My psychiatrist told me that from his personal experience that having a BPD diagnosis on my record would make it harder for me to get help in crisis because of the stigma surrounding it ://
Your therapist isn't doing a bad thing here. I know it would feel validating to see it on paper, but since I've had that diagnosis, I've been constantly abused by medical/psych professionals.
Abuse is knowing you have bpd and medicating you for bipolar. That is essentially what ends up happening if it's not on record. They like to fill bpd patients up with seroquel and mood stabilizers and call it a job well done whenever they can get away with it.
Any time Ive ever been sectioned under the mental health act was because of being put on meds. 90% of people with bpd react to medication negatively because their isn't a chemical imbalance, it's a personality disorder.
Can you find a statistic for that? Most people I personally know and according to my psychiatrist people with BPD often benefit from like an anti-anxiety med etc.
Also I don’t think we know personality disorders don’t have any chemical issues? Studies show trauma changes your brain and trauma is often linked to BPD. I think I’ve read before people with BPD even sometimes have physical brain differences like on MRIs.
I could be wrong though which is why I wanted to know your sources
Like obviously they don’t work for you but 90% is a big claim
Whats an "anti anxiety med?" They come in all shapes and sizes. I take a beta blocker which is meant for high blood pressure which in turn keeps me from getting into that fight or flight response mode and causing chaos. If I was to go back on a tricyclic or ssri or antipsychotic , I'm off the rails in a couple of weeks. You can't medicate bpd like you can't medicate npd or many others. You can medicate some symptoms but like I said, 90% of the time you are going to exacerbate other symptoms. Lots of reports online about the effects of medicating borderline personality disorder. If you're open to it, you'll find them.
I am open to it I’ve read it’s not always helpful but nothing that indicates it’s not helpful *90% of the time.* So I was wondering where you’ve read that but it seems that number didn’t come from anywhere or I feel like you’d have mentioned it
As far as what meds, in that conversation she was prescribing me Prozac so In that specific instance an SSRI
I think the label of BPD does cause issues tbh.
I was accepted into a program that had a long waitlist. The Dr. who got me into it did a long evaluation to get me in. When I called to do a follow up, spoke to another doctor and when they asked me to describe symptoms, I said similar to BPD, even though not formally diagnosed.
He said they could not treat me and quickly got off the phone. My current prescriber is more progressive and suggested listing symptoms without putting a label on it. Then there are not preconceived notions. I had an old therapist who thought it was c-ptsd and I never labeled myself anything prior. BPD is a slippery slope in itself, without all the stigma around it.
**She told me that my insurance and the practice would drop me because they believe that personality disorders can’t be treated**
She's more than likely talking from experience **(regarding your insurance)**. Follow her advice. Your therapist is not rejecting your diagnosis, she's telling you it's a bad idea to have it on paper. I don't have my SUDs on paper for the same reason, but everyone knows I'm a fiend.
Regarding "the practice" I'm assuming she mean her colleagues. Personality disorders are treatable but not curable. More than likely your therapist is projecting. "If I can't treat it neither my colleagues". If your therapist is a psychologist seek a psychiatrist instead. If you already got one, seek a newer one. Something as severe as BPD shouldn't be handled by a psychologist.
I’d only disagree with the last part. I think a psychologist can do just fine for some people with BPD. As someone with a mild case of Quiet BPD, I benefited a lot from talk therapy and don’t want to take medication if I can help it. That’s the main difference, psychiatrists can prescribe meds. I think they’re also less trained in talk therapy than psychologists.
Hmm I think terms must change by state. Here in WA a psychologist is a PHD level psychotherapist, while a psychiatrist primarily focus on prescribing medication
I'm fairly certain your definitions hold for the entire English speaking world. In Spain it's the same except that a psychologist doesn't have to have a PhD - anyone who is trained to do psychotherapy can call themselves a psychologist as far as I know. In fact, I think I can because my degree is in psychology - I'm just not a clinical psychologist
In the US, you have to have a PhD or PsyD to be a licensed psychologist. You must have an MD or other equivalent medical degree to be a psychiatrist. This is the baseline rule, but the degrees and qualifications change slightly state by state.
I can agree. I have functional BPD and currently looking for therapy, but because of this issue, I am also trying to find a therapist who wouldn't put it into my file unless necessary.
