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I am often asked why Borderline Personality Disorder is not as recognized and as accepted as bipolar disorder . I think there are four main reasons:
No celebrity has come out and announced that they have the disorder. While several celebrities have said they have bipolar disorder (just search on the Internet and you’ll see), no celebrity has announced they have BPD. Why? Probably because of the stigma (see below). There are certainly candidates for the disorder, but no poster child yet.
Many people believe that BPD is just a case of the person behaving badly. Non-BPs are definitely guilty of this in spades. The behaviors associated with the disorder – including drug abuse, lying and manipulation – lead many people, including family members and therapists, to believe that the disorder begins and ends with behavior. While behavioral therapies seem to be the most effective in treating the disorder, emotional dysregulation and cognitive disortions play a big role and shouldn’t be ignored. A person with BPD is not just someone behaving badly. They are trying to adapt to the large amount of emotional pain that they feel. Sometimes these adpatations will take the form of dangerous and distructive behavior, but that behavior is not about anyone other than themselves – in other words the behavior is not about you (the Non-BP).
When Hope is Not Enough
Get the Non-BPD book that is designed for
staying and working on the relationship
Bipolar is an Axis I disorder and BPD is an Axis II disorder. This really must change. Historically, BPD has been considered a “personality” disorder. People see it as a character flaw (even some of the sufferers). It is not a character flaw – it is a serious emotional and mental illness that should be treated as such. There are biological components to BPD just as there are biological components to bipolar disorder. It’s time to get rid of the Axis II classification of BPD and treat it like bipolar disorder.
There is a huge stigma surrounding BPD. If you do a search on the Internet and read Non-BP stories, most are in the vein of “I’m glad I got rid of my borderline wife.” There are several Non-BP books that are also in this vein. There is little worse in the mind of the public than someone having BPD. It’s time to remove the stigma. I hope that deeming May as BPD awareness month will help to increase awareness and remove the stigma.
Related posts:
- Does Britney Spears have Borderline Personality Disorder?
- A personal post about living with Borderline Personality Disorder
- Charlie Sheen and Borderline Personality Disorder
- Widely Used Bipolar Screening Test Widely Wrong
- People with Borderline Personality Disorder over diagnosed with Bipolar Disorder
- Kurt Cobain and Borderline Personality Disorder (BPD)
- A New Name for Borderline Personality Disorder (BPD)?
- Update on Britney Spears and Borderline Personality Disorder
- Celebrities with Borderline Personality Disorder (possibly, not for sure)
- Miami Dolphins Player Brandon Marshall admits to Borderline Personality Disorder
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This may be bad to say, but I was really hoping Britney Spears was borderline instead of bipolar. She sounds so much like borderline. I hoped she’d have it so we’d finally have a celebrity “face” for the disorder. I thought it would bring attention to the disorder and raise awareness.
Well, I suspect Britney IS borderline (although I’m not supposed to diagnose her according to the press lately). You may notice that the press says she has A form of bipolar disease which it can be argued could be either biploar II or borderline, since both are rapid cycling “mood” (emotional) disorders. I saw in a sidebar in People (at my daughter’s therapist of all places) that suggested BPD for Britney. Even if she does have it I suspect unless the K-Fed thing turns uglier, her people will try andprotect her from the diagnosis and the stigma. Sad really…
Thanks so much for this post! In honor of BPD Awareness Month, I just wrote:
Borderline Personality Disorder Awareness Month: Discussing, Understanding & Publicizing an Under-Recognized Epidemic
In it, I talk about this very thing – how BPD is often misdiagnosed as Bipolar. I think one more reason is that the insurance companies are more willing to pay for Bipolar so some are purposely diagnosed as that for financial reasons.
I really hope this month will be used to help raise awareness and put BPD on the table as a well known and understood condition. Thanks!
I do not think that lying and manipulation are part of this diagnosis. If they seem to be present, look either to another PD or to shame and anxiety as the cause, along with a long history of learning to never overtly state what you needed to be okay, or to express how rotten you felt, as the consequences always seemed to be much worse…
Sometimes it seems as if people hate those that are dx BPD precisely because they haven’t quite gone off the deep end for good. It’s bewildering how many professionals seem to resent them for this too.
