PORTRAYAL OF BORDERLINE PERSONALITY DISORDER WITHIN THE MEDIA

What is Borderline Personality Disorder?

Borderline Personality Disorder (BPD) is one of the lesser-known mental illnesses and yet it is also one of the most stigmatized and scrutinized, especially in regard to how the media and T.V present it (if ever). According to the official NHS website, Borderline Personality Disorder is a psychological disorder which affects how a person might feel, react, think and interact in social settings. The NHS also state that the current treatment for this disorder includes psychotherapy and heavy medication [1].

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BPD and Self-harm

It has been found that patients who suffer from Borderline Personality Disorder often consistently have issues with addiction, self-harm and other dangerous behaviours. Self- harm relates to the act of purposely hurting or mutilating the body; it is sometimes referred to as nonsuicidal self-injury (NSSI) [3]. This behaviour is not predictable and can result in death (intentional or otherwise). Many patients have admitted that they use self-harm in order to feel a sense of control over emotions and psychological trauma, though there can be many other factors as to why a person might feel the need to self-injure [4]. For example, Salters-Pedneault (2020) found that attachment issues such as emotional neglect along with sexual abuse and dissociation, significantly increased the likelihood of someone self-harming [5]. Nia (2018) has found that patients with BPD often self-harm in order to relieve intrapsychic pain. Intrapsychic pain is more commonly known as psychological pain or, in even simpler terms, a feeling of intense numbness[6]. It is linked to the part of the brain that is also affected by opioids [7].

BPD and Substance Abuse.

Addiction has always been a problem for many different people (and will continue to be a problem) but it is an even bigger problem for those who suffer from mental health issues, especially BPD. Perry M. Duncan states that people who are diagnosed with Borderline Personality Disorder can be defined as self-sabotaging and emotionally unstable which often correlates with the diagnosis of substance abusers, more specifically those that abuse opioids [8]. Opioids, such as heroin, codeine and fentanyl, are most commonly used as a form of pain relief [9]. BPD is known to cause extreme mental pain and turmoil so it isn’t all that surprising to learn that patients commonly abuse opioids as a form of coping with their condition.

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BPD and Societal / Self Stigma

In such a progressive society it should never get to the point where a serious illness (mental or otherwise) is overlooked or stigmatized by qualified health professionals.

“People with a diagnosis of personality disorder often experience stigma both outside of, and within, mental health services.” [12]

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Societal stigma around mental illnesses is extremely harmful (a fact we are all painfully aware of) but self-stigma can be just as harmful, if not more. Self-stigma can be defined as when a person with any mental health issue becomes too aware of a well-known stigma around the disorder they suffer with and then they often internalize what the media is saying [14]. This can often be very detrimental to a patient's condition.

"Women with BPD suffer from more self-stigma. This may reflect intense labelling processes as being mentally ill due to repeated hospitalizations, frequent interpersonal difficulties, and visible scars." [15]

In the very rare chance that the media chooses to write or report on Borderline Personality Disorder, it is often presented in a negative view. It was found that, in a 10-year period, personality disorders such as BPD are often mentioned in relation to violence [16].

The idea that people who suffer from this illness are violent or manipulative is both old-fashioned and harmful. An example of this would be the character of Hulk [17] from Marvel films. He is shown as not being able to process any real feelings and instead switches from a kindly, quiet man to a ‘monster’. If the media continues to depict BPD in this manner, there will be no hope of educating or bettering society and the way we talk about mental health.

BPD only affects up to 2% of the population but it has an extremely high mortality rate with 10% of all patients committing suicide [18]. Ischaemic heart disease has a very similar mortality rate and yet there are many charities set up with the sole purpose of funding new treatment options and clinical trials. There is none of this kind of support for BPD patients despite the death rates being very similar. The main difference is that heart disease patients present with physical pain rather than the mental pain and turmoil BPD patients go through every day.

References

1. Overview: Borderline Personality Disorder. (2019).NHS. [online] Available at: https://www.nhs.uk/mental-health/conditions/borderline-personality-disorder/overview/ [Accessed 5 Mar. 2021].

2. Clearview Women’s Center. (2021). Available at: https://www.clearviewwomenscenter.com/blog/splitting-in-bpd [Accessed 5 Mar. 2021].

3. Klonsky, E. D., Victor, S. E., & Saffer, B. Y. (2014). Nonsuicidal self-injury: what we know, and what we need to know. Canadian journal of psychiatry, 59 (11), 565-568. [online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4244874/ [Accessed 5 Mar. 2021].

4. Self Injury/Cutting. (2018). Mayo Clinic. [online]. Available at: https://www.mayoclinic.org/diseases-conditions/self-injury/symptoms-causes/syc-20350950[Accessed 4 Mar. 2021].

5. Salters-Pedneault, K. (2020). Self-Mutilation and Borderline Personality Disorder. Verywell Mind. [online]. Available at: https://www.verywellmind.com/self-mutilation-425484. [Accessed 4 Mar. 2021].

6. intrapsychic. (n.d.) Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. (2003). Available at: https://medical-dictionary.thefreedictionary.com/intrapsychic [Accessed 3 Mar. 2021].

7. Nia, B.A. (2017). Opioid addiction and borderline personality disorder. The American Journal on Addictions,27(1), pp.54-55.

8. Duncan, P. M. (2020) Substance Use Disorders: A Biopsychosocial Perspective. Cambridge: Cambridge University Press.

9. Opioid Overdose. (2020). World Health Organisation. [online]. Available at: https://www.who.int/news-room/fact-sheets/detail/opioid-overdose [Accessed 4 Mar. 2021].

10. Homeland Security. (2021). Available at: https://www.dhs.gov/opioids [Accessed 4 Mar. 2021].

11. Weight, E.J. & Kendal, S.(2013). Staff attitudes towards inpatients with borderline personality disorder. Mental Health Practice, 17(3), pp.34-38. [online]. Available at: http://eprints.hud.ac.uk/id/eprint/26848/ [Accessed 4 Mar. 2021].

12. Bowen, M. (2019). Stigma: A linguistic analysis of personality disorder in the UK popular press, 2008–2017. Journal of Psychiatric and Mental Health Nursing, 26(7-8), pp.244-253.

13. Help Guide. (2020). Available at: https://www.helpguide.org/articles/mental-disorders/borderline-personality-disorder.htm [Accessed 4 Mar. 2021].

14. Corrigan, P. W., & Rao, D. (2012). On the self-stigma of mental illness: stages, disclosure, and strategies for change. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 57(8), 464-469. [online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610943/ [Accessed 4 Mar. 2021].

15. Rüsch, N., Hölzer, A., Hermann, C., Schramm, E., Jacob, G.A., Bohus, M., Lieb, K., & Corrigan, P.W. (2006). Self-stigma in women with borderline personality disorder and women with social phobia. The Journal of nervous and mental disease, 194(10), pp.766-773.

16. González, R.A., Igoumenou, A., Kallis, C., & Coid, J. W. (2016). Borderline personality disorder and violence in the UK population: categorical and dimensional trait assessment. BMC Psychiatry 16, 180. [online]. Available at: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0885-7 [Accessed 5 Mar. 2021].

17. The Incredible Hulk. (2008).[film]. Directed by L. Leterrier. Universal Pictures.

18. Understanding Borderline Suicides. (n.d.). Tara4BPD. [online]. Available at: https://www.tara4bpd.org/new-page-16 [Accessed 3 Mar. 2021].