Dealing With Diagnosis

by Sarah Myles

Why do I refer to myself as someone that has Borderline Personality Disorder? Well, because it is a fact. Not everybody approves of my choice, however.

For me now, it is no different than my Mother stating that she suffers from arthritis, or my friend mentioning that she has diabetes. Nobody ever asks them why they “choose” to label their illness that way – as if they had a choice in the first place.

When I was first told of my diagnosis, I was in the midst of an extreme crisis and, exhibiting ‘splitting’, demanded that this defect be fixed immediately. There’s something wrong with me. Fix it or get out. Of course, BPD doesn’t work like that, and over an extended period of time, my mental health team guided me through the process of first accepting my diagnosis as a chronic problem, and then learning how to understand and manage it. Acceptance came through my own research. I did not blindly agree to the “label” I was given – I trawled all the information I could find and found that I agreed with the mental health professionals treating me.

Originally, the term ‘Borderline’ in this context referred to the patient being on the border between neurosis (OCD, anxiety, hysteria, phobias, etc) and psychosis (loss of contact with reality – delusions, dissociation).

Yep, that’s me.

More recently, BPD has been characterised specifically as mood instability, extreme thoughts and/or splitting of mental concepts. It can also feature disturbance in the sense of self, leading to periods of dissociation, and is often triggered by perceived failure, rejection or being alone.

Yep, still me.

As definitions and criteria for mental illnesses seem to be constantly changing, the term Borderline Personality Disorder has gathered many negative connotations. It is widely perceived as a “controversial” diagnosis, often handed to people who are regarded as “difficult” to deal with, diagnose and treat. While I can see this might be a problem in some cases, I am confident that my diagnosis was correct. The wider effect of those connotations, however, is that they then become associated with everyone that has BPD – correctly diagnosed or not – and that doesn’t help anyone. It creates a situation that discourages people from being open about their mental illness – particularly in the case of BPD, where fear of rejection can be debilitating.

Ultimately, a person does not choose to suffer from a mental illness, any more than one can choose to suffer from arthritis. Their relationship with the “label”, however, is something that is within their control.

I chose to find out the facts for myself and accept my diagnosis in an informed way, moving forward with treatment and management. I do not consider it to be my “label”, and it does not define me as a person. It is simply a chronic health problem that flares up from time to time.

A correct diagnosis can be incredibly helpful, because it is the gateway to in-depth understanding, which puts the patient back in control of their life. So, when a person refers to their diagnosis, it should not be assumed that they are in any way limiting themselves to that definition, but rather have been brave enough to acknowledge their illness, seek help, and make the choice to be in control of their situation, in an informed way.

Projecting negative assumptions onto a person based on the connotations associated with their mental health diagnosis reflects badly only on the person making those assumptions. Openness and honesty about diagnosis are the best ways to combat that.

Sarah Myles


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