They may curl up in a fetal position for hours, but then they will struggle out of bed and go on. They smile at us, while their inner world self-destructs. They might seem as alive as anyone, but -in the best of times- they feel dead inside; and as intelligent and gifted as many of them are, they never realize their full potential. But they would rather die than admit this to the outside world.
Who would today be dx’d BPD? Vincent Van Gogh, Kafka, Proust, Nathanial West, Sylvia Plath, Anne Sexton, Janis Joplin, Jim Morrison…
It’s ironic that they are so often seen as “emotional” when what they lack is a full nuanced range of emotions. Inner tension keeps anxiety coiled, emotionally stressful situations release it, and before they have a chance to think through what they feel, they are overwhelmed by fear and anger and despair. They get mired in their negativity. Studies have shown that those with BPD do not get angry more often than anyone else, but they have trouble leaving it behind when they do. And afterwards they drown in remorse, because these reactions are NOT felt to be syntonic. No one seems to pay much attention to this, but all other “personality disorders” are understood to be PD’s because they are syntonic with the personality. This is radically different in BPD.
That right there should raise lots of doubts about what this dx is. Is it part of the affective disorder spectrum? Is a akin to partial seizures in frontal lobe epilepsy? Is it a developmental disorder akin to autism? This is all possible, and perhaps BPD is a dx given to many different people who do not share underlying causes. This should at least stop us from quickly claiming that they CHOSE to feel the way they do. As if they were hell bent on living in hell…
When they do awkwardly, fearfully, try to communicate this pain, when they do reach out for help, they generally do so when their psyche is at it’s most shattered. They will quickly learn that their behavior is not acceptable to anyone. So they’ll go through DBT or through some other behavioral therapy, and sink into so much shame and guilt that lo and behold they will no longer qualify on the DSM for BPD; they will have learned to suffer in silence and to isolate (if they haven’t before – many of those with BPD will never consult a therapist in their lifetime and go through life pretty much invisible), learned to not bother anyone, but the dysthymia, the insomnia, and the dysphoria will still be there, eroding their lives, their aliveness. And as hard as they try, fear will still strike them out of the blue when they least expect it. As hard as they try, they will still plummet down into misery with the least negative emotion. Skinless creatures, they can not tune out human suffering, they can do nothing about the heightened sensitivity that they were born with. Only now no one will know. And so hopefully, thankfully, no one will ever call them “Borderline” again.
Zephyr,
Thanks for the comment. Yes, I don’t think lying or manipulation are part of the diagnosis either. In my book, I report shame as the main cause of lying and manipulation – however, I think that manipulation in itself is a pretty poor way to describe any behavior. All behaviors have a purpose and any could be seen as manipulation, depending on your viewpoint.
I believe that three main factors “cause” (or at least fuel) BPD: emotional dysregulation (which I think for the most part is biological, although the “triggers” may not be), impulsiveness (which could be considered biological as well) and shame (which is probably not biological, but a reaction to invalidation or a feeling of brokenness). I think that all the other symptoms arise from one or a combination of these three factors. Of course, that is only my personal opinion…
It is troubling that professional resent people with BPD. My wife fears “going off the deep end for good” to the point of refusing to get some of the help she needs.
I would agree that BPD, IMO, is part of the affective disorder spectrum, with impulse control issues added to the mix. It will be nice when they rename BPD to something else – and Emotional Regulation Disorder (ERD) is a pretty good choice IMO.
Bon
As someone who was diagnosed with Bipolar I/co-morbid Panic Disorder about five years ago and I find it TOTALLY offensive that Bon Dobbs has made the statement that Bipolar Disorder has been accepted. I can tell you that as someone who lives with it everyday that it is NOT accepted. That statement beyond insulting. Going to pharmacy and picking up different medications (e.g. Lithium) and the way you’re looked at by the pharmasist is even hurtful. The way people (even within your own family) treat you differently after you tell them is heartbreaking. People talk. They see you, and they look and react to you like you are completely different person then you were before. People STILL think you’re ‘crazy’.
