This piece is part of our Mental Health Month blog series, where we highlight and explore lesser-known mental health challenges. Here’s Genevieve’s experience with and perspective on borderline personality disorder.
I sit intently at the table where we hold our morning rounds, listening quietly as we discuss treatment options for the patients admitted under our care. Their diagnoses, their medical history, their lives—where do they live? What are their goals for the care they are receiving? What do they view as an ideal outcome? Conversations around these questions allow the humanity of medicine to shine through, and those are the moments I live for.
We continue our discussion: “This patient also has a history of borderline personality disorder.” I hold my breath. I hold my breath and wait for what feels like the inevitable digression this discussion will now take, interspaced with worlds like manipulative, unstable, frequent flyer, untreatable.
I hold my breath. Every. Single. Time.
Our conversation moves on, without more than a passing thought seemingly given to our patient’s diagnosis of BPD. I sit there hoping that no one noticed how my heart raced as I analyzed each and every word that came out of their mouths, the inflection they spoke with, the subtle changes in their expressions and body language. While no one chose to voice them out loud, I am fixated on the biases and judgments that are undoubtedly in the mind of many of my colleagues around this table. One diagnosis, three words on a sheet of paper, and an entire set of preconceived notions that will influence every moment of our patient’s admission.
Each diagnosis brings along with it a series of expectations and assumptions about the person it refers to, including when it applies to yourself. Coming to terms with a new diagnosis can shake the very core of your existence. A diagnosis can put a name to your experiences. It can bring light to places that were previously dark, providing answers that were long hoped for after a lifetime of searching for where things went “wrong.” But while these answers can sometimes lighten our own burden, leading us to redirect the blame we previously internalized to this external diagnosis, it can also lead us to question the good parts of ourselves too.
I had never considered that kindness could be pathological, but when I was diagnosed with Borderline Personality Disorder, I questioned the motives of my kindness for the very first time. I had spent years believing I had developed this selfless, unrivaled sense of compassion. I thought that somehow, I beat the odds, and found a way to escape the cycle of addiction and abuse that I had been born into. But the more I learned about BPD, the more I realized that kindness was my greatest defense mechanism. I grew up desperate to be enough, so I utilized kindness in a desperate ploy to please everyone around me, trying to ensure that I would never be abandoned again.
If I had only known then that despite my best efforts I could not will others to change.
I believed in my heart that if I could mold myself into what those in my life wanted me to be—my parents, my friends, even complete strangers—then I would earn their love and appreciation. But in basing my self-worth solely on the value I believed others ascribed to me, more often than not I ended up disappointed. Add in the complexity of BPD, I was incapable of appreciating that things were not only black and white, and that people could have complex emotions, bad days, and need to be alone without it being my fault.
In my mind, I was only loved or hated, cherished or forgotten.
Coming to terms with a diagnosis of BPD is made even more difficult by the overwhelming stigma that exists both inside and outside of the medical community. While self-help books seem to be available for every diagnosed condition under the sun, BPD is unique in that for every self-help book available, there are at least as many others aimed at helping the friends and family of borderlines cope with their very existence. This stigma paired with the shame and guilt I had already internalized about my diagnosis led to me feeling more isolated than I ever thought possible.
I felt this consuming sense of cognitive dissonance. Having this huge secret I was trying to hide from everyone in my life made me feel like I was living a lie every day, waiting to be caught at any moment. In my mind, I was a borderline, that was my existence encapsulated. I was unable to assimilate my diagnosis into the person I believed I was before, so it consumed me, and I couldn’t tell a soul.
Therapy has been a critical part of learning to manage my BPD. My psychiatrist has shown me that it is OK to mourn the life you wished for and never had—a stable home, a family that cared for you the way they were supposed to, living free of mental illness—but it is also OK to only expend your time and effort on those who make your life better, your chosen family. My chosen family are few in number, but their love and support are what have allowed me to challenge my fears about living with BPD. They are patient with my slow progress and help me to appreciate the things that BPD has given me, instead of only dwelling on what it has taken away. While I feel minor disappointment and sadness as unimaginable, all-consuming grief, I show love and hope and kindness with this same passion. And possibly above all else, they’ve helped me appreciate that I am not only a borderline, and my diagnosis does not define me.
While I consider my diagnosis of Borderline Personality Disorder to be a significant part of my existence on this earth, I know that I am not just a “borderline.”
I am a great friend.
I am a wife.
I am a doctor.
I am kind.
I am strong.
I am worthy of hope and love and life.
I am more than my diagnosis.
I am more than my shortcomings.
I am more than my fears.
I am more than my trauma.
I am more.
Your diagnosis is not the end of your story. You are capable of living with borderline personality disorder. Treatment exists. We encourage you to use TWLOHA’s FIND HELP Tool to locate professional help and to read more stories like this one here. If you reside outside of the US, please browse our growing International Resources database. You can also text TWLOHA to 741741 to be connected for free, 24/7 to a trained Crisis Text Line counselor. If it’s encouragement or a listening ear that you need, email our team at firstname.lastname@example.org.