Borderline or emotionally unstable personality disorder?

What's in a name? Quite a lot actually. Back when I first started the blog I thought long and hard about what to call it. Now, I have to think long and hard again about another new name - do I want to call my new label borderline personality disorder, or emotionally unstable personality disorder? I mentioned before that I've so far been referring to it as 'this whole borderline thing', and with Therapist we've been calling it 'what you've/I've got' but I need to pick one and settle with it, if for no other reason than it'll make referring to it in sessions that bit easier. Also I need to take ownership, and if even applying the name to myself defeats me, then I've a long, long way to go in terms of acceptance.

To be honest, I think I prefer borderline, although that's a term that's fallen out of favour and I don't think it's used in the DSM anymore. While it sounds scary, it's also kind of vague - do the vast majority actually know what borderline means? I think (and I could be wrong) that the name originally came about because when the disorder was first recognised, people were thought to be on the borderline between neurosis and psychosis, hence borderline personality disorder. Since then, (and I'm still learning so don't quote me on this) it has been established that the disorder is far more complex than that, and as emotional instability is a key factor in diagnosis, a new name was born. I'm less enamoured of this one. First off, it's a mouthful. Also, it pretty much says what it is. I don't like to think of myself as emotionally unstable. I wouldn't like to say to someone that I'm emotionally unstable. I feel like it carries a whack more stigma than depression, that by it's very name it implies that I'm unpredictable and reactive. I feel like it's a name that would scare people a whole lot more, make people far more wary of me. But in reality, does it? Or is that my own fear coming through? Because here's the thing. I am unpredictable and reactive. I can be incredibly emotional, and my reactions can be out of all proportion to a particular event. Thankfully (for everyone else anyway) my more massive reactions tend to turn inwards and affect me more than anyone else, and right now, things are starting to stabilise. The extreme spikes in mood of two months ago have levelled out a lot, and I'm starting to recognise when my reactions may be disproportionate to what has triggered them.

Image credit: Dirk's big bunny blog
I saw Therapist yesterday, and we spent quite a bit of time trying to tease this out. She had an analogy for me that made a lot of sense, I'll try and explain it. Take meningitis. There are a lot of different symptoms, and not everyone gets every symptom. Likewise, one symptom alone doesn't lead to a diagnosis of meningitis, for example, while a rash is a typical symptom, a rash alone is not meningitis. However, a rash and a severe aversion to bright light might be more serious. Does that make sense? What she was trying to get me to understand (and if you can follow this she succeeded) is that I need to look at my moods and reactions and see if they're in proportion to what's going on (just a rash) or else extreme (rash and bright lights). When I start to be able to make that distinction, then I can start to take more control of it, by recognising what's going on. How that control is going to come about though is a whole other ball game.

By the end of yesterday's session we had agreed on emotionally unstable personality disorder, or EUPD which is slightly easier to say. It's still a mouthful. It's still a huge label. Therapist keeps telling me how much work I have ahead of me, that it's a cruel diagnosis, but that we've a lot done already. So I'll keep on keeping on. I'm still not sure I can actually say out loud 'I have emotionally unstable personality disorder'. It sounds too big, too scary, unreal somehow. But I can write it. And I'm starting to see the difference between just a rash and something more. I know I've a long way to go, but I also know I'll have a lot of help on the way. Once I remember that, it doesn't seem so threatening.




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