My descent into the cracks of the mental health system began after I was assaulted. I was referred for trauma intervention and diagnosed with CPTSD. In trauma therapy for the first time in my life, I was experiencing real progress, learning to map my triggers and understand how what happened to me affected my body. Then, halfway through, my psychologist told me he believed I had ADHD. He ran an assessment that confirmed what he had already decided, and then, rather than exploring how ADHD might coexist with complex PTSD, he cut me off from trauma therapy entirely. There was no transition plan, no step-down care, no support.
When I said that I wasn’t ready to be discharged, that there was still a lot of trauma we hadn’t gone through, he said, “Wait for ADHD medication, it will help you with everything.” So I waited over a year for the magic pill. Only to see another psychiatrist who did another assessment and concluded that it wasn’t ADHD — she suggested that I was possibly autistic.
During that year, my complex PTSD, now unmanaged and aggravated by abandonment, began to worsen. Flashbacks returned with new intensity. The hypervigilance I had worked so hard to calm became my constant state.
So, I went back to the consultant psychiatrist and said that since the diagnosis was wrong, and I had been cut off cold-turkey from my weekly trauma therapy, I wanted to resume it. She said no, that they only gave people trauma therapy for one year and then discharged them. As I pushed for my original trauma treatment to be reinstated, out of the blue she said that I had EUPD: Emotionally Unstable Personality Disorder in the ICD, also known as Borderline Personality Disorder (BPD) in the DSM.
Shocked, I said, “But we haven’t even done an assessment.” She said it was her “clinical diagnosis.” I asked for a second opinion, she said no. She was the head of the clinic, and the power dynamic was a real barrier. Who do you complain to? Who cares? Who wanted to do the right thing? From my experience it was no one.
She had weaponized my symptoms against me. Difficulty regulating emotions, hypervigilance, struggles with concentration — to a clinician eager to close a case, these can look like ADHD, autism, or EUPD/BPD on paper. They are also the textbook hallmarks of complex PTSD.
Symptom overlaps are well known. A clinical guide published in the British Journal of Psychiatry was written specifically to help clinicians tell CPTSD and BPD apart, because the two conditions can look identical on chart, but require two different treatment plans (Karatzias et al., 2023). A 2024 study by Sarr et al. highlights the profound overlap between complex PTSD, autism, and EUPD, confirming that these conditions share nearly identical profiles in emotional dysregulation and social difficulties. Without deep, longitudinal assessment, it is impossible to distinguish them.
The ICD-11 specifically identifies disturbances in self-organisation as the hallmark of CPTSD, along with affective dysregulation, negative self-concept, and interpersonal disturbances. These mirror the executive dysfunction of ADHD and the sensory hyper-reactivity of autism so closely that a rushed clinician will almost always reach for the convenient label over the complex one.
There is a dark logic to how these diagnoses are deployed. In my country, an autism label allows the public health system to claim that it lacks specific resources for adult neurodevelopmental support, effectively pushing patients toward the private sector, cleaning the public books by reclassifying them into a category the state has no obligation to fund.
The EUPD/BPD label is perhaps the most damaging. Globally, it has become a wastebasket diagnosis for trauma survivors who do not recover on a bureaucratic schedule. By framing my trauma response as a personality disorder, the system shifted the problem from the events that harmed me to me as a person. It marked me as difficult, treatment-resistant, and easier to discharge. It’s a diagnosis that can easily be weaponized against the patient.
Research on clinician bias found that clinicians tend to rate the same patient’s prognosis and problems more negatively once they have a BPD diagnosis, compared to similar symptoms without that label (Lam et al., 2015). Research from high-income health systems has repeatedly found that clinicians hold more negative attitudes toward patients labeled with BPD and they are likely to describe them as difficult to treat, and in some cases might avoid taking them on (Baker & Beazley, 2022; Black et al., 2011).
The stigma around BPD isn’t just systemic, it also exists in the people around you. Once you have been labeled as “Borderline,” anyone who wants to hurt you can use this against you. If you disclose it to employers, that puts you in a bad position and you are always the problem. There’s a huge stigma around BPD.
Now I had three clinicians who had given me three different diagnoses, for literally the same symptoms: hypervigilance, fear of abandonment, recurring nightmares, difficult regulating emotions, difficulty in relationships, and trouble with concentration. And at the end of the day, being labeled as EUPD was enough for all of them to dismiss me. The difficult patient that no one wants to deal with? That’s personality disorder. Not a vulnerable patient with CPTSD who has suffered enough trauma and still needs compassion and real support. The way they weaponized my trauma against me was so painful and dismissive. When you go to mental health specialists, you believe that they will help you, you drop your guard down, only for them to use your vulnerability against you? That would hurt anyone.
The system is built to protect its own people, the providers, not the patient. I left this clinic with more trauma than I started with. My trust is shattered, and there’s a deep sadness that I feel every time I think of what they did. How did we normalise systematic gaslighting and messing with vulnerable patients who are already hurt?
I filed a complaint after my psychiatrist labeled me as EUPD without an assessment. Someone has to say it loud, as the system isn’t really built to listen to patients. There’s this idea that once you are labeled as Borderline you are somehow less than, and what you say doesn’t matter. From my experience, they want to keep everyone medicated because when you’re medicated, you don’t have the clarity to see what’s going on.
I believe we need to speak up to hold clinicians accountable. And if someone really has BPD, this label shouldn’t be used to discriminate against them or discharge them without a transition plan.
