My NP refuses to consider I might have BPD

Like it says on the tin.

My counselor is considering it, or seemed to be, but now I'm wondering if that's a dodge or fake-out, to keep me from being upset. IF they're just dismissing my strong certainty, research, and gut deep knowledge/feeling that all the things that aren't explained by my Bipolar and PTSD, are coverd by the BPD explanation. That I may not be a doctor, but when I can easily note that I have NINE OF NINE criteria the DSM-5 lists as being symptoms, and only FIVE are required for diagnosis, that I think it's safe to say I'm not malingering or a victim of half-assed Munchausen's Syndrome.

I don't follow my feelings often, but this one is too gut- and bone-deep to ignore. And it's backed up by RESEARCH. This hypothesis is based on things I've read and learned, recent though those readings and learnings are. The clinical stuff, such as DSM-5 criteria, is met. The articles I've read by both doctors and lay-folk has broadened and deepened that understanding. The anecdotal videos and blogs I've been following only cement all of that. I feel these people's pain. Not because I'm so empathetic--I'm really not. I've got a heart of freakin' stone, some days and find myself faking empathy just to a) get along and b) not hurt feelings by making other people's problems about my lack of fellow-feeling--but because I feel the same way. The only place I don't identify as much is the bingeing: I hate gambling, don't drive fast because I have severe driving phobias, don't usually overspend, since I'm broke. Though I do have a tendency to overeat. But I have a very addictive personality. Which is why I don't drink/use drugs recreationally very often. (And even then, only the so-called Gateway drugs. But not much in the past few years.)

So, I'm feeling very disregarded and discounted by my NP, who says I'm not manipulative and don't seem like I have BPD at all. I wanted to scream at her: "*****, you don't know me like that!" Because she doesn't. She sees what I show her: the pleasant, neutral facade. The charming, funny, quirky, upbeat scatter-brained idiot that I pretend to be to get along and not rock the boat. To draw people in on the rare occasion that I exert myself to make acquaintances. And that's what she is. A professional acquaintance. She doesn't really know me at all, even after several years. I'm not who she sees and even with me telling her that flat-out, she doesn't get it. Is tone-deaf to who I am. She's not seeing or hearing the real me, whether it's got BPD or not. And that pisses me off. I just got done having nightmares about it.

"You're just not manipulative."

Right. What've I been doing to her for the past four years? She thinks I'm a nice and kind and wonderful person. And I'm really, really not. The very definition of a successfully manipulative person is the one you can't tell is manipulating you! I'm not saying that in a slamming-myself way, but in an honest and direct knowledge-of-myself way. So please, don't anyone--out of kindness--reply telling me that I'm probably a very nice and awesome person. I'm not really any of those things, except as pretense, mask, cover, and occasionally by accident. I have no real center of self or hard lines. I am whatever I have to be to whomever I have to be it to. I'm all things to everyone except myself.

And now, paranoia has me certain that my counselor is just shining me on. Keeping me pliant and docile by agreeing that I could "possibly" have BPD. I dunno what to think anymore, other than that I'm being reverse-gaslighted: they're trying to make me think I'm saner than I am for their own reasons. And I don't like it.

But I don't know what to do. I do, however, and have for the past twenty years, taken to heart something I once heard: "If someone tells you who they are . . . believe them."

And it was regarding someone who'd admitted to being mentally unstable to a friend who didn't, out of kindness and loyalty, probably, accept that. That may be what my NP is doing, but it's not helping me. It is, in fact, hurting. I'm so angry I could spit and the small trust and faith I'd put in her ha completely shattered.

Sorry for the long-*** ramble, but thanks for listening. Any advice would be appreciated.

Hello Bugs-N-Hugs: Well... I don't know what to tell you about this. I can certainly relate to what you've written here. I've had similar experiences over the years. I've never actually been offered a real diagnosis (seemingly accurate or otherwise) by any of the mental health professionals I've seen over the years. And it has always seemed that it didn't much matter anyway. Because, in the end, all I would get offered were the same old antidepressants. As a result, I now only check in with my pdoc a couple of times a year, just to keep my foot in the door, so to speak. (I'm no longer on any kind of med's.) And I don't see a therapist. My personal feeling is that, in the end, we simply have to take care of ourselves as best we can. So that's what I do.

Be thankful you don't have this. You can get the same treatment that we get. You have nothing to lose. Stop complaining it is not a diagnosis anyone wants. Give it a break.

Hi there,

This is the first time I've seen someone actually WANT a BPD diagnosis...it's very stigmatized and some "professionals" will treat a person with that diagnosis differently than someone who doesn't have it.

