Talking about Borderline Personality Disorder
From Girl, Interrupted to Crazy Ex-Girlfriend, pop culture has long wrestled with the topic of Borderline Personality Disorder – but could we be doing better?
“I’m either psychotic or neurotic. Neurotic: bad for me. Psychotic: bad for you.” This bone-cutting summary of Borderline Personality Disorder (BPD) from comedian Tommy Tiernan both captures its essence and reduces it to the most base of explanations. His routine about the subject, seen in his 2014 Stray Sod show, expands his feelings a little. In a nutshell: "I’m not good on my own or with people."
As a comedian living with BPD, his job is to laugh at the issue, to remove the harsh initialism from its spiky casing and coax out enough humour to soften its rusty edges. It’s a frightening and lonely thing, made worse by stigma and misinterpretation.
In terms of widely-discussed mental health issues, BPD hasn’t really been one we’ve heard much about. While it’s one thing for someone actually living with the condition to reduce it to simplistic terms – psychotic or neurotic – when it comes to the general public’s understanding, there aren’t many readily accessible sources out there to help them understand it. For many, it’s a baffling concoction of syndromes which, as with most mental illnesses, differs wildly from person to person. Few have attempted to illustrate BPD explicitly for what it is – no euphemisms, no bullshit – in the mainstream, as opposed to the portrayal of better known mental illnesses, like how BoJack Horseman deals with depression, or the illustrations of anxiety and panic attacks in This Is Us.
Despite this, BPD is flirting pretty heavily with the general public at the moment, thanks to news about Pete Davidson, a stand-up comedian and cast member on Saturday Night Live with BPD, and his alleged engagement to Ariana Grande after dating for a matter of months. Eyebrows raised, news, gossip and fan sites are pseudo-confused but are mainly using these events as an excuse to assign it the same fate as other mental illnesses – Obsessive Compulsive Disorder (OCD), depression, bipolar disorder - that the phrase "that’s so BPD" has been born.
It’s true that impulsive acts, particularly when it comes to relationships – romantic or otherwise – could be considered a blend of some of the nine diagnostic criteria. But the act of reducing BPD to a character trait is both unhelpful and unhealthy. It’s already seen as a punchline and a trope; to trivialise or cartoonise it is dangerous.
In TV, film, music and books, portrayals of characters with BPD are few and far between. Girl, Interrupted, the 1999 film starring Angelina Jolie and Winona Ryder is based on American author Susanna Kaysen’s memoirs of being hospitalised, and is one notable example of BPD on film.
It’s not the mainstream’s responsibility to ensure that every mental illness is coddled into user-friendly, audience-attracting, money-grabbing media. One TV show, however, has firmly grasped this nettle: The CW’s Crazy Ex-Girlfriend. Perhaps it’s because many have found a relatable protagonist in Rachel Bloom’s confused and often self-aware character, Rebecca Bunch, or perhaps it’s because the team had two seasons under their belt – allowing audiences to connect, empathise with and fall for characters – before slipping in the reality behind what makes the eponymous ex-girlfriend ‘crazy’, but the response has been, generally, favourable. In the musical comedy series, Bunch confesses something to her therapist, which has shades of what Tiernan spoke about in his ‘either/or’ routine: “My whole life I’ve only known how to be really good or really bad, but being human is living in that kind of in-between space.”
Maggy Van Eijk, author of How Not to Fall Apart, a book that uses the author’s hard-earned lessons to give advice on how to live safely with mental ill health, cites Crazy Ex-Girlfriend as a useful representation. “It was great for me, especially her diagnosis episode,” she says. “It really depicted the mixed feeling of not wanting to be stigmatised, but also finally wanting some semblance of a label, so you can start to piece together what’s going to help you moving forward.”
As Crazy Ex-Girlfriend demonstrates, it can be difficult to get a BPD corroboration from a doctor or psychiatrist; in my case, it took more than a decade and included mis- and re-diagnoses of depression, anxiety, OCD, and disordered eating before the word ‘borderline’ was ever uttered. I’m one of many who feels ‘textbook’, but it’s understandable that psychiatrists are wary to pinpoint it as the be-all and end-all.
“I am aware that a lot of people feel diagnostic labels can be stigmatising,” says Dr. Ed Burns, Consultant Psychiatrist at The Priory in London. “However, I have seen a lot of patients who do not find the terms ‘borderline’ and ‘emotionally unstable’ stigmatising and instead have expressed relief that they have a way to describe or categorise their symptoms. This often comes with the realisation that they are not alone in suffering and that once ‘named’, there may be ways to help manage their condition.”
When we reconsider the recent eyeballing of Pete Davidson for his quick engagement to Grande, it’s laudable that he is vocal and seemingly unashamed to discuss his experiences. Chris Young, author of Walk a Mile: Tales of a Wandering Loon, believes that it’s important to have content makers look harder at how they render Borderline Personality Disorder in their work.
“I can’t think of any well-thought-out depictions of other men with BPD in the media,” he says. “This reflects the stigma and prejudice around the diagnosis. If we can enable the producers of content across the media to look at BPD in a realistic way – not in a sensationalist or othering way – then things will gradually change.”
Stripping away screens, editing and viewer pleasing, the reality remains that diagnosing and being diagnosed can be a muffled and inconsistent experience. Almost every diagnosis of BPD contains parallels with other mental illnesses; in fact, it is often considered an umbrella, sheltering many others under its malleable canopy. This inevitably makes it difficult to portray it in a way that will please everyone; can the reality of living with BPD ever square away with its filmic or literary image? It’s hard enough to get a doctor to tell you that you have it, let alone to find someone who can piece together its myriad quirks in order to present it in a way that will be comprehensible for passers-by.
While it’s obviously important to bring the subject to light, it’s just as imperative that content producers don’t fall into the trap of having a character be defined by their BPD and nothing else. This is difficult; the complexity of the condition can be overwhelming and it’s easy to see how those with no lived experience can find it hard to separate the person from the diagnosis. In my experience, however, people living with BPD are fascinating, funny and incisive with lots to say – and not just about their diagnosis. This is why it’s so important to see BPD represented in the likes of Crazy Ex-Girlfriend and Girl, Interrupted, as well as having spokespeople like Pete Davidson around to bring three-dimensionality to the condition. Visible depictions of illnesses are crucial, but above all else, the people – intricate, nuanced, authentic – behind these must also be revealed.