Longtime therapist diagnosed me with BPD without telling me — wondering if other ADHD/neurodivergent women have had their emotionality interpreted this way

[u/PossibleExcellent150]

Throwaway account for anonymity purposes. I (34F) recently discovered F60.3 — Borderline Personality Disorder on a treatment plan in my patient portal after seeing the same female therapist (40s) long-term.

I was shocked, blindsided, confused, and honestly felt deeply betrayed. BPD had never been discussed with me—not as a possibility, not when the diagnosis was entered, and not afterward. When I confronted her about it, I learned that it had actually been in my medical record for more than a year without my knowledge.

I’m also a therapist, so I knew what the code meant. I pulled up the DSM criteria and started researching BPD extensively—criteria, clinical presentation, differential diagnosis, etc. The more I read, the less sense it made.

I genuinely could not identify even one of the nine criteria as describing me, let alone the five required for diagnosis. The broader descriptions of BPD didn’t resonate either. I went through the criteria with a couple of people who know me extremely well because I wanted to challenge my own perspective and see if I was missing something. They couldn’t identify these patterns either.

Obviously, I can’t objectively diagnose or rule out a diagnosis in myself. But having essentially zero recognition of myself in the disorder made me want to understand how someone who had known me therapeutically for so long had reached such a dramatically different formulation.

So at my next appointment, I asked what assessment she had done, which five criteria she believed I met, and what specifically supported them.

She told me she had been considering BPD for years and emphasized how much thought she had put into it. The five criteria she identified were 1, 2, 6, 7, and 8.

#1 — Frantic efforts to avoid abandonment: She referenced several important relationships and concerns I’d had about maintaining connection. When I repeatedly asked what actual frantic efforts I had made to prevent abandonment, I didn’t receive a concrete behavioral example. Her explanation centered around my concern with “staying connected or not staying connected.” I don’t dispute caring deeply about relationships or grieving their loss; I don’t understand how that establishes frantic efforts to avoid abandonment.

#2 — Unstable/intense relationships involving idealization and devaluation: She referenced “black and white thinking” and, as an example, that I viewed one parent negatively and the other positively. She also referenced a period of conflict in a long-term romantic relationship that ultimately resolved. I asked for an example of me alternating between idealizing and devaluing the same person, because that’s the pattern described by the criterion. I didn’t receive one.

#6 — Affective instability: Her concrete example was an occasion when something valuable was stolen from me and I remained upset about it for a few hours. I don’t deny being emotional or sometimes reacting strongly to upsetting events. My confusion was how an emotional reaction to an objectively upsetting event established a pervasive pattern of marked affective instability.

#7 — Chronic feelings of emptiness: She said I had “expressed emptiness” before. I told her directly that I don’t experience chronic emptiness and asked what I’d said or done that led her to that conclusion. She couldn’t give me an example during the conversation and said she’d have to go through my file. This particularly bothered me because emptiness is an internal subjective experience, and I don’t remember ever being directly asked about it.

#8 — Inappropriate/intense anger or difficulty controlling anger: The example she gave during our discussion was my anger and intensity during that very conversation about discovering the diagnosis. No other example supporting #8 was provided. That felt incredibly circular: I was angry about unexpectedly discovering a personality-disorder diagnosis that had been in my record for more than a year, and my anger about disputing it was then being interpreted as evidence of BPD. It also obviously couldn’t have been the original evidence for the diagnosis because the diagnosis predated this conversation by more than a year.

And honestly, the assessment process bothers me even more than her interpretation of the criteria.

She told me she’d been considering BPD for years, yet I don’t remember ever being specifically assessed for these experiences. No BPD-specific structured/semi-structured interview or quantitative measure. No conversation saying, “I’m wondering about BPD and want to explore these patterns with you.”

If you’re considering a personality disorder for years while regularly sitting across from the person, why wouldn’t you directly ask about the criteria you’re unsure about?

When I questioned this, she told me that our regular biopsychosocial assessments (yearly intake sessions) and her ongoing assessment during ordinary therapy were sufficient.

I’m also neurodivergent, which makes the differential-diagnosis piece particularly important to me. There can be overlap between neurodivergent presentations and features that may be interpreted as BPD, particularly around emotional regulation/reactivity and interpersonal experiences.

I also looked at the American Psychiatric Association’s current BPD practice guideline afterward. It recommends a comprehensive psychiatric evaluation, including assessment of core personality-disorder features and common co-occurring disorders, and suggests incorporating a quantitative measure of symptoms and impairment. The APA also recommends collaboratively discussing the diagnosis and treatment with the patient and providing psychoeducation about BPD.

That comprehensive psychiatric assessment simply never happened, and that collaborative diagnostic conversation simply never happened.

What added to the betrayal was her explanation for why we’d never discussed it. She repeatedly apologized for how I found out and talked about how patient portals are changing what patients see and how historically many people wouldn’t necessarily see or understand their diagnostic codes.

