The progressive world that we know today is characterized by constant new scientific discoveries, such as cures to long standing diseases and discovering the intricacies of the human genome, as well as an ongoing cultural revolution: everyone must be treated with fairness, and be viewed in the same way, no matter a person’s race, ethnicity, gender, or sexual orientation, disability… and the list goes on. Inclusion is now being taken a step further, especially when compared with viewpoints from as few as maybe 15 years ago: people are now fighting to remove the stigma from mental illness. Which is great. No one chooses to have an extra, often debilitating, battle assigned to them on top of what life already throws at everyone. Even a very common mental illness that seems as “simple” to outsiders as generalized anxiety disorder can control a person’s life: the constant panic, the physiological fight-or-flight responses constantly being activated by threats that no one else can see, the looming fear of something terrible happening beyond your control, the inability to perform simple tasks due to a feeling telling you not! to! do! it! for no real reason other than a far-fetched idea of something that could happen given very specific circumstances, and running and running and running through your head the same few outcomes, the worst possible outcomes, to those situations. And these are just a few of the things that people with one of the most common, but typically less severe, mental illnesses have to deal with on a daily basis. I know. I’ve been there. Along with so many others, unfortunately; but, on the bright side, people and providers in Western societies today are a lot more open and comforting to people with mental illness. They are no longer seen as inferior, unable people, but as functioning members of society. Furthermore, they are no longer resented by healthcare providers for being “untreatable” or “crazy”, and are often offered sympathy and comfort. Unfortunately, it is not the same story for people with personality disorders, with one of the most studied being borderline personality disorder (BPD). I hadn’t heard of this until recently. During one of my recent depressive periods, I was watching videos on the Internet, and stumbled upon a video contrasting bipolar disorder with BPD, which intrigued me because the brain is so intriguing to me. According to a well-known book about BPD, called I Hate You Don’t Leave Me by Jerold J. Kreisman, M.D., symptoms of BPD can include frantically trying to avoid abandonment, unstable relationships, lack of sense of identity, impulsivity, suicidal thoughts/behaviors, mood swings, feelings of emptiness, inappropriate displays of anger, and stress-related paranoia. Some of the symptoms looked familiar to me. The next time I visited my psychiatrist, I was explaining to him how things had been going for me and how I’d been feeling, after which he asked me if I’d heard of BPD. I was shocked to receive that diagnosis, followed by my doctor telling me that he was not going to add it to my chart to avoid having a stigma placed upon me by other medical professionals, who may think of me as a harsh stereotype: that I, myself, am crazy… and untreatable. It hurt me to learn that people in my same situation could be facing some kind of discrimination for being themselves and dealing with something they can’t control (as BPD has been correlated with observable brain atrophy), as I am myself living with something I can’t control. It does seem that a lack of knowledge about the condition is a cause of some of the stigma. According the article “The Stigma of Personality Disorders” by Lindsay Sheehan, Katherine Nieweglowski, and Patrick Corrigan, a BPD diagnosis “can cause exclusion from treatment when mental health professionals refer out upon diagnosis…57% of people with BPD in an Australian study reported that providers shunned them, compared with only 29% of people with other mental diagnoses.” I have a hard time understanding how providers could turn away those who clearly need help the most. Events like this, as well as the stigma in society, leads to a vicious cycle for those with BPD, as the article goes on to explain: “Self-stigma is an established problem for people with BPD; they may feel shame about their diagnosis and stay away from treatment to avoid self-labeling as sick, weak, or incapable of handling problems independently. Indeed, people with BPD have more ‘existential shame’ than those with other diagnoses (e.g., anxiety, depression, ADHD)”. A lot of these feelings in people with BPD are caused by the condition itself; however, it definitely doesn’t make it any easier for us to cope with when there is a constant fear of being judged, resented, or feared. Overall, I appreciate very much all of the efforts to remove the stigma from mental illness. It has definitely made life a better place for me now than it would have been years ago, as I struggle with multiple mental illnesses as well as BPD. But, I really would like to heavily acknowledge how far we have yet to go. So, I’d just like to ask anyone who has read this to please think about it… Those with BPD are real people. You probably know one of us. We’re more common than you think, but we’ve been warned not to talk about what we go through, so we hide. We lead “normal” lives that you wouldn’t be able to tell apart from that of an average person. But we need you. We need to be heard. So after all, I’m just hoping: would you join me in the effort to remove the stigma from personality disorders?
Sheehan L, Nieweglowski K, Corrigan P. The Stigma of Personality Disorders. Current Psychiatry Reports. 2016;18(1). doi:10.1007/s11920-015-0654-1