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Diagnosed with "traits of Borderline Personality Disorder" confused


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A few weeks back, I was able to see a list of my diagnoses, and I was shocked to see "traits of Borderline Personality Disorder" listed.  I go to a psych resident's clinic where my doc changes every year, and I had recently seen pdoc #2 for the last time and was waiting to see pdoc #3. 

 

So I called up pdoc #2, (who gave me the diagnosis) and asked for an explanation.  He says, "I don't think you have Borderline Personality Disorder."  (great, so why give me the diagnosis at all?)  He basically went on to say that I had the diagnosis because I have low self-esteem, which he claimed to have spoken to me about.  I don't remember having this conversation with him in the past, and I'm pretty sure it never happened, but it's basically my word agaist his. 

 

In an attempt to understand about why I had been given this diagnosis, I read up on BPD, and no where did I read "low self-esteem" as a symptom of the illness.  I tried to be really honest with myself, but don't see how the crieteia fit me. 

 

I spoke with pdoc #3, who will be taking over my care for the next year, about the diagnosis.  He said that he wouldn't take the diagnosis from me (which I didn't expect him to) on the basis of one meeting, but instead gave me a list of characteristics of people with BPD--none of which fit.  So as we went through my history, he pointed out things that do fit with the diagnosis of BPD.

 

1.  suicidal thoughts.  I get suicidal thoughts that tend to come and go, which pdoc #3 says fits with the characteristics of BPD.  he says that people with depression get suicidal thoughts that tend to stick around.  Now I haven't actually attempted suicide since I was 13--which was over 20 years ago.

 

2.  self-harm.  I banged my head as a kid.  Haven't done it since I was 13.  In the past year, I have had obsessive thoughts of cutting myself, but haven't acted on them.

 

 

I'm really frustrated and confused with this diagnosis.  I know it carries a lot of stigma, and I'm angry about having been given it.  It's on my medical records now, and all I can do is accept it and maybe petition pdoc #3 to remove it after we have worked together for a long time.  I am upset that it's on my medical records though because all my other medical providers can see it (they all work for the same hospital system and I know for a fact that they can see this diagnosis, I actually found out about it through my cardiologist), and I'm afraid they won't take me seriously when I need them to take me seriously because I have a lot of other medical conditions that need to be treated. 

 

So how do I cope with this?  is there any way to get it removed from my medical records?  How do I ensure that I keep getting the same treatment from my other medical providers that they gave me before I had this diagnosis?

 

 

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I have this on my list of dx's but actually, maybe not anymore? I don't really know for sure, but it was on there. I think mainly because of the self-harm at the time (been over 2 years, coming up on 3, since I've done it) and impulsivity? I guess?

 

I know it carries a lot of stigma and I have a few friends have full-blown BPD, and I am nothing like them. My tdoc explained it as a...I don't know the word she used, can't remember, but that some people are a lot more severe than others, it's all a range. All I knew about BPD was the level at which those 3 friends have it. Super intense. That was my only comparison so I was super upset to see that on my list, but I kinda chalk it up to we all have personality stuff, if you look at things closely enough you can dump them into a category somewhere (for my dx I mean, not implying that statement for everyone with BPD or BPD traits).

 

That's not to say it doesn't deserve some attention or help, it's just how it helped me deal with it. That I can work on it, it's not a forever dx for a lot of people, and the actual label doesn't 'matter, it's how you treat the symptoms.

 

I'm not sure about getting it removed from medical records...pdoc never even told me he wrote it down as a dx, I was told when I was tdoc what pdoc had listed.  Right now, the bigger issue for me is the schizoaffective stuff and getting that settled down.

Edited by forgetmenot220
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With medical records, at least here, you have the right to request that they be amended.  If your physician refuses to amend them (which it seems like may happen here) you are entitled to attach a note to your medical records stating that you disagree with XYZ portion and believe that it is incorrect.

 

The thing about BPD and CPTSD is that there is actually a fair bit of overlap in the middle - it has been explained to me as almost like a Venn diagram.  So a lot of people with CPTSD are going to have some things in their history that "look like" Cluster B traits.

 

At this point probably the best thing that you can do is to discuss this further with your new pdoc as he gets to know you better, so that you can get a clearer idea.  Going over the criteria one by one and trying to match it up isn't really a substitute for someone with an understanding of your whole clinical picture.  If you are very upset about what is in your medical records, you can request again that they be amended or attach a note.  But given your doctor situation you may have to be a little patient.