You say that clinicians should be held accoutable, but they never are. Psychiatrists and psychologists can do whatever they want while taking no responsibility for their incompetence. I am certainly not the only person who was forced to see countless psychiatrists and psychologists and who came to the conclusion that they are all charlatans. All that they want is power, prestige and money. It is so easy to exert power over people who are psychologically vulnerable and make a good salary while doing so. If a victim complains, he is normally dismissed with the reasoning that he is still too mentally ill to make a coherent criticism. I have a tee-shirt that says: “I do not need therapy. I just need to go to Ireland.” But you are already in Ireland. In 1968 I went to my grandmother’s village in West Cork to recover from four years of psychiatric torture in the United States. I have been living a wonderful life outside the United States for 58 years, and it all started when the bus conductor in Drimoleague told me: “Welcome home.”
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Just by the title and the “most difficult of animals to capture by psychiatrists” and the exit sign, I would have to repeat “you wish”.
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Just another example of how little “mental health professionals” really know about their subject. Go ask Steve Burgess what he has to say about all this. Though he has declared a truce with Psychiatry for professional reasons, he would never handle a patient the way this author has been handled.
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Well, therapy is a scam to begin with. As Dr. Szasz said, it’s just talk. You might be shocked at how many of these therapists are struggling with their own unresolved psychological problems that they are unable to fix. You would be better off going to the internet to find people who had success in actually healing, or even just talking to friends. It will be free, too.
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Talk with a friend would be the first best choice.
But Steve Burgess calls what he does “therapy.” And what most Scientology practitioners do with people is generically called “therapy.” But these practices are actually difficult for both the practitioner and the patient, and with any luck, they actually accomplish something that years of merely talking could never accomplish.
I think most people in this business simply aren’t courageous enough to actually help someone else. I know I am partially trained in some of these more demanding practices, but I do run into problems of courage from time to time.
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Preach Sister. Thank you for sharing so clearly a story of abuse that I share at least in broad strokes. It makes me feel stronger and more able to speak up myself against a system that demeaned, debased and gaslit me for so long too.
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I am so sorry to read of your experiences. Something was working and you felt helped only to have that basically ripped out from beneath you. Your story goes to how people seeking help are at the whim of the beliefs and “training” of the people they see — as though the professionals don’t have their own biases. Not to mention that they are likely trained under the dominant biomedical model.
To diagnose people with basically permanent “disorders” based predominantly on behavior patterns without any consideration of context –such as a person’s past trauma and abuse, current stressors, etc, is absolutely ludicrous. It is also ridiculously non-scientific.
I have a master’s degree in statistics. The idea that you can ignore potentially important factors that a person is dealing with or has dealt with (or has tried to deal with) is scientific malpractice.
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Hi Amaal,
Thank you so much for sharing your painful and powerful story. You are so brave for seeking help with your pain, and I’m so sorry to hear that your courage and honesty were taken advantage of by the predators in the system. I am very glad that you know in your heart you do not have BPD and are taking active steps to heal your nervous system with the compassion, empathy, and understanding the “experts” never gave to you.
Your story was very validating for me. I had a similar experience of being labeled BPD when it was actually CPTSD all along. I, too, was demonized and shunned as an abuser when the medical providers and, subsequently, the people in my life began weaponizing the diagnosis and its symptoms against me. The providers even tried to force me into an institution against my will for a year and a half. Because of this, I do not have my Master’s degree today… they convinced me that I was not capable of getting through graduate school and that needed to go to the institution instead. These experiences were so painful.
I am now doing trauma therapy and working through things in my own way as well to calm my hypervigilance and flashbacks. I moved to a foreign country halfway across the world and simplified my life. I am prioritizing nutrition, exercise, and time in nature. Even though things have calmed down, the word “borderline” still rings in my ears every day like the little devil on my shoulder. But I know that one day I will have complete freedom from this dehumanizing label.
Thank you again for sharing your story and encouraging your readers to find empathy and compassion for themselves.
Sincerely,
Natalie Rose
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You don’t have to take the diagnosis.
You don’t need a diagnosis.
A label is an approximation of anything that will receive maximum financial returns for the labeller. Whatever is written in their notes may have little to do with realities. This is excused by saying it is their educated take on the situation at hand, that leads to what they do.
Labels can change for no rational, logical, factual, reason, other than the professional decides to do so. Blowing in the wind.
It is not always beneficial to talk to friends about trauma, as it changes the otherwise lighter dynamics.
Stick to the facts: assault.
What is your version of events, thoughts, feelings, sensations, beliefs? This can be kept private for you to think through – gently, patiently.
Do you actually want a trauma specialist?
Do you need a trauma specialist ?
What specific qualifications does the trauma specialist have and what types of trauma have they had success in helping?
What type of therapy is on offer?
Do you feel comfortable with that type of process after being given information material for a fully informed consent to be made?
[We] have to stop giving our agency, autonomy, and power away. [We] have to stop assuming that a professional of some sort, knows [our] story, better than (their ego in play) than the person who the experience belongs to. [We] need to be aware of healthier alternatives and options that are available. [We] have to realize, that giving away [our] time, energy, privacy, internal workings at the time, does not guarantee that the therapist is actually genuinely interested in guiding per se, the individual in front of them.
[We] get caught up in expectations that have been engineered to look good on governments’ political and policy papers. Often overly influenced by therapists with varying Degrees.
Therapists don’t like to fail. They see themselves through biases, just like the rest of the population.
“Have to” in this context to be read as a suggestion (not a directive, not an imperative).
Keep well
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