Early Intervention for Borderline Personality Disorder

AUG. 05, 2020

By Andrea Rosenhaft LCSW-R


When I was in my twenties, I was using cocaine, starving and cutting myself. I destroyed a promising career in marketing due to multiple long-term hospitalizations for severe anorexia. After I was discharged from the eating disorder unit for the second time, my company dismissed me, and I collapsed into a severe depression and attempted suicide.
 
After even more suffering, and another attempt at my life, I was diagnosed with borderline personality disorder (BPD). By then, I was 29 years old. 
 
I’d like to think if I’d been diagnosed ten years earlier, I could have avoided decades of self-destruction and emotional pain. I could have learned coping skills to help me tolerate seemingly intolerable feelings. However, it was 1990 when I received my diagnosis. And, at the time, it was unheard of to diagnose an adolescent with BPD. 
 
Unfortunately, today it’s still “the norm” to ignore a potential BPD diagnosis during adolescence. This has to change. Especially as research is making it increasingly clear that to prevent a BPD diagnosis from becoming a life-long trajectory of pain and suffering, we need early intervention and treatment to be a priority. 

How Early Intervention Could Have Helped Me

I grew up in a chaotic household. My father, who was extremely intelligent and an alcoholic, verbally and emotionally abused me. His cruel and sarcastic barbs shot straight through to my core, even as a young child. His words damaged me in a way that stayed with me as an adult. 
 
If I’d been diagnosed earlier, while I still lived at home, I would have had access to treatment sooner. Working with a therapist, I could have learned coping skills to help me keep my father’s abuse
at an emotional distance rather than internalizing it. 
 
Instead of the young girl who sought refuge in drugs, cutting and starving, instead of the young woman who believed she did not deserve to live, a different young woman might have emerged from that home. One who carried herself proudly, who possessed self-confidence and who did not need to self-destruct to fill a void.
 
Unfortunately, that’s not what happened. And when my father died in 2013, so many years after his abuse, my boundaries cracked. A year after he passed away, I attempted suicide. I’d been ensnared in an abysmal depression for months preceding the attempt. I was not mourning his death. Rather, I was full of repressed rage and resentment. Anger was not a feeling that was permitted in our childhood home. So instead of exploding — I imploded. 
 
However, I was fortunate that through a combination of insurance coverage, family support and clinicians who generously adjusted their fees, I had uninterrupted access to the intensive treatment I needed and was able to recover. 

Advocating for Early Intervention

In 2017, the Global Alliance for Prevention and Early Intervention for Borderline Personality Disorder (GAP) was formed. This initiative aims to promote early detection and intervention across the health, education, welfare and justice system. This includes ensuring that mental health providers receive education and training for how to identify BPD in young people. 
 
Putting this initiative in place will serve to fight the stigma against BPD that continues to exist within the psychiatric community. Educating additional clinicians will help them understand that we are not manipulative, we are not merely seeking attention and that we do really want help. 
 
I once heard Marsha Linehan describe those who have been diagnosed with BPD as having emotional third degree burns. My hope is that more clinicians will be open to treating people, especially young people, diagnosed with BPD.
 
My therapist and I stopped treatment at the end of 2016, when I was fifty-five — a marker I considered an enormous achievement. By that point, I had been going to therapy consistently for 33 years. There were times I believed I’d never be able to function without paying someone to talk to each week.
 
While I believe this amount of time could have been significantly shorter if I had been diagnosed sooner, I’ve learned to stop asking “what if?” Instead, I focus on the strength and resilience I’ve gained, and I advocate for early intervention. Our kids deserve nothing less. 


Andrea Rosenhaft is the founder of BWellBStrongBPD, a mental health advocacy and awareness organization. BWellBStrongBPD recently launched with the purpose of fighting the stigma that exists around BPD and to let others know that full and sustained recovery from BPD is possible.

 

 
 

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