That being said, if you did get an official diagnosis of BPD, what would change? As far as I'm aware, there are no medications specifically for BPD. What extra treatment options will this diagnosis offer?

Regarding BPD and manipulation, everyone is different. I have a BPD diagnosis and sometimes wonder if I even still fit the criteria (I have changed a lot in the past few years) and don't come close to filling all 9 criteria, and I'm not manipulative. For those who are manipulative, I don't necessarily think it's pre-meditated manipulation like someone with ASPD has.

What are the problems you're experiencing; what makes you think you have a borderline personality?

A diagnosis may be helpful. Mainly to find people like you. But it's not like most people, including clinicians, will suddenly understand everything about you. But they might think they do. That's not very helpful. A BPD diagnosis is at best a lot less helpful than a BP diagnosis.

Do you ever feel very strong emotions and you fear them, especially the pleasant ones, like (or i.e.) love (or empathy)? Do they (seemingly) control your thoughts and behaviour (at times)? Do you ever feel inadequate?

Do you have a strong sense of identity; do you (generally) know why you do the things you do?

If it helps to explain some aspects of your behaviour, being diagnosed with BPD could be desirable. I don't see a problem with that, necessarily. What strikes me as odd is that you want to be seen as manipulative.

Do you like to pretend? Do you ever feel like an impostor?

Do you ever feel shame? Do you ever do things out of desperation?

Please don't just say "yes" or "no" to any of these questions, but try to give examples.

Long before I was diagnosed with BPD, I randomly stumbled across BPD on the internet and its list of 9 criteria. I skimmed over it and none of it jumped out at me as being me. Later my mom's ex brought up BPD again, because she thought my mom had it. Once again I skimmed through the criteria, and while I recognized the behavior in my mom, I didn't recognize it in me.

I later saw a psychiatrist and was diagnosed with BPD. I told her that I didn't really know what BPD was other than having heard of it/seen it online a few times. She explained to me how my actual behavior fit in with the criteria instead of reading a list of symptoms. That just further proved to me that a list of symptoms on their own is no good because what is important is how those symptoms show up in your actual life, which is different for each person, even with the same disorder.

For instance, I didn't even know I had a severe fear of abandonment until my psychiatrist pointed it out to me. I was constantly having panic attacks over my then-boyfriend dying or not coming back home, and had never connected the two to my traumatic past involving abandonment. So reading "fear of abandonment" on a BPD criteria list isn't going to do any good because technically the criteria for BPD can show up in many people. How, why, and with what intensity/frequency the symptoms show up is the important part.

Oh, believe me: I know. I'm definitely not just going on the list of symptoms but how they affect me and at what intensity. Except for the gambling/bingeing one, they all affect me moderate to high. Five high, three moderate and the bingeing one . . . not as much. Though I do sometimes binge eat when depressed or nervous of stressed. But some of that has to do with GERD.

But yes, I'm not just going on textbooks, but on anecdotal evidence and how I feel. I didn't just check off symptoms, I felt each one like a punch to the gut, the recognition of myself and what I do/how I am was so STRONG. I immediately saw how each one of those symptoms had hit me and was effecting me. Some stronger than others, but still. And I spoke with my counselor about it, a couple days ago, and she said she wasn't just humoring me or putting me off--just my paranoia, I guess--but that though BPD could be tough to diagnose, she thought that from what I'd described to her about how I felt and some of the behaviors I never discussed with her/was too embarrassed to mention to her, I may very well have it. But that from a treatment end, the counseling I was receiving would remain the same. The DBT skills practice would intensify, but that as far as counseling went, we were on the right track. So I'm relieved about that. It's the meds that have me worried. I've been on wrong meds before and once nearly burned down my house with everyone in it, I got so low in my effed-up mania. So to avoid that, I'd like to know for sure what I've got, how bad, and what's good for it and me. I wouldn't just trust in a symptoms list to tell me that.

I just wish my NP would consider it. That maybe she doesn't know me as well as I know me, and see what happens if she adjusts my meds accordingly. Heavens know she already does at the drop of a hat. Sometimes to disastrous results.

I know why I do some things. I'm a writer, for instance. I write because it's everything to me. It's comfort, friend, fantasy, haven, escape, solace, obsession, and just plain fun. And I'm pretty good at it, so that helps with the enjoyment part.

As to everything else . . . well, there IS nothing else. I don't do anything but write and read. I barely hang out with the friends I used to have. Though yesterday I hung out with someone I hadn't seen in two years. It was fun, but very stressful and I was fighting look at my phone for the time.

