Borderline Personality Disorder: A Coming-Out Story

polaroid with quince branch

The following is the first in a series of posts about mental illness called, What ______ Really Is, in which I, and perhaps some guest posters, tackle a variety of mental illnesses and disorders with stigmatizing stereotypes. This series, or anything I write about mental illness, is not meant to replace information from a mental health professional, and simply reflects my own experience and/or research. I hope you like this first one.

I’m pretty open about having schizoaffective disorder, bipolar type on this site, which people have called me brave for. It’s true that psychotic/schizophrenic symptoms are highly stigmatized in our society (as well as depression, bipolar disorder, etc.) — but what I’m about to write about today is perhaps more stigmatized than any of those disorders in many circles, including in the medical community. And this is why I do not write about being diagnosed with borderline personality traits. 

This is why my psychiatrist, whom I know respects me a great deal, continually refers to it as “your personality” or “your Cluster B symptoms.”

hateyouThis is why, when my friend ranted about his “crazy ex-girlfriend,” whom he was sure was an “undiagnosed borderline,” and referred often to owning the classic bestseller, I Hate You, Don’t Leave Me: Understanding the Borderline Personality, I didn’t say anything about having been diagnosed by at least four different psychiatrists with borderline personality disorder (heretofore referred to as BPD) since 1999. Check out the awesome, totally non-stigmatizing cover art of the book at left, which has barely changed since the book’s release over two decades ago. (Credit: Amazon)

This is why one of my oldest friends, K, who is a formerly BPD-diagnosed person herself, asked me if she should stop seeing her therapist, whom she liked, because the therapist had suggested that she might have BPD — simply because my friend mentioned “cutting” as a younger person, and then K asked — rhetorically — who didn’t cut as a younger person? (She also commented, later: “A borderline diagnosis just means the psychiatrist is calling you an asshole.”)

I have questioned my diagnosis, which began when I was too young to even be diagnosed, since I was 16. People aren’t supposed to be diagnosed with personality disorders until they are at least 18 and therefore “adult,” but Dr. C didn’t seem to care about that particular nicety. At Yale, I went to Sterling Memorial Library and checked out feminist books about the feminization of BPD, a disorder that is controversial by its very nature and diagnosed in women far more commonly than it is in men; at the same time, I was lying down in fMRI machines for studies conducted by one of my professors, a neuropsychologist, to examine vulnerabilities in the brain of those with BPD when exposed to neutral faces. Years after I was hospitalized twice in the same facility, I requested my records — and discovered that “borderline traits” was part of my diagnosis, alongside bipolar disorder.

I denied that I had borderline traits for years. After all, any manipulative behaviors I engaged in had stopped in college. I’d ceased to self-injure, although that particular behavior would return in graduate school. I chalked my association with BPD up to “youthful psychiatric indiscretion.”

Before I go any further, I’d like to refer to the National Institute of Mental Health’s definitions of what BPD is (link). The NIMH page lists the DSM-IV’s (DSM = Diagnostic and Statistical Manual, found on pretty much every psychiatrist’s bookshelf, if not their desk) official criteria for a diagnosis about halfway down the page; because I, and even the NIMH, who has pulled their support for the upcoming DSM-V, have doubts about the validity of the DSM, I will refer primarily to the NIMH’s opening paragraphs:

“Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed BPD as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.

“Because some people with severe BPD have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name “borderline personality disorder” is misleading, a more accurate term does not exist yet.

“Most people who have BPD suffer from:

  • Problems with regulating emotions and thoughts
  • Impulsive and reckless behavior
  • Unstable relationships with other people.

“People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.”

Did you see the part about how people with BPD have brief psychotic episodes? If someone had heard of BPD before, do you think that this symptom, which is mentioned in the very opening of the page, is what they were thinking about?

The brief psychotic episodes under stress is what happens to be, along with self-injury, my primary symptom of BPD. This is unrelated to the fact that I have schizoaffective disorder. When I have a psychotic episode due to schizoaffective disorder, the episode lasts for weeks, or if I’m particularly unlucky, months. When I have a psychotic episode due to BPD, the episode lasts for hours, and is usually gone by the next day.