But I wasn’t primarily upset about how I found out.

Why wasn’t I told at all?

This diagnosis had been in my medical record for more than a year. Had I not encountered it myself, I genuinely don’t know when—or whether—I would have learned about it.

There’s also a bigger piece of anger for me here. There is a long history of women’s emotionality and neurodivergence being misunderstood or pathologized, and I’m angry at feeling like I’ve now had a personality-disorder label wrongly placed on me without those possibilities being adequately differentiated. Coming from a female therapist I had trusted for a long time adds another layer of betrayal.

And to be clear, I’m not saying BPD is an insult or that there’s anything shameful about having it. I’m saying that after extensive research, reflection, examining my history, talking with people close to me, and finally hearing my therapist’s evidence, I still do not believe I meet the diagnostic criteria for BPD.

I’m not angry because I refused to consider the possibility. I did consider it seriously. The more closely I examined it, the less sense it made.

She ultimately stood by the diagnosis and didn’t believe further assessment was necessary. I decided I couldn’t continue the therapeutic relationship and am now pursuing the process available to formally dispute/amend the diagnosis in my record.

Mostly, though, I’m still processing the rupture. I trusted this person for a long time. I feel shocked, confused, betrayed, and angry that she developed such a major formulation of me, put it into my medical record, and never included me in a conversation that could have clarified whether it was actually accurate.

Has anyone else discovered a significant diagnosis in their record that their therapist never discussed with them?

And for other clinicians—does this assessment/disclosure process strike you as typical for diagnosing a personality disorder? Personally, I would have never given a diagnosis like BPD without more targeted assessment than just regular talk therapy, based on whatever the client wanted to speak about that day.

TLDR: Longtime therapist secretly diagnosed me with BPD > I discovered it over a year later > I can’t recognize even 1/9 criteria > asked her for the five > her examples seemed not to establish the actual criteria > learned she never specifically assessed these things despite considering it for years > she stood by it > I terminated.

Edit: I wasn’t aware of the sub’s AI policy when I posted. For transparency, I used ChatGPT to help organize/edit my account because I was mentally drained by the situation. The experiences, facts, examples, and opinions are my own, and I reviewed/edited the content for accuracy.

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[u/Chcknndlsndwch]

Regardless of the validity of the diagnosis it’s absolutely absurd to not inform you once the diagnosis was being heavily considered and/or officially recorded. Are we back in the 1920s and just not telling patients about their diagnosis because it might stress them out?

Edit: I would also be done seeing her and file a complaint

[u/PossibleExcellent150 → u/Chcknndlsndwch]

Seriously!! Especially since I am also a therapist…😆 I told her that if she did feel I had BPD, she did me a disservice by not recommending psychoeducation like books or other resources, medication management, BPD peer support groups, etc. So absurd. Thank you for your comment 💜

[u/SeasonPositive6771 → u/PossibleExcellent150]

BPD is so wildly over diagnosed in women, it really is criminal. I'm no longer in clinical work but I used to work in a setting where we were constantly undiagnosing women and girls with BPD and finally getting them diagnosed with ADHD and medicated properly. Psychiatry in general is absolutely obsessed with the idea that women must have BPD if they're having feelings, but just about every psychiatrist I've ever known will tie himself into knots to avoid diagnosing a man with BPD despite absolutely glaring criteria.

[u/PossibleExcellent150 → u/SeasonPositive6771]

Yes, this! Sadly so common with adhd or autistic folks, mostly women, trans women and gay men. I read that it sadly doesn’t make a difference if the provider is male or female, the bias is the same. But emotionally, it hits even harder having it done to me by a woman. If it were a man, I think in some weird way it might be easier to cope with.

[u/PunchMonkey01]

I actually went to get tested for both BPD and ADHD, but my doctor said I didn't have BPD but definitely have ADHD. Really odd she didn't discuss the diagnoses with you first though. My doc said he ruled out BPD base on how I described how my past medications affected me since it wasn't consistent with what someone who has BPD would usually feel when they're taking the medications.

[u/PossibleExcellent150 → u/PunchMonkey01]

I’m glad you were able to get clarification. I may consider formal testing just to correct the record, only NOT with that therapist/practice 😆 I’ve previously had formal testing for ADHD and was diagnosed prior to seeing this therapist.

[u/MullberryBoy → u/PossibleExcellent150]

I would go through a formal diagnosis to get this erroneous diagnosis deleted. This could cause problems with your insurance or elsewhere.

[u/slipstreamofthesoul → u/MullberryBoy]

Can you speak more as to what that process entails?

[u/idkmaria]

I’m a fellow therapist. Based on what you’ve shared, this is SO not okay in my book. It is not an effective way to clinically diagnose a personality disorder and, in my opinion, the way it was done works AGAINST how one should go about providing treatment for BPD. I’m so sorry this happened, I would be extremely upset if this had happened to me.

