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Living with Borderline Personality Disorder BPD is difficult for many reasons, including unstable relationships, emotional reactivity and dysregulation, impulsivity, and other challenging features.

So how is it possible that a prevalent condition is so misdiagnosed? Here are just a few reasons why that could be. BPD is one of the most heavily stigmatized mental health conditions a person can experience. This rampant stigma has both tangible and emotional consequences that can worsen existing difficulties with BPD. In the form of judgments, blame, negative assumptions and discrimination, stigma can lead a person experiencing BPD to feel ashamed and hide their suffering. This leads to further negative emotion shame, loneliness, fear and attempts to suppress distress.

Even if individuals are determined enough to push through the stigma and seek treatment, they may encounter even more stigma. In addition, many professionals incorrectly believe that it is not possible to diagnose BPD in adolescents. This results in underdiagnoses and inaccurate prevalence rates. People with BPD typically also meet the criteria for multiple other diagnoses, including depression, anxiety, post-traumatic stress disorder, substance use disorders, eating disorders, bipolar disorder, and so on.

These disorders, of course, are not independent of BPD, but are connected and related through shared psychological, social and biological pathways. This is most likely due to some similarities between symptoms: impulsive behavior, intense emotions and suicidal thinking. Some of the problems with diagnosing result from the fact that there was no evidence of effective treatment for BPD until the s. Before then, many clinicians blamed people with BPD for not getting better, rather than acknowledging that professionals had not yet figured out how to treat people with BPD successfully, or trying to find more effective pathways for treatment.

This leads some professionals to avoid giving the diagnosis even when someone meets the criteria. Gender is another factor in misdiagnosis. The epidemiological rates of BPD in males and females are roughly equal. This happens in part because women are overrepresented in most studies and treatment.

Stereotypes about masculinity and femininity are also likely at play. Of course, there are many other factors that influence the accuracy or inaccuracy of a BPD diagnosis. However, the more individuals with BPD and their families become aware of these problems, the more they can advocate for accuracy.

A lack of understanding about BPD already prevents people from seeking treatment. And that starts with getting the correct diagnosis.

Alan E. He has adapted and implemented dialectical behavior therapy for underserved populations, and developed many successful DBT programs for people with borderline personality disorder and other problems with emotion regulation.

This article originally appeared at the NAMI. Fruzzetti, Ph. BPD Looks Like So Many Other Mental Health Conditions People with BPD typically also meet the criteria for multiple other diagnoses, including depression, anxiety, post-traumatic stress disorder, substance use disorders, eating disorders, bipolar disorder, and so on.


Alan Fruzzetti

Residents at Mountain Valley receive a comprehensive approach to care in a specialized setting, using evidence-based practices, including CBT based Exposure and Response Prevention Therapy with an emphasis on Acceptance and Commitment Therapy. Mountain Valley residents are typically bright, talented, perfectionistic — and stuck. About The Practice. Emotion Dysregulation in Families. If you are interested in the student rate please email emiller behavioralcarenj.


Alan Fruzzetti, PhD

You hear and read a lot about ways to improve your relationship. But if you've tried these without much success, you're not alone. Many highly reactive couples—pairs that are quick to argue, anger, and blame—need more than just the run-of-the-mill relationship advice to solve their problems in love. When destructive emotions are at the heart of problems in your relationship, no amount of effective communication or intimacy building will fix what ails it. If you're part of a "high-conflict" couple, you need to get control of your emotions first, to stop making things worse, and only then work on building a better relationship. The High-Conflict Couple adapts the powerful techniques of dialectical behavior therapy DBT into skills you can use to tame out-of-control emotions that flare up in your relationship. Using mindfulness and distress tolerance techniques, you'll learn how to deescalate angry situations before they have a chance to explode into destructive fights.

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