Borderline personality disorder + PDD-NOS?

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After completing my psychological testing last November, I've started doubting the results of my tests. My psychologist confirmed PDD-NOS, but wouldn't confirm Asperger Syndrome because I am by far 'too social', and hesitantly mentioned 'some characteristics of Borderline and Avoidant Personality Disorder'. It was a hell of a struggle trying to convince my psychologist of the distress my PDD-NOS symptoms cause me, as she refused to acknowledge several symptoms because of what she regarded to be extreme high-functioning. My aversion of anything new could never be as upsetting as I made out to be, otherwise I would have never started university, never mind got my master's degree. My social awkwardness could never be as intense as I claimed it was, because I could behave normally enough during my conversations with her. The list went on and on, and only after she spoke extensively with my mother did she relent and give me the diagnosis of PDD-NOS. My problem is not with her unwillingness to pin a false diagnosis on me, but with her unwillingness to consider a diagnosis that ought to incapacitate me.

I have several symptoms of Borderline Personality Disorder. Every psychologist I've ever spoken to about this has waved my concerns away and claimed that I would be doing much worse and getting much less out of life if I would have BPD. Fact is, however, that the symptoms I experience do cause me significant distress. I am extremely scared of rejection and abandonment, going so far as to end all types of relationships with people lest they do so first. I have very little sense of self, find it impossible to describe myself or form an image of myself, both physically and mentally, have no concept of 'me', also I feel empty a lot of the time, as if I were a shell of a person that's only half-filled. I have extreme moodswings that flip-flop rapidly, too rapidly to qualify for any kind of mood disorder, and can be completely debilitating. I have binge eating episodes, binge drinking episodes, used to self-harm frequently and have exhibited dangerously promiscuous behaviour. Furthermore, I'm impulsive and have severe problem controlling my temper, almost childishly so. All in all, I meet 6-7/9 symptoms for BPD, yet my psychologists all refuse to recognise these, because I ought to be doing much worse in my life. I shouldn't have been able to get a degree, shouldn't be able to hold down a job, shouldn't have a social life. Honestly, I don't get their point. Whatever I can do in life, does not cancel out the things I can't do or have trouble doing. My life is impaired in ways that upset me deeply. Yet because I haven't spent all my money on impulse buys, because I haven't had a series of abortions or STD-treatments, because I have made it through 4,5 years of university, I can't get the diagnosis. Also, the diagnosis of PDD-NOS would make it highly unlikely that I could also have a personality disorder, according to my psychologist.

I find this unfair and upsetting. Not having a diagnosis means that councellors will treat me only as somebody with PDD-NOS, without paying attention to the BPD problems I have. My behaviour is seen as deliberate rather than something that is outside of my control. I can help my meltdowns over perceived abandonment as little the ones I have over somebody messing up my routine, yet one seems to be validated and the other a dramaqueen-type act. The fact that I come from a stable and supportive home doesn't help my case either - I've had a psychiatrist ask me whether I had been sexually abused as a child, because it would make the diagnosis easier for him. Honestly, I believe I would be much more disturbed had I not come from a stable home, but my life is hardly a cakewalk now. Would it be worth it to demand another series of tests? Should I try to convey my displeasure at being labelled a drama queen and an attention seeker by those who ought to be treating me? I'm wondering whether it would be worth the time and the effort and if the pros would outweigh the cons. For future therapy for my BPD-symptoms, it would be necessary to get the diagnosis. I've found that psychologist often refuse to treat what the file finds is not there, or they will make whatever symptoms are experienced fit in with diagnoses that are confirmed. I'm almost scared to go through the whole process of diagnosing and intakes again, simply to correct a mistake that wasn't mine to begin with.

The last line you write is something I have noticed as well, and often.

I have a friend who have managed to get a list of differing, opposing diagnoses, and each time would
the professionals read into his behavior all the symptoms and signs they expected to see. It was abso-
lutely ridiculous. He couldn't convince them that he didn't have this or that condition.

