BPD Bpd: ptsd for women

[ExitLight]

I was diagnosed with BPD when I was 16. Usually people are diagnosed in their early 20's. I was diagnosed by a really old, wrinkly white guy. I didn't even hear the diagnosis myself until I was 18, after a suicide attempt and my mom felt it was then necessary for me to hear it. When I heard her say it, I shouted "THANK f*ckING GOD. I knew it!" from the hospital bed. I had been googling it recently, and it seemed most applicable to me. Well, recently I've wondered why are so many of those symptoms applicable to not only me, but just women in general?
Given that I regularly use CBT, DBT, and try to cope with the BPD, I still feel like there's little to no progress with the panic and anxiety attacks that I have regularly.
It is my personal belief that BPD is simply put, an cheap diagnosis. It is the only diagnosis so far, that lists Self Harm as a symptom, and even furthermore, it is incredible hard to treat.
It is way more heavily diagnosed in women than men. And I feel like that's because so many of the symptoms are just as cheap as listing self harm like it's a symptom of an illness rather than an unhealthy way one chooses to cope with a pre-existing illness that isn't being addressed properly.

1. Frantic efforts to avoid real or imagined abandonment - is phrased to be able to be left to interpretation of the doctor, and we all know that not all therapists are "bad," but if that is true, then not all can be "good" either. Therapists can still be sexist. More often than not, I find that women are painted as needy people who don't like to be abandoned.
2. Patterns of rocky relationships - is phrased to be able to be left to interpretation of the doctor.
Impulsive behaviors is phrased to be able to be left to interpretation of the doctor, and the examples listed specifically target mostly women. 3/5 are heavily associated with other stigmatic illnesses, or just women in general, and are more likely to be interpreted as such.
3. Self harm/Suicidal behaviors - is listed as a symptom when it is most definitely found as a coping mechanism or last resort due to other illness like depression, PTSD, etc.
4. Intense highly changing moods or behaviors - have you ever heard of PMS? And do you take it seriously? Because it is serious. If PMS is not taken seriously, it is more likely to be an assumed symptom of a different illness, such as BPD.
5. Chronic feelings of emptiness - Symptom, phrased like a symptom.
6. Inappropriate intense anger - Using the word inappropriate automatically sways the potential for this to be diagnosed in women more often. Usually when I get mad, it's not appropriate. Like any other woman could probably verify, our legitimate problems are constantly gaslit and ignored. When we try to be heard about our problems, most definitely sometimes it will start yelling. This one in particular is cheap to me because not everyone internalizes their anger. Compare and contrast the difference between Fight or Flight (and I even believe there's an in between when you have Fright and can do nothing). Everyone reacts to fear differently. Everyone processes their anger differently. To me, it's not beneficial to list how someone may deal with their anger as a symptom.
7. Stress related paranoid thoughts - Again, can be pointed towards women specifically. If a woman believes that she has been wronged, or unheard etc, it's up to whoever else isn't her to believe her. When women are constantly belittled, disbelieved, and gaslit for actual problems, one can easily shrug off their complaints, problems, or issues as ... paranoid thoughts.
8. Having severe dissociation - Symptom, phrased like a symptom.
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Understandably, this is all theoretical to me, and these are my beliefs. Whether or not you believe some of it, all of it, or none of it, I still believe this way.
Given that in my mind, there are only two legitimate symptoms listed, I'd look next to why I deem this an illegitimate illness.

If these coping mechanisms are listed as symptoms, why is the person choosing these coping mechanisms? One may feel unheard, betrayed, or just simply does not have the support around them to look further into why someone may use cutting, or spending, sex, drugs, etc. to numb whatever they have inside them.
Current school systems fail so many kids. Current parenting styles fail so many kids. There is so much stress in the world that people growing up have to deal with, and there has been for a long time.

I think creating the term/illness BPD was a step in a direction not too far from the right one. We've acknowledged the fact that people can develop unhealthy and unsafe coping mechanisms. I feel like a lot of psychiatrists missed the point that these unhealthy and unsafe coping mechanisms are developed in traumatic childhoods.
I think BPD can be usually diagnosed as something else entirely. If it cannot be treated, and even stems from a place of victim blaming, then why is it an illness? Look further into why someone may cope the way they do. If it is diagnosed with another illness, is someone paying enough attention to the first illness? What about PTSD/CPTSD? What about anxiety disorders?

