It is four years since I was diagnosed as having a borderline personality disorder. I was 23 and seeing a consultant psychiatrist for the first time. Having entered the mental health system at the age of 17 I had only ever been treated for anorexia. But the consultant thought there was more to my problems.
No one told me what my diagnosis was. I met the consultant's senior house officer (SHO) in accident and emergency. She had assessed me following self-harm and said she was doing a psychotherapy course and could take me on as a client. I felt special - she had chosen me. When I started seeing her she mentioned her tutor's name and a day centre that I could attend and I looked both up on the internet. I discovered that the SHO was on a course on treating severe personality disorders. I dropped out of the therapy since I felt that the doctors had not been open with me. I did not want to be used as a case study.
I also opted out of seeing the consultant who diagnosed me because he was dismissive. I felt that the label personality disorder meant I was defective.
Now I can see that I do meet some but not all of the criteria for borderline personality disorder (BPD). I had been going downhill since my mid-teens with anorexia and a secret habit of scratching my arms with a disposable razor. I hate people leaving me since I can feel abandoned. As an in-patient I used to think it was because of me that my keyworker went on holiday. Discharge would cause me to feel rejected.
I also have a sense of inner emptiness which I think is because I don't have sufficient good memories - only ones of being unwell. However, I don't get angry, have mood swings or display impulsive behaviour which are said to be features of BPD. Instead of treating me for BPD my community psychiatric nurse says that I have reactive depression. My diagnosis was revoked once when I was more stable but the consultant changed it back to BPD when I started self-harming again. Some of the BPD symptoms have improved as I've got older and worked with my CPN.
The gold standard treatment for BPD is a therapeutic community regime. But having been in a residential project run along these principles I would not consider this option. Talking about negative emotions five days a week felt like too much analysis. Although many therapeutic communities have good results and are run by highly skilled professionals I think my time is better spent on my voluntary work.
Yesterday was my care programme approach meeting. The same consultant who gave me the BPD diagnosis heard of my achievements direct from me. He seemed pleased. He has been respectful and a good listener, and has taken positive risks with me when I have seen him in emergencies, reviews and for hospital admissions. I am glad that those treating me see me as more than a patient with BPD and have high hopes for me.
Alex Williams uses mental health services and is a volunteer.