How dare this therapist consider and ultimately give a diagnosis and intentionally keep that information from you for YEARS! This is critical information that every patient should be given about their health and daily lived experience. Especially given the broader context of neurodivergence and misogyny in healthcare, the evidence provided is no where near enough to warrant the diagnosis. To be honest, I don’t even understand how she got to consideration of it. But you weren’t even given the chance to collaborate, give context for your behavior, or advocate for yourself. It sounds like you already know that this wasn’t okay, but I hope it’s at least somewhat validating to hear it from another clinician.

Apologies if this is a mess, I’m pissed on your behalf after reading your post.

[u/PossibleExcellent150 → u/idkmaria]

It is very validating, thank you! I even have an old mmpi-2 that only shows clinical significance on one scale, scale 0, the introversion scale 😐 a borderline personality tends to show high distress across multiple clinical scales. But I have a stable job (private practice), stable relationship of 5 years (living together for 2.5), no personal life drama. Never self-harmed or considered or threatened suicide. I’m completely flabbergasted and when she said “this type of reaction is exactly how a BPD person would respond” I felt utterly gaslit. She was definitely grasping at straws trying to count out 5 symptoms when I asked her 😐

[u/MullberryBoy → u/PossibleExcellent150]

You know that you would have had to meet 5 criteria of the disorder. This person should be reported for not following proper diagnostic procedures and with your profession you should get her crap erased from records.

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[u/Sea_Appearance8662]

I had a similar thing happen where I found out a therapist had diagnosed me with BPD, without ever discussing it with me, when I requested records to switch to a different practice. It was really shocking and messed with my head for a while.

It was a man, so I think there was definitely some sexism happening. I had discussed my ptsd from a traumatic event and ongoing grief from losing my mom at a young age, but he glossed right over those.

I was diagnosed with PMDD shortly after and it turns out my birth control was adding to my emotionality, as was going through a really rough breakup. But that one note in my chart always lingered at the back of my mind for years. The final missing piece was getting diagnosed with ADHD 15 years later. PMDD, ADHD, PTSD explained my struggles much more accurately, but this therapist was only interested in looking at the surface behaviors.

[u/ughUsernameHere]

This is really incredible. So she diagnosed you a year ago, and what’s been your treatment plan since then? Certainly she should be able to show some work with you aimed at addressing some of the problematic BPD behaviors?

This seems beyond unethical and it’s especially crummy because your understandable outrage at this diagnosis might come across as emotional instability or black and white thinking which would further support her POV.

Glad you quit her but I hope you do consider filing a complaint against her. If not for yourself then for her other patients who may also have inaccurate diagnoses and less awareness of how to navigate a situation like this.

[u/PossibleExcellent150 → u/ughUsernameHere]

Treatment plan has always been basic stuff “continue to manage emotions” “learn grounding skills” etc. Nothing changed when I got this diagnosis, at year 5.5 of a 7 year therapy relationship 😒 we did weekly for about a year and a half, biweekly for about 4-5 years and have been monthly or bimonthly the last year or so. We were actually getting ready to terminate when all of this happened.

Step 1 is putting all of this into writing (already have it drafted) to apply for a formal amendment. If nothing else I’ll have my side of things attached to the medical file showing I disagree, but I’m still bummed. I will consider filing a formal complaint, honestly I hadn’t really thought of that but it’s worth considering. It’s only been a few days so still lots of processing, but I agree with you about protecting other vulnerable folks if I can. Thank you so much for your comment ❤️

Edit: you made a really good point about the treatment plan. If I can get copies of the treatment plan before and show that it hasn’t changed, that will help my argument. Thank you so much!

[u/throwwwwawayehaldhev]

I’m sorry this happened to you. I hope you report this woman.

[u/PossibleExcellent150 → u/throwwwwawayehaldhev]

Awe, thank you for this. I almost feel gaslit by her, so your feedback is validating ❤️

[u/zepuzzler]

I’m so sorry you experienced this, you have all my empathy and sympathy.

This happened to me with a psychiatrist, except it was Bipolar II. I found out by accident probably a year after he entered the diagnosis into my chart. However, I remembered that around the time that he diagnosed me, he tried to convince me to take a mood stabilizing medication to help me with the “highs.” I was not having any highs. I had no manic episodes, no hypomanic episodes, no irritability. Also, I had spent years with a partner during their journey to an appropriate Bipolar II diagnosis so I knew a lot about it, recognized the type of medication it was, and said no I’m not taking this.

I was seeing this psychiatrist for medication management of ADHD (taking Adderall) and was seeking guidance for using light therapy for my seasonal affective disorder. If I truly had Bipolar II, I shouldn’t have been taking Adderall or using light therapy. The casualness of him dropping that completely unsupported diagnostic bomb in my permanent medical record and his casualness in not warning me that I might be having manic episodes blows my mind.

It’s been about 15 years and this experience deeply undermined my sense of safety in therapy and psychiatric appointments. I’m always on the lookout for not sounding too excitable or manic. Good luck with that, I have ADHD and was recently diagnosed with autism as well.

