BPDFamily.com

I am constantly questioning whether a friend has BPD, and in my case it is wishful thinking, because the option of still mixed up and scared after a painful relationship split would be far preferable.

As it is, I recently honestly thought the latter was the case, and allowed myself to get close again. What this revealed was that the mental distortion of this friend was much worse than I'd thought.

While 'amateur', however well-informed and backed by professionals, diagnosis isn't ideal, in UK right now, depending on where you live, it's all you're likely to get. Many health authorities no longer assess for or diagnose emotional dysregulation/BPD because they don't offer treatment for it. They do, however, offer assessment for bipolar, so that can be ruled out.

My feeling is that the whole definition and approach to psychosis, personality disorder etc, is changing. And that rather than a diagnosis of one main condition, with one main cause, there seems to be recognition of symptoms fitting an overlap of conditions, similarly for causes or treatments. And that events and behaviour can affect brain chemistry, and vice versa.

It also became evident that the person I know measured his 'normality' by his behaviour, and only realised he had a serious problem when events pushed that off the scale. But what he still hadn't noticed was that his patterns were and most likely always had been different from those of a psychologically healthy person. He didn't realise it was not healthy or normal to blur between fantasy and reality, without any distinction between them. So unless you really talk to someone and ask the right questions, you might not get the full picture of their condition.

Obviously, different symptoms, conditions and causes, will benefit from specific treatment. But having said that, I suspect many people, including psychologically healthy, would benefit from, and more to the point would not be harmed by working through a reputable book of dialectical behavioural therapy exercises. And as that is the only help the person I know is likely to get, I am encouraging them to try it, preferably with someone trusted to go through it with them.  

Whether a person gets a formal diagnosis or not, doesn't really change things. The way you behave toward him/her with or without a diagnosis is the same. You will still use validation, don't JADE, boundaries, etc. All of these tools are set up to use with someone with BPD or for people we meet every day and interact with on a daily basis. If we practice the ideas taught in the lesson with everyone, then they begin to become a habit with us and then it becomes natural to do them with our pwBPD.

Hi Julia S,

The friend/emotional closeness ambiguity must be very painful and confusing.

If your friend were to receive a formal diagnosis, what would that mean to you? What would change?