Thanks for letting us know more, and I'll ask a few more questions:
No problem, I'll try to answer them...
Women are diagnosed with BPD much more often than men are. Do you think this partly reflects an actual difference in likelihood of having BPD, and/or do you think that sexism plays a significant role in either women being over-diagnosed, or men under-diagnosed, or both?
Men and women are pretty much equally likely to develop this condition, however it is stereotyped to be a female disorder. This is actually one of the more common misconceptions, but I think that it's getting more awareness now.
It is disturbingly common for men to be misdiagnosed, while women are generally more accurately diagnosed with this condition, so it would seem that sexism could be a component to this, but there are other factors. For example, another factor is that men and women with this condition apparently do tend to present slightly differently, with men being more likely to have a history of substance abuse, and women a history of being medicated. Men also tend to be less likely to seek help and less likely to open up about their problems than the majority of women. As well as that, I think that men are more likely to feel ashamed about the needy side of the condition (I know I have trouble with this), which is unfortunate since there's nothing wrong with needing help and support.
Additionally this disorder is often enough comorbid with other disorders, such as Antisocial Personality Disorder, and men with comorbidity are likely to get a diagnosis for the comorbid condition, and the BPD symptoms are more likely to be either ignored or attributed to that other condition (with impulsive behaviour, for instance, which is also a symptom of Antisocial Personality Disorder).
Do you find that people with BPD are more stigmatized by mental health professionals than people with other mental disorders?
Some mental health professionals do have a negative bias about this condition, though I think it may not be the most stigmatized condition out there, it is certainly stigmatized more than other conditions.
How would you differentiate between stigma and understandable human responses to emotionally intense people?
This can be a difficult one for someone with BPD, as there is a real element of paranoia as well, so someone simply not saying "hello" to an individual with BPD can make the individual doubt the person cares about them, for instance, but it can be done with self awareness and rational thinking. Some different scenarios might help...
If the person has no idea that an individual has BPD and is strongly reacting to their behaviour, then obviously that is not part of the stigma.
Reacting to BPD behaviour when the person does know about the condition doesn't mean that they have a stigma either of course, say if a person sets clear boundaries for the person with BPD, or doesn't reward aggressive behaviour, that doesn't mean they have a stigma, but could indicate that they want to help the person, or at least continue the relationship.
Sometimes it is very clear that the person has a stigma however, as some people are very open about their negative feelings towards people with BPD, and seem to want to spread the stigma more. So often enough it is quite obvious if someone has a stigma, but not always, and when it isn't obvious, I'd really have to try to analyse it and try to get more info first.
When you tell someone you have BPD, is the label more likely to help them understand you, or to induce them to judge you negatively?
Without a good explanation to it, and/or if they don't know me well already, I think there's a greater risk of being judged than understood. That being said, people who know me well, even if they have a wrong opinion about the disorder, they will likely see that I'm not like the misconceptions they've likely heard about. I generally don't tell people who don't know me well, as I feel safer that way, and I think many people with BPD do tend to live in the shadows so to speak, especially in parts of the world where mental illness has a particularly negative stigma to it ~ like Japan and S.Korea for instance...Cool countries, but among the worst places to have to live with mental illness, especially one that is connected with suicidal behaviour.
Do you think that there's lots of confusion between borderline and
antisocial personality disorder, aka sociopathy? In particular, your sig says:
All four of those are APD traits, much more than they are borderline ones.
Yes, very much so! Basically one of the biggest misconceptions people seem to have in my experience is that they think of BPD as pretty much the same thing as APD or NPD. BPD is wrongfully stereotyped to mean that the person is dangerous, egocentric, and lacking in the ability to feel empathy for others...All of which is entirely incorrect, with the exception of some with comorbidity with conditions that have this symptoms (well some individuals with BPD can be dangerous too, but the majority are absolutely not). Regarding empathy, studies have shown that people with BPD actually feel more empathy than the average person, so that misconception is particularly hurtful. Manipulative behaviour is however a common symptom for BPD, but being self aware one can definitely over come this tendency, and not all people with BPD are manipulative. It's therefore not fair to think of all people with BPD as manipulative, even though it is common.
The worst misconception I've personally come across, which is directly tied in with the stigma, is the belief that BPD is the same disorder as Vulnerable/Covert Narcissism. This may be because that superficially and from a distance these two conditions can appear to have similarities, or again because of some cases of comorbidity, but actually they are very different conditions, sometimes polar in their differences.
I have a cousin who used to work at a mental hospital. She described borderline as "essentially sociopathy for women" and really disliked interacting with borderline patients - they frequently became extremely angry and verbally abusive for the slightest reason. Of course, she only saw the ones who were so affected that they ended up in a mental hospital. While she was wrong in that sociopathy and BPD are actually quite different, I can't help but think that some of the stigma comes from the fact that a large fraction of borderline patients, especially the more severe ones, are extremely unpleasant to interact with. Of course, the resulting negative stereotype then hits all people with BPD, not just the ones who are hostile. Lose-lose all around...
It's sad to hear of people working in mental hospitals having stigma, but this does happen. That's a good example of the stigma too, by the way.
Like all conditions, there are opposites within the condition. There are people who are self aware and people who are not self aware. There are people who are in control and people who are not in control over their own behaviour. Each of these factors will affect how tolerable it is to be around a certain individual. This is why some people have best friends who have BPD and have a stable relationship, while other cases of BPD everyone who comes in contact with the person would rather be elsewhere.
The good news is that those who aren't self aware can be taught to become self aware (or become self aware by themselves over time), and those who have little to no self control can gradually gain control over themselves. There's always the possibility of progression, and BPD is actually a disorder that has good percentage rates of significant progression, as it is a very treatable condition.
Its that variability or diversity that has allowed us to exist
