personality stigma
20 years ago aged 18 i was diagnosed with this condition. since 1998 i have been told that i no longer meet the criteria for this diagnosis. however my two older children were placed in the care of their father by the family courts some 5 years ago due to my mental health condition. my younger two remain on the child protection register although all the social workers who have worked with me say that they can see that my children are very well cared for and much loved. at the last review conference everyone who knows me voted to remove the kids names from the register but this was overruled by the chairman; his stated reason because i have borderline personality disorder. my psychiatrist insists she is only seeing me to keep the social workers happy and she doesn't believe i have any diagnosable mental health issues. I am expecting a baby in 4 weeks and have been told that as soon as this child is born i will be expected to undertake an intensive course of dialectal behavioural therapy despite wanting to breast feed as i have all my kids.
yes as a teenager i had issues, life was tough and i was angry but now in my 30's i can truthfully say that the most damaging and debilitating thing about my experience of mental illness is the fact that i have been left with this label.
BPD
@crochetkid75 totally inspiring! you go girl (boy)!!! we need more of this to inspire others and show how things can be turned around. I volunteerd to try and get myself better. But I lost my volunteering job when they found my medication (one of them was a chemist) and jumped to conclusions even though they knew i had depression when i started. I tried to fight it but it was just too much and I was not covered by the law because it was a voluneer post and not paid employment so that was that so i couldnt go to a tribuneral :( I miss it so much and it totally wrecked my progress to that point. even if the law protected me it would have been very unpleasant to stay x
BPD
Thank you for writing about BPD. I have BPD but find I am unable to mention it. I was retired from work when things got really bad for me but when people ask why I can't work, I say mental illness or bipolar because the stigma against BPD is so severe. Most of the general public know little about BPD but if they google it, they will find a wealth of inaccurate and stigmatising information. And yes, the worst stigma I've received is from the NHS. I have countless nightmare stories about how I have been treated in hospital, by crisis teams and by GPs. Before I had the diagnosis, I was treated completely differently. The diagnosis of BPD was even kept secret until I demanded to know it and was then labled 'angry'.
I am not ashamed of having BPD. I am however ashamed of the inaccurate portrayal of BPD. Anti stigma campaigns focuss a lot on issues like depression and bipolar and I truly support the work they do. However, I feel left out knowing my condition, the one that arguably carries the most stigma, rarely gets a mention. Stephen Fry turned public perception of bipolar disorder on its head with his documentary and had dramatic effects of reducing stigma. I think it is time something is done to fight the stigma of BPD.
Very true
It took me 6 years to get this diagnosis, yet, the entire time they knew I had this disorder.
I found out by seeing notes on my GP's screen about Borderline Personality Disorder from the mental health hospital and went back for an answer.
The truth is, if no one on paper has this diagnosis then they profit from a huge cut in treatment costs (long term psychotherapy would be very expensive). This is why Psychiatrists try not to diagnose this disorder, and also why I have no treatment options anywhere near here.
Would be great to have the opportunity to get better, but, I guess i'm just being a pain.
Great blog post
Hi, I had a similar presentation at uni about various mental health problems, with the same prejudiced opinions being delivered to the class. I have a BPD diagnosis, as well as depression. I was furious but went for a quiet word with the lecturer afterwards. He'd never met me before so I introduced myself: "Hi, you know those untreatable nuisances that have BPD? Well you have one in your class...and it's me." We had to write an essay on one of the conditions he'd covered. I then said "Your prejudice is based on what you see on the outside, so I'd like to write about how I experience BPD from the inside and see if I can change how you feel about these patients". He nearly fell over - a 1st Class student with BPD calmly challenges his ignorance. I wrote the essay, got 100% and an apology and admission that I'd made him change his mind.
Keep challenging the stigma!
@crochetkid75
Stigma in society
I just want to say that it's great what you did. We need more people to stand up to the stigma and challenge perceptions. I'd be really interested in reading what you wrote if it's not too personal to share?
Wow
Fantastic that its affirmative action...!!!! It's so much more the judgement than the symptoms that its so difficult to deal with good for u!!!
Borderline personality disorder discrimination
I can relate to this. I was told by a Psychologist that, 'it would take a lot of time and commitment on both sides to treat me and that it just wasn't available.'
It left me feeling that the only way to get help would be through hurting myself
I fear that there are many people out there who are missing out on potentially life saving support due to these attitudes.
That's shameful.
Wow, I've never heard of this before. The stigma seems so unjust and mental health professionals who share this negative opinion should be ashamed of themselves.
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