Reprinted from "Stigma & Discrimination" issue of Visions Journal, 2005, 2 (6), p. 12
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) lists a set of criteria used to diagnose borderline personality disorder (BPD). These criteria include a frantic effort to avoid real or imagined abandonment, patterns of intense and unstable relationships, unstable self-image, impulsivity, and a chronic feeling of emptiness.
Once a diagnosis of BPD has been made, it brings with it a set of consequences. Some may be good, some not so good. At the Borderline Personality Disorder Association in Kelowna, we requested feedback from individuals living with BPD and their family to better understand what it is like to have the disorder or to care about someone who does. Below is what we discovered.
In what way has the diagnosis been helpful?
General consensus was that it can be a relief to know “there is a name for it.” Once something is identiﬁed, it’s easier to get information and begin to get help. One individual with BPD commented that not knowing what was wrong was difﬁcult, and from that perspective, the diagnosis was a relief. Sadly, that is pretty much where the positive comments ended.
In what way has the diagnosis been hurtful?
Using the word borderline in the name is itself stigmatizing. One individual commented that the name implies not knowing how to categorize someone to make them ﬁt societal norms, so they are on the borderline— but on the borderline of what?
Another frustration is lack of understanding in the general community. One individual diagnosed with BPD was asked by a prospective landlord if she becomes violent. This individual feels it may actually be better to lie and make up a different disability when asked why she is on a ﬁxed income. So, not only are her options to ﬁnd housing extremely limited, but she now feels she has to lie in order to be accepted. This kind of stigma is often reinforced by the media, which portrays people with mental illness as violent or who are to be feared. While there is a little less stigma and discrimination around some disorders that have received more media attention in terms of education, public awareness of BPD is still in its infancy.
The lack of resources available for people with BPD is also hurtful. As previously mentioned, it can be a relief to get a diagnosis so that help can be sought. So often, however, there is not enough help. Even within the mental health system, resources focus on what are categorized as ‘Axis I disorders’ in the DSM-IV, which include schizophrenia, bipolar disorder, depression and anxiety. Although many individuals with BPD may also have, for example, depression or an anxiety disorder, treatment for the personality component is often minimal.
As someone living with BPD, what would you most like people to understand?
The societal fear around BPD and mental illness in general needs to be addressed. It can be very isolating living with BPD because of misconceptions, a lack of professional support, and because, by virtue of having BPD, relationships are challenging.
Living with BPD is a struggle that doesn’t need to be compounded by stigmatization and discrimination. People’s misunderstanding and false perceptions lead to more hurt and de-humanization. As one person said, “Please don’t treat us like you don’t know what to do with us.”
As a family member, what would you most like to share
Family members indicated that educating themselves about the disorder was very important. As well, getting a good support system in place can make a tremendous difference. Find a support group, or start one if necessary.
What is needed?
As previously mentioned, support for BPD seems limited. Additional research into BPD is necessary, and more therapists must be trained to meet all the needs presented by individuals diagnosed with this disorder. Outside of the professional realm, educating the general community is crucial. Stigma and discrimination will not lessen if people continue to have no information, are misinformed, or buy into fearful myths.
About the Author
Carmen is Administrator of the Borderline Personality Disorder Association in Kelowna and a consultant for non-profit organizations. She can be reached at (250) 470-9586 or [email protected] The association would like to thank the individuals who have provided feedback and shared of themselves so freely as background for this article
For more information about BPD, please contact the Borderline Personality Disorder Association, 504 Sutherland Avenue, Kelowna BC V1Y 5X1, Phone: (250) 717-3562, or e-mail us at [email protected]
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author