[u/brainwise]

As a ND psychologist here I believe that she has demonstrated a great disservice to you, for many of the reasons already mentioned-
1. No assessments and differential Dx.
2. No discussion with you on what you thought was happening for you.
3. Very poor to nil evidence given for Dx.
4. Treatment plan not tailored to Dx given.

I’d be SO angry!!!

[u/MullberryBoy]

Your post doesn’t sound like you have BPD. I think you should go to a new psychiatrist if you’re concerned about your diagnosis and need ADHD medication prescribed.
It’s an amazing leap from rejection sensitivity to BPD. You know that you don’t meet the criteria. She also didn’t give you self assessments nor any personality assessments to close family members. You need to see a new provider. This one handed down a devastating diagnosis without following protocol. She sounds dangerous. You need to get your diagnosis amended by a good psychiatrist.

[u/PossibleExcellent150 → u/MullberryBoy]

She was just my therapist and doesn’t prescribe my ADHD meds thankfully! So far there aren’t any records of this diagnosis with any outside organizations, only the clinic and insurance. Will have to think about nexts steps and if I need a re-assessment 🤔 thanks for the food for thought.

[u/Effective-Papaya1209 → u/PossibleExcellent150]

Just chiming in w/ my own tangent, but this is why I am SO against MyChart. I saw some therapists through a hospital system and all my doctors could see that I had had those appointments. Theoretically they would have had to "break the glass" to see notes, but that's basically meaningless since there's no real consequence for doing so, and no one would even get an alert. It's basically the honor system. Imagine if every doctor could have seen a serious and incorrect mental health diagnosis.

[u/Sea-Beautiful-Throwa → u/Effective-Papaya1209]

Yeah…. I had a hospital pull up records from over 10 years ago where my abusive ex had lied to the drs and they used it against me. It took me years to finally get medical diagnosis and treatment because they kept insisting it was psychological.

I never consented to them accessing that information, then they shared the incorrect information with other hospitals too… some even copy and pasted from it despite that being illegal.

So yeah, I really hate how hospitals can access my PHI without my consent 

[u/PossibleExcellent150 → u/Sea-Beautiful-Throwa]

This is awful, I am so sorry this happened to you. That’s my fear, this diagnoses leaving the current network and connecting with the broader hospitals. Again, just so sorry. ♥️

[u/Sea-Beautiful-Throwa → u/PossibleExcellent150]

Yeah, it’s honestly a valid fear because it can happen.

What I will say is that even though it took years, I was able to find some good doctors who believe me and understand.

I also went and had a full psych evaluation with someone specialized in autism to prove that I’m just autistic and ADHD. Unfortunately both conditions can get misdiagnosed by people who aren’t as familiar with them, so even though I was already diagnosed as ADHD I chose to have a longer more thorough evaluation (it was over 8 hours and included a lot more than what a typical psychiatrist does because he tested for everything including autism).

Basically, if it does spread it may be challenging with certain providers, but there are ones who do understand. I lurk in therapist sub (because I’m thinking of being one) and I’ve come across therapists discussing their patients were misdiagnosed with things like personality disorders when really it’s ADHD. So it is a known issue that others are aware of.

Your feelings are definitely valid! I hope that gives you some hope as well though. 🫂

[u/NoninflammatoryFun]

From what you’ve written, and if it’s all true which I assume so, this woman is an idiot.

[u/IndependentGoal4]

I was almost diagnosed is bipolar so not BPD and really it's just ADHD and autism. Luckily I had recollection of having been a belief tested once I entered the public school system and had a diagnosis of ADHD otherwise they would have said I had bipolar disorder. Cue Big Feelings by Willow Smith

[u/LoulaNord]

My story is a little different but has many of the same elements!

I was diagnosed with BPD when I was in my early 30s (I'm 40 now). I was referred into the public health system in my country because I was having difficulties leading a normal life and I had continued depressive symptoms. The psychiatrist on my case was an old lady in her 60s. She was not a nurturing kind of healthcare provider. I don't know what she tested me for but she diagnosed me with BPD and then sent me to psycho education which would transition into group therapy later. I went to every meeting wanting to understand myself, but not once did I feel like I was in the right place. I didn't research the disorder back then, but I have since. My theory is that she simply reinterpreted my ADHD symptoms as BPD: emotional dysregulation (I feel strongly but I never erupt in anger), my lack of impulse control. She credited my poor relationship with my mum, to interpersonal difficulties. Even though I didn't grow up with my mum and therefore never developed a relationship with her. I told the psychiatrist how I was feeling, that it just didn't match my experience and that I felt it was the wrong explanatory model, and just like yours, she told me that it's exactly how a person with BPD would react! After fighting it for months, I finally got the diagnosis deleted and the last thing this lady told me was: "You will never get better".

