What’s Your Diagnonsense?

Borderline Personality Disorder, that’s what. Here’s what I knew about BPD before being diagnosed:

– more women than men receive this diagnosis
– many argue BPD does not actually exist
– it’s often viewed as the last resort diagnosis; given to someone who is too difficult to treat
– and of course, Susanna Kaysen in Girl, Interrupted is the poster girl for BPD

And that’s about it. Despite my fascination with all things mental health-related, I didn’t know much about Borderline Personality Disorder. That’s because there’s not a lot of information out there. My first question, of course, was the same as Susanna Kaysen’s: “Borderline between what and what?” And when I tell folks about my newest diagnosis, that’s usually their first question, too. BPD was named in the 1930’s, and originally referred to a borderline between neurosis and psychosis: a person diagnosed with BPD was considered to be too neurotic to be neurotic and not psychotic enough to be psychotic. That’s not the view anymore, but the name persists. Other names have been put forth by mental health activists and professionals, such as Emotional Regulation Disorder and Emotional Intensity Disorder, but it’s still widely referred to as BPD, and if we want to change it, well, that’s up to you and me and eventually, the DSM. Right now, I’m okay with the name. Just don’t call me “a borderline.” As I often remind folks, that kind of language is dehumanizing and unnecessary. You don’t call someone a cold, nor do you call them cancer. Want some examples of what to say? How about, “Maranda has been diagnosed with BPD,” or, “Maranda has BPD.” The second one is a little iffy since it can’t be proven, but I do fit all nine diagnostic criteria to the nth degree, so… I guess I can describe myself as someone with BPD, but would prefer to be referred by other people as someone who has been diagnosed with BPD. (I wish this was the last time I had to have this conversation! So tired of the language thing!)

Moving along…

I received this diagnosis while I was in an intense inpatient program, after having completed a Psychological Assessment Inventory (PAI) and having a few appointments with a psychologist. Incidentally, I had filled out the same 344-question PAI back when I was fourteen, but was never told what my results were. After being given this new diagnosis, I started my research. The library at the treatment centre had only a handful of books, especially compared to the dozens upon dozens of books on depression, anxiety, and bipolar disorder, and I read whatever I could. The more I read about BPD, the more my life made sense to me. I suddenly understood my constant feelings of loneliness that have persisted since childhood, I understood the ridiculous and regrettable behaviour of my early-twenties, I understood my lifelong tendency toward self-destruction, my constant feelings of instability both in life and in my head, and my ever-unstable sense of self and identity. It all made so much sense.

A few book recommendations:

Borderline Personality Disorder: The Facts by Roy Krawitz and Wendy Jackson
I Hate You – Don’t Leave Me: Understanding the Borderline Personality by Jerold J. Kreisman, M.D. and Hal Straus
The Buddha & the Borderline: My Recovery from Borderline Personality Disorder through Dialectical Behaviour Therapy, Buddhism, & Online Dating by Kiera Van Gelder

For the first time in my life, I felt grateful for a diagnosis. Of course, I was also angry that it had taken so long to figure it out when it now seemed so obvious, and I was also angry at having spent the last few years being treated for something I didn’t have (bipolar disorder). But I could also see why BPD tends to go under the radar and be misdiagnosed quite a few times before somebody finally figures it out. On the surface, BPD and bipolar disorder can appear very similar: they both have extreme highs and lows, they both result in erratic and often stupid behaviour… The trick in distinguishing the two from one another, among other things, seems to be naming the emotions behind the actions, and noticing how long a high or a low tends to last. And those things make such a huge difference. I could never relate to the bipolar diagnosis, and now I know it’s because it was never mine.

Having this diagnosis has given me a greater ability to learn about myself, to understand myself, and to have a better relationship with myself (and maybe even other people?). After my time in the hospital, I am now better able to separate my thoughts, feelings, and behaviours, to label my emotions before I act, and to live in and focus on the present moment. It’s all much more complicated than I’m letting on, but it is also very simple. I am embarking upon a new way of living, and I am a different person than I was only two months ago. This is a new era of my life.

Diagnonsensically yours,

P.S.: If you’ve benefited from my writing in any way – if my words have inspired you, helped you feel less alone, or sparked some weird feeling within you; if you’ve felt encouraged, or curious, or comforted – please consider compensating me by offering a donation of any amount. Whether you’ve been reading my writing for years, or just stumbled into me this afternoon, I invite you to help me sustain the process!

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