I have personally encountered some of these “myths” or long held beliefs with regard to Borderline Personality Disorder. It can be very discouraging when you are trying to get a correct diagnosis and work with a mental health professional and some of the things I have researched below come into play. I have found that you have to continue to do the research and press in on your own until you find a trained professional...that includes a psychiatrist and a counselor….that will help you in your journey to healing. If you feel in any way uncomfortable, misunderstood or as if the professional is treating you is doing so in a condescending way, it is time to move on and find someone who will listen and has had experience with treating BPD. Otherwise, in my personal opinion, it can be a nightmare and lead to worsening of your symptoms. Again, I am not a clinician, these are just what I have found out on my own.
Here are some of the most common and harmful myths:
1. Borderline Personality Disorder is Not a Valid Psychiatric Diagnosis
Many mental health professionals did not feel that borderline disorder should be considered a valid diagnosis because of confusion with regard to the symptoms of the disorder. BPD was included for the first time in the third edition of the Diagnostic and Statistical Manual (DSM-III), published by the American Psychiatric Association in 1980.
The diagnosis of Borderline Disorder has been made stronger by finding that it is associated with specific biological disturbances in the brains of those who suffer from it. Research has further shown that genetic factors contribute significantly to the risk of developing the disorder. Unfortunately BPD is considered to be a “wastebasket” diagnosis mostly in part because there are other mental disorders that frequently co-occur with BPD. Clinicians who are not experienced with the disorder will often not diagnose BPD because of this reason.
This particular myth leads to people with the disorder being misdiagnosed and diagnoses made instead of borderline disorder which include bipolar disorder, depression, anxiety and panic disorders, post traumatic stress disorder (PTSD), and attention deficit hyperactivity disorder (ADHD). Misdiagnosis of BPD can lead to years of ineffective treatment and much frustration on the part of the patient, their families, and clinicians.
2. Almost Everyone Who Has Borderline Disorder is a Woman
What this myth leads to is women being less receptive to the diagnosis of BPD and it decreases the awareness of the diagnosis in men. Although research studies have suggested that BPD seemed to occur two to three times more frequently in women, recent studies show an equal occurrence in men. Women are more likely to seek mental health treatment over men which also tends to skew the research studies in relation to the number of men being diagnosed.
3. Borderline Disorder Cannot be Diagnosed Accurately Before Age Eighteen
This myth is based on the reluctance of psychiatrists and mental health professionals to make the diagnosis of BPD in a young person, thereby stigmatizing her or him. Many misdiagnosed adolescents with borderline disorder can receive years of care for other disorders, with minimal or no success treating the BPD. This can unfortunately result in harmful behaviors by the teen, a delay of learning how to cope with symptoms during critical years of adolescence, and a sense of hopelessness by the teenager and their parents.
4. Borderline Disorder Does Not Respond Well to Treatment
This is perhaps one of the most harmful myths of all with regard to BPD. I have heard it many times myself during my own treatment. It can be very discouraging to the patient and their family and cause them from seeking effective help. This can result in much suffering on behalf of the patient and discouragement with regard to their future. Part of the reason for this myth is that years ago patients with BPD did not respond well to the typical form of psychotherapy or “talk” therapy. Sometimes the patients would actually become worse.
Sometimes patients with Borderline did not show sustained improvement in their treatment, especially those with severe forms of the disorder. However, research has recently shown that patients with BPD DO improve significantly with the right treatment. It is proven that a combination of medication and psychotherapy (or “talk” therapy) combined with Dialectical Behavioral Training (DBT) can significantly help the patient.
5. Medications Have Limited Use in the Treatment of Borderline Disorder
This myth is based on the thought by some psychotherapists that the main cause of BPD is environmental. It would then stand to reason that the treatment of the disorder would be “talk” therapy, not medication. It has also been said that medications can interfere with the process of the “talk” therapy as they may provide a false hope in the patient of a quick “cure” of their symptoms. Medications by themselves have, on the contrary, been shown to decrease a number of the core symptoms of borderline disorder. This allows the patient to engage more effectively in psychotherapy. This is also shown in findings which demonstrate a strong genetic component of borderline disorder, and that significant biological brain disturbances occur in people with the disorder when compared to those without it. Because of this, the use of medication in the treatment of BPD has found to be very helpful.
6. Dialectical Behavior Therapy (DBT) is the Psychotherapy of Choice in Borderline Disorder
This myth appears to be a misunderstanding about the amount of improvement in the treatment of patients suffering from BPD and the media attention given to this form of therapy. Those patients who have been shown to benefit most from DBT demonstrate suicidal and other self injurious behaviors, and require or request numerous brief hospitalizations, primarily for these actions.
The effect of using DBT on a patient with Borderline is very helpful, but a misunderstanding has developed in that it appears that some mental health care providers are so eager to determine an effective treatment for BPD, that they have made the assumption that DBT is more effective in general than other forms of psychotherapy in the treatment of BPD. Many patients and their families search in vain for therapists who are specifically trained in DBT when the treatment may not be indicated, and do not seek help from therapists highly skilled in other forms of therapy who would be of help.
7. It is Disruptive to Include Families in the Treatment Process of Patients With Borderline Disorder
Doctor-patient confidentiality is essential in the treatment of mental disorders. However, some mental disorders require a more close family involvement in the treatment process if it is to be effective. In the case of the treatment of schizophrenia, this has been proven. Research data now also suggests that family involvement is very effective treatment of borderline disorder. Unfortunately, many psychiatrists and other mental health clinicians continue to deny input from family members, to aid in the treatment process. This can make the situation very frustrating for family members, who often provide financial support for the patient’s treatment expenses, and much of the moral support, but they then, on the other hand, receive no response from the professionals. Given the importance of the family in establishing relationships in the lives of people with BPD, this can be a particularly harmful myth.