September 18, 2010

Between what and what?

The proposed revisions for DSM-V are available to view on the internet and so I went along and had a read of the revision for Borderline Personality Disorder. I was pleased with the revisions, but this has led me to start thinking a lot more about my illness lately, and I have come to terms with and realised a few things about what it actually means to be Borderline.

So what have I realised? Honestly, what I have realised is that the majority of people who know what BPD is either a) thinks the disorder doesn't actually exist, or b) they fucking hate us. No, really.

Let me elaborate a bit. I have been reading on a lot of forums about people who have been diagnosed with BPD and their experiences in the mental health industry. The consensus seems to be that once they had their diagnosis, professional support was withdrawn and they were treated with disdain. At least nine out of ten people had negative experiences as a direct result of their diagnosis. I used to be that one person in ten that didn't... until I actually started looking back and scrutinising my experiences in the mental health system, and then it became apparent that I never really did receive the support I should have. For example, after I was diagnosed (five days into my seven days stay in hospital for a suicide attempt) the doctors and nurses started telling me I was using a bed that could be used for someone with real needs (in those words), and when I was diagnosed, my doctors gave me only the name of my disorder and a prescription. I was never offered an explanation of what I actually suffered from, and had to learn it for myself from the DSM-IV.

My experience was not bad by any means though obviously it was not as helpful as it could have been. However, it is certainly an example of how the system will treat you differently after a diagnosis of BPD. Other experiences I have read about have been much worse. Someone once mentioned on a forum that while an inpatient a large amount of work was done to organise continuing care and support for when they left the hospital. Once they were diagnosed with BPD, those plans were cancelled and the individual was left with no support once they were discharged from the unit.

I sent my mother a link to the proposed revision of Borderline and made the comment of Borderline's being treated differently by the medical field which prompted her to contact a friend who worked for a long time in the mental health field. Her friend confirmed that doctors and nurses do indeed treat Borderline patients differently. She once asked a doctor why they virtually ignored people with BPD and received the answer that "they can't be helped anyway". I recently also witnessed a mental health worker talking about Borderline patients and her comments were that we are "impossible" to deal with unless medicated, and that we were unpredictable and abusive.

When I was first diagnosed I went looking on the Internet for resources about Borderline to help me. All I found were resources to help the abused partners of Borderlines seeking advice on how to leave a Borderline and divorce advice, as well as sad stories about the children of Borderlines being abused by their parent. This worried and upset me so much that I was afraid to live. I knew what my disease was, finally, and was ready to fight it, but what was the point in knowing my disease when I would just become a husband and child abuser? What was the point in living, in fact? Obviously I did fight my disease, and I am now in a relationship, but every time my irrational and quick anger fights through and I say something nasty to my partner I have this sinking feeling inside me. I mean, not only am I afraid to lose myself to my anger and hurt my loved ones, but I am also afraid of passing on whatever genetic link exists inside me to my children and having to watch them suffer from the same demons that I do.

After that little side-track, I suppose I would like to know why the medical profession despises Borderlines so much. Is it because they view us as manipulators and liars just trying to get attention? This reminds me of the debate about whether or not people who self-injure for attention are worthy of support or help, and my argument has ever been that no matter why they self-injure there is still something wrong and they still deserve help. So with a disorder like Borderline which is characterised by desperate and manipulating attempts to avoid abandonment would a doctor not just see that as part of the disease that needs to be treated? Would a doctor not see irrational anger and abuse to be part of the disease that the individual needs to be helped overcome? Or are Borderlines simply placed in the "Too Hard" basket and left to become the abusive parents they become when left untreated?

Everyone has the right to supportive treatment by the mental health field, no matter what their disorder is or how mild that disorder might be. No one should be left to fend for themselves or go untreated because a doctor feels that they are undeserving of treatment.

So to every Borderline that is reading this, I want you to know that you deserve treatment and support. You can, with treatment, live a healthy life and manage your disorder. You're not destined to be an abusive partner or parent. You're not undeserving, and you're not impossible or untreatable. So next time someone tries to shrug you off, stand up and demand the respect and help that you deserve.