If you need a refresher on what “psychotic” means, i.e. not “homicidal maniac,” please refer to my series, What I Talk About When I Talk About Psychosis.

It means that I can be running late to something, arrive, have one or two more stressful-but-minor things happen to me, and wind up crying in a conference room because I think that the government is trying to invade my brain with rays spread by a man whom I saw carry computer parts up the elevator — and be totally fine four hours later.

It means that I can be at the office, feeling “normal” stress from a workday, and start hallucinating phantom creatures running around by the kitchen.

I am not a manipulative person. I am not “that evil girlfriend.”

And yet Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder is one of the most popular books about BPD in publication. Apparently, C has to “take his life back” from me. Poor guy! Read any one of the reviews about any of the most popular books about BPD, and you, too, may be convinced that people with BPD are to be avoided at all costs. Many psychiatrists and therapists will not treat patients/clients with the BPD label attached to them, due to their reputation as “troublesome” clients who will stop at nothing to manipulate anyone and everyone in their lives. Threatening suicide! Going to the ER more than once!, etc.

Stigma does not help anyone with a mental illness; it especially does not help those prone to suicidal impulse or, as the NIMH puts it, “[completion].”

And that’s my coming-out story.

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  • I actually had NO idea that the NIMH pulled out their support of the new DSM. What is happening??

    Thank you for sharing, love. PTSD is a different story when it comes to mental illnesses, but I definitely feel like sometimes think I’m just a crazy, ‘overreactive’ girl- to explain why I am so different, so much more loud and passionate and ’emotional’ than I was in high school. Another way of silencing (hence, the stigma).

    Sending so much love, as always. xoxo.

    • You’re growing and some things have changed you, but you are always going to be that awesome person you are deep inside. I know that sounds corny, but it’s totally true. Thank you for being here. x

  • Wow I love this post for so many reasons. I am struggling with blogging about my own long history with depression and anxiety and reading your blog inspires me that someday I can put it all out there – not because I feel like I have to but because I feel like it would help me (and save me hand cramps from writing in a paper journal for hours!).

    The differences between Schizoaffective disorder and BPD are interesting to read about – is there something you can recommend that would explain the differences in more detail(user friendly)?

    • Michelle — I do hope that you’ll consider, when it’s released, joining my online course about journaling specifically for purposes of dealing with mental illness (sorry to sound sales-y, but I passionately believe in the curriculum I’m developing!); I also think it might encourage people to blog publicly — or at least, under pseudonyms — about mental illness. Regardless, thank you so much for visiting, for commenting, for being a soft place to land in this space I’ve created.

      In terms of the differences between schizoaffective disorder and BPD, I have yet to read anything specifically about the differences. Both involve the same types of psychotic symptoms (hallucinations and delusions); the only difference is the transient nature of psychotic symptoms in BPD. I’ll definitely get back to you if I manage to find anything specific, but that’s the main feature.

      Thanks again & with care – E.

  • thank you for writing this. I’ve been in the closet about this for much of my life. I can handle all the other diagnoses, but not this one, because of the stigma…..the worst is having a doc right now that is starting to become more dismissive of me — not being supportive about my recent increasing breakdowns that have nearly gotten me fired from my job. I gave him too much credit by being open about having bpd traits, now that’s all he sees in me. never mind the psychotic episodes and real actual pain/suffering bpds feel. somehow, having bpd is enough to make that all null and void. I’d rather be a leper than be known to have bpd today, and that is sad (because how self-loathing is that? very.)

    but thank you for sharing. it’s nice to partially come out of the closet.

