Borderline Personality Disorder (BPD) is a diagnosis that comes with the stigma of being attention-seeking, resistant to treatment, manipulative and incapable of maintaining a healthy, stable relationship. I have borderline personality disorder. Here’s what I want you to know.
*’most stigmatized’ according to Dr John Grohol in this article.
When my best friend told her therapist that I had borderline personality disorder, her therapist panicked. She started spouting all sorts of information, telling my friend that she needed to be aware of my manipulative ways, that she needs to set clear boundaries in the friendship and, to paraphrase, keep me at arm’s length. Needless to say, this upset me a bit: I’ve always known the way that people perceive my mental disorder but it hurt to hear my best friend questioning whether the entirety of our friendship was based on manipulation.
But it also hit home to me how little is understood of BPD, even within professional circles. I feel that if I, and others like me, are to learn to live beyond the ‘borderline’ label, this is something that has to change.
What is Borderline Personality Disorder?
Also known as emotionally unstable personality disorder, the DSM-5 characterises BPD as:
When I was first diagnosed and went online to find out more about what was actually wrong with my brain, I was horrified with what Google told me. It seemed to me that BPD was just a medical way of saying that I’m a monster, best avoided at all costs.
Spoiler alert: It’s not.
People with borderline personality disorder are manipulative…?
I am the first to acknowledge that those with BPD can come across as manipulative. But the word ‘manipulative’ implies an element of selfishness and premeditation that simply is not there. If someone doesn’t reply to a text, or cancels plans with me, my brain instinctively starts telling me that I’m hated, that I’m not worthy of friendship, that everybody leaves. BPD is a manipulative disorder: it manipulates and distorts my view of the world into a place where everything is black or white; the most amazing or the worst thing ever. And of course, some people with BPD do let this leak out and poison those around them. These emotional responses can be seen in brain scans.
The brain on the right is that of a healthy person while the brain on the left shows that of someone who suffers with borderline personality disorder. As can be seen in this image, BPD impacts the brain via overactivity in the amygdala, hippocampus and orbitofrontal cortex, which are involved in the regulation of negative emotions and behaviours.
This said, emotional responses do not automatically correlate to behaviours. It takes a significant amount of mental energy, but I and (I assume) other borderlines are able to prevent this from leaking out and poisoning the lives of those around us.
People with borderline personality disorder are attention-seeking…?
People with BPD are possibly best known for impulsive and attention-seeking behaviour: most stereotypically through promiscuity and self-harming behaviour. I will deny that a lot of this behaviour is, albeit subconsciously a way of seeking attention. However, what people don’t understand is that seeking attention is a natural human behaviour: we are social creatures and when we struggle, we want people to notice, we want people to care.
On average, 70% of BPD sufferers will attempt suicide at some point in their lifetime. If this isn’t enough to demonstrate that the pain which is conveyed through ‘attention-seeking’ behaviours, I don’t know what is.
Side note: if someone feels the need to seek attention to the extent that they resort to harming themselves, then don’t you think maybe there’s something deeper going on that really does require some attention?
People with borderline personality disorder are untreatable…?
It certainly used to be the case that many therapists would refuse to take on BPD clients because they are notoriously difficult to treat: the unique and complex combination of symptoms means that many of the go-to therapies are unsuitable for them. Nowadays though, there are treatments with a proven success rate. Dialectical Behavioural Therapy (the treatment that I credit with saving my life) has been shown to reduce suicide attempts by half.
It is not a disorder that one ‘recovers’ from, but it is one that doesn’t have to prevent sufferers from living full, functional lives.
People with borderline personality disorder are incapable of developing and maintaining healthy relationships…?
Emotional and physical abuse are admittedly more common in relationships involving those with BPD than those without. But the BPD party is just as likely to be the victim as the perpetrator: the intense self-hatred and fear of abandonment places them at increased risk of staying with an abusive partner, while their extreme emotional responses can make them behave in an abusive manner. This said, it is important to stress that not all BPD relationships are unhealthy, and fewer are abusive.
I will admit that it is very difficult for me to develop and maintain a healthy, positive relationship. I don’t want to rely on someone too much but at the same time, I can’t be close to someone if I can’t tell them when I’m struggling. I need to constantly reevaluate my mental state and corresponding behaviour within the relationship and sometimes I question whether it’s really worth all of the effort. But deep down I know it is worth it, and always will be.
My diagnosis made me feel like a monster, but I live every day of my life consciously trying to prove it wrong. It’s hurtful to know that if I tell people my diagnosis, there are some who would immediately view me as a freak, an attention-whore, someone to be avoided.
I am not defined by my disorder, I’m just learning how to live with it.