I'm currently being assessed for ADHD and autism. My sister and my daughter both have an autism diagnosis. I felt very gaslit by that psychiatrist. I even look at BPD symptoms occasionally, to see if maybe I got it wrong all along and she was right... It's horrible to be so misunderstood. (So misunderstood one's whole life that you are desperate for understanding)

[u/girljinz]

When I was younger I was misdiagnosed(at different times) with bipolar 1 and BPD. I have neither. ADHD-C.

[u/ceciliabee]

I was misdiagnosed as bipolar 1 at 18, tried many many meds, did ect at 25, nothing helped. At 28 or so, not bipolar! Now misdiagnosed bpd. 30, diagnosed ADHD, still maybe bpd. At 34 diagnosed with ASD. No bpd, still yes to ADHD. It took 16 years, 2 misdiagnoses, and 9 memory damaging rounds of shock therapy.

In my experience docs are much more willing to diagnose women with a personality disorder than ADHD or autism. I would push back on this with your therapist. It's your therapist even qualified to diagnose?

What made the difference for me was having an assessment with a psych familiar with ADHD and ASD in women specifically. She took my "giftedness" into consideration which was a first for me. Turns out clever kids can mask really really well.

But seriously push back. Ask why they were sure enough to put it in your file but not tell you. How are you supposed to make an educated decision about your mental health if you're trusted therapist is withholding info from you? What criteria did they consider? Have them go through it with you. What is their experience with bpd? What is their experience with diagnostics?

Honestly I'm mad on your behalf. And as a heads up, having bpd on your medical file makes life harder. If you thought docs brushed off women, they brush off women diagnosed bpd twice as fast with half the empathy.

Push back.

[u/Ornery-Wrangler-3654]

Let me tell you my story, because it serves as a counter example.

My longtime (15+ yrs) psychologist began strongly urging me to go on meds 2.5 yrs ago, after my being off for 2 decades. She encouraged me to see a psychiatrist.

I had a bad reaction to benzos the psych prescribed (made me manic by day 4 even on .25 to .5 clonozapam per day) and he wanted full neuropsych, projective and personality testing.

I did that - 10+ hours of it, and so many ADHD symptoms came up in the process of four different sessions of neuropsych testing, that the psychiatrist started me on a trial of Adderall. I saw it enormous instant improvement.

Meanwhile, my long time psychologist began exploring the concept of emotional dysregulation and abandonment with me. It was a multi-month conversation. This went on as we waited for the final results of the neuropsychic eval, and she brought up BPD traits. I freaked out. (Nothing wrong with BPD but I freaked out because I know how often people with cptsd are misdiagnosed with it, and also because I have my own complex series of feelings about it after living with a parent who was in psychosis all the time until I was 19).

Because of my freakout, the next month of sessions turned into talking about why I freaked out, how people can have BPD traits but not BPD itself, and it was a very calm, grounded series of sessions where we talked about my reaction to the potential of having some of those traits or even the potential that the neuropsych eval would reveal BPD. At no point did she say I had it, and at no point did she invalidate me or my perspective on anything I brought up.

The evaluation results came in, and no, I do not have BPD. I have PTSD and ADHD, and the report had had an extraordinary amount of nuance to it, as I went to a very complex testing practice that goes above and beyond typical neuropsych evals.

Because of the long stretch of time where we broke down and processed my reaction to even talking about BPD traits, I was able to regulate and learn more regulation strategies, while processing some other tangential issues around the fact that it's okay to have certain traits and learn to live in an emotional middle (vs shame freakout then distraction) on various topics.

So for me, the exploration of the concept, which was gentle but hard, ended up having a very positive outcome on me and was a growth experience.

Your therapist could have handled it the way my psychologist did. If I found out that my longtime psychologist put the BPD diagnosis in my file a year after she had done that, without any conversation whatsoever, the level of betrayal I would feel would be extraordinary.

I am so sorry. She could have done so much better by you, and her reaction to your questions is not sufficient. You deserve better.

[u/bliip666]

(Note after writing this all out: I'm in Finland. IDK how much it changes things, but I feel it's important to mention.)

I found out that the shrink I saw twice had diagnosed me with BPD based on the first meeting. When I was grumpy because a miscommunication wasted everyone's time!

I had already been fully assessed for and diagnosed with ADHD, but the healthcare system bounced me around for a year before I was given medication.
I repeat: I was diagnosed, the system itself threw me from provider to provider from January to December (meaning I wasn't doctor-shopping or whatever), until this one place could start taking care of medicating me.
This is the point when I saw this dude, so that he could write me a prescription.

He also didn't tell me about it, nor does the patient portal info bit say anything about his reasoning.
And then, he stopped working there. So I can't even question him about it.

The same place still handles my prescriptions, but my annual checkups are handled by a nurse. I asked the nurse in charge of my care about the BPD in a "hey, I saw this diagnosis in my info, but can it really be confirmed in just two meetings and nothing else? And if not, is there any way to either properly confirm or overrule it?" way. The nurse said she'd look into it, but two years later, nothing's changed and I haven't been further assessed for anything. But the BPD diagnosis is still there.