    • Hi — thanks for writing, even anonymously. It’s a step. And it’s good for me, too, to know you’re out there. x

      • I wanted to say one more thing about bpd in regards to men who talk about the “psycho ex girlfriend”. it took me until my current relationship (loving, supportive, complementary) for me to realize that most, if not all, my past rocky relationships were due to finding men with a similar “brokenness” inside them. so the fact that many ex’s of bpds talk about “the psycho ex gf” says more about them (perhaps they have bpd traits too, and this is their way of expressing their pain) than it does the “psycho ex”.

        I still do bpd’ish things in my current rl when under stress, but if we ever broke up, I can say with certainty that he would never use “bpd psycho ex” as a descriptor. and it’s getting better with age (I’m in my 30s now)….I’m learning techniques for keeping my life as low-stress as possible. it’s a bit of a process….as you well know. 🙂

        sorry for this epically long comment, but your post really meant a lot to me. it’s validating to know others experience the same. much love to you….

        • Much love to you, as well. I do wonder if exes of mine refer to me as “that psycho ex,” but to be honest, it’s my relationship with my husband that’s seen the worst of it — AND the best of it. In my opinion, anyway. Glad to hear that you’re getting better. Research shows that BPD symptoms tend to decrease with age, so that’s something to look forward to. (I’m in my early 30s.)

  • Gosh this post is affecting me in weird ways. I’ve been reading on depression and other illnesses lately because and I could check most of the symptoms for related mental disorders. The last two years I’ve been struggling with crazy heights of emotions that happened almost beyond my control, and in times when I do still feel in control I can’t help but just slide all the way with my feelings. I haven’t talked to my family about this because yeah I don’t talk to them but I do think I need to get help. But I don’t know where to start or how to even see a psychiatrist. I’m pretty “fine” at the moment but who knows when things get worse and completely out of hand. I’m 17 and so sometimes I think what I’ve been going through is just a teen thing but then my friends who sometimes have rough times too are just perfectly fine. I’m the only one with issues. I’m aware of it. So yes I do want to know for sure what is wrong with me — it’s been obvious there is — with a professional’s help if needed, . Can you suggest how I’d begin on figuring that out and how I can actually make myself do whatever it is?

    • Do you have an okay relationship with your parents? I didn’t when I started getting help for mental health issues — but I still went to them when I realized (at 16) that I needed to seek help. If you have a horrible relationship with them (e.g. they’re abusive, etc.), you might be able to see a psychiatrist without your parents; you’d go to your primary care physician and get referred to a psychiatrist or a therapist. Another route is to see the counselor at your school, who may also refer you to a psychiatrist (this is what happened when I was in high school).

      I might also add that I’m not a mental health professional in any way, and therefore this advice is simply based on my experience. I do encourage you to talk to someone in your family for help — usually, if you think you need help, you do, and a psychiatrist or a therapist is usually the way to go in such situations.

      I wish you all the luck in the world, love.

      xo

  • Hi Esme, I’m currently researching this phenomena of BPD stigma in relation to the poorly executed and indeed stigmatising nature of the US BPD Awareness Raising organisations. While the NEABPD is producing reliable scientific research its president is committed to fighting the stigma arround family members and partners of those with BPD and advocating their needs. The needs of those with BPD to fight stigma has been left to NAMI who have no specific programme or agenda to address this. Randi Kreger herself is a good friend of NEABPD’s president, Perry Hoffman, and was instrumental in pushing the motion of BPD awareness month through the house of representatives. All the organisations involved in raising awareness of BPD encourage people to run fast and loose with the diagnostic criteria, labelling all manner of abusive behaviour as Borderline. I have written an article about this myself but I have no public platform to get this message heard. I would like to share my research with you and ask if you could please report on this phenomena yourself. Thanks for listening x http://makebpdstigmafree.wordpress.com/2013/11/21/bewareness-raising/

  • Thanks so much for this post, Esme. Given that “I Hate You, Don’t Leave Me” and “Stop Walking on Eggshells” are so problematic, are there any resources you are aware of that you’d recommend for families of people diagnosed with BPD? I appreciate it.

