Yeah, both the psychiatrist and my group's therapist have both stressed that BPD is treatable, and that with 6-8 years of DBT, etc. many people (most people?) can stop having enough symptoms so that they are no longer diagnoseable. They know I have a mental health background, so they've been reassuring, which I've appreciated, since in the course of my career I've heard therapists and case managers complain about their borderline clients, how unmanageable they are, how they are probably never going to get that much better, etc. So it isn't a life sentence necessarily, and thank you for reminding me of that.Whistler wrote:I just read on Wikipedia (sourced to the DSM) that at least half of cases improve over time, so my stereotype is not true.
Well, in some ways it is a relief. I've had a lot of therapy and a lot of tries with meds, and I have never really improved. Now there is an explanation for that. I also have more of an idea of what I need to improve (DBT, mindfulness, etc.).Whistler wrote:If you're comfortable talking about it, I'm curious about how your self-conception has changed with the diagnosis. Do you have different expectations of your future mental health now? I also understand if you're not in the mood to delve into it here.
I don't have a "classic" BPD presentation, which is probably why I have never been diagnosed before. For example, I don't rage out on people (but boy howdy what happens in private) and as far as I know other people are not usually overwhelmed by my emotions. I've always known I had borderline tendencies, and I feared that I might have BPD, but nobody ever diagnosed me with it. I guess I always thought of myself as someone with good control of their emotions (except the depression and anxiety), but now in retrospect I realize that I have very strong, out of control emotions that I have managed by shoving them down until I cannot feel them anymore. I've thought of myself as someone with a lot of self-control, but now I look back and see impulsive, self-destructive choice after impulsive, self-destructive choice. It's like the version of myself that I am least comfortable with has now been confirmed to be the true one.
All of a sudden I can see how my extreme fear of abandonment has really screwed me up for my entire life. The word the DSM uses is "frantic," and that is absolutely accurate. I guess I just always glossed over it until now. Unstable sense of self is also absolutely accurate. I pinned my feelings of emptiness as depression but they make more sense in the context of BPD. I have never taken my paranoid ideation seriously, or my chronic dissociation. Things are clicking into place, but it isn't a place I wanted to be. I wanted to be stronger than this (though, of course, having a personality disorder does not make one weak, obviously, and I would never characterize it that way about anyone else).
The DSM took out the axes when they published the V, but in my brain there is still a big difference between axis I and axis II. Axis I disorders (depression, anxiety, PTSD, eating disorders, etc.) mean that your personality is sound, but it got sprinkled with some maladaptive stuff, which can be fixed. Axis II (personality disorders, etc.), though, means that your personality, your base, is messed up, and it may never improve. It's a much more fundamental, inherent kind of damage, I guess, at least to me in this moment. I worry that I can't get better (though, as I said, I'm grateful for a reason that the standard 8-12 weeks of CBT didn't cure me years ago), and also that people have just been putting up with me politely all this time. I worry that if I do start to improve, if I do start to untangle my emotions, I'll end up going full, classic borderline and destroy my life, such as it is. (Not that it's great now. I mean, it's pretty well destroyed. I finally ran out of resilience over a year ago.) I worry that people, if they find out, will write me off as truly crazy, even if that isn't fair or accurate or compassionate. I worry that I've been an out of control mess all this time and that some of the things my particularly awful ex-boyfriend said to me about me are actually true.
Anyway, long, ranty answer, but it changes a lot. It also gives me hope, though, as I had stopped believing that anything would help me and had pretty much resigned myself to killing myself. I was giving day treatment a shot because those closest to me asked me to give a higher level of care a shot, but I didn't think it would work. Now there's a reason and a prescribed path. So, at least there's that.