What a Difference a Label Makes

Judging by the many things I’ve seen people writing on blogs and Twitter, the diagnosis of borderline personality disorder, also known as emotionally unstable personality disorder, carries an extra component of stigma, visible in the actions of many medical professionals (e.g. doctors, nurses, psychiatrists etc). People with BPD/EUPD are often labelled as “manipulative” or “attention seeking” by supposedly-trained “professionals” and are treated badly by people who really should know better. These are my experiences in hospital before and after an EUPD diagnosis was given to me. The stays were three years apart but largely involved the same members of staff and was in the same hospital.

WARNING: This blog post discusses potentially triggering topics. Hospitalisation under section, forced treatment (and restraint) and self-harm are mentioned, so if you could be triggered by these topics, please read no further.

During my second psych ward stay, my diagnosis was “a schizophrenic illness.” By my third stay however, my diagnosis was now “paranoid schizophrenia with emotionally unstable personality traits” from now on referred to as EUPT. Some of the differences in the treatment I received was dramatic. Here are a few of these experiences, and also keep in mind that both of these stays were in the SAME hospital and while I was on a section 3.

Incident: Staff forgot to give me my night time medication (keep in mind I was on a section both times)

Before EUPT diagnosis: “I’m so sorry, I’ll make sure you get it tonight.”

After EUPT diagnosis: “Well it’s your responsibility to ask for your meds, it’s not my fault they weren’t given.” Said by the ONLY nurse who could have given me my meds the previous night and was the exact same nurse who had apologised to me three years previously. Also bear in mind that I couldn’t ask for my night meds because I had fallen asleep early and slept through until morning!

Incident: Lying on the floor, crying

Before EUPT diagnosis: A nurse knelt down beside me, trying to console me. Persuaded me to go and sit on my bed and once there, stayed with me until I calmed down.

After EUPT diagnosis: A nurse stood over me, talking down to me in a loud voice. “Get up off the floor and stop being silly. It’s not dignified what you’re doing.” Like I really cared about dignity whilst suffering intensely!

Incident: Male staff member wanting to weigh me

Before EUPT diagnosis: I asked for a female member of staff to weigh me. “No problem, I’ll find a female member of staff to weigh you.” Male staff member finds a female nurse, who weighs me and records my weight.

After EUPT diagnosis: I asked for a female member of staff to weigh me. After a very loud sigh, “Hang on a minute, I’ll see if anyone’s free.” Male staff member finds a female nurse, who weighs me but then she walks to the desk area, where the initial male member of staff is sat, which is within earshot of numerous other patients, including men. She loudly informs the male member of staff what my weight is and he writes it down, telling her (without lowering his voice) that it has gone up since the previous time I was weighed.

Incident: Being caught cutting, but not needing treatment

Before EUPT diagnosis: The implement was taken from me and my wounds were cleaned, while a nurse talked about what I’d done in a bid to stop me doing it again.

After EUPT diagnosis: After a loud sigh, “Go and clean yourself up. I don’t have the time to deal with you.” The implement wasn’t taken away and the nurse didn’t check to see if I had cleaned the wound, or even if I had stopped cutting.

Incident: Not eating

Before EUPT diagnosis: A nurse sat with me and talked about why I wasn’t eating. Helped me to start eating small amounts.

After EUPT diagnosis and also while I wasn’t drinking anything either: A healthcare assistant walks into my room with a drink, saying “I’m not leaving this room until you’ve had a drink.” She sits herself down beside me on my bed holding the drink towards me. I refuse to take it from her. “Come on, drink it” the HCA says. I shake my head, saying nothing. After around 15 - 20 seconds, she gives up and walks out, taking the drink with her.

Incident: Trying to struggle free whilst being forcibly injected

Before EUPT diagnosis: There were only three female staff members available. All three were present along with one male member of staff. Whilst having to use additional force to hold me down due to me trying to struggle free, they didn’t use excessive force or face-down restraint. After the injection, a nurse stayed behind to console me and explain why I had been injected.

After EUPT diagnosis: There were at least five female staff members available, possibly six or more. Only three were present, along with three male members of staff. Two of the men shouted at me to stop fighting. Eventually, one of the men picked me up without explaining to the other staff what he was doing, causing my arms and legs to be still held on the bed while the man had picked me up. I think it goes without saying that that hurt! Once the other staff had let go of me, the man turned me over, shoved me roughly back onto my bed, face-down, with his elbow in my back as the other staff held my arms and legs down again. After the injection, a nurse tells me (as she’s walking out) that I could have had the injection willingly, without “all this fuss.” I’m left alone on my bed, still slightly winded from being shoved face-down onto my bed. I’ve heard that face-down restraint is banned in Wales (which is where I was) but am not 100% sure of this.

So why the difference in the way I was treated? Given that the incidents largely involved the same members of staff and was in the same place, you couldn’t say that it was different hospitals, meaning different guidelines. The staff all remembered me from my previous hospital stay three years prior, and all involved either nurses or healthcare assistants, meaning they were (supposedly) fully qualified and not students. The only factor that really changed was the addition of the EUPT label. I don’t think I’m alone in experiencing different treatment due to a BPD/EUPD diagnosis and I know so many people who say that psychiatrists are really quick to add a BPD/EUPD label to people who have another mental health diagnosis, are female and self-harm. I’ve never been told why I have my EUPT label, despite a letter written by my previous psychiatrist two years ago, stating that these traits would be “assessed and explored” or words to that effect. In two years, the only time my EUPT label is mentioned is in official letters sent to places like the DWP and DVLA. To have a diagnosis that has such an impact on my treatment to not be explained to me is doubly wrong in my opinion. All diagnoses should be explained and no diagnosis should have an impact like this on a person’s treatment. BPD/EUPD does NOT mean a person is a mad, bad, manipulative attention seeker. BPD/EUPD is an illness that needs care, support and treatment like any other mental health diagnosis. Or even any other physical health diagnosis for that matter. Care, support and suitable treatment is what a person with any illness needs. A BPD/EUPD illness is no different.

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