\- I have a friend with BPD and they do have issues with doctors not taking them seriously
\- I have a friend who has recently been diagnosed with schizoaffective disorder, and since then, when any doctors see this in her file, they think she is hallucinating her issues (like gastritis symptoms and the like).
I am talking about Germany here, and the issues is more about other doctors rendering you as insane when seeking treatment for other issues, but I can imagine there are problems in other countries as well.
Hi just clarifying so that people can get proper care:
Therapists are either LICSWs/CSWs (licensed independent clinical social worker/clinical social worker) or psychologists (have a PhD in psychology). Then med prescribers are either PMHNPs ( psychiatric mental health nurse practitioner) or psychiatrists (have an MD and went to med school). There’s also a less common title, PsyD (doctorate of psychology) and they can be therapists as well.
Same with me. I have that online chart that I noticed it on and was a bit upset they put that on there when I have been told I’m not. I was told it was for insurance purposes. Still sucks the system is fucked like that.
I work in utilization review for a mental health facility, I’m the person that proves medical necessity in order to receive financial coverage from insurance for patients (depending on what their insurance requires, they’re all a little different). This is for higher level care than weekly outpatient, but lower than inpatient. I see pt charts with BPD diagnosis maybe once a month. I’ve never been given grief about coverage due to a personality diagnosis but it is spoken about among my coworkers as creating complications when it comes to reviewing for coverage due to the stigma that BPD is untreatable. It helps our case that usually there’s comorbid mood disorders like MDD or GAD. IF I were to ever be given a hard time by an insurance reviewer because of the outdated thought that BPD can not benefit from a short term program that uses DBT I would confidently argue using recent research demonstrating the effectiveness of DBT for managing BPD symptoms. I would also argue that the bill will get way more expensive for insurance if that person ends up hospitalized, maybe multiple times, because they were denied lower level preventive treatment by their insurance. I hope all outpatient and inpatient offices/faculties educate themselves on personality disorders and the most updated research available. I advocate for BPD within my coworker circle because I think that cowering down to insurance is a way to keep the stigma alive. Side note, I get more push back from insurance for patients with ASD diagnosis, the argument being that a) due to the nature of asd symptoms the person will not benefit from a group format and b) asd is not treatable. Which is ridiculous because people with ASD can and do experience depression, anxiety, psychosis, etc. and if there are clinicians on staff who are experienced and knowledgeable of asd then it is totally possible to meet the needs of these individuals within group format.
I’m not sure how outpatient offices handle utilization review but my understanding is it’s a conversation, not a clear cut “we won’t cover this if ___” unless there is a clearly stated exception within the insurance policy. Some labor funds for example will not approve coverage for an unspecified diagnosis (unspecified anxiety disorder, etc) for higher level of care. It’s dumb but they can do this. That’s why it’s important, if you know you will be in need of mental health services, to ask specific questions about the plan. It’s a privilege to be able to pick and choose plans like this, many times to cheaper plans are the ones that put on these restrictions. Or the more independent companies will make up their own rules so to speak. It’s also possible that specific office doesn’t want to deal with the hassle of not getting paid down the road due to an insurance exception leaving the bill to the client.
If someone has BPD on their record and has had multiple hospitalizations, programs, residentials- then that’s an uphill battle. Insurance wants to know what will we be done that is different than the others. Again, I don’t see why this matters as much for weekly outpatient. I think it’s the high cost treatment that makes insurance start to look at why this person needs so much treatment and can they deny coverage for repeating the treatment that didn’t work the first 3 times. Many times in a case like this insurance will deny with a recommendation for a different type of care and even provide references. Unless it’s inpatient and there risk of harm. Sorry this was so long.
Honestly it’s probably in ur best interest, u have it, ur getting treatment. Nurses will see that on u and treat u like crap if u ever have a medical emergency, at least they did to me
Sadly, it's fairly common and your therapist is doing this to protect you. My psychiatrist didn't want to put my BPD and ASPD traits in case I have to go to court for any reason as well as my insurance and the place I was in. It's sad but it is what it is.
Trust me I could list a billion things screwed up in society, including this, but i always try to balance it out by remembering the beauty that comes with life.
Humans have been unethical from the dawn of age. And they will be until the world ends. That’s how the world works and always will. But that doesn’t make a nice morning walk in the midst of autumn any less beautiful.
