For decades, it was clear something wasn’t right.
My mother, a professional educator, knew there was something wrong with my behavior, so she sent me off to my first therapist at the tender age of 14. I can still remember him blowing smoke rings while I cried. My first therapy experience was not very productive.
Why was I even there? My mother knew I was acting out in school (a Catholic elementary where all of my teachers K-8 were nuns) and even to the point of being defiant. But they had no idea why and I wasn’t telling them.
After the disaster of that first try at therapy, I was pretty much on my own until late college when I started going again, on my own volition. For the most part, I had a deep desire to talk to someone — someone who would agree that my problems with keeping friends, getting along with co-workers and fits of rage, were because of wrongs done to me.
Borderline personality disorder (BPD) was not that well understood when I was a young adult. The diagnosis didn’t appear in a diagnostic manual until the DSM III in 1980. Marsha Linehan introduced dialectal behavior therapy (DBT) as an effective treatment in 1993.
By 1993, at the age of 30, I had already seen more than 10 therapists. Most of them believed I was living with some form of depression. I got all kinds of pills — I was on the psycho-pharma merry-go-round.
In 1996, my first marriage ended and in 1997 a new one began with barely enough time to find myself, let alone a compatible partner. I had married the first women who would say yes; now, terrified of being alone, I married the second woman who said yes. I should have been a better husband in both cases and I truly regret that.
Through the 90s and into the 2000s, more therapists and more diagnosis came and went — dysthymia, major depressive disorder (MDD), mood disorder not otherwise specified, anxiety, generalized anxiety disorder (GAD) and so on. Later, post-traumatic stress disorder (PTSD) and bipolar disorder II were added, not without reason.
By 2010, I was married for a third time. I had lost a job in radio and in print journalism after absolutely pointless fit-throwing and immature ranting. As the decade wore on and the effects became worse, it gradually dawned on me that the only constant in all of these lost marriages, jobs and friendships was me.
By the summer of 2017, I had been on over 30 different medications and had over 30 different mental health professionals in my 54 years.
I started seeing my current psychiatrist in 2013. While seeing her, I went through four more therapists. I was seriously ready to give up on therapy.
During one check-in with my psychiatrist last summer, I ranted again about people who had, in some way, wronged me. I described a mass unfriending of Facebook friends as a “decapitation” that had been a long time in coming.
The doctor had a funny look on her face — one she’d had before during one of my “episodes.” A cautious woman, at this point, whatever I had been saying to her for the last four years reached critical mass.
She got up and got her copy of the DSM-V. She opened it to the nine criteria of which five must be present for a diagnosis of BPD. She put the book in my lap.
I’ll never forget the sinking feeling of looking at the criteria. Silently, I tallied them up in my head. “Seven of them unmistakably, two of them probable,” I told her. She nodded. After over 40 years, I finally had a proper diagnosis.
How did I (and everyone else) miss this?
Many of my symptoms mimicked bipolar disorder II and that diagnosis still sticks, although now as a secondary. But what about before that diagnosis? I had spent years talking the ears off my therapists to no avail — however, I had to admit that, up until now, I had not worked with a therapist for over one year and most for six months or less. They never got to really know me.
And with all the therapists I fired, I lashed out at those I felt were not taking me seriously or telling me what I want to hear. And then fearing life without therapy, I would quickly look for another therapist again. Two symptoms are present right there.
I could talk all day but I had to admit – many times I was putting on a show for the therapist. I’d manipulate (symptom) the conversation to score points and demonstrate not only my intelligence, but the fact my problems were the result of the way others treated me.
And BPD was something so off the charts for me that I never even considered it. It was in front of my face all the time. I could have been diagnosed much earlier if I had dared to be honest with myself and my therapist. And, finally, I spent enough time with one mental health professional for her to put the puzzle together.
If I had to offer any advice for those seeking a diagnosis that fits, no matter how much we hate it, my best tip is this: consider the problem may be in your own behavior, your own reactions to people and events and your own inability to rationally process your anger. If you can face these truths honestly, and be open enough about them in therapy, you may save yourself from years of frustration.
I should have been diagnosed no later than age 35. And it was mostly my fault. Therapy should not be treated as a game — realize that real work has to be done by you and that honesty is the most important facet of counseling. Sometimes, possibly in my case, these realizations only came with a long march toward emotional maturity.
I wish you well in your journey toward mental health and greater self-awareness.
Editor’s note: Please see a doctor before starting or stopping a medication.