When I was 18, a psychiatrist kicked me out of her office in my hometown of Montreal. A framed Sigmund Freud witnessed my humiliation. I’d raised my voice, confessing that I’d scratched up my arm again because I was “fucking sad.” My psychiatrist told me to go to the hospital. She couldn’t help me, she said.
I wondered if she knew how helpless I already felt during our sessions. I wondered if she noticed how the frenetic sound of her keystrokes made me tense, or how I would hold my breath when she’d interrupt the logging of my despair into her laptop to look me in the eye. Would she again suggest that I was lazy? Could she tell my pupils dilated whenever we discussed my medication? I knew that she couldn’t help. What I didn’t know was that I had Borderline Personality Disorder (BPD) and for the next 17 years, help would be hard to find.
If you read an article on BPD, you’ll likely see the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), the standard classification system of mental disorders used by mental health professionals in North America. These criteria can tell you that a person with BPD likely has significant impairments in personality and interpersonal functioning, such as unstable self-image often associated with self-criticism. That doesn’t explain what it’s like to spend most waking hours feeling hollow. The DSM-5 describes pathological personality traits, such as anxiousness, separation insecurity, and depressivity. That doesn’t tell you what it’s like to think you might lose your mind because someone you care about is an hour late. The DSM-5 lists impulsivity, citing “self-harming behaviours under emotional distress,” as well as hostility, manifested as “anger in response to minor slights and insults.” That doesn’t illustrate that despite improvements, BPD remains one of the most highly stigmatized diagnoses.
The professional stigma against BPD is only worsened by the performative one. Two percent of the North American population suffers from BPD. Yet mainstream representations of BPD consistently use the same characters bending to the same arc—a white, cisgender, heterosexual woman (think Girl, Interrupted; Welcome to Me) who has often been spurned by a male lover with whom she becomes violently obsessed (Fatal Attraction; Malicious; Play Misty for Me).
Through this lens, we only see BPD sufferers on their worst day. Context and history seem less important than presenting audiences with the hysterical woman, perhaps because it’s easier than trying to understand the complexities of the disorder. But these representations negate the individual narratives of those with BPD and reinforce the stigma. The stigma reinforces silence. The silence reinforces stigma.
I’ve been contributing to this cycle for nearly half my life. I have never publicly disclosed my BPD diagnosis until now, because I’ve finally realized that not saying something says something.