So I don't have BPD...

Hmm, I just got out of a hospital stay which was both informative and different.

My previous psychologist who diagnosed me with BPD never put it down on my Axis II, as if she were unsure of the diagnosis. No less, I did make some changes with myself being "BPD" in mind, so I guess it was not for naught.

I took a psych test and answered as truthfully as possible; however, I was in a hypomanic state(which I still am--but its coming down drastically)--which probably caused some bias.

No less, I'm more likely a schizoid. I really cannot relate to others need for attachment here. I thought promiscuity = borderline, but I used frivolous sex to ensure that no emotional bond was made.

Have any of you questioned your BPD diagnosis? For those that have BPD, do you feel as though this is a waste-basket Dx? Do you feel that this is getting better or worse with studies?

Me neither, but I still got the diagnosis back in 1994 at the age of 16.

I'm 36 and still haven't had sexual relations and somehow I still got diagnosed with BPD. I'm not avoiding intimate relationships nor do I have a history of abuse. Sexual relationships have never really interested me. Anyway I don't want to marry and have children. This is my choice and there is absolutely nothing wrong with it. I have a problem with clinicians who think this is a problem. What gives them the right to tell me how to live?

I definitely questioned it. This is my nature. I don't agree with the diagnosis and would love to get it removed from my medical records, because it has prevented me from getting appropriate care when I really needed it. For example I went to emergency for psychotic symptoms that were actually a part of an emerging psychotic disorder that fully manifested itself about 4 months after that visit. The psychiatrist dismissed me and told me it was due to BPD. After that incident I vowed never to return to the Emergency Department. I'll never reach out to psychiatry again.

I was told I don't have the disorder but that doesn't matter because it is in my records.

I have read a lot about BPD. Almost all the literature I have read was research papers, psychiatric textbooks and books written for clinicians. From this I have concluded I was diagnosed based on my interactions with psychiatry and on three BPD traits; anger, suicidal ideation and self harm (I learned this while in hospital). I did not meet the other criteria, but that did not matter because the psychiatrist was irresponsible and too lazy to do a thorough assessment that included a developmental history.

My history isn't filled with abuse etc. I actually come from a stable family who cares about me. The tough years I had during adolescence was due to not knowing I had autism spectrum disorder, severe bullying and a negative reaction to SSRI. My BPD symptoms emerged while in hospital and receded when I discontinued the SSRI. I consider my BPD diagnosis to be due to iatrogenic harm, because I learned all the BPD behaviors from the hospital.

After my awful experience I discovered I had autism spectrum disorder which made so much sense to me when the doctor described it. Suddenly my life experiences such as my weird obsessions, literal mindedness, and my difficulties understanding how to socialize and read nonverbal communication had an explanation that BPD could not explain at all. My developmental history supports it. What child with BPD repeatedly spins their toys? Back in the 1990s the doctors tried to explain my other symptoms such as muted affect with PTSD. They even went so far to try to tell me I was sexually abused so that I could fit the BPD diagnosis.

In the 1990s clinicians would ask me if I was ever diagnosed with autism. They saw it but never bothered to investigate it. I suffered dearly because of this. Now I refuse to shut up.

If you are a female, who has some anger and has done some cutting a BPD diagnosis is pretty much guaranteed. Here in Canada a lot of psychiatrists use it to prevent access to services.

All my reading confirmed my beliefs. I knew I was right, but since I am a layperson the professionals won't listen.

IDoNotExist,

I suggest that the current conception of BPD as a medical diagnosis is fundamentally flawed. Borderline conditions are real, when they are considered as a cluster of complex emotional and relational problems that exist on a continuum or spectrum of severity. However, it does not make sense to create a medical "diagnosis" for borderline conditions based on 9 specific symptoms that must be assessed based on the subjective judgment of an outside observer (the psychiatrist). This is not meant to invalidate anyone - instead, it is saying that we have not developed accurate ways to measure exactly at what point someone has a strong enough version of a certain observable trait to "cross the border" and receive a BPD diagnosis, or not.

There are many professional therapists who support this viewpoints. If you Amazon the books of Thomas Szasz, Peter Breggin, Robert Whitaker, Paula Caplan, Stuart Kirk, and Allen Frances you can get an idea of some of the counter-DSM viewpoints out there. Allen Frances was former chairperson of the DSM task force, and has now turned against his former colleagues to critique the diagnoses based on the DSM.

In that way I agree with you that BPD is somewhat of a wastebasket diagnosis, although paradoxically it can still be useful to think in terms of it sometimes. Rather than the DSM model, IMO the more useful model is a psychodynamic one, which "diagnoses" it based on the degree of splitting and associated defenses a person has. If they have a predominance of all-bad splitting (i.e. their negative images of themselves and others are stronger than their split-off positive images, or memories, of themselves and others) then they can be considered as borderline. Although this approach could also be criticized as being subjective and non-scientific (and those criticisms would be correct), for me it is more useful because it looks underneath the constantly shifting symptoms that are part of BPD to identify the "engine" of the primitive defenses, and the historical lack of positive relational experience, that are driving it.

I recently read in a John Gunderson article that 80% of people diagnosed with BPD are on three psychiatric medications or more, and that for many of those, medication is all they are getting on a regular basis. This was a stunning fact that really hit home how poorly we are managing borderline conditions in the United States. It is truly a tragedy that many millions of people are not getting the intensive social support and/or therapy they truly need to recover from borderline conditions. However, it is not surprising, given that many psychiatrists have realized that they can make more money by prescribing pills that control symptoms (and seeing patients occasionally for brief periods mainly to manage meds) rather than working intensively with patients in long-term therapy (which makes them less money per patient). Psychiatrists and drug companies therefore profit, even when it gives borderline patients less of a chance to recover.