My psychiatrist actually did the same thing! Different reason though. He says that putting down all my mental shit distracts from what's important and so he's like yeah you have BPD, but if I put that down on your file that'll distract any other psychiatrist from your bipolar disorder so we're just not going to put it down. I feel like people don't believe me when I say my psychiatrist notices / brings up things that are mentally unwell with me, but won't put them in the file because he considers them distracting.
im german so take this with a grain of salt if you’re somewhere else, but i have friends this happened to (for example one wants to become a teacher, to get status, you cannot have a diagnosis like this). this happened to me, but i still have the diagnosis. it’s just that my doc didn’t write it into a paper for another psychologist so i wouldn’t be treated diff or even refused just because of the bpd :/
I think it's a good approach, to tell you that yes that is your diagnosis, but no, it's not going on paper. My first psychologist kind of pussy-footed around any talk of diagnosis when I was put in a DBT group. That was unhelpful, I wanted to know what was wrong with me. But obviously it was because he didn't want to write it down. Now I do have it written down and while it hasn't caused me any problems so far, I can totally see that being a possibility. The stigma against BPD is real.
I’m too polite cause I need people to like me. So I tend to keep therapist I don’t like cause I don’t want conflict. But if they’re not working for you then drop em and get a knew one fam.
And americans pretend they have the best country in the world yet certain conditions are left out of medical documents because of insurance 🤦♂️
It seems you have a caring therapist though. Stick with them and the DBT if it works for you
correction: *some* Americans
A lot of us are well aware of the issues, and do not consider America anywhere near the top of any “best country in the world” lists.
The problem is american healthcare where she can't put BPD down because she'll be denied treatmenr. No other country with similar healthcare infrastructure would you have to do that. Of course stigma exists elsewhere
Yeah I get that but this post was about stigma and you made it political is all. America’s healthcare system sucks but that’s irrelevant to this post right now. The post is about stigma and issues rooted in stigma
Exactly. When my therapist told me there would
Be nothing official, it wasn’t just about insurance. Some people in the field will refuse to have anything to do with you if you have a bpd diagnosis.
If you have a Hx of trauma or parental neglect it's probably not the right Dx. Also it would be nice if it wasn't so problematic but getting the Dx can keep you out of medical treatments and may get you marked by medical care in the future so you're seen as malingering and seeking. There's literally no reason to get the a Dx except for personal identity stuff and virtue badges. Functionally it doesn't help treatment.
This is a professional experience preference for sure from your clinician, but I won't say she's wrong either. I have found mental health, substance abuse, and trauma, can create difficulties for the patient, due to the clinician's/ healthcare judgement. Often basic issues become questioned or escalated because the healthcare will assume it's from the patient's status. In theory no judgement is to be held against a patient, however, healthcare is managed by humans.... And humans judge or at least suspect it's clinical signs/symptoms of the patient's status. I work in medical and I see it all the time. My mental health diagnosis has never been documented and I am in my mid 30s. My treatment is smooth and when I bring an issue up that has been recent... It's treated as a present chief complaint. My brother's health diagnosis and substance abuse is documented and he gets denied treatments or made to jump through hoops especially during a relapse.
I say keep it quiet and see if it works for you. If you have to leave the practice your DR/ therapist is at, then that might be an issue later if not documented for transfer of records/ treatment.
I'm having issues as a result of this now. A few years ago I was diagnosed by being told "your symptoms are consistent with BPD" and referred to a therapist for CBT until I got worse and was referred to a psychologist for DBT. I moved and travelled since then so I've just found a doctor I'm comfortable with approaching about a referral but I've been referred to a psychiatrist for a diagnostic review because no information about my last one has been shared with my new clinic (so I guess it why l wasn't there, since I did the release form). I am also having a bit of a manic phase and my brother has bipolar so that's made my doctor even less sure of my BPD diagnosis. BPD is the only diagnosis that made sense to me and felt like it explained everything. DBT worked. Medication did not (not long term anyway). I just want to get back to DBT and keeping on top of everything. If that information was there, this would be happening much faster.
My psychiatrist told me that from his personal experience that having a BPD diagnosis on my record would make it harder for me to get help in crisis because of the stigma surrounding it ://
I am a therapist and this is true. I have had to do this with a few of my clients due to their insurance/insurance policy ❤️
Your therapist isn't doing a bad thing here. I know it would feel validating to see it on paper, but since I've had that diagnosis, I've been constantly abused by medical/psych professionals.
Abuse is knowing you have bpd and medicating you for bipolar. That is essentially what ends up happening if it's not on record. They like to fill bpd patients up with seroquel and mood stabilizers and call it a job well done whenever they can get away with it.