Hear me out, what if anxiety disorders are actually a serious thing, and when women are not taken seriously about theirs, doctors find it easier to label them as BPD? (Heheh, meant to be tongue and cheek.)

To create an analogy, if I wanted a therapist, I'd want them to share my interests. Just like if I were an apple tree, I'd want to receive advice from a more experienced apple tree on how to let myself grow. I would rather not seek advice from an orange tree.
It seems to me that more apples are getting paired with orange trees. Or orange trees with apples. When this type of discord, and lack of understanding happens in a patient-doctor relationship, I feel like BPD is more likely to be diagnosed.
If women can't find women therapists/psychiatrists that look at them as a human, person, and woman, I feel that they are more likely to be unheard about certain issues that well, certainly should be heard.
And I feel like I'm seeing the result of this lack of understanding written out in plain text when I see the label:
Borderline Personality Disorder.

 

[Llith]

I would most likely fit the BPD profile to a T, however I am uninterested with any label except for C-PTSD because I think that explains everything, without needing anything else.

I believe modern phycology at the moment is in what I would call 'second program syndrome'.

Typically when you build software you build the first program, that doesn't do a lot of things, is messy, and generally is a learning experience. That is what we have been doing since we first started realising mental illnesses were even a thing.

Then we started building the 'second program', we realised that a lot of people were getting left out, they had issues that no-one had a diagnosis for, so we started creating diagnosis's left right and centre, trying to explain everything. This is generally called 'over architecting'. It can create just as bigger mess as the first one!

Now the third one onwards is normally when people start getting it right, understanding more of the real issues and addressing them as they come along without going over the top. I think we are quite a long way from here though because our understanding of the brain is so little I think its a joke to even categorise things a lot of the time.

----- Summary -----
I think most diagnostic phycology is a mess, and you could easily have 5-10 disorders at once. Humans are large and complex machines, trying to generalise what a person is going through and putting it in a box normally results in bad treatment plans and a lack of understanding.


That was a ridiculous answer, I hope you appreciate for what it is, a gigantic metaphor ahahha. xD

 

[Cannottakethis]

Bpd and Cptsd have a lot of similarities. Bpd can come from childhood abuse or neglect. My diagnosis is Cptsd, generalized anxiety disorder, bipolar 2 and bpd. Definitely a complex machine :)

Obviously I have the Cptsd based on my life history. But that same history/behavior patternsfits bpd so much. Was hard for me to hear and accept but I have now because I don't want to feel the way I've felt most of my life.
And I've actually been able to identify thought patterns in my own brain that are definitely bpd that now that I "get it" I've been able to make changes.
I'm only speaking for myself and my personal experience.

 

[ExitLight]

----- Summary -----
I think most diagnostic phycology is a mess, and you could easily have 5-10 disorders at once. Humans are large and complex machines, trying to generalise what a person is going through and putting it in a box normally results in bad treatment plans and a lack of understanding.

Actually, this is perfect. This is just about the same kind of thoughts my Fiance has about mental illness. At some point, when someone labels something so many different ways and so intensely, the meaning of a label starts to get lost.
If someone labels something, then labels the labels within that label, and then the next... At some point everyone is categorized even down to something ridiculous like, the type of food they eat, why they eat it, and when they eat it. You know what I mean?
And then what are we even treating in the first place?

And @Shells, I've been feeling resistant to my diagnosis lately. I have a feeling I'm going to be making my own hard realization about my own behaviors real soon. Lately, I constantly feel like I'm trying so hard to think about the words I'm saying, and the way I'm phrasing them, all in an effort to basically, prove that I'm "not" BPD.
But in doing so, it's only really proved the other way around, heheh.

 

[Cannottakethis]

And @Shells, I've been feeling resistant to my diagnosis lately. I have a feeling I'm going to be making my own hard realization about my own behaviors real soon. Lately, I constantly feel like I'm trying so hard to think about the words I'm saying, and the way I'm phrasing them, all in an effort to basically, prove that I'm "not" BPD.
But in doing so, it's only really proved the other way around, heheh.