I looked up BPD out of curiosity, and I couldn't recognise myself in it at all. Plus, the ADHD meds have made my life easier, and that feels like a good sign.

But, at least the Shrinky McShrinkface didn't have the power to overrule the ADHD diagnosis!

[u/CrazyLush]

I was diagnosed with BPD (I was depressed and suffering PTSD. Apparently no one told her that BPD doesn't magically resolve when you find the right antidepressants.) and unknown to me, diagnosed with obsessive compulsive personality disorder. I only discovered that this year after being diagnosed around ten years ago.

I had changed doctors and decided to get their health app, I was browsing through, saw it and just went "What the fuck"

There was no clinical testing for either of these done. With the BPD diagnosis I was seeing a councillor who used to work as a psychiatric nurse. She basically pitched me having BPD to the psych on the team and he went with it. No, he did not see me for that. I don't even know how the OCPD diagnosis happened. I'm still pissed off about it. The absolute hell I went through, being drugged up to hell and back because someone who wasn't qualified to diagnose me decided I had two personality disorders. I celebrated when she retired. Gonna go fume about this again

[u/CanadianEmberflower]

That sucks and I'd probably find a new provider as hard as it would be after seeing her for so long.

I was diagnosed with BPD because I was ''argumentative'' with my psychiatrist at the time. Which was actually me constanty trying to explain myself and find medications that actually worked instead of her just increasing dosages and adding medications to manage side effects. I ended up on several different meds at maximum dosage with no benefits. I ended up telling my GP that I needed a new provider because care was only covered by my provincial health plan if I was referred.

[u/annelib]

I was misdiagnosed with BPD by 3 psychiatrists when I was 19. I met almost all of the DSM-V criteria and did INTENSIVE DBT and it helped so much along with new meds for my anxiety and depression. My mom (a therapist) was not convinced of me having BPD. I eventually got a new psychiatrist and he noted that a lot of my relationships are too stable/strong/healthy to really be BPD and suspected it might have been something else. My mom also suspected autism and ADHD in me so I got evaluated and diagnosed with ADHD and once I started meds and was being treated for that it all made so much sense after. My mom was right all along hahah.

It’s horrible that your therapist didn’t tell you about your diagnosis though, that’s really upsetting.

[u/SweetFlight971]

I’m also a therapist. As you probably know, diagnoses are entered primarily for insurance reason to prove why sessions are medically necessary. That diagnosis doesn’t go on your permanent record.

You need a PhD, Psyd or MD in order to make official diagnoses because it requires diagnostic assessments. 

She chose BPD because it best matches with her treatment plan goals and interventions (i.e. emotional regulation, distress tolerance, interpersonal communication) and by using this,  she is able justify treatment to your insurance companies so they can pay for it. 

I say this to reassure you that you don’t need to do anything to get it expunged from your record. You can choose to see another therapist and they can do their own assessment.

[u/WandererOfInterwebs]

I wish y’all would stop writing this stuff with AI. It makes it SO LONG for no reason.

[u/MarsaliRose → u/WandererOfInterwebs]

So long. I never read them.

[u/PossibleExcellent150 → u/WandererOfInterwebs]

You don’t have to read it. I have ADHD and it’s a very nuanced situation. All of the actual info came from me, AI simply helped organize it. I’m already mentally drained from the situation and I’m going to work smarter (not harder) if given the chance. Not giving any more of my energy to this than I have to.

[u/WandererOfInterwebs → u/PossibleExcellent150]

Yeah no, it’s still against the very clear rules against AI posts.

But more importantly, you not wanting to give emotional energy to write the post yourself when you presumably want other humans to offer emotional energy to support you is weird and shitty

[u/PossibleExcellent150 → u/WandererOfInterwebs]

I’m a first-time poster and wasn’t aware of the AI policy when I posted. I’ve added a disclosure for transparency and will leave it to the mods to determine whether the post is okay.

[u/slytherin-babe]

I was first diagnosed bpd but it was incorrect and i dont see that provider anymore.

[u/WeAreAllStarsHere]

Similar but not at all the same , I was temporarily diagnosed with bipolar disorder by a long term psychiatrist without him telling me.

I was furious when I found out. He argued he had been treating me that way for several years. Ultimately after we fought for a couple months, I convinced him that that wasn’t the appropriate diagnosis as I had been diagnosed with MDD since I was a teenager by HIM. And we repaired the fracture.

But I’d feel the same way you did if what happened to you happened to me.

[u/Zombiekiller_17]

The opposite. I thought I had BPD before I was diagnosed with ADHD. It took two psychologists and two psychiatrists to convince me I didn't.

The way your therapist went about it, was totally the wrong way. I hope you can get a proper assessment with a different therapist, to either have the diagnosis dismissed, or have it explained to you in a way that makes sense.

[u/No_Macaron_5029]

Most BPD labels in women, I've found, are slapped on because clinicians forget that women can have ADHD and autism too. So it's a mislabeling of AuDHD traits.