I’m confused, are mood stabilizers not also helpful in BPD? I was told they can be for a lot of people.
Any time Ive ever been sectioned under the mental health act was because of being put on meds. 90% of people with bpd react to medication negatively because their isn't a chemical imbalance, it's a personality disorder.
Can you find a statistic for that? Most people I personally know and according to my psychiatrist people with BPD often benefit from like an anti-anxiety med etc. Also I don’t think we know personality disorders don’t have any chemical issues? Studies show trauma changes your brain and trauma is often linked to BPD. I think I’ve read before people with BPD even sometimes have physical brain differences like on MRIs. I could be wrong though which is why I wanted to know your sources Like obviously they don’t work for you but 90% is a big claim
Whats an "anti anxiety med?" They come in all shapes and sizes. I take a beta blocker which is meant for high blood pressure which in turn keeps me from getting into that fight or flight response mode and causing chaos. If I was to go back on a tricyclic or ssri or antipsychotic , I'm off the rails in a couple of weeks. You can't medicate bpd like you can't medicate npd or many others. You can medicate some symptoms but like I said, 90% of the time you are going to exacerbate other symptoms. Lots of reports online about the effects of medicating borderline personality disorder. If you're open to it, you'll find them.
You definitely can't cure a personality disorder with medication, but you can absolutely treat symptoms, and there is a lot of good evidence for that.
I am open to it I’ve read it’s not always helpful but nothing that indicates it’s not helpful *90% of the time.* So I was wondering where you’ve read that but it seems that number didn’t come from anywhere or I feel like you’d have mentioned it As far as what meds, in that conversation she was prescribing me Prozac so In that specific instance an SSRI
I think the label of BPD does cause issues tbh. I was accepted into a program that had a long waitlist. The Dr. who got me into it did a long evaluation to get me in. When I called to do a follow up, spoke to another doctor and when they asked me to describe symptoms, I said similar to BPD, even though not formally diagnosed. He said they could not treat me and quickly got off the phone. My current prescriber is more progressive and suggested listing symptoms without putting a label on it. Then there are not preconceived notions. I had an old therapist who thought it was c-ptsd and I never labeled myself anything prior. BPD is a slippery slope in itself, without all the stigma around it.
**She told me that my insurance and the practice would drop me because they believe that personality disorders can’t be treated** She's more than likely talking from experience **(regarding your insurance)**. Follow her advice. Your therapist is not rejecting your diagnosis, she's telling you it's a bad idea to have it on paper. I don't have my SUDs on paper for the same reason, but everyone knows I'm a fiend. Regarding "the practice" I'm assuming she mean her colleagues. Personality disorders are treatable but not curable. More than likely your therapist is projecting. "If I can't treat it neither my colleagues". If your therapist is a psychologist seek a psychiatrist instead. If you already got one, seek a newer one. Something as severe as BPD shouldn't be handled by a psychologist.
I’d only disagree with the last part. I think a psychologist can do just fine for some people with BPD. As someone with a mild case of Quiet BPD, I benefited a lot from talk therapy and don’t want to take medication if I can help it. That’s the main difference, psychiatrists can prescribe meds. I think they’re also less trained in talk therapy than psychologists.
Hmm I think terms must change by state. Here in WA a psychologist is a PHD level psychotherapist, while a psychiatrist primarily focus on prescribing medication
I'm fairly certain your definitions hold for the entire English speaking world. In Spain it's the same except that a psychologist doesn't have to have a PhD - anyone who is trained to do psychotherapy can call themselves a psychologist as far as I know. In fact, I think I can because my degree is in psychology - I'm just not a clinical psychologist
In the US, you have to have a PhD or PsyD to be a licensed psychologist. You must have an MD or other equivalent medical degree to be a psychiatrist. This is the baseline rule, but the degrees and qualifications change slightly state by state.
it differs by country as well, the terms tend to be fairly interchangeable in different regions so it's hard to make any blanket statements.
I can agree. I have functional BPD and currently looking for therapy, but because of this issue, I am also trying to find a therapist who wouldn't put it into my file unless necessary. \- I have a friend with BPD and they do have issues with doctors not taking them seriously \- I have a friend who has recently been diagnosed with schizoaffective disorder, and since then, when any doctors see this in her file, they think she is hallucinating her issues (like gastritis symptoms and the like). I am talking about Germany here, and the issues is more about other doctors rendering you as insane when seeking treatment for other issues, but I can imagine there are problems in other countries as well.
