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Notes -
Borderline is better conceptualized as more like depression or anxiety than schizophrenia when it comes to severity. Many people with depression or depressive thought process never present for care, nor do they need it. Some of these people kill themselves.
The same is true with Borderline. At state hospitals in the U.S. you often see a mix of psychosis and severe borderlines who won't stop hurting themselves. It can be very bad. You also have borderlines where the symptoms are so rare or mild that you'd have to have a long relationship with a therapist to catch it.
Don't underestimate how "harmless" it can be.
When it comes to treatment it is treatable. Certain kinds of therapy work (chiefly DBT). Patients accumulate coping skills and calm down just by aging. Medications don't work great but can be helpful for symptomatic management.
Hmm.. I assume my experience here is markedly different primarily because the general level of awareness surrounding mental health in general, and BPD in particular, is so poor that anyone who still manages to get the label is absolutely fucking insane.
And of course, there are plenty of people who keep things under control or are barely worth the diagnosis. And it's the flagrant cases who get signal boosted. Would we know Freddie De Boer was schizo, or Scott had OCD, if they didn't tell us?
That's about as reassuring as the same effect in violent criminals, who do age out of their tendencies. I'd rather not have to wait that long, so I hear BPD, I'm fucking out, at least romantically.
Yeah don't date one, but you gotta keep in mind that if you are seeing them (at this phase in your training) it's either so bad they are on an inpatient psych unit or in the ED, or they are in the hospital for other reasons and they are such a pain in the ass that the diagnosis makes itself clear.
In training you'll get the skills to pick up more mild cases in the community, and presumably also see more mild cases in therapy clinic.
This also is true for things like depression and anxiety (early in training you'll only see total shit shows, but more mild cases exist they just don't need you).
This is also, also true for things like hypertensive emergency vs. generally outpatient family medicine seeing mostly controlled shit.
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