Okay, it may seem odd: Why would anybody get several diagnosis for things they don't suffer from?
In my friend's case it was because he didn't know what was the matter with him. He didn't know there
is something called Asperger's Syndrome, so he really didn't know what made him different. But he
knew from experience that it gave him problems that made it impossible for him to function on the
same level as normal people. So he would find things that fit some disorder 'somewhat' and then add
the rest him-self.

But it never seemed to be enough. He was still expected to perform at a higher level than he could -
especially since he didn't understand his own problems (something I can relate to, by the way). So
he would find another condition, more severe than the former one, so at one point he even got
himself diagnosed witrh Schizophrenia, and guess what: Professionals SAW HIM AS SCHIZOPHRENIC!! !

My god, this guy has never had an hallucination in his life!!

The greatest problem as I see it in our time is that we somehow have to have a diagnosis in order
for professionals, and often also others, to respect that we may not be like everybody else and that
we may in fact have problems most others do not have.


I wish I could give you a word of advice, but it is very hard for me because I don't know you.

As I'm sure you're aware of, most of the symptoms that come with a PD are things everybody experi-
ence. The PD lies not as much in the symptoms as in the severity of the symptoms.
An example: You mention you have fear of rejection and sometimes reject others so as to not risk
being met with rejection from them first.
You're right, this is one of the central problems that people with BPD struggle with. The problem is
that so do most other people, the difference lies in the severity. And it isn't possible for me to deter-
mine without knowing you well if your troubles with this are severe enough for it to be a sign of BPD.

There's another concern: You can have the same symptoms as people with BPD have, and still not
have classic BPD. There may be other issues that makes your condition different from classic BPD,
and it would take an in depth research of your situation and background, etc., to find out what the
real issue is.

I understand your confusion, perhaps better than most, because I too am not 'typical' even as an
Aspie. I have the diagnosis, but I was very fortunate in that I had the money to pay for the assessment
myself. Otherwise I would never have gotten diagnosed at all. I was also fortunate in that I had one of
the leading experts in Asperger's diagnose me (it's probably the only streak of luck I have ever had in
my life, lol).


Can I ask you what your relationship with Asperger's Syndrome is?

Thank you for your reply! I'm very sorry about the struggles your friend had with getting a proper diagnosis. I hope he will get a professional to listen to him someday and help him with the issues he's struggling with instead of the issues they presume he should be having.

The ironic part of this whole story is that I have studied Clinical Psychology at university (obtained a MSc degree, in fact), and therefore psychologists expect me to attribute symptoms to severe disorders without even having listened to my side of the story. I don't have an anxiety attack and think: "Well, that's it, I have panic disorder.". The same goes for the BPD symptoms. You're right that most of the symptoms are experienced by most of the population, but the severity is much worse with me, I feel. Even when I'm in a mutual, loving relationship with a person (whether with my parents, sister, friends or romantic partners), I keep looking for reasons to reject them so they won't reject me. It interferes heavily with my social life and my relationship with my boyfriend, and that's just one of the symptoms. The binge drinking and binge eating as well as the promiscuity have put me in dangerous situations as well as caused me a lot of grief. The psychologists I've met appear to have some kind of cut-off, and if you fall under said cut-off you will not get a diagnosis, no matter how much distress you're in.

I'm not entirely sure what you mean by asking me about my relationship with Asperger's. Do you mean what leaded up to me believing I might be on the spectrum or how I experience it in my day to day life?

Thank you, Melpomene.

Yes, I wish I could do something more to make things better.

I wondered if you have Asperger's Syndrome, or if you know someone who do?

I was diagnosed with PDD-NOS, but I think I fit the symptoms for Asperger's better. The psychologist who did the initial series of tests overlooked the 'active but odd' social interaction criterium, claiming I was 'far too social' to have Asperger's. The fact that I had no friends until I was twelve (I mean this literally) and that my friendships now are not always age-appropriate and took years to develop was entirely overlooked. Quantity over quality.

I know a whole score of people with Asperger's - the region of my country where I live has a disproportionately high number of Aspies, so there's a lot of them to go around. Furthermore, autism was the topic of my master's thesis at university. Both from an empirical and scientific standpoint, I know a lot about Asperger's!