[content warning: general mentions of abuse, self harm, and suicidality]
I was fresh out of an abusive relationship when I realized I probably had Borderline Personality Disorder (BPD). I was 21 and I’d just moved out of the house where I’d been living with my girlfriend, back across the Puget Sound, back into the house where I’d lived with my family since I was 12.
I found myself standing in my old room, in a state I’d now recognize as dissociation, feeling more connected to my room as a physical space — the recessed window that looks out under the deck, the strangely textured walls, the mirror angled uselessly up at the ceiling because the bolts would never quite tighten enough — than to the person I’d been when I lived there before.
In terms of characteristically Borderline moments, it was pretty gentle and subdued, but that was when it became clear to me. I’d been following some people on Tumblr who frequently posted about BPD in their own lives, and suddenly I realized that my experience aligned with theirs.
In the DSM-IV, my distance from my past selves would fall under the BPD diagnostic criterion of “Identity disturbance: markedly and persistently unstable self-image or sense of self.” (Unstable self-image remains one of the defining characteristics of BPD in the DSM-5, but the DSM-IV wording resonated more with me.) I think everyone feels disconnected from their past selves at times, but for people with BPD, these divisions are often more extreme. I can easily cut the timeline of my life into smaller segments that feel almost entirely separate from each other, and it’s been long, hard work trying to reintegrate these selves into a single narrative, a single stream of memory that I can freely access.
That moment of disconnect from my past selves and connection with the personal BPD narratives I’d read spurred me to look further into BPD as an explanation for my own patterns of behavior and thought. The diagnostic criteria explained so much of my life, tied it together more effectively than my previous explanations of “I have Generalized Anxiety Disorder” or “I’m just really excitable.” BPD explained my constant fear of abandonment, my trail of burnt bridges, my sudden diametric mood swings, my frequent feelings of emptiness — everything I hadn’t quite been able to put words to.
This isn’t an article about diagnosis and ableism within the medical system, so I’ll just briefly say that the medical professionals I’ve tried to discuss BPD with have written me off as too morally good, too self-aware for it. They see that I’m managing, that I’m somewhat stable, and they ignore how much painstaking work it’s taken to get to this point. I’ve been working from self-diagnosis, based on the diagnostic criteria and the personal accounts of other people with BPD, because that’s what’s been accessible to me and it improves my quality of life.
Once I realized how well BPD fit me, I started more actively seeking out Borderline community on Tumblr, which had become my main social outlet in the upheaval of my recent breakup and move. I started reading through what was posted in BPD-related tags to continue learning and connecting with other people, and I frequently posted to the BPD tags myself as I processed my feelings, identities, and experiences with going back to school. In the depths of my isolation, Borderline blogging made me feel witnessed and connected. I met one of my best friends — at the time, my only friend — at the intersection of Borderline and Jewish Tumblr. I learned more BPD-related words, like “mirroring” and “imprint,” that further helped me make sense of my world.
As I was rejoicing in my new community and understanding of myself, some anon came along to tell me that I couldn’t really have BPD, because they don’t diagnose it in anyone younger than 25. That isn’t true. It isn’t true now, and it wasn’t true when I was 21. I knew it wasn’t, and a few other people online jumped in to say so too, but here I am still thinking about it 4 years later anyway.
Clinicians do consider age and development in deciding whether to make a diagnosis, but 25 isn’t a magical or policy-dictated number. The idea behind waiting to diagnose BPD is that all adolescents have unstable relationships, emotions, and senses of self, and so on — in short, that all teenagers are a little bit crazy, and no one can tell which ones are really crazy until they all mature a little more. And sure, adolescents probably have more mood swings and general turmoil than somewhat older adults. But it’s wrong to flatten together the BPD experience and the teenage experience. Having BPD as an adult doesn’t make me a perpetual teen, and I’m sure that my trauma and BPD-like symptoms would have been distinguishable even when I was a teenager, had anyone taken a close, compassionate look.
