#not dedicating myself to romantic attraction and relationships means my life is sad and empty apparently

[zibah-ho]

about to start chewing glass fr

[duchessofostergotlands]

Hi, jess! A couple of months ago I sent you an ask about a reality tv show (the farm) and a participant who has bpd (she didn’t win the 1 million price, btw - but she was so happy when she found out that a good portion of the public supported her, specially women ❤️ she’s famous because of only fans and most of her followers on social media, before her participation on the show, were men. So she said she was happy to see so many women supporting and following her now). Anyway while watching the show, I realized many of her behaviors were so similar to mine. Then my mom and sister, who live with me, told me they noticed that too. I decided to ask my psychiatrist and psychologist (I’ve been dealing with depression for the past 10 years), but both didn’t give it much credit. At the time I agreed with them - they said I probably don’t have bpd because the behaviors I was describing only happens when I’m home, with people I trust. I’m very “controlled” when I’m with other people, including my dad (who hasn’t lived with me since I was a kid). The point is, I’m ALWAYS making a huge effort trying to control myself in public - it’s exhausting and I believe it’s one of the reasons I tend to isolate myself. I think I’ve actually learned to camouflage my feelings and to avoid things that trigger me. I used to be more “uncontrolled” as a kid, before I created this deep rooted fear that people’d leave me because of these behaviors and reactions. Do you think it’s possible to camouflage some of bpd’s symptoms? And, if so, do you have any tips on how I could talk to my psychiatrist and psychologist about it? —— I didn’t want to make this ask any longer than it already is, but one of my childhood friends was recently diagnosed with autism. We don’t talk much nowadays, but she messaged me last month to tell me about her diagnosis and to ask if I felt I had some of the same treats - thinking retrospectively, we were very alike. It made a lot of sense and I remembered you said sth about bpd and autism sharing some similarities in some aspects of how the brain works. She also told me about recent studies showing the underreported diagnosis in women. My psychiatrist and psychologist also dismissed it, because I don’t avoid eye contact and have friends. I’m really confused right now, but it’s also kinda relieving to get to know myself a bit more and to think that the struggle I’ve felt my whole life is real. (Sorry for the long text!)

Hey :) Sorry it’s taken me so long to get back to you. Just like to be able to dedicate a bit of time to longer messages like this and I rarely have the attention span for it! But of course I remember the conversation, it was really interesting to hear about what the contestant went through. 

So yes, BPD and autism are often misdiagnosed as each other as there are similar traits that are often found. Usually around attractions to patterns and structure and also around empathy. Like I don’t generally feel empathy for people in the same way most people do. I’d say unless you’re a close friend or family member - or maybe if you’re a child - I probably wouldn’t feel empathy towards you. I generally make decisions about moral standpoints and such based on what logically makes sense to me rather than any kind of emotional connection because I just don’t really feel that. I think the reasons autistic people may sometimes struggle with empathy are different but to an external person would seem very similar so can often be confused. 

To address your two points that made you unsure about the diagnoses, BPD is definitely highly interpersonal so it can change drastically depending on who you’re with. I can be friends with someone for quite a while and they have no idea but if I’m in a romantic or physical relationship with someone they’ll know within a few days. Romantic relationships are my personal trigger so they’re where I struggle the most. Then in terms of autism, lack of eye contact doesn’t really mean anything. I think that’s a common misconception people have but two of my cousins are autistic and they were both very outgoing and friendly, they were incredibly tactile, I didn’t notice them not looking me in the eye but I probably don’t look people in the eye much because that feels weird haha. Women in particular are not well studied when it comes to autism as you kind of mentioned. They are generally better at “masking” and so are often misdiagnosed or their condition isn’t picked up until well into adulthood. So even if you have friends and can look people in the eye it wouldn’t necessarily mean you wouldn’t fit the criteria. 

I wouldn’t want to diagnose you with anything myself as I’m not a professional and I don’t know you personally. The DSM outlines the criteria for being diagnosed with BPD. You have to demonstrate at least five of the following and as with all mental illnesses they have to cause a significant impact on your ability to carry out your responsibilities and go through daily life:

Chronic feelings of emptiness

Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

Frantic efforts to avoid real or imagined abandonment

Identity disturbance with markedly or persistently unstable self-image or sense of self

Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)

Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

Pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as "splitting")

Recurrent suicidal behavior, gestures, or threats, or self-harming behavior

Transient, stress-related paranoid ideation or severe dissociative symptoms.

Those are the criteria that would most likely be used to assess you. In the UK we can be diagnosed with depression and anxiety by a GP but have to go to a psychiatrist or psychologist to get a PD diagnosis. It sounds like you’ve already been in contact with them. I’m not too sure how it works where you are. Can you get a second opinion? Are there other doctors you could make an appointment with? Could you go private? I’m very aware of the fact that having the NHS in the UK means that my experiences are not applicable to everyone’s circumstances but for me when I first went to get help I was given meds and a depression and anxiety diagnosis and sent on my way. When that didn’t help I went back and got a higher dosage. And then it still didn’t help and finally I was kind of at rock bottom (or I thought so at the time) and needed help and so what I did on that occasion was have a friend accompany me into the room. They had created a list of things they’d seen me do or heard about me doing that were concerning to them and gave them to the doctor, and they kind of backed me up and gave me moral support. It shouldn’t have taken someone else being in the room for me to be taken seriously but having someone there who could express what I might have been too shy or self conscious to say was really helpful. In the end I got referred for treatment and it wasn’t right for me ultimately as my problems were more complex but it helped for a bit. I don’t know if there’s anyone in your life you trust to be able to be there to support you but I think it can be really intimidating to push back with doctors and professionals and having someone there who knows you and cares about you can be the thing that gives you that extra bit of courage you need. 

I’m not sure how helpful that is but I’m available if you want to ask me any questions about BPD or any explanations of how I experience the symptoms or anything like that :)