 

This doesn't have to define or re-define you.  There is not much that you can do about how other doctors will see it, because they have their own entrenched ideas.  All you can do is continue to advocate for yourself as you have been doing and, at worst, change doctors.  I have had mixed experiences.  For the most part I have been able to get needed medical care but I also have the option of not disclosing my diagnosis to other providers and I usually do not disclose it.

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I would be very frustrated in your situation

 

And that is his criteria?  Suicidal thoughts and some headbanging or self harm as a youth?

I think that is sort of flimsy

 

By those measures my husband would be DX with BPD traits, and I almost would

 

Do you have access to other psych or Pdocs?  Can you get another opinion?

Can you get  help from a therapist?

Can you put a letter in your medical records disputing this DX of BPD Traits?

 

I hope you can do something, it might take time

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Thanks for the support. 

 

 

Forgetmenot, you reminded me that I had some psychological testing done a year ago, and one of the results of that was that I tested for being high in impulsivity. Maybe that's a part of this.  I don't know.  No one has really given m an explanation that makes sense to me. 

 

 

bpladybug, I appreciate the validation. 

 

Unfortunately, getting a new pdoc isn't really an option.  I have Medicare and Medicaid, and I'm lucky to be going somewhere that accepts them both.  Finding a pdoc who accepts Medicare around here is virtually impossible. 

 

And the thing is, I like pdoc #3, who will be treating me for the next year.  He was friendly, personable, funny, but didn't crack jokes at the wrong times, and appropriately concerned when I talked to him about my suicidal thoughts.  He was also willing to take time to address my concerns about the BPD traits diagnosis.  He just didn't have a very good answer because he's not the one who gave me the diagnosis and he just met me.

 

It was pdoc #2 that I had a problem with.  I tried to get transferred to a different doc after our first appointment, and that just blew up in my face.  The good thing is that I don't have to see him anymore.  The bad thing is that I am stuck with his diagnosis now, and getting a personality disorder diagnosis changed feels like an uphill battle. 

 

I spoke with my therapist about all this.  She doesn't feel like I have BPD, but explained that the diagnosis is on a continuum now so that it's basically been watered down to apply to a lot more people.  Given my complex trauma, and the # of years I have been in therapy (10), she says the docs need to justify to the insurance companies my continuing to get treatment (which seems stupid, I thought insurance companies didn't want to pay for Axis II diagnoses because they don't really get better).  Her suggestion was that I talk with the nurse at my pdoc's clinic about all this and that my best defense was that pdoc #2 never told me about the diagnosis.  When I spoke with the nurse, she referred me back to pdoc #2, who claimed he had already told me about the diagnosis. 

 

 

Tryp, Thanks as well.  I'm in school to be a counselor, and we have actually talked quite a bit about the politics behind C-PTSD vs BPD.  And BPD made it into the DSM-5 whereas C-PTSD didn't.  So I guess the only legitimate diagnosis they can give me is "traits of BPD" even if I don't meet the full criteria for the diagnosis.  I wish I had the option to not tell my other providers about my psych diagnoses, but one of the reasons I chose the clinic that I go to is because I wanted my docs to be able to talk to eachother.  I just have to hope it doesn't bite me in the ass.  I like all my doctors, and I don't want to have to change now. 

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If you have doctors that you like and trust, who already know you, it probably raises the odds that they will continue to treat you with respect and not mind the paperwork too much.

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I agree with tryp.  I only found out about my "Traits of Cluster B Personality Disorders" via my SSDI paperwork -- that was a mindfuck and a half.   My psychiatrist eventually admitted that he probably would've diagnosed me with full BPD when he first saw me, but he didn't know me well enough.  I've seen him for seven and a half years and I do trust him.

 

That having been said, only one of my clinicians has ever treated me poorly because of it (someone I specifically sought out because he was trained in DBT and we just were NOT a good fit personality-wise) and I did find the strength to leave, so...  it's not a death sentence for being taken seriously.  No one else, including the psychiatrist who initially gave me the diagnosis, thinks that I qualify for BPD 'now', but I keep the diagnosis hanging around my signature to remind me how far I've come, basically, and because I've been there.

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Unless a lot of people say that the diagnosis is accurate and claim that you're simply in denial about it, I've found that it's best to mentally dismiss diagnoses that don't seem to fit. I was labeled with Borderline Personality Disorder traits as well (and two other full-blown personality disorders), and I'm glad that I never took the diagnosis seriously. It would have negatively impacted my view of myself and my self-esteem if I had. 

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