Sanctuary and Serenity

Myths about BPD

Posted on: March 26, 2010


Myths about BPD

The DSM (Diagnostic & Statistical Manual) contains the definition of psychiatric disorders.  These criteria based definitions are the results of a consensus created from hundreds of psychiatrists of many different perspectives and beliefs from all over the world.  As research becomes available, these definitions are revised.  The latest publication of the DSM IV was in 1994.
Physicians have the right to explain and treat disorders according to their knowledge, training and expertise-but not to establish their own criteria for a particular illness.  And in most cases, all of the criteria for an illness does not have to be apparent for a diagnosis.  Therefore, a physician cannot say, for example–“I don’t believe you have diabetes because you are not thirsty”.  All areas have to be considered carefully.  Also if a physician disagrees with the established criteria, he/she needs to explain the reasoning in the chart.
Unfortunately, due to the nature of Borderline Personality Disorder, there are many misconceptions about the diagnosis:
1.  that the diagnosis is based on why it may have happened—NOT TRUE!    There is no one clear cut biological or environmental factor that causes a person to develop BPD
2.  that the diagnosis is based on severity of symptoms–NOT TRUE!   BPD is unique to each person.  Some people with this illness are severely dibilitated while others are high functioning.   Some are habitually suicidal while others never reach that point.
3.  that the diagnosis somehow requires a response or lack of response to  certain medications be made—NOT TRUE!   Because of the many biological and environmental factors that effect a person’s development, there is no one medication that can effectively treat all persons with BPD.  Plus each person’s chemical makeup reacts differently to medication in regards to dosage, side effects and effectiveness.
4.  that the diagnosis is based on the actual brain or thought mechanisms involved–NOT TRUE!  No clinical proof has yet been given to verify actual brain functioning or thought patterns related specifically to BPD.  Although it is currently believed that the serotonin levels in the brain may have something to do with this disorder.
5.  that missing some symptoms–such as self mutilation–means the diagnosis is not present–NOT TRUE!  A person does not have to meet all nine of the diagnostic criteria, nor do they have to show symptoms relating to specific criteria on the list.  Any five of the nine criteria need to fit this definition for a diagnosis.
6.  that the diagnosis has a predictable outcome for everyone–NOT TRUE!  Like any illness, the outcome of a BPD is related to many factors including proper diagnosis and med treatment, willingness of client to participate in treatment and therapy, and a qualified and knowledgable physician.
7.  that it’s a label and not a diagnosis—NOT TRUE!  Persons with BPD have an illness, they are not the illness, much in the same way the a person with cancer is ill, they are not cancer.
8.  that having the BPD or Bipolar diagnosis means one cannot have the other diagnosis as well–NOT TRUE!   They are not mutually exclusive and many individuals have more than one diagnosis, including both BPD and Bipolar.
It’s crucial to remember that it is a criteria based illness and is described as a “pervasive pattern…beginning by early adulthood and present in a variety of contexts…”  For the BPD to be diagnosed, five of the nine criteria need to fit this definition.
The following information was compiled from an article written by Dr. Leland M. Heller, M.D.

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