I actually did the same thing till recently. It took a very skilled, kind psychiatrist to explain it to me, and then to my husband for it to all come together. After 5 years or more. It takes time.

 

[joeylittle]

Really interesting post, @ExitLight - thanks for sharing your thinking. I had a few thoughts when I read it.

I was diagnosed with BPD when I was 16. Usually people are diagnosed in their early 20's.

You were diagnosed young - prevailing practice is to delay diagnosing any personality disorder until a person is over the age of 18, since many of the developmental phases that occur in the teen/early adult years can mimic the symptoms of a personality disorder. The likely reason for the majority of diagnoses occurring in the early 20s is simply that those are the years immediately following the late teens; but, people can be diagnosed into adulthood.

Now, this doesn't mean your diagnosis was wrong - but it also could mean your doctor jumped the gun.

If it cannot be treated, and even stems from a place of victim blaming, then why is it an illness?

Treated is not the same as cured. There is debate over whether many mental illnesses - including PTSD - are curable. There is no scientific way to objectively confirm the presence of many mental illnesses; and so, there is no objective measure to know when they have been fully eradicated and will not return ("cured").

Treatable - or, to borrow from some other illnesses, able to be put into remission (meaning the illness has become dormant/retreated to such a degree as to be rendered 'gone', for practical purposes) - is very possible. I don't think BPD has been considered untreatable since the early 2000s. If you are hearing that, it's a myth.

Most mental illnesses are treatable. Many mental illnesses can go into remission, meaning the individual has demonstrated a lack of symptoms for enough time to create some confidence that they have fully emerged from the diagnosis.

I think many people with mental illness would be most likely to describe their condition as 'manageable'. That they can live with it, have developed a personal regimen that keeps it firmly at bay, and they know how to recognize signs of recurrence and can get on top of those signs quickly, minimizing their impact. Most people I've encountered who would say they have their BPD under control would also say that it requires regular symptom management, and ongoing therapeutic support. But that's an awful lot better than living in the throes of the disorder, unchecked.

If these coping mechanisms are listed as symptoms, why is the person choosing these coping mechanisms?

Part of what makes a disorder a disorder is that the coping mechanisms are no longer temporary - they have become part of a pervasive pattern of behavior that is unchanged regardless of time, place, or circumstance.

In other words, it has stopped being a choice; it is now a reaction. This is (part of) why these disorders are so hard to treat - the individual has an incomplete understanding of what other reactions may be available to them, or even that other reactions exist. They often cannot see the entire scope of their behavior, because their reality is subjective. Treatment is some form of cognitive approach, because learning to perceive a more objective reality, and think thoughts/make choices that are informed by that reality....this is what any form of cognitive therapy does, and it's very very effective. It is also time-intensive, and has slow progress with frequent setbacks at first. There's also a high drop-out rate, as many people with BPD are in therapy because they've been forced there, not by choice.

Given that I regularly use CBT, DBT, and try to cope with the BPD, I still feel like there's little to no progress with the panic and Anxiety attacks that I have regularly.

First off, congratulations on sticking with CBT and DBT. That's awesome.

Do you think the anxiety is stemming from the BPD? It's very possible that it isn't, and that you have a comorbid anxiety disorder, or comorbid PTSD, or that you didn't have BPD in the first place - there are huge overlaps between the symptoms experienced by PTSD sufferers who had complex early trauma, and BPD.

I feel like a lot of psychiatrists missed the point that these unhealthy and unsafe coping mechanisms are developed in traumatic childhoods.

I actually disagree here. I think that once BPD has fully taken root, it will not be addressed only through trauma therapies. Also, while the 'why' is generally connected to the symptoms, the disorder has taken on a life of its own. And, because of the self-harm component, there is an immediate need to treat the more active aspects of the BPD symptomology, before trauma work can begin. All forms of PTSD treatment correctly emphasize that stabilization and symptom management skills for the here and now are needed, before getting into trauma processing - because, as we know, a lot of shit gets worse before it gets better once trauma is opened up.

