A psychiatrist didn’t give me a diagnosis for borderline personality disorder (BPD) until I was detained in hospital on suicide watch in October last year. They called it voluntary admission, but if I had refused to speak with the psychiatrist, I would have been held against my will.
I suspected for many years that I had BPD, but many mental health professionals are reluctant to suggest the diagnosis because of the stigma attached. I had assumed that you needed to show all the symptoms of BPD to qualify for the diagnosis. Therefore, I assumed that because I don’t regularly dissociate, that I couldn’t have the disorder. Without the hospital psychiatrist, and confirmation from my psychiatrist, I may have gone years without a diagnosis for BPD.
It was no surprise to me when I was formally diagnosed with depression and anxiety in 2014. I had spent years during high school struggling with low mood, intense stress, extremely low self-esteem, and crying fits. My friends had told me for years that my behaviour was out of control, and that I needed to seek therapy to cope with my emotional problems.
I have always avoided self-diagnosis, because I believe that I could find some of my symptoms represented in most psychiatric disorders. Other than the accuracy that a proper diagnosis provides, these are the other reasons why it is so important.
1. You can get access to the correct therapy and medications.
In my country, Australia, it is essential to have a formal diagnosis to access government-funded therapy. You need a referral from a doctor to get access to ten government-subsidised sessions with a psychologist in a year. You also need a more formal diagnosis for accessing dialectical behavioural therapy (DBT), which is the therapy specially designed for BPD. I had to fill out a form with my psychologist and qualify for a minimum number of symptoms to be put on a waiting list for the public group therapy. I’m not sure how it works in other countries, but in Australia, at least, a diagnosis is essential for accessing affordable mental health care.
A diagnosis is also essential for accessing the right kind of medications. Working with a doctor or psychiatrist is very important to find out the right kind of medication for you, especially when it comes to antidepressants. I have been on several doses of two kinds of antidepressants, and have only recently found the medication and dosage that helps me, rather than putting me to sleep for most of the day.
The issue of access doesn’t only apply to mental illness, of course. I have friends who are going through hell trying to get a diagnosis for physical illnesses that they cannot access treatment for. The onus is truly on doctors to trust their patients and work hard to uncover the correct diagnosis.
2. It validates your history and emotional responses.
I think that the most important thing about a diagnosis is that it validates everything that you have felt and experienced. I always felt so alone before I knew that I had BPD. I felt like I was the only person who was emotionally explosive and living with a brain that wanted to emotionally manipulate everyone around me so that they could never leave me. When I got my diagnosis for BPD, it felt like a huge weight had lifted off my shoulders. Finally I wasn’t alone in what I feel and experience; other people in the world are exactly like me.
There is nothing more comforting than realising that you are not alone. It also helps you to realise that while you still may be irrational and overly emotional, you are these things in ways that can be explained because of your disorder. I feel like I have always thought that I am crazy, but now I know that I am a particular kind of crazy that has explanations for its origins and symptoms. It is so affirming to have a name to give to your experience, so that you know that it isn’t all in your head.
3. It opens the door to support networks.
A diagnosis gives you a key to entire communities of people who have the same experiences in life as you do. This can stretch anywhere from group therapy, to online support groups, and becoming closer to friends and acquaintances who live with the same illness. I have found solace in a Facebook group where sufferers of BPD can talk about their issues and seek support. I have also shared lived experiences with acquaintances on my social media who live with the same disorder that I do.
If you can talk and relate to people who have the same experiences as you do, you will feel so much less alone. It also helps you to gain insight into other strategies and coping techniques that people use, and try to apply them to your own life.
A diagnosis is not the be all and end all. Some people are certain of their condition before they are formally diagnosed. But is is incredibly important to access therapy and medications, as well as to feel valid in your history. A diagnosis also helps you to find communities of people who are suffering in the same way that you are, and find solace and help in those spaces. There is an enormous sense of relief that comes with being diagnosed and realising that you are not just imagining your problems, and it allows you to tackle them head on.