[Christine001]

Hi, I think I have BPD, thought 45 and never been diagnose, was sort of diagnosed with bi polar 17 years ago, well I was on antipsychotics, ads and litium to help my mood swings and anger. NOt sure BPD was so well known then.

I have recently had hospilisation for depression, now and about to start some assessment by pdoc and community team.

what is likely to happen, how do they diagnose and how long, ie how many visist could it take.

reason I am asking is that I am struggling on my own with all the realisation that my past behaviour was dysfuctional and hurt other people, my family, my relationship and my friends or friends I have upset and dont see anymore. Its too much.

should i tell them what I suspect I have or let them work it out via the assessment? what if I am wrong and they say its just depression? where do I go then. How do I cope with therapy in a group setting, which has already been suggested, i would be terrified people would hate me after a while.

[Rapunzel]

A mental health assessment can be as short as an hour - several hours if formal testing is done. Therapists can go through a list of symptoms and come up with a working diagnosis in about that much time - first or second visit. Sometimes personality disorders are not evident at first and could take months or years before they are recognized, especially if the therapist is not specifically looking for personality disorders. Quite often they aren't, since primary complaints are more likely to be depression or anxiety or something with more obvious and immediate effects, and because insurance usually doesn't cover personality disorders. Also, a lot of therapists are reluctant to diagnose personality disorders because they can be negative labels with a lot of stigma.

Definitely, you should tell them about your concerns and realizations. It is your treatment, and your responsibility to choose what you feel is most important for you to work on. The therapist is there to guide you. You could choose to work on understanding your behavior patterns, changing any that still continue to harm you or people you care about, repairing relationships and finding new relationships - also accepting yourself as you are now and making sense of your life.

They may or may not agree with you about having BPD. If they disagree, it doesn't necessarily mean that you are wrong - mental health diagnosis is still pretty subjective. They can still be very helpful with your concerns. Longstanding or recurrent depression comes from somewhere - your past experiences, genetic predispositions, social environment, how you think about yourself and your life, biochemical stuff, etc. That is true regardless of what diagnosis they assign to you, and those are the kinds of things that will be addressed in treatment. Getting a diagnosis is only a start towards deciding what kind of treatment is most likely to help you.

The idea of group therapy is scary if you have had problems in social situations and with relationships, but actually is a really good way to address those problems. The other people in the group would be people who have similar problems and fears. In a group, with support and guidance, you get the chance to experiment with new ways to relate to other people, and learn what works better for you than what you have always done. You might not like everyone in the group, but you probably will like most of them and they will like you too. If conflicts happen, that's what the group is there for - to learn to work through them so that you can also work through similar stuff with the people in your life.

[Perna]

Definitely tell your therapists and helping team all you can about your background history and suspicions now.

Dx's can take awhile and/or change over time as more experience (with meds and therapy) shows different aspects than were seen before, etc. It can need "tuning" :-) It's not a static thing and is useless/meaningless without your participation since they're working on what will help you feel better.

If they feel it is "just" depression, work with that awhile, I've done lots of groups, try not to worry about what the others think of you but on yourself and getting better!