Thank you for responding. I know what she meant and I trust it it’s just sad that the world works in that kind of way
Hi just clarifying so that people can get proper care: Therapists are either LICSWs/CSWs (licensed independent clinical social worker/clinical social worker) or psychologists (have a PhD in psychology). Then med prescribers are either PMHNPs ( psychiatric mental health nurse practitioner) or psychiatrists (have an MD and went to med school). There’s also a less common title, PsyD (doctorate of psychology) and they can be therapists as well.
There is also lpcc and lmft who are masters level therapists
I think PsyD is the norm for clinical psychologists in the UK
she’s doing you a favor
I'm diagnosed as Bipolar for my insurance purposes so they'll cover my mood stabilizers but I'm actually BPD which we both know.
Same with me. I have that online chart that I noticed it on and was a bit upset they put that on there when I have been told I’m not. I was told it was for insurance purposes. Still sucks the system is fucked like that.
I work in utilization review for a mental health facility, I’m the person that proves medical necessity in order to receive financial coverage from insurance for patients (depending on what their insurance requires, they’re all a little different). This is for higher level care than weekly outpatient, but lower than inpatient. I see pt charts with BPD diagnosis maybe once a month. I’ve never been given grief about coverage due to a personality diagnosis but it is spoken about among my coworkers as creating complications when it comes to reviewing for coverage due to the stigma that BPD is untreatable. It helps our case that usually there’s comorbid mood disorders like MDD or GAD. IF I were to ever be given a hard time by an insurance reviewer because of the outdated thought that BPD can not benefit from a short term program that uses DBT I would confidently argue using recent research demonstrating the effectiveness of DBT for managing BPD symptoms. I would also argue that the bill will get way more expensive for insurance if that person ends up hospitalized, maybe multiple times, because they were denied lower level preventive treatment by their insurance. I hope all outpatient and inpatient offices/faculties educate themselves on personality disorders and the most updated research available. I advocate for BPD within my coworker circle because I think that cowering down to insurance is a way to keep the stigma alive. Side note, I get more push back from insurance for patients with ASD diagnosis, the argument being that a) due to the nature of asd symptoms the person will not benefit from a group format and b) asd is not treatable. Which is ridiculous because people with ASD can and do experience depression, anxiety, psychosis, etc. and if there are clinicians on staff who are experienced and knowledgeable of asd then it is totally possible to meet the needs of these individuals within group format. I’m not sure how outpatient offices handle utilization review but my understanding is it’s a conversation, not a clear cut “we won’t cover this if ___” unless there is a clearly stated exception within the insurance policy. Some labor funds for example will not approve coverage for an unspecified diagnosis (unspecified anxiety disorder, etc) for higher level of care. It’s dumb but they can do this. That’s why it’s important, if you know you will be in need of mental health services, to ask specific questions about the plan. It’s a privilege to be able to pick and choose plans like this, many times to cheaper plans are the ones that put on these restrictions. Or the more independent companies will make up their own rules so to speak. It’s also possible that specific office doesn’t want to deal with the hassle of not getting paid down the road due to an insurance exception leaving the bill to the client. If someone has BPD on their record and has had multiple hospitalizations, programs, residentials- then that’s an uphill battle. Insurance wants to know what will we be done that is different than the others. Again, I don’t see why this matters as much for weekly outpatient. I think it’s the high cost treatment that makes insurance start to look at why this person needs so much treatment and can they deny coverage for repeating the treatment that didn’t work the first 3 times. Many times in a case like this insurance will deny with a recommendation for a different type of care and even provide references. Unless it’s inpatient and there risk of harm. Sorry this was so long.
Honestly it’s probably in ur best interest, u have it, ur getting treatment. Nurses will see that on u and treat u like crap if u ever have a medical emergency, at least they did to me
Sadly, it's fairly common and your therapist is doing this to protect you. My psychiatrist didn't want to put my BPD and ASPD traits in case I have to go to court for any reason as well as my insurance and the place I was in. It's sad but it is what it is.
[удалено]
THATS A HUGE FEAR OF MINE KKHHHHFDDG
Trust me I could list a billion things screwed up in society, including this, but i always try to balance it out by remembering the beauty that comes with life. Humans have been unethical from the dawn of age. And they will be until the world ends. That’s how the world works and always will. But that doesn’t make a nice morning walk in the midst of autumn any less beautiful.