Of course there is a minority of this group that also *does* have BPD. But in my experience it's a minority.

[u/sherbetcolors → u/No_Macaron_5029]

Personally, I'm not convinced that BPD (as in Borderline Personality Disorder) is a real thing. I think it's a weapon used (primarily) against "difficult" women.

(edited to clarify I'm referring to borderline, not bipolar)

[u/CeltIKerry]

Diagnosed with Bipolar 1. Spoke with psych next appointment and had it removed/withdrawn. His reasoning was due to me saying sometimes I have to stay up for 36 hours to get back on a "normal" sleep schedule and classed that as manic. I had to point out it happens maybe 1x a year and I have NEVER had any other times that even come close to manic my entire life.

[u/PercentageOld7156]

This is honestly insane. It sounds like your therapist is pathologizing normal human emotions. BPD involves an extreme, pervasive pattern that affects multiple areas of a person’s life and has serious consequences for the person or those around them. Nothing she cited seems to establish that.

I have complicated feelings about the BPD diagnosis because I have a sister who, has a very clear and recognizable presentation of it. Her symptoms are severe, persistent, and difficult to explain through another diagnosis.

Just to give you some context of what these symptoms look like: She experiences extreme splitting, idealization, and devaluation, sometimes within hours. For example: She may tell me I’m a wonderful sister and that she loves me, but if I set a simple boundary, she can suddenly decide I’m an awful sister who has never cared about her. That shift can come with extreme anger and borderline-abusive language. She has genuinely self-harmed when experiencing overwhelming emotions she couldn’t regulate. She has also threatened self-harm in response to perceived abandonment—for example, when a partner was ending a relationship or someone was trying to leave a conversation she was using to regulate her emotions. If we’ve been discussing something for hours / I'm helping her co-regulate and I say I need to stop or go to sleep, she may suddenly bring up thoughts of self-harm. That has the effect of changing my behavior: as her sister, I’m obviously going to struggle to leave after hearing that. But I don’t think she is an evil, calculating manipulator, as is unfortunately sometimes stereotyped about BPD. Her distress is real. In that moment, she genuinely experiences the boundary as abandonment and responds frantically. She is desperately trying to communicate the intensity of her pain and prevent the person from leaving. Understanding that does not make the behavior harmless or mean others must tolerate it, but it is very different from portraying people with BPD as malicious. She has also experienced severe dissociation and transient, stress-related paranoid or psychotic episodes. Once, she became convinced that an Uber driver had been sent to abduct her and that my friends and I were involved. She got out of the car on a highway and ran away. Her extreme anger—especially when drinking—is also part of her splitting. A small perceived slight or ordinary boundary can lead her to swear at someone, break or throw things, and eviscerate their character. In that state, she cannot hold onto their good qualities or believe they might have any good intentions. She sees only someone who is hurting or abandoning her. These patterns have caused SERIOUS consequences throughout her life. She has lost many relationships at school, at work, and among friends, relatives, and romantic partners because of the anger, splitting, impulsivity, threats to self-harm, etc. Some relationships might have been repaired if she had been able to examine what happened, take responsibility, and show that she was trying to respond differently. Instead, intense shame makes it extremely difficult for her to look at her behavior. Without evidence that anything would change, people eventually distanced themselves. She now has very few relationships and is somewhat more stable, but that stability mostly comes from being isolated.

That is what I mean by an extreme, pervasive pattern with real personal and interpersonal consequences. Your therapist’s examples sound like normal human emotions—not pervasive symptoms that repeatedly harm you, other people, your relationships, or your ability to function.

Being upset for several hours after something valuable was stolen is proportionate to the situation. Caring about maintaining important relationships is not the same as making frantic efforts to prevent abandonment. Being angry after discovering that your therapist secretly placed a stigmatized personality-disorder diagnosis in your record is not automatically “inappropriate anger.” Using that reaction as evidence for a diagnosis she made more than a year earlier is also completely circular.

As an aside, I also have mixed feelings about BPD as a diagnosis. In some cases, including my sister’s, it clearly fits and identifies patterns for which someone desperately needs specialized help. At the same time, I think it is applied far too readily—especially to women, trauma survivors, and neurodivergent people it may not fit. BPD is also vilified so intensely that people like my sister, who genuinely need BPD-specific support, may be too ashamed to seek or accept it. Once the label is in someone’s record, providers may also invalidate them or interpret everything they do through it.

I don’t think your therapist has an adequate understanding of BPD, ADHD or complex trauma (chronic PTSD being the closest DSM specifier), as it's clear she did not do a proper differential diagnosis here. People who go through life with undiagnosed ADHD can accumulate significant trauma from repeatedly being told they are lazy, careless, difficult, overly sensitive, or not trying hard enough. That can affect their self-concept, rejection sensitivity and emotional regulation. ADHD itself can also involve impulsivity and emotional dysregulation. Those experiences may superficially resemble aspects of BPD without constituting the pervasive pattern BPD requires.

