Blog
As a child there were indications that I wasn’t the same as other kids and I found socialising with peers challenging, and engaged in self-destructive behaviours. After struggling with my mental health for several years I was given the diagnosis of borderline personality disorder (BPD) whilst inpatient on an acute ward. This fitted some my experiences, but the label was given based on observations and without a formal assessment. I was also missing certain key traits that would make a diagnosis more accurate, for example I have no history of trauma, I did not have erratic or extremely intense relationships, nor was I impulsive. Alongside a previous diagnosis of OCD I accepted BPD as the probable cause of my difficulties.
In my early 20’s I was struggling to access therapy, and it was recommended that I undergo an assessment for autism. I hadn’t really considered autism as something that I related or connected to, but I could see how many of the criteria fitted my experiences. Once I was diagnosed with autism, I felt hopeless and begrudging. To me it meant that no matter how hard I tried and how much effort I put into therapy I could never eradicate the distress that I had to endure daily. I never fully accepted that I have autism.
Once I had the label, accessing psychological help became even more difficult. Even though both BPD and autism were recorded I was turned down for long term therapy because my risk was considered too high, I was not stable enough and autism was considered the primary diagnosis. After committing to several therapeutic processes and seeing little benefit I was referred to a specialist personality disorder therapeutic community in London. As part of their research programme, I completed the BPDSI and IPDE assessments several times, coming out definitively below threshold for a diagnosis each time. I learnt a lot about life skills and discovered a resilience I acutely needed but it took hindsight to realise that I put in a lot of effort for comparatively little reward.
After discharge I still couldn’t function well enough to hold down a part time job or to stop myself from spiralling. I was desperate to make changes but because I’d had such extensive intervention in the past, and autism was now my primary diagnosis I was considered unsuitable for further treatment and I felt hopeless. Throughout all of this I was under the care of CMHT who advocated for me to access therapy at all junctions. Without them I wouldn’t have then been accepted to then take part in an 18-month DBT programme which ultimately changed my life. The DBT team worked in a person-centred, compassionate, adaptive way that saw my difficulties and strengths holistically, as part of a whole person, not as a walking diagnosis.
Several years later I am now going into my third year of a medical science degree and have lived semi-independently in halls for the first two years of my degree. I’ve also done a lot of lived-experience work within the NHS and for research studies. I have purpose and a plethora of coping skills that allow me to study, work and have meaningful social interactions. Without the BPD diagnosis I would not have had access to this life-changing help.
I’m still not convinced autism is an accurate diagnosis, but I think it is a better fit than BPD. In addition to access to more psychiatric help it has allowed me to give myself permission to use stimming and unconventional relaxation techniques in private, and to understand better certain aversions to strong sensory inputs.
Whether autism or BPD; both, either or neither could be accurate in my case, but misdiagnosis has not been wholly negative, and without both diagnoses I would not be where I am today.