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.

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

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.

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!