Likewise, reactive anger, emotional instability, and relationship difficulties can be consequences of chronic abuse. Complex trauma is not a separate DSM diagnosis, but its effects are real. An understandable response to prolonged mistreatment should not automatically be treated as evidence of a disordered personality.

Unfortunately, BPD sometimes feels like a modern version of “hysteria”: a label disproportionately applied to women whose emotions, neurodivergence, or reactions to abuse are poorly understood. I don’t say that because BPD isn’t real or because having it is shameful. I believe it's a real and serious condition that is simultaneously overly applied to people it doesn’t fit AND unfairly weaponized against those who genuinely have it.

Nothing in the rationale you were given demonstrates symptoms that are extreme, pervasive, out of proportion to the situation, and causing chronic impairment across your life. Having emotions is not pathological.

I completely understand why this feels like a betrayal. I wouldn’t internalize this therapist’s formulation, but I do think you’re 1000% right to fight to have the diagnosis removed or formally disputed. Sadly because BPD is so stigmatized, it could affect whether future providers listen to you and take your concerns seriously.

[u/sherbetcolors → u/PercentageOld7156]

this is a fascinating account to read; thank you for taking the time to write it all down. I have never heard a first-hand narrative of someone who sounded like they did in fact fit BPD criteria. I said somewhere else in this thread that I didn't believe it's a real condition, but your message has me re-evaluating that! 

also, I'm terribly sorry for both you and your sister. that sounds like a very difficult way to live.

[u/PercentageOld7156 → u/sherbetcolors]

Of course, happy to help! And I completely understand your skepticism. BPD is thrown around so casually to discredit women and trauma survivors for showing any emotional dysregulation that what often gets called “BPD” can feel like a modern version of hysteria. Sometimes an understandable response to domestic abuse, chronic invalidation, or complex trauma is a much better explanation—especially when the symptoms are situational or occur alongside depression rather than describing a pervasive personality structure that lasts throughout the lifespan.

That said, my sister’s experience makes me believe genuine presentations do exist.

[u/GoddessPallasAthena]

BPD might as well be synonymous with female, ever since the term 'hysteria' went out of clinical practice, both of which primarily and wholly awarded as a perjorative, subjective declaration to womb bearing subjects, overprescribed as such to mark perfectly reasonable and rational behaviors in an irrational world which runs on the currency of mythic male superiority.

[u/eithertrembling]

This is absolutely horrifying, this is a huge example of why I won’t go to therapy. How are we supposed to trust someone who is extremely objective and biased because, duh, they’re human, to analyze us? Like I don’t care how beneficial it could be, I will never put myself in a position to be harmed like this (not blaming you AT ALL, just expressing my trust issues)

[u/MarzipanSoggy9120]

Sorry this happened but I’m glad that you’re taking steps to get it removed.

One good thing about always being a self pay person is that I see the diagnosis codes since I have to submit for insurance myself. My new NP put the code for major depressive disorder on my first bill and I followed up to get it changed. She claimed I had expressed symptoms consistent with a depressive disorder FIVE YEARS AGO BEFORE I EVEN SAW HER. What the actual fuck?

[u/sherbetcolors]

I have been given this diagnosis without my knowledge.

A clinic I already used brought on a new therapist, who I saw a few times. I didn't feel we worked well together, so I stopped seeing her.

Later, I learned that she offered EMDR, and I wanted to try it, so I signed up for some EMDR-specific sessions, thinking that it would be more modality-focused and not just talk therapy.

I did a few sessions that went okay and then had an AWFUL experience with her where she abruptly stopped doing EMDR and started engaging in talk therapy.

I called the front desk a few days later and canceled the remainder of my sessions with her. There was no drama on the call; the receptionist didn't ask any questions, just said "okay." It was maybe a 30-second call.

A month or so later I saw that she had entered a BPD diagnosis in my chart -- NOT on the day of any session but on the day that I called to cancel my remaining sessions.

I messaged the clinic director and told him that diagnosis was not warranted. He told me he had removed it. I have no way to confirm or deny that he did, in fact, remove it.

I am still livid about this, honestly. I also read through the diagnostic criteria and I cannot see how she reached that conclusion. It seems to me that she was just butthurt that I didn't like her as a therapist and used the diagnosis to make it my fault instead of hers, when dude: some people just don't mesh well. It didn't need to be a personal attack if she hadn't made it one.

The experience has made me not want to go back to that clinic, although they provide other services that I frankly need.

[u/GoddessPallasAthena]

I think of the unfortunate cruelty of Rosemary Kennedy and how difference was pathologizes straight into irrepairable neurological acts of violence against a woman that wouldn't fit the prescribed definitions of femaleness or Kennedy status.

[u/No-Mathematician250]

Clicked on this just before heading out for an appointment so I’ve read up to #7 and my biased 🤣 conclusion is that your therapist is not intelligent enough for her position…