Nurses hovered over my body and pressed me down onto the hospital bed. I collapsed onto my back, battling sparks that ricocheted between my eye sockets. Leather straps swung up from beneath, fastening down my legs and arms. I yanked the latter up, kicked, and screamed, hoping for some slack, yet I knew I was going to pass out the moment I felt a needle piercing my flesh. I gulped for air, my lungs pressing against my ribs, as I waited for the storm to abate.
I was diagnosed with Borderline Personality disorder in 2019 and was admitted to a psych ward for my self-destructive behaviors. Do not get too hung up on the label ‘borderline’ if you are unfamiliar with it, though, as I, myself, refuse being identified as such. ‘Borderline’ is an outdated, potentially stigmatizing term characterizing patients, mainly ‘women’, who are hard to treat, that is, those who elicit unpleasant reactions or behaviors. In "Women and Borderline Personality Disorder: Symptoms and Stories," Janet Wirth-Cauchon wrote, “the label ‘borderline’ may function in the same way that ‘hysteria’ did in the late 19th and early 20th century as a label for women.” Although the discussion of women with mental illness has become less blatantly sexist in recent years, there is still a widespread belief that women are more likely to suffer from BPD and to demonstrate ‘abnormal’ behavior. Having one of my psychiatrists call me a ‘manipulative borderline’ when I was most vulnerable and hurt was to be told there was something intrinsically wrong with the core of who I am—that my whole identity and self-worth were flawed.
This one-dimensional misconception of the disorder is apparent not only within the medical community but also in several TV films, such as Fatal Attraction (1987) and The Call (2020), portraying women with BPD as sociopaths and violent—hence dehumanizing them and failing to present the true nature of the disorder. Although suicidality, self-harm, and impulsivity are often symptoms of BPD, the latter is more complex than destructive behaviors. There are certainly many males who are diagnosed with this disorder as well. “While BPD is reported to be more prevalent in women than men, that is not correct. What is correct is that patients in clinical treatment settings are much more likely to be women than men,” says John Oldham, MD, professor of psychology at Baylor College of Medicine in Houston and author of the classic personality-type manual, The New Personality Self-Portrait.
So what is then BPD?
“Prick the delicate ‘skin’ of a borderline and she will emotionally bleed to death” - Kreisman and Straus
BPD has been described as emotional hemophilia. Patients have problems regulating their emotions; their moods may shift from extreme joy to deepest despair within hours or even minutes. BPD is the most common personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Some of the symptoms include lack of clear sense of self, recurrent suicidal and self-injury behaviors, chronic feelings of emptiness, intense and often short-lived displays of anger, stress-related dissociation, and paranoia. Like schizophrenia, BPD is a devastating mental illness, usually diagnosed in adolescence or early adulthood. In my case, it struck when I was 17 years old, but I was not admitted to the hospital until 19 years of age.
During my admission, my battle for survival looked like jagged cuts on arms, rageful fists at 3 a.m., and shrieks of terror at the sight of a doctor. I would stand entirely alone, feeling like an empty shell, looking into a mirror, and seeing a stranger. Or worse still, seeing my head hanging loose as though detached from my body. I would go to great lengths to avoid that situation, because, as an emotionally dysregulated person who experiences feelings in extremes, that situation would put me headfirst into a tailspin, so I would self-harm to relieve the emotional pain caused by my identity confusion.
What is equally frustrating is having chameleon skin that would make it harder for me to sit in a crowd. My chameleon skin is the reason attending funerals is excruciating. It is the reason I cannot watch any movie without weeping once or twice and then sobbing for an entire hour after the movie ends. My chameleon skin is why I can be at a party and seem drunk, for I am drunk off the happiness in the room. I react inappropriately at times due to these intense waves of emotions, but I am ashamed of every last one of all the reckless actions I so righteously defend. I take the rage I am not allowed to express in public and put it into myself. I hurt myself so much more than I will ever hurt you.
BPD in Women= Madness?
As you become familiar with the micro-reality of BPD, you realize that no woman's madness is individual. It does not grow outside of society but is rooted in it and its power structures. We are labeled as histrionic, manipulative, defiant, masochistic, and attention-seeking when, in reality, we are reacting in the sanest way possible to the insane conditions that confine us. These conditions are often brought about by social constructions of BPD. In other words, many people stigmatize us due to the normalization of negative discourses associated with the illness. The authority of clinicians who wield terms descriptive of BPD may reinforce creating negative qualities in their patients.
But, if we look into the history of women with BPD, we would notice that many—not all—have encountered childhood trauma. They have been abused emotionally or sexually by either a family member, a partner, a friend, a stranger, or even oppressive social systems at large. Hence, their emotional reactions are an expression of the often powerless situations they find themselves in. Screaming to gain one ounce of power back, these women do not fear having their basic freedoms taken away from them.
I am one of these women, and I am a core believer in radical change. I stand with replacing the label ‘borderline personality disorder’ with a more accurate, up-to-date label—one that carries within its definition a neutral representation of the diagnosis, primarily a gender-neutral one. We must not assume women are ‘mad’ or ‘over-emotional' whether they do or do not have BPD but rather empathize with their lived experiences and understand the power in the ability to ‘diagnose’ emotion. We must ensure that people with BPD enjoy all fundamental freedoms and rights, including the right to make decisions for their lives based on their informed consent. The medical community must make decisions around medical interventions and continuous observations in collaboration with BPD patients regardless of the stigma associated with the illness. Sometimes, they need to put science aside and listen to us, women, speak.
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