Borderline Personality Disorder: Tackling a treatment crisis


People with BPD have difficulty
regulating their emotions, difficulty regulating their behavior,
regulating their thoughts and this leads to a lot of
chaos in their life. My experience of BPD was primarily around my anger and my inability to tolerate intense emotions and turning to self-harm and idealizing
suicide as ways to try and cope
with my suffering. The diagnosis is recent,
but the difficulty isn’t. I used to self-harm when
I was in adolescence. I had a very difficult childhood,
I was bullied really badly in school and I was really angry and I was also extremely
out of touch with my emotions. I didn’t even realize that
I was experiencing anger until I started working
with a psychologist. There are a lot of old ideas hanging
around from older days in psychiatry about what borderline
personality is and what it means to have
that kind of diagnosis. Borderline personality disorder isn’t
looked on as a legitimate illness. It’s looked on as having a bad
personality, a bad character. We also have some lingering stigma
associated with the disorder so not all health professionals are
aware of the new evidence, and are aware that actually, people
with BPD can be treated effectively with the right treatment. We know that after
one year of treatment, we know that
the rate of self-harm, the rate of attendance at hospital
emergency departments drops a lot. Dialectical behavior therapy
was really integral for me. It helped me to lay the foundation of
distressed tolerant skills so that I could start to be aware of thinking
of my thoughts as just thoughts. Now that we know that treatment can
be helpful, there’s a lot of people interested
in receiving treatment. The problem is we’ve got a
shortage of treatment programs. And we have a shortage of
clinicians who are trained in how to deliver
effective treatment. It usually takes about a year
to complete a standard program. And so that’s costly and what
we’re interested in examining, is whether or not people
could benefit just as well from a shorter length of treatment and we have
some reason to believe that they can. We’ve made tremendous strides
over the past 20 years. We’ve come from
a place where people believed that this was
a disorder that was not treatable. We’re now at a place where
people can feel positive that treatment
can be helpful, that they don’t have
to suffer forever and that they can
really have a life where they feel
more satisfied. Another myth about BPD is that
people do not get better. Well, we know that
that’s not true. In fact, even without treatment, people with
BPD, many do improve over time. Receiving a diagnosis of borderline
personality disorder does not have to be a life sentence
and it doesn’t have to be a disorder that stays with
people forever. And I don’t see any reason why anybody who
has BPD, no matter how much they struggle, and how much they suffer, can’t
eventually get through the worst of it, Even if it happened so slowly that they’re
not realizing that change is happening. It does happen, it will happen,
you just have to want it badly enough.