This is not to say that I don’t have deep empathy for people who suffer from BPD. A close friend of mine has recently been diagnosed with BPD and her suffering is gut wrenching to see. She refuses to get real help. And the “help” that she has gotten, has been useless. I agree that the name of BPD should be changed. I also don’t think, along with many experts in the field, that “Bipolar” fits the disease.
I take serious issue that non-experts all over the internet and media in general, take celebrities and diagnose them. It’s just not right. Unless, you are that person’s Dr. and know their truths and symptoms, you have no right to pass judgement on anyone. I take serious issues with a couple of posts.
“Who would today be dx’d BPD? Vincent Van Gogh, Kafka, Proust, Nathanial West, Sylvia Plath, Anne Sexton, Janis Joplin, Jim Morrison…”. Umm…How do you know?? I’m sorry, but you don’t.
“This may be bad to say, but I was really hoping Britney Spears was borderline instead of bipolar.”. That’s not “bad” thing to say; it’s DISGUSTING.
I see one of the foremost Psychiatrists in NYC and he agrees. Unless that person is your patient, you can speculate all you want to, but until they’re sitting face to face with you, one cannot without a shadow of a doubt diagnose them. It’s wrong.
The fact is, people should be focusing their energy on removing the stigma of mental illness in different ways, instead of looking to celebrities to come save day. It wouldn’t even nessacarily be a good thing. Anyone who has a mental illness knows what a private decision it is to be able to be open about it.
I apologize to anyone who I’ve offended if what I’ve written seems harsh, but as far as I’m concerned, it’s truth.
““Who would today be dx’d BPD? Vincent Van Gogh, Kafka, Proust, Nathanial West, Sylvia Plath, Anne Sexton, Janis Joplin, Jim Morrison…”. Umm…How do you know?? I’m sorry, but you don’t.”
You’re right I don’t. I was citing opinions of professionals well regarded in the field.
Thank you so much for this website. You’ve provided a lot of helpful information for those of us who don’t know much about BPD, but who want to know more about it. I am diagnosed with Bipolar 1, and I don’t have Borderline Personality Disorder myself, but I have a close friend who does. She has been physically and emotionally abused by her mother for most of her life, and has had some counseling, but she (my friend) is so numb at times (i.e., when she talks about the abuse, it’s always matter-of-fact; says ”it’s no big deal”).
Other times her emotions are very inappropriate for the situation. You have to stay on neutral subjects, or she will get very charged-up with anger (not toward me, always toward someone who’s not present- coworker, boyfriend, sister, etc.). I have never understood this.
I have also noticed that my friend blames a lot of her actions on her past- and she does not seem to want to let go of the pain. She says she does, but she won’t, or doesn’t know how. It breaks my heart to see that kind of pain, as I don’t know if she’s ever been truly happy. The other day she told me that she wished she ”could stop manipulating people, but [she didn't] know how.” This was an uncharacteristic thing for her to say, and I just didn’t get it. She really doesn’t strike me as the manipulative type, but who knows what is inside another person’s mind besides that person?
She is empathetic and asks me about my mood swings, but we just can’t seem to relate to each other well. Although it seems that our depressive states are very similar (one big difference, though- she does get the urge to self-injure, but says that she no longer does that).
Bipolar Disorder and BPD are such different illnesses, with many different symptoms. I was looking to find out more info on BPD, and this website has been very helpful. I’m not looking to give her advice, because I know it’s up to her to work through her pain (though I’ll be there for support). I just wanted to learn more about BPD in general, since she rarely talks about it.
Zephyr- I have heard that BPD is manifested in various ways, and people who have the disorder may experience a variety of symptoms, but your description was the best I have read in terms of what may really be going on inside the mind/heart of someone who has this painful condition, and why it’s difficult for them to get the treatment they need. I just wanted to thank you for your post.
