Dear psych professionals: please screen for BPD

This is a short message for anyone in the psych industry who reads this forum.

Please, please, please screen for Borderline Personality Disorder in all of your new patients. Read the DSM definition. Understand it. Understand that the patient only needs 5 out of the 9 symptoms. Understand that the patient may not display the stereotypical symptoms of self-harm and reckless behavior, so you have to look more closely. Pay attention when they talk about attachment problems. Don't assume that rapidly changing moods are because of Bipolar Disorder. If you have actually been trained properly you will be able to tell the difference before long. Remember that PTSD and BPD often occur in the same person, but not always. Understand that people with BPD feel extraordinary distress in their daily lives, distress which many people underestimate. If you underestimate the distress level, you are probably going to fail in treating the person, as they will simply move on to any other behavior that lowers their distress.

Above all, don't wait weeks, months, or years to give the diagnosis of BPD, or even worse, fail to tell the patient at all. This is the worst mistake I see, and it happens over and over again. You are basically stealing time from a suffering person's life. Don't do it. Tell them what the hell is going on.


Thank you.

Agree.

katana wrote:Agree.

Thanks!

And please don't play into the fear of abandonment by refusing to treat them after the diagnosis because it would be "too hard"!

betterlatethannever wrote:Tell them what the hell is going on.

I agree completely. A patient has a right to have a role in their treatment. Hiding a diagnosis without consent (implied or otherwise) is unethical.

Completely agree with all of this!

Thanks to everyone who has responded.

Telling the truth is absolutely vital to therapy. It's what validation is all about.

Agree that telling the truth is important. Validation is one thing therapy can do for people, and can be really important if they have never had their feelings validated in any way, and it isn't the only thing honesty is important for - its hard to get help with anything without being honest in therapy.