Dancing on the Borderline

Often misdiagnosed, mistreated, or ignored, borderline personality disorder has emerged as one of the most troubling -- and most common -- challenges in psychiatry.

by Alicia Potter

"I'm better off dead than alone."

So Sholeh [*patient's names in this article have been changed] thought when she shoved her girlfriend, Amy, out of the bathroom, locked the door, and slumped to the floor with two bottles of Advil and a fifth of Bacardi. She swallowed the pills in fistfuls of five or six, washing them down with the rum.

Amy, due to leave for a weekend in New York, banged on the door. Sholeh ignored her. Then Amy did the unexpected -- or was it the expected? She promised to cancel her trip. Already dangerously dizzy, Sholeh stopped. She jammed her finger down her throat and vomited.

"It was as if I was saying, `Don't you dare go to New York,' " explains Sholeh, 19. "What I really was afraid of was that she'd meet someone else and leave me."

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Border patrol
Borderline Personality Disorder: A Definition

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This wasn't the first time Sholeh had resorted to drastic measures to avoid being alone. By the time she got to college, nights alone were triggering such severe anxiety attacks that she deliberately stretched her days well into the evening, scheduling back-to-back classes, activities, dinners with friends. Still, there were times in the wee hours when panic had its way. On those nights, she'd dig a razor into her shins and watch the blood wind crookedly down her legs.

She was depressed, or so the therapist told her before scribbling off a prescription for Prozac. But one afternoon Sholeh randomly opened Amy's psychology textbook to a photo from Fatal Attraction. She'd never seen the movie. She didn't need to. Sholeh immediately recognized the description of Glenn Close's bunny-boiling femme fatale, with her fear of abandonment and her manipulative suicide attempts, as almost a kindred spirit. According to the text, Sholeh's turmoil had a name: borderline personality disorder, or BPD.

It's not surprising Sholeh's therapist failed to diagnose it correctly. BPD shares characteristics with some better-known mental illnesses, such as depression and bipolar disorder. Sholeh's suicidal tendencies, low self-esteem, and mood swings might have pointed to one of those. But her intense anger, fear of abandonment, and "black-and-white thinking" -- that is, an insistence on seeing people and situations as either all good or all bad, with no in-between -- are hallmarks of the BPD sufferer.

On to part 2

Alicia Potter is a freelance writer living in Boston.