Strong sense of identity? I don't know. I don't know what a strong sense of identity would feel like, to tell if I have one or not. I just know that if most people have a core of some sort, a baseline character, mine doesn't exist. Or it's so protean, it may as well not. I'm different people depending on who I'm around, and when I'm not around anyone, I'm NOT anyone. I either stare into space, sleep, or write.

Oh, goodness, NO. I don't WANT to be seen that way, I just try to be honest about who and how I am. I do whatever suits me. Damn the consequences to others. I will do whatever I need to to get what I want--which is usually, luckily for others, to be left alone. I wear a mask of happiness and twist people every which way to make them think I'm fine, even when I'm one remark away from screaming or crying, because happy people get left alone. No one asks: "Hey, why're you happy?" If you're sad or angry, everyone wants a piece of your misery. Which I find really creepy.

Writer. So, yes. I like to be my characters/other writers' characters. Even the jerky ones. It's better than being me. Pretending seems like a too-shallow description of the level of fantasizing I engage in, even on a good day.

Feel like? Am. I'm not even sure there IS a person under the masks. MAybe there could be, someday, but as of now . . . pretty sure there's just howling emptiness swirling with spite and despair.

Constantly. And guilt. But at least guilt is motivating. Shame is just crippling. So, of course I feel it more

Everything except breathe. THAT I do out of habit.

I don't know that I've given concrete ones. I've just blurted out feelings, really. I breathe out of habit, not because I enjoy being alive. I write mostly out of desperation. It's a point in all the pointlessness and if I stopped, I'd kill myself. There would literally be no more point to me. And yes, it came to that once. Nearly two years of writers block in my twenties. This year, I stared down the barrel of six months and that nearly did me in. I'm not as resilient as I was.

I feel intense shame for simple things, like typos and misspells. For appearing anything less than intelligent, logical, and unemotional. The opinions I express will sometimes fluctuate depending on whom I'm with. When I'm alone, I don't care enough about anything that isn't the Oxford comma to bother with opinions. For the most part. I'm always putting on a mask one of dozens or even hundred, to deal with people. But then I complain that no one ever sees me. And then, still, I have serious doubts there's a me to see.

As for manipulation . . . oh, so much of it. Even besides the masks I put on. I manipulate people into paying for things when I'm broke. Sometimes I'll start doing it without conscious thought, then realize afterwards that I just cozened and connived my way into--a movie. A dinner. A small present. But thankfully, I don't have expensive tastes. If I did, either I'd be disappointed or my equally impoverished-*** friends would be. I do feel uncomfortable about it, from a "what if I'm caught at it," sense. But that's about how I would look to others. I already know or assume the worst about myself, so very little I do surprises me. Very little I do makes me feel guilty. Shamed, yes. Guilty, no. I'll do it again, just a little smarter, so I don't get caught and thus have to feel shame.

Most of it is so petty and slimy, I can't even really talk to my counselor about it. I value her good opinion. I like appearing to be a decent, if not well-adjusted person. But I suspect a lack of character at my "core" that would bother some of the people I know.

Sorry this reply is such a mess. These days, if it ain't fiction, I can't organize a thought for love nor money.

I did not read your entire post but if you are not truthful honest and forthcoming about the entire you you are handicapping your therapist on how to help you. I know it is hard and will take a long time to reach this level of trust but she can only treat what she hears and sees. You know they are trained to see behind the masks and the fronts. She probably knows more about you then you know about yourself.

That's true. I try to be honest and not evasive or prevaricate with her, but it's so tough because I really like her--she's a great person, aside from being a caring and fantastic counselor. So I tend to wanna pile on the masks around her. Lately, I've been forcing myself to take them off, one at a time, and tell her how I feel and how I really am. WHO I really am. It's slow going, but I think I'm making progress.

I'm not claiming to know you but this typically is not how manipulation in BPD works. When it is present, not only are we often unaware of it (yours seems to be often pre-meditated) but it almost always is related to desiring emotional validation, reassurance, and confirmation from others (that they still care about us and won't leave us). For instance, we may threaten to harm ourselves (and sometimes do) if the person we love/are emotionally attached to decides to spend time with someone else for a while. We feel replaced and like that person no longer cares about us. I in particular struggled with this one and I was not aware that it was manipulative. I was in so much pain and I wanted them to see that. I just wanted confirmation that I was still loved and that I was not being abandoned. It was not for self gain, which many of your examples of manipulation seem to show.