  • So, what you are basically saying is ,ignore the fact that you have been attacked with a smear campaign , false allegations, jail, courts, restraint orders – financial ruin, ostracized by all , because someone has a mental illness ?

    Many bp people have co- morbid conditions ie, narcissistic, sociopathy, bipolar etc.

    I understand you are probably not like this, but many are. I for one don,t intend to jump in front of a bus to help them out, because they FEEL like they have been slighted in some form or other. IMHO it is far better for all to stay FAR away from these people to save there own life from being ruined, along with any that are surrounding them, UNTIL THEY GET HELP!. And from my understanding , most refuse, or end soon after they start.

  • Jails, courts and a restraning order, oh my!! Sounds like the abuser’s classic routine known as DARVO. It adds a nice touch to a blog that adresses the stigma of BPD and then goes on to stigmatize BPD. Why not blame the victim when it feels so reassuring?

  • Oh no… I’m a recently diagnosed BPD male. I can’t say that after a few days of internet browsing on the subject that I’m very optimistic about my chances for recovery. It seems like everywhere I turn there are arguments and fighting. Answers for the newly initiated would be nice.

    Is there some kind of primer out there on dealing with my medical condition?

    – A L T

  • Coming to this post quite late.

    Thanks for it. It’s good to come across something that touches on the political aspects of this diagnosis. I believe that one day it’ll go the same way as ‘hysteria’ and be seen as an oddity of the past.

    An articulate, intelligent post.

    To the person who last commented I’d recommend “Reinventing Your Life” by Jefffey E. Young et al. You can find a talk he gave on YouTube about his therapeutic approach as well. Don’t know the aetiology of your disorder but if it’s rooted in trauma looking up Judith Hermann and a wonderful talk by meditation teacher Tara Brach might help (it’s about trauma and meditation).

    Staying away from certain parts of the Internet when first diagnosed is probably a good idea. However, it can be quite enlightening to read posts from folks who rail against “borderlines” but who seem rather emotionally dysregulated and given to black and white thinking themselves. Lots of projection going on.

  • And just a correction: there’s a Judith Hermann and a Judith Herman. I meant the Judith with one ‘n’. The other Judith looks interesting too.

    Watched your video on YouTube, Esme. Lovely!

  • Thank you, Esme, My sister went to a therapist for years, who never diagnosed her correctly. Finally, a psychiatrist, 13 years later diagnosed BPD. I had never heard of the term, but when i read the criteria and symptoms, I had a eureka moment. My sister’s therapist medicated her into ruins and she commited suicide. I miss her terribly, and my life is forever in ruins without her.

    • I’m so sorry to hear that your sister’s case was mishandled so horribly. I believe that you really loved her, and it’s clear that you miss her. I hope that by opening people up to understanding BPD beyond stereotypes and discrimination, we might all be kinder to one another, and more understanding of people who live with BPD.

  • Wow…what can I say thoroughly immersed in your work bravo. I have attempted myself to write a similar story. But alas it ends in dismal failure.
    So thank you

  • I’m really glad you’re doing well, but my mother has BPD, and she IS unstable, she is manipulative, and her psychotic breaks are, at their best, worrisome and at their worst, focused specifically on the people around her including me. She won’t get help, and most of the time you can’t convince her that she’s wrong about anything literally ever, so she doesn’t feel the need to get any kind of help. Part of me wonders if it’s the combination of her personality and her disorder that make it so bad (and I’m sorry, but it really IS bad, she’s wildly abusive both directly and indirectly), and I used to be really close with her even though we had this cyclical relationship that was, in the long run, terrible, and now I can’t do it anymore. I would love for her to get help, but I don’t know how to even convince her that she needs it. I was wondering if you could provide any guidance for me…I don’t want to have this arms-length relationship with my mother anymore.

    • I have no wise words, but would advise you to bring this to a therapist who is experienced in such things. It seems like you’re in a truly sticky situation, and could use some guidance; I’m not the right person to provide that, but I believe a good therapist would be. I wish you all the best as you deal with this situation with your mother. x