Q. I have just recently realized that I have borderline personality disorder. I have been in therapy for 8 years. The diagnosis has been confirmed by my therapist but she tells me that I do not have all the symptoms any more. She does not believe in labels so I took the label into her. I have come to realize that I seem to be overtaken at times by a very strong mood in which I want to withdraw from everything and be alone. It feels like a depressive episode and often is masking something deeper. I am looking for confirmation that this sort of thing is part of the symptoms that are BPD. My therapist seems hesitant to discuss it with me.

 

 A. You indicated that you experience strong feelings of depression that make you feel like you want to be alone. While deep depressive episodes can be a part of bpd, they can be part of many mental illnesses. Therefore, your therapist may not want to jump to the conclusion that you have bpd. It may also be that your therapist likes to treat symptoms instead of treating an illness. This is a popular approach since it allows clients and therapists to be focused and goal-directed in their treatment. However, from your description it sounds as if your therapist does not like to use labels (or diagnoses) at all. Labels or diagnoses can be quite helpful if they increase a client's understanding of their illness and helps direct the treatment provided by the therapist. At this time, you and your therapist may need to discuss your treatment plan, whether you agree on what the diagnosis or problem is that you're working on, and whether you believe that both of you share the same belief and understanding as to what the expected outcomes are from treatment.

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