I'm not saying all psychiatrists are geniuses; only that trauma work is best begun by stabilizing the client in their here-and-now; this will mean that disorders comorbid with PTSD will need to be stabilized, before the PTSD can be tackled. That stabilization can take varying lengths of time, and the comorbid disorder won't necessarily go away - but, if that comorbid disorder is BPD, it will be managed sufficiently so that the root of the disorder - the trauma - can then be worked on. The hope is then that both disorders move further into remission.

It's also super-important to remember with personality disorders - all the PD symptoms can be manifest by anyone, from time to time. Teenagers? Intensely so. People with PTSD? Absolutely. Complex developmental trauma? Hell, yes.

To meet the diagnostic requirement

of a personality disorder, these traits must be inflexible; i.e., they can be regularly observed without regard to time, place, or circumstance...Furthermore, these traits must cause functional impairment and/or subjective distress.

Dead Link Removed

You've got to be a very talented diagnostician to solidly diagnose a personality disorder in one session. Smart doctors may diagnose BPD initially, but rely on subsequent sessions to confirm the diagnosis. Or, the other way round.

OK, so that was more than a few thoughts :) It's interesting stuff.

 

[ExitLight]

@joeylittle, I love how you explain things, because a lot of what you described is very helpful to me.

Treated is not the same as cured. There is debate over whether many mental illnesses - including PTSD - are Curbale.

That's very helpful, because the way I've been interpreting this point of view through years of therapy... is that basically nothing is curable in the mental health spectrum. Curing has been taught to me as making some ailment go away forever, or for a long enough time that it's "caught" the next time, like a cold. When I talk about treating, I talk about medicine and other physically altering ways to help the brain and body function. To me, telling someone which way to think to treat a mental illness is problematic, and teetering the line of what "treating" means to me.
If someone doesn't like the fact that someone may use the word "but" too often, telling them to use "and" instead of it is literally removing vocabulary from your own dictionary in order to make other people feel better about the words someone is saying.
So in turn, therapists can dislike the fact that I may say "My mom and dad hate me!" as a child, but they have failed to dig further into why I feel that way. Instead, the focus is immediately pushed on "Well, phrase it like sometimes I feel like my mom and dad dislike me."
And to me, that invalidates the metaphorical "punch" the phrase should have. Hearing something like that come from a child should be jarring. Because a child, to me, should not feel hated by their parents. Because that's what I felt as a child. I would have rather had a debate than for them to tell me to phrase it "nicer" or prettier.

I think I feel that way because in my experience, therapists have let me down on that. Numerous times. I've struggled with a consistent sway of push pull, black and white, all or nothing. My parents constantly fought over minor issues. Mom was usually found cleaning something, always making plans to fill the time, and had her own anxiety disorders from her childhood. My dad was really relaxed to the point where it became problematic with his lack of responsibility and ambition. When I lashed out or threw a fit, they thought I was just unruly and needed to be fixed or calmed. I felt like they hated me because I didn't feel heard. My mom felt like I was the problem, and dad just agreed that I was the problem - even though I think he had a little more insight than he showed. If I were an outsider looking in I would not blame a child for thinking that way. Because growing up, my parents did look like polar opposites. It was so toxic, agreeing on little to nothing, fighting in such different extremes, religious vs non-religious, male and female, man and woman, good or bad, the whole package, Learning What Life Looks Like: Opposites Edition.
This becomes an issue when I am blamed regardless of the behaviors that I learned from example. I hit all of my milestones early and was extremely smart. I still am extremely smart. I feel like ultimately, being like a little information sponge, children who learn quick have the capacity to learn unhealthy things... and quickly.
Yet, I was still blamed for acting this way. I was still unheard. I was still "playing victim."

If I say "I feel like the victim of BPD," I anticipate being told that I'm "playing victim." I feel like people with BPD are more likely to be assumed of acting like a victim rather than actually being a victim. And I feel like that could easily get out of hand specifically with the way we already assume women* (*including people who are assumed to be women) are always* playing victim. Hence the notion that BPD is far more likely diagnosed in women, and from my belief, as a way to justify not feeling an urgency to treat the trauma rather than the behaviors that come after.
*(And when I say always in this sense, I mean to say it, because I hands down firmly believe that it's so close to always that the minimal margin of sometimes doesn't have enough weight to it to argue the other way around. That is something that I'll let slide for myself. A lot of people assume women are always playing victim.)