The other major reason that clinicians worry about making a hasty BPD diagnosis is the stigma (read: ableism) that comes with the label. Our culture reviles traits associated with BPD (e.g., attention-seeking, neediness, fear of abandonment) as annoying, and when those traits are clustered together under a diagnosis, ableism heaps on the fear that, additionally, we are dangerous. In ableist fiction and psychological writing about people with BPD, we’re the abusive mother, stalker, murderer — you name it.
(For more on BPD in the media, I recommend Katie Meadows’ “I Hate Myself and I Want to Die: Borderline Personality Disorder and Representation in Film”)
No one wants to see that in themself. It’s a risky thing to introduce to someone’s self-image, especially if that person’s perception of themself is already volatile and that person is prone to self-harm, as many people with BPD are. A stigmatized diagnosis can spur fresh anxieties (“Am I destined to be an abuser? Am I already an abuser? Have I been abusing everybody without trying or knowing? Am I like my abuser? Is anything I think I know about myself real?”) that could easily outweigh potential benefits, especially if the diagnosis is given without proper consideration and explanation.
A BPD diagnosis also comes with risk from the outside world: risk that, on the basis of that diagnosis alone, some therapists will refuse to work with a patient; risk that doctors of all sorts will see that label in a file and conclude that a patient is making everything — mental health-related or not — up.
Clearly, diagnosis is fraught. I don’t believe in telling young people they can’t possibly understand their own minds until they’re 25, but I don’t believe that the best thing for them is to make more and earlier BPD diagnoses, either.
The Better World that Isn’t Yet
I dream of a future without ableism. I dream of a future with more flexible understandings of health, wellness, and happiness. I dream of a future without abuse culture, which would mean a future with less abuse, which would mean a future with less trauma, which would mean a future with fewer people with BPD. I do not dream of a future with fewer people with BPD for its own sake. I dream of a world with a vastly different medical and psychiatric system, in which diagnosis likely works quite differently from its current process and in which the available labels are different, if we have them at all. But I cannot live full-time in this imaginary future.
Until that future, as we work toward it, I believe we can remake what it means to have a BPD diagnosis, to have a Borderline identity. We can erode ableism. We can create and promote Borderline culture. We can make a BPD diagnosis less like a sentencing and more like an invitation to community.
Here’s the truth about turning 25 with BPD: I have stabilized over the last four years, and sometimes I do wonder if BPD is even mine to claim anymore. Sometimes I wonder if I am Borderline, if I was Borderline, if it’s time I made some big announcement about a shift in myself. Can I be happy and secure in myself and my relationships and still be Borderline?
Then I remember how much work it’s taken to get here, how much work it takes to stay here — the hours of therapy, the years of writing, the constant filing and interpretation of evidence. I have stable, healthy relationships, AND those relationships are built on catalogs of evidence — sometimes actually written down — that the other person likes me, doesn’t think I’m boring, is getting something out of our relationship, and so on. On top of that, I’ve developed strategies for assessing the reliability of my evidence and of my analysis themselves.
I write not just because I enjoy it, or for the benefit of an audience, but because I need to write to keep track of my life. It’s the best way I know to understand my loved ones and myself, to reintegrate the pieces of my past, and to maintain a sense of continuity through the shifts in my life.
I’ve been shouldering the weight of BPD for so long that it feels like a part of me. It is a part of me. I’ve gotten used to lifting its heft; I can maneuver nimbly with it. Sometimes I forget it’s there. Often I forget that not everyone has to do this much work to have fulfilling relationships and a sense of self. Being Borderline, to me, means doing this work.
The Way Through
And here’s the crux: I wouldn’t know what load I was carrying, wouldn’t know what work to do, if I hadn’t realized I was Borderline. Without this diagnosis, this identity, this community, this culture, I would likely have remained confused, isolated, desperate, lost.
For most of my life, my survival has felt precarious. If I hadn’t figured out, when I was 21, that I was Borderline, I’m not sure I would have made it to 25. But thanks to the people I’ve been able to connect with through disabled/crazy community and art, I’m not only alive but thriving. My survival feels as wondrous as ever, but after several years of secure relationships and building an integrated identity that feels true, survival is also starting to feel natural, dependable, expected.
I’m 25. I’m still crazy. And I love my life and I look forward to my future.
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Read more of my writing about BPD: