Why is it controversial?
Our understanding of mental health problems is constantly evolving. So is the language we use when talking about them. The diagnosis of ‘personality disorder’ can be controversial because:
- specialists disagree about how to understand personality disorders
- it doesn’t take social context into enough account
- the term itself can be stigmatising.
Some people with this diagnosis hold the view that their feelings and behaviours are a reasonable, human reaction to going through difficult life experiences. So it’s unhelpful and upsetting to call it an illness or ‘disorder’ in their personality. They argue that professionals should consider what in their life may have contributed to their difficulties, and help with these. Not focus on finding problems in them as an individual.
On the other hand, some people find that getting this diagnosis helps them to name and understand their experiences, to explain themselves to other people, and sometimes get treatment and support they otherwise might not.
Mind HK is committed to ensuring that voices on all sides of this debate are heard. This includes those who:
- understand their experiences and behaviours as a disorder
- think of them as a natural reaction to adversity
- reject the personality disorder label
- do not fully agree with the label but accept it being as a way to access support.
Specialists disagree about how to understand personality disorders
The system of personality disorder diagnosis we list on our page on types of personality disorder is the one psychiatrists tend to use in the UK. However, some psychiatrists disagree with its use and find it unhelpful because:
- Most people who are diagnosed with a personality disorder do not fit any one category, and may be diagnosed with more than one.
- Some people believe the focus should instead be on what each person needs in order to deal with their problems and discover new ways of living, not what category they are in.
It doesn’t take social context into enough account
People are complicated. There are many social factors that can affect our capacity to cope, to relate to others and to respond to stress. For example:
- Experiencing trauma in childhood (such as abuse or neglect), or trauma that lasted for a long time.
- Issues to do with your situation and environment, such as poverty and social deprivation, or having to move home to a totally new place or culture.
- Experiencing stigma and discrimination, like racism, sexism, homophobia, biphobia or transphobia.
- If people have treated you badly in past relationships (including your parents or carers).
Any of these can lead to you often feeling overwhelmed with unbearable feelings. This can make it very difficult to deal with the daily challenges of adult life. For more information on how traumatic experiences may affect your mental health, see our pages on trauma.
The term itself can be stigmatising
Some people feel that the term ‘personality disorder’ can sound very judgmental. Being given a diagnosis or label of personality disorder can feel as if you’re being told there’s something wrong with who you are. You may feel upset, insulted and excluded. Language evolves and it may be that a different term will be used by professionals in future.
“Stigma can sometimes come from the professionals themselves, whether intentionally or not.”
It’s important to remember that you’re not alone – there are other people out there experiencing what you are. However you choose to make sense of your difficulties, you deserve to be treated fairly. Here are some options you can consider:
- Show people this information to help them understand more about what your diagnosis really means.
- Get involved in your treatment – our pages on seeking help for a mental health problem provide guidance on having your say in your treatment.
That said, it takes energy to challenge stigma. When you are particularly unwell you may not have the capacity to do any of these things. Be kind to yourself and try not to put yourself under pressure to do anything other than rest and recover when that is what you need.
“The stigma of being violent and dangerous is the worst for me. I am a caring and empathetic soul who would do anything for the people I love.”
Could my diagnosis be wrong?
Some symptoms of personality disorder can be very similar to, or appear alongside, other mental health problems. Depending on your mood and what’s happening in your life when you speak to mental health professionals, they might find it hard to identify the diagnosis that best fits your experiences.
If you’re worried that your diagnosis doesn’t reflect the way you feel, it’s important to discuss it with a mental health professional so you can make sure you’re getting the right treatment and support to help you.
