Borderline Personality Disorder (BPD), also known as Emotionally Unstable Personality Disorder (EUPD) is arguably one of the most misunderstood mental health diagnoses. The myths surrounding BPD are not just annoying for those who experience it, but can also be harmful.
Here are just five of the most prevalent myths surrounding BPD and those of us who live with the diagnosis.
1. We are manipulative attention-seekers.
Many people suggest that those with BPD are constantly seeking attention, and will often be manipulative in order to get it. This in itself isn’t entirely wrong, but it is framed entirely incorrectly.
Those of us with BPD are intensely afraid of abandonment and/or rejection, and we will often persistently ask for reassurance or validation (which may be seen as “attention”) in order to calm ourselves and ascertain that those we love are not imminently going to leave us. In some cases, this can display itself in ways that are deemed “manipulative”, but we are not making the active decision to manipulate you. We are acting out of fear, and responding in the only way we know how.
We don’t have evil intentions in mind. We aren’t trying to hurt you. We just need reassurance.
2. BPD isn’t a valid mental illness.
Often BPD is dismissed and its sufferers are seen as simply behaving inappropriately, rather than having a “legitimate” mental illness. Whilst there is still research being done to further investigate BPD, it is a valid diagnosis, recognised in the Diagnostic and Statistical Manual of Mental Disorders (DSM) used by mental health professionals. However, there are still cases of some mental health professionals refusing to acknowledge BPD as a valid diagnosis, and this can lead to some of us not receiving the treatment or support we need.
3. It is impossible to have a relationship/friendship with us.
Many of us with BPD struggle to maintain relationships with family, friends, and partners, again due to fear of perceived abandonment or rejection, and also due to marked emotional instability (rapid mood cycling, intense and overwhelming emotions, etc). However, there are many reasons why this doesn’t necessarily mean a relationship with us would be impossible.
Having BPD can display itself in ways which are generally not conducive to a stable relationship, however, those of us with BPD also have a significant capacity for love, empathy, passion, support, and kindness. We often instinctively put others’ needs before our own, sometimes to our own significant detriment. We have a lot to contribute to a relationship, and whilst leaving BPD untreated can cause relationships to become damaged, we have an amazing foundation of love and compassion on which to build a relationship, and with effective treatment, these relationships can be successful and fulfilling.
Learning to effectively manage our emotions and relationships is a large part of the treatment we receive, whether it comes in the form of Dialectical Behaviour Therapy, Cognitive Behaviour Therapy, or Psychotherapy, to name just a few options. Our skills improve, we learn more effective coping strategies, and this, on top of our core ability to love and be loved, makes for an amazing relationship, be it romantic or platonic.
4. BPD only affects women.
The assumption that BPD only affects women is both incorrect and potentially harmful. Whilst the statistics tend to show that BPD occurs more commonly in women, it is still very much an issue for men too, and it is worth bearing in mind that these statistics only represent those who have been officially diagnosed. This may speak more to the fact that men are less likely to seek help with mental health issues, particularly when the issue with which they are struggling is seen as a predominantly “female” diagnosis so we may not know the true extent of the number of men experiencing BPD.
5. Everyone who has BPD experiences the same thing.
This is a significant myth because it is not only wildly false, it can also mean that we are pushed towards treatment methods that are entirely ineffective and do not address the issues we face.
In order to receive a diagnosis of BPD, you would need to meet 5 out of the 9 criteria below (taken from the NHS website):
- Do you have an intense fear of being left alone, which causes you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody (but not including self-harming or suicidal behaviour)?
- Do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they’re wonderful to hating that person and thinking they’re terrible?
- Do you ever feel you don’t have a strong sense of your own self and are unclear about your self-image?
- Do you engage in impulsive activities in two areas that are potentially damaging, such as unsafe sex, drug abuse or reckless spending (but not including self-harming or suicidal behaviour)?
- Have you made repeated suicide threats or attempts in your past and engaged in self-harming?
- Do you have severe mood swings, such as feeling intensely depressed, anxious or irritable, which last from a few hours to a few days?
- Do you have long-term feelings of emptiness and loneliness?
- Do you have sudden and intense feelings of anger and aggression, and often find it difficult to control your anger?
- When you find yourself in stressful situations, do you have feelings of paranoia, or do you feel like you’re disconnected from the world or from your own body, thoughts and behaviour?
As you can see, there are multiple combinations of five criteria one could meet, and some people meet more and up to all of them. Consequently, if you stood in a room full of people with BPD, it is unlikely that you would meet two individuals who meet exactly the same criteria as each other, and even if they did, it is almost impossible that they would experience those criteria in exactly the same way.
For example, even if you were to meet two people who both experienced identical criteria, including “impulsive activities” as one of them, one individual may experience this in the form of drug abuse, whereas the other individual may experience it in the form of reckless spending. These two forms of impulsivity carry with them their own risks and consequences. Therefore, even within the criteria itself, there are several variations.
Those of us with BPD may find we have certain similarities, but we are by no means experiencing the same things in the same way. As such, it is crucial that treatment and support are flexible and adaptable to each person’s needs, so we don’t a) waste time and resources on ineffective treatment methods, and b) run the risk of someone slipping through the net and being failed by the medical system.
So those are just five of the most common myths about BPD! What other myths or misconceptions have you heard? Has a BPD myth impacted your access to support? Let me know about your experiences in the comments below.