If you ask me, this particular aspect of you immediately stuck out to me as antisocial personality disorder, combined with the fact you said you lack empathy for people, in your original post. Lack of empathy is not a BPD trait. I'm not a professional, and I'm not saying that because of these two traits you have ASPD, but it definitely doesn't scream BPD to me.

I don't know what to tell you other than the fact that I experienced exactly the same thing.

My shrink refused to diagnose me with BPD. He leaned more towards Bipolar 2, but I'm convinced, in the same way that you are.

I understand your frustration.

Maybe u need a different therapist so it won't be so hard to be your true self. You know that what you are seeing is her training. They are trained to be the type of person you want to see. She makes big $$$ to protray a certain type of person really don't be fooled.

Thanks for answering all those questions!

I also don't think borderline is the best way to describe your personality, even if it's probably quite like it (it is like it but not it, if based on your answers).

Shame and feeling quilty, as well as empathy, is what we generally, in some way, have too much of, while we might appear to have to little of it. We may feel shame for no reason. We generally feel disproportionately guilty at least at one point for no reason. Any manipulation is generally out of desperation (and less so boredom or compulsion, for example).

So I'd say it's similar to, but not, BPD.

I think it might be a personality which could be called narcissistic. But it isn't clearly that either. I agree there's at least somewhat antisocial which is different and a part of your personality to a higher degree than what you'd expect when someone is diagnosed with BPD.

BPD, NPD and ASPD are somewhat similar. The problems all have to do with (lack of) emotions, compulsions, beliefs and pretence, uncertainty about one's identity and pain, basically. HPD shares similarities with BPD and (to a lesser extent) NPD.

I hope this helps and I hope you find the answers you're looking for. At any rate, accepting there may be a problem is a big step. That probably also means that however you should call it, it's not very severe (at least if it's any of the PDs discussed here).

If you do you have bpd and you aren't diagnosed correctly, in my opinion you aren't getting the help you need. No one wants a bpd diagnosis for the hell of it but I sure as **** didn't get the proper help until I had the proper diagnosis. Specifically DBT. I see this all the time on this forum people questioning someone wanting the bpd diagnosis and stating it's just a label and a ****** one at that but if your being treated for bipolar when you're really bpd you're not getting the right treatment. Get a second opinion and not from anyone here we're not doctors go to a psychotherapist they are the bpd masters.

Not too long ago I thought I had BPD too. No offense to anyone who has been diagnosed, but my counselor was able to squash my suspicions once I brought them up to her. She said that the "hallmark" symptoms of BPD are really lying and stealing. Talking with her about the differences between seeing someone who has BPD and looking at the diagnostic criteria really helped me to understand. Maybe your NP or therapist can do the same with you? BPD is such a complex diagnosis, there is really a lot to it that isn't written down in books.

Interesting I have never stolen anything in my life. I am a very honest person and it is hard for me to even tell white lies.

Not all counselors are trained to deal with BPD so a lot of misinformation gets spread.

I've stolen and lied just because, but it's by no means the hallmark of BPD. Many therapists are useless.

If anything, the hallmark of BPD is most likely the fear of abandonment.

That's pretty much my biggest fear. Being left alone and lonely. Even though I self-isolate so much everyone I know is worrying about me. At least they seem to be. But the idea of losing someone or not really having them--or thinking I have them only for them to dump me or phase me out is terrifying. It makes me want to sob until I puke. I push people away before I have a chance to love them because if I'm gonna lose them anyway, might as well get a jump on it, right? Why wait and drag **** out? And why be the dumpee when you can be the dumper? Saving dignity, right?

Riiiiiight.

I can't stand being alone because it leaves me with my thoughts, which can often become very negative. It's like I need someone to drown them out for me or they get louder and louder. That's why I know that when I want to be alone, I'm in a very bad state of mind because I don't really want that. I know what you mean with pushing people away, but for me it manifested in a really subconscious way. After a lot of abandonment and/or failed relationships with people, I realized that overtime despite being able to talk to people fairly easily, I could not bond with them easily at all. It's like my heart locked itself up overtime to protect me. There have been exceptions to this, but it's very rare.

We may have been separated at birth, because that's me all over, alas. Being alone with my thoughts is the literal worst for me. Just--awful. I can't focus on the things I use to distract myself, so it's a nightmare these days. One that only gets worse over time. Plus, I'm socially facile on the surface, but underneath, I'm . . . not at all enjoying myself or comfortable. But I put on a very good act. Intimacy of any kind is terrifying and horrifying to me, and yet I crave the thing I fear most. If only because when one is taken up/taken over by others, one has little time or inclination to focus on or drown in oneself.