On The Borderline

Help us Bring Borderline Personality Disorder into the light!

Please sign this petition to support changing the name and designation of Borderline Personality Disorder (BPD) in the next publication of the Diagnostic Statistical Manual of Mental Disorder - 5th edition (DSM-V).

Background

The DSM is published by the American Psychiatric Association and provides diagnostic criteria for mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies and policy makers. The DSM-V is due to be published in 2010. The DSM organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability (only two are important to us):

• Axis I: clinical disorders, including major mental disorders, as well as developmental and learning disorders
• Axis II: underlying pervasive or personality conditions, as well as mental retardation

BPD is currently categorized under AXIS II because it is deemed a personality disorder.

Changing BPD to AXIS 1

The BPD Awareness Campaign is dedicated to changing BPD to AXIS I for the following reasons:

• BPD is a major mental illness and should be treated as such
• The most recent research on BPD indicates that this disorder is a highly treatable condition. It is not permanent and unchanging as is currently indicated under the AXIS II designation.
• BPD is excluded from many managed care and healthcare plans, and most parity bills in the United States
• In Canada treatment is often restricted to those with an Axis I diagnosis such as Schizophrenia, Bipolar Disorder and Clinical Depression
• Due to stigma, support groups are virtually nonexistent and family members are often blamed for the illness
• Clinicians, aware that a person meets criteria for BPD, often substitute an Axis I diagnosis such as major depression, bipolar disorder, and/or posttraumatic stress disorder, which are reimbursable. This results in under-diagnosis of BPD and over diagnosis of other disorders.

Putting BPD onto AXIS 1 would make it a mainstream serious mental illness that is worthy of care and treatment.

Changing the Name

The BPD Awareness Campaign is dedicated to changing the term BPD for the following reasons:

• It is inaccurate and confusing - Mental illness is no longer categorized as either neurotic or psychotic. Therefore BPD cannot fit on the “Borderline”.
• It imparts no relevant or descriptive information-  It says nothing of the key elements of BPD- Emotional dysreguation, Impulsivity, Cognitive dysregulation
• It reinforces stigma-  the very mention of the term “personality disorder” suggests that the person’s  personality is flawed. This is very upsetting to individuals in recovery, especially when they are already questioning their self-worth and identity.
  
  

  One possible alternative proposed by Marsha Linehan, Ph.D (an expert in BPD) is Emotional Regulation Disorder. This term integrates a key component of BPD - Emotion dysreguation. Another term proposed isEmotional Processing Disorder.This last term better integrates emotional dysreguation and the cognitive dysreguation which is now thought to be a key factor in BPD.