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And furthermore to address this whole concept I have brewing in my mind on the legitimacy of some of these mental illness labels... I feel like a lot of specifically women, are not taken seriously enough in psychiatry. I know I have a personal problem regarding my own childhood, being ignored, pushed too hard, and neglected, possibly more (who knows, heheh). And I'm aware of how stubborn I am sometimes on irrational, or personal subjects.
I feel like I may not necessarily have all the points to convince someone of my stance the legitimacy of this issue, but overall, I still believe that it's important to have an understanding that psychiatrists can be bad at their job, and/or jump the gun like joey said. It can also get in the way when those decisions, like jumping the gun, cause the doctors to ultimately not hear a crying child talk about their parents, or childhood, school life, and say they hate those things.
When a child doesn't feel heard about these things that can all be traumatic in many different ways, maybe BPD comes up more often as a way to put, in a sense, a bandaid over something overlooked that should have been addressed. If I were to define BPD as something else, it would be "The disorder you get after traumatic events are unresolved." And sure, I'll take the label BPD shorthand for that, yet the stigma still remains. Even though the bandaid is there, the wound is still underneath, unresolved.

If a person is self harming, or acting very dangerously, yes: Treat those immediate dangers first. I feel like the part that fails people comes after keeping them from dying, harming self or others, or a hospitalization.Therapists want to keep people alive, but what do they do with them after that?
Whether or not doctors, and even family should have given more effort to hear me or not, I feel like I wasn't. I know I can't change that, but it's still important to me to address that in the future, I'd like to see psychiatry as a practice put more effort and belief into children, and the reasons why they feel the way they do - and early on.

Spoiler: Analogy

We are not born blank slates, but we are born as a type of canvas. Each individual and unique from the other. Some people may be the type of canvas of where paint works really well, but graphite pencil may not do as well. Some people may be the type of canvas that graphite works super well on, and maybe not paint. Most are mixed media, others are a little bit more rigid, some are thin, some are large and textured, some are small and bold. There's a whole world mixed full of these canvases.
When I think about doctors and psychiatry, I feel like they are looking at messy canvases*(traumatized children). When the artist(parents) chooses the wrong tool for their canvas, the doctor tries to repair the canvas. I feel like more effort should be put into telling the parents(artists) to use the right tools for their canvas(children) and use them wisely and with moderation. In the meantime, teach the canvas how to embrace their messiness. Teach the child, or messy canvas, how to use what they are now to succeed.

*The messy canvas is only messy if whoever's looking at it thinks it's messy.

I don't think my doctor was talented. I think he was old, a little outdated on his views, and a bit rushed with another patient or two during that day I was evaluated. I think my personal diagnosis is accurate to a point. I stopped receiving treatment for mine though. I still use what I can, and what information I know, but as we all know, that can only get someone so far. And in the most broad view, I feel like I was let down after a childhood that ensured I'd be in therapy for the rest of my life (which was once scary, now I wish I had), and then transitioning into adulthood where really, not a lot of doctors are talented in the first place, and there's not a lot of them in my area. If you do get a doctor here, it's hard to build a doctor patient relationship that feels genuine, or like they have your best interests in mind. I feel like a lot of other people, and specifically women can relate to that statement.

I'm gonna be salty real quick. In a somewhat satirical tongue and cheek and slightly ironic way, maybe all of this can be shrugged off as ODD. Maybe I only feel that way because I have BPD. Maybe I'm just moody today because of my Mood Disorder NOS. Maybe I just think too much and can't concentrate. Maybe I didn't understand the initial problem. Maybe I just feel what I feel, there's truth to why I feel the way I feel, and I decided to make an argument about it. Because wouldn't that just be easy to tell me that my argument is based on flawed reasoning therefore invalid and doesn't need to be heard? :p
That's definitely pointed at my past therapists and doctors that weren't too great, heheh. Sometimes it just feels like there's a way to invalidate me no matter what and I know that's one of my weak spots. *shrug* I have a lot to discuss with a therapist. I just hope I'm next on the waiting list. :<

It is a lot of information, and I think mental health in general is a super intricate thing that has a lot of information and opportunities for discussions. If I were to go to school, I'd love to do something with philosophy/psychiatry. Probably the philosophy of psychiatry, haha.