Dear Zephyr,
Thank you for your incredibly insightful and poignant observations. Do you have a publication available to the general public? I would most certainly purchase it.
Sincerely,
BPD guy
Hello,
I’ve been doing a whole bunch of research on nutritional psychiatry. I’d like to share it so as to save others the same trouble but I’m not sure how at this stage and I’m only just figuring out the forums.
After a long life struggle I have recently sought out and been confirmed as having BPD. It is alarming to read all I have about this condition; some of it I relate to, some of it I don’t (for instance on the point of manipulation discussed earlier. Btw, stlouis7, your friend may not be so much manipulative as suggestible – it’s all over the literature and, in having low self-esteem, might leave her open to believing these things of herself).
Anyway, I digress. While waiting to begin a course of Mentalisation therapy, I have undertaken other actions to make life ok. While I’m investigating a long list of supplements etc, I have only been actively taking Omega 3 fishoil (2g – though professionals in this are recommend 9g daily), Zinc, Magnesium, Vitamin B complex and sometimes Omega 6 Evening Primrose Oil/Starflower Oil. In addition to this, I have been meditating – this too is v important. Through these things I have experienced a remarkable shift – and very quickly (a week or so – but this may vary). I would say I am 80% better and would probably not qualify if I were to be tested today. More importantly I feel happier in myself, I’m less argumentative and less sensitive (less inclined to take the harshest view on things and readier to let things go too) and I’m sleeping much better. The bonus in the key supplement, Omeg 3, is my skin looks great and my knees don’t hurt!
The other supplements I’m looking into are: Vitamin D, melatonin, Gingko, B6 (P-5-P) specifically, and Chromium Picolinate as well as a few Ayurvedic seratonin precursors. I am not actively recommending these as I have yet to try them myself; they are just on my list of considerations for further research.
My list of nutritional supplements that I’ve been researching have come from doctor’s writings on nutritional psychiatry (not many talk about BPD specifically however so I look more at symptom lists), as well as writings of others with BPD and clinical trials. I came across a condition called Pyroluria which informs half the list of supplements. Look it up, it’s v interesting. It’s a condition which underlies many psychiatric disorders. I also looked at the relationship between PTSD (a condition which shares some ground with BPD) and hypoglycemia.
I have spoken to my (GP) doctor about these supplements, and as you might expect, he suggests that supplements should only be taken where a confirmed deficiency exists. Yet many of these things are not easy to test for. Personally I would prefer to be my own guinea pig with moderate amounts of substances which the human body normally needs rather than delve into the pandora’s box of pharmaceutical drugs which seem to have relatively modest effects with BPD. Though I eat quite well, I suspect (and I’m making big leaps here – it’s a personal theory based on my readings!) early trauma changed my brain and biology (or perhaps it was inherent in my biology). Some of the damage done to parts of the brain relating to sensitivity, emotional lability and empathy can be addressed with meditation and other biological aspects can be addressed by the supplements (I suspect I don’t process some substances well and/or my needs are greater. This is why the supplements help).
In case I haven’t made this clear, I am not a doctor, nor a scientist, but I am an intelligent person who has put a lot of time and energy and personal experience into looking at this. What works for me may not work for you, so do take care in thinking things through for yourself, I just hope to provide a starting point. The one thing I would strongly recommend and have scientific validation for for BPD is Omega 3. *Definitely* please at least try that. Most people in the west are deficient due to changing diets and it could potentially make a huge difference to people with BPD.
I support your statement.
BP (BiPolar) [Axis I] vs BPD (Borderline Personality Disorder) [Axis II]
The “Axis” is a mathematical term which comes from statistics. Get over it because it is not going to change. Statistics is an analytical tool which can be applied to co-relate lots of data. If statistics (as a mathematical tool) is miss-used then you will be co-relating totally unrelated data & drawing nonsensical conclusions.. Example:
Co-relate: BP genetic markers, relationship problems, burnt toast, tampon brand. You can do this but then implying anything about burning bread & tampons against molecular bonds in DNA is ridiculous. The 1st lesson from statistics as a branch of pure mathematics is “co-relation is NOT causality”.