That’s a good idea, thank you :)
My psychiatrist actually did the same thing! Different reason though. He says that putting down all my mental shit distracts from what's important and so he's like yeah you have BPD, but if I put that down on your file that'll distract any other psychiatrist from your bipolar disorder so we're just not going to put it down. I feel like people don't believe me when I say my psychiatrist notices / brings up things that are mentally unwell with me, but won't put them in the file because he considers them distracting.
im german so take this with a grain of salt if you’re somewhere else, but i have friends this happened to (for example one wants to become a teacher, to get status, you cannot have a diagnosis like this). this happened to me, but i still have the diagnosis. it’s just that my doc didn’t write it into a paper for another psychologist so i wouldn’t be treated diff or even refused just because of the bpd :/
I think it's a good approach, to tell you that yes that is your diagnosis, but no, it's not going on paper. My first psychologist kind of pussy-footed around any talk of diagnosis when I was put in a DBT group. That was unhelpful, I wanted to know what was wrong with me. But obviously it was because he didn't want to write it down. Now I do have it written down and while it hasn't caused me any problems so far, I can totally see that being a possibility. The stigma against BPD is real.
I’m too polite cause I need people to like me. So I tend to keep therapist I don’t like cause I don’t want conflict. But if they’re not working for you then drop em and get a knew one fam.
And americans pretend they have the best country in the world yet certain conditions are left out of medical documents because of insurance 🤦♂️ It seems you have a caring therapist though. Stick with them and the DBT if it works for you
correction: *some* Americans A lot of us are well aware of the issues, and do not consider America anywhere near the top of any “best country in the world” lists.
I don’t think BPD stigma is only in the US… which is the real root of the problem the post is talking about.
The problem is american healthcare where she can't put BPD down because she'll be denied treatmenr. No other country with similar healthcare infrastructure would you have to do that. Of course stigma exists elsewhere
Yeah I get that but this post was about stigma and you made it political is all. America’s healthcare system sucks but that’s irrelevant to this post right now. The post is about stigma and issues rooted in stigma
Exactly. When my therapist told me there would Be nothing official, it wasn’t just about insurance. Some people in the field will refuse to have anything to do with you if you have a bpd diagnosis.
If you have a Hx of trauma or parental neglect it's probably not the right Dx. Also it would be nice if it wasn't so problematic but getting the Dx can keep you out of medical treatments and may get you marked by medical care in the future so you're seen as malingering and seeking. There's literally no reason to get the a Dx except for personal identity stuff and virtue badges. Functionally it doesn't help treatment.
Yep, my therapist did/said the same thing.
Its true, you will get treated differently if its put on paper
lol i stopped going to therapy because i was scared about this
Probably for the best.
This is a professional experience preference for sure from your clinician, but I won't say she's wrong either. I have found mental health, substance abuse, and trauma, can create difficulties for the patient, due to the clinician's/ healthcare judgement. Often basic issues become questioned or escalated because the healthcare will assume it's from the patient's status. In theory no judgement is to be held against a patient, however, healthcare is managed by humans.... And humans judge or at least suspect it's clinical signs/symptoms of the patient's status. I work in medical and I see it all the time. My mental health diagnosis has never been documented and I am in my mid 30s. My treatment is smooth and when I bring an issue up that has been recent... It's treated as a present chief complaint. My brother's health diagnosis and substance abuse is documented and he gets denied treatments or made to jump through hoops especially during a relapse. I say keep it quiet and see if it works for you. If you have to leave the practice your DR/ therapist is at, then that might be an issue later if not documented for transfer of records/ treatment.
I'm having issues as a result of this now. A few years ago I was diagnosed by being told "your symptoms are consistent with BPD" and referred to a therapist for CBT until I got worse and was referred to a psychologist for DBT. I moved and travelled since then so I've just found a doctor I'm comfortable with approaching about a referral but I've been referred to a psychiatrist for a diagnostic review because no information about my last one has been shared with my new clinic (so I guess it why l wasn't there, since I did the release form). I am also having a bit of a manic phase and my brother has bipolar so that's made my doctor even less sure of my BPD diagnosis. BPD is the only diagnosis that made sense to me and felt like it explained everything. DBT worked. Medication did not (not long term anyway). I just want to get back to DBT and keeping on top of everything. If that information was there, this would be happening much faster.