Most borderlines who have recovered to become non-borderline have done so through some combination of intensive long-term psychotherapy, long-term group therapy, and strong community and family/friend support. Medications can help with symptoms but do not cure. However, borderline conditions can be "cured" through interpersonal support, even though cured is not really the right word. Developing a healthy personality, recovering meaningfully and deeply, or becoming mostly symptom-free would be better terms.

I feel that the situation with BPD as a diagnosis is getting worse. This is especially true because university lab researchers, many of whom have never even worked with real-life borderlines, are now using the faulty DSM conception of BPD as a diagnosis to try to identify the genetic basis of BPD. In this, they are fundamentally mistaken, since it is not possible to determine what percentage of BPD is genetic for several reasons. One reason is that BPD as a medical diagnosis is faulty and cannot be reliably assessed, thus skewing results. Another reason is that twin studies are currently under siege and have had many of their basic assumptions challenged by the emerging field of epigenetics, as well as by common sense criticism. Jay Joseph and Evan Charney write well about this.

I realize that my view is incompatible with mainstream psychiatry and might be unsettling to some. However, I would urge people to consider the degree to which psychiatrists, hospitals, and drug companies profit from medicalizing BPD, given the amount of money it allows them to make from prescribing pills and short-term treatments rather than providing long-term therapy and support. Providing long-term intensive therapy is unfortunately not as lucrative, and it requires that people with BPD be viewed as unique individuals with a history contributing to their current condition, something that takes much more effort than prescribing a pill.

If we are not satisfied with the current system of understanding and treating BPD, and find we are not recovering as fast as we would want, then perhaps there is something wrong with how the current system understands and treats BPD. That does not mean we are not responsible for getting better, or that recovery should be done for us. Rather, it means that understanding BPD and recovering from it are complex challenges and that the way society deals with the condition is important. I hope that idea is useful to some on here. Thank you for listening to my rant

What's Axis 2?

I've questioned my diagnosis. Sometimes I agree with it, sometimes I don't. I don't know if it's officially in my medical records though, and I'm not sure I want it to be.

Thank you for your commentary; I read each one.

Axis 2 = Personality Disorder section of DSM.

Regarding Borderline: What is particularly unnerving about borderline is that the DSM has an implicit ambiguity of which virtually any symptoms can be, almost without any bend of DSM pedagogy, attributed to nearly any other personality disorder.

In order to make this more clear, these are my issues:
-identity disturbance--this is by far my most obvious trait, which fits right in BPD. However, in the DSM, it does not go far enough to be disambiguated. Schizoids, contrary to the rigid DSM classification, often adopt palpable social personae in order to coax others into some utilitarian task or to smoothen interaction in general.

The cause is not really investigated as per DSM. What makes the difference is that I am normally aware of which mask I am donning and why. Once in solitude, my identity feels more stable.

I recall coming home from high school one day and even pretending to "hang my persona" up with my jacket. It was to appear less weird, as I've always felt detached and drained by continuous socializing.

Frequent Suicidal Ideation:
This could literally any disorder. Any. OCD. PTSD. Hell, it could even be NPD with a persecutory-laden narcissistic hunger. In my case, I have a mood disorder that predisposes me to such. Also, the medication I was on was causing more harm than good.

Splitting:
Defining splitting is almost paradoxical, insofar as, in defining it, it itself becomes black and white.

What really defines idealization and denunciation? You could easily go into okcupid.com and find ramdom people believing their 98% compatability rating ensures some long-term relationship. Likewise, you can find people splitting based on race, gender, and political orientation. In fact, we might as well call extreme left and right wing people borderlines in this regard.

What is scary about this is that the diagnosis is both maligned and easy to confer. I was surprised when a nurse at a recent hospital used the idea that I did not demand care and attention immediately as a reason for me not being borderline--something most laypeople would attribute to NPD.

Even if you are borderline, It'd probably be best to get treatment and a diagnosis of PTSD or so as its less maligning and often involves similar treatment. I am going to call my previous hospital in attempts to remove it as it is the black sheep of all psychology while never being able to be delineated.

Also, I am not even sure if my schizoid dx is "bad". I like being a loner. I'd certainly not want that to be completely removed. The descriptive videos online are almost laughable "These people don't like walks on the beach or anything romantic; they like technology".

Nearly every technologically oriented person I know is into nature in solitude, as they view it as an extension of the mechanics of the Universe.

I'm having a lot of doubts on the veracity of the DSM. For example, a recent PhD diagnosed Jodi Arias with BPD--just BPD, ignoring her total and complete lack of remorse throughout even the most haunting re-enactments and shaming by the victim's tearful and angry family.

Perhaps when more fMRI studies show more correlations and separations, it will be more viable, but it seems that "I am confused as to this patient's diagnosis, but it is bad" is being chunked into the closest Axis 2 available. My emotional flatness during sessions, long psychological distance, and fear of intimacy should have, in my opinion, caused a second look. But it is possible that she gave me the Dx to "work on myself" as it was never written down explicitly.

This hits home soooo well. I really agree. As I've said before I'm trying to get an official BPD diagnosis, because I think then a lot of my issues would be better understood. But I've been told many times that I can't be BPD because I'm not manipulative or really impulsive. Trying to fit 9 (very specific criteria) is a hard way to diagnose something. So I'm only 'cluster b' lol.

A lot of my problems are internal... identity issues, feeling disconnected from others, boredom, self harm, etc. Borderline is a hard diagnosis to make, and I wish the diagnostic criteria were more on a spectrum, etc.