BP: The expression of polymorphisms in the alleles of the genes of chromosome pair #15. There IS something there at a DNA level. The issues may be internalized or externalized (the part we NONs will take issue with). Not all BPs externalize behaviors which would draw complaints.. BE depressed, just don’t be nasty.
BPD: Nasty Perpetually Argumentative B I T C H E S. The best explanations I saw was in a psychiatric paper “Multimodal etiology for the development of ABP from untreated ADHD-PI” One path indicating a maladjusted coping strategy for executive functioning (differing responsibilities by attacking others) another mode being the development of narcissistic tendancies from overzealous unwarranted praise from a parent.
These conditions are differentiated by psychologists arguing among themselves, I am not so sure that their classification system is completely consistent. I would suggest that BP & BPD are not mutually exclusive.
Anyway, the premise of your post seemed to indicate a belief that BPs are “excused” & BPDs are not. There are a lot of therapists who have pushed this “understanding & forgiveness” to the limit.. Here it comes, I am a NON
There are no “get out of jail free cards”, I personally reject the “it’s not my fault” BECAUSE I have read too many 1st person accounts by both BP & BPD people that indicate premeditation for the purpose of harming others.
My ex-wife is/has BP, ADHD-PI, ODD, OCD, BPD.. But rather than the “alphabet soup” it is simpler to describe her in three words: “a narcissistic sociopath”. As this occurs in multiple domains (mathematical term, read home, work, church) & the externally noted symptoms have lasted 35 years, that diagnosis & description is accurate.
I have to live by certain rules of acceptable social behavior. I do not accept that some other bunch do not, especially when that behavior is a source of harm to others.
What am I saying, your premise is wrong (at least for me). I have no acceptance for mental health issues IF THE PERSON AFFECTED will not try to limit the negative fallout they inflict (often intentionally).
I have noticed that people with your opinion are typically speaking about their “ex-partner” or “soon to be ex-partner”. I often wonder if your opinion would be different if your child had such a disorder? Are there no “get out of jail free cards” for your children? It is not illegal to be mentally ill. It is also stigmatizing. I find it fascinating that some many of the people on one “side” or the other of this debate are so passionate about the behavior of people with mental illness and so quick to deem the other “side” wrong. At least you said (at least for me). My premise is that family members of those with mental illnesses can positively affect the outcomes IF (and this is a big if) the family members are willing to accept certain attitudes and learn certain skills that are effective in the relationship with a mentally ill person. For many this is an insurmountable if. I never (at least I try not to) say I’m right about all this or that others are wrong. Yet I think that a new way of thinking about mental illness is required to get to an effective place. Many (including you) disagree.
[...] A while back I received a comment on the article Four Reasons Bipolar is Accepted and Borderline Personality Disorder is Not that was apparently re-posted on a forum for people with BPD. It turns out that many of the people [...]
(Re-submitting b/c auto-fill gave my site administrator’s email instead of mine.)
Another reason BPD has a worse stigma attached is because of a sad but unfortunate truth: many of those diagnosed with BPD have treated those close to them pretty horribly, and done so pretty consistently. And often in ways–for for supposed “reasons”–that don’t make a lot of sense.
Whether you think it’s fair or not, it’s a plan fact that this kind of thing just adds to the stigma.
Having a diagnosed BPD in my family, I’m not so quick to call them “psycho” or spew out the kind of hate you saw in the comment above.
But having been close to more than one BPD, and knowing others who have had the same experiences, it seems to be a pretty common phenomenon that the closer you are to someone with the diagnosis, the more likely you are to be treated in a pretty rotten way.
Like it or not, this is a big reason for the stigma. I would gamble to say it’s probably the MAJOR reason.
And when people start using their diagnosis as the “reason” they treat others badly, rightly or wrongly, it tends to just fan the flame (just imagine all of these statements making up a huge campaign of micro public relations incidents; it’s what they basically are).