YOU ARE NOT ALONE - A companion online community discussion board for The Mental Illness Happy Hour podcast with Paul Gilmartin

I'm curious what other people might have heard or experienced about rendering a diagnosis of BPD. There seems to be a school of thought that when a person has BPD, the therapist and family should not tell them. I've not gotten a solid answer why though or even if this is, in our modern times, still considered the most helpful strategy.

Some say it's to prevent stigma associated with the disorder, but I question this. 9/10 people I talk to who don't have formal psych training or know someone personally have never heard of it. "Borderline?" they ask, "You mean like they they're not sure if they have a disorder or not?" Someone else said it's completely untreatable so there's no point. I question that as well given the advances in treatment for personality disorders. I noticed a surprising number of people I know who exhibit blatantly obviously BPD symptoms yet have the diagnosis of Bipolar Disorder, which they don't seem to have symptoms of. I wonder if that is due to widespread flaws in diagnosis (most often done by GPs, not psychiatrists) or it's due to this strategy of not telling them yet still getting them to take meds that might control the BPD.

Selkie-
That's a good question. I have always wondered why my mom hasn't been diagnosed as BPD or at least Borderline Personality Traits. She has had the diagnosis of Bipolar2 for a long time, and I still don't see a consistency in her mood 'swings'. Her mood and behaviors aren't easily treated with medication either. What I think is amusing is that when I told her I had been diagnosed as Borderline and how I feel SHE is also Borderline- she basically reacted (in what I feel) is a 'Borderline way' "Oh! And you don't think YOU are?!" Umm... no need to get defensive mom; that's not what I was saying at all.

So as far as your question, I'm curious as well. Sometime it seems like BPD can be a 'catch-all'. Other times it seems under-diagnosed. The therapist I was seeing for 2 yrs hadn't diagnosed me with it, but did say I had a lot of the traits/behaviors in my history (only after I told her I was diagnosed in the hospital). She said she hadn't given it much thought because I was compliant in her office, not manipulative, and not difficult to deal with like her other BPD clients.

I think the fact that it's difficult to treat and does have a stigma attached to it probably adds to it. It'd be interesting to hear what a professional has to say

Jamous thanks for your reply and you hit on a facet of this I overlooked. It seems like a lot of people I know that have the diagnosis received it in a hospital, not an outpatient setting like talk therapy or with their GP. Maybe with in-patient they simply have to, like it's policy or required to take the needed actions under the acute circumstances. Whereas in therapy sessions it's not necessary because it's a gradual, non-urgent matter.

btw two of the people I know who have BPD are also mother and daughter, and that mom reacted almost the exact same way when the daughter tried to talk to her!

*raising hand*

My psychoanalyst of many years elected not to tell me until I was terminating therapy. She whipped it out during our last, very acrimonious session. Nice. But she was right, although it took me quite a few years and several total meltdowns to accept it and look for help. My new therapist (not an analyst) agrees that I am "borderliney" but she doesn't focus much on the diagnosis -- she focuses instead on alleviating symptoms and changing the faulty thinking and behavior associated with them. I find this refreshing because it makes my problems seem manageable (because I'm not a walking diagnosis from her perspective) and gives me hope that by addressing the hallmarks of BPD I can transcend that diagnosis eventually. IOW, I'm not doomed just because someone said I have BPD.

I think it's helpful to not think of yourself as "being borderline" but instead thinking of yourself as working to overcome the symptoms of borderline personality disorder. It's a subtle but important distinction to me.