Causal Rewrite – iwantpopsicle

The Stigma of Borderline Personality Disorder

Despite how cruel the stigma of this mental health affliction is, it doesn’t exist for no reason. People with BPD are admittedly uncontrollably troublesome, incessant, and hard to control. The frequency of their suicide attempts is often seen as attention seeking, and people hospitalized from their BPD are often discharged faster than any other group of patients in a hospital. (Sheehan 2016) This is because of their emotionally extreme and outrageous behaviors.

Those with BPD have a lot on their plate, as we already know. They can’t control their emotional responses nearly as well as an average person, and their moods never settle to a stable position for very long. They have to hide their diagnosis out of fear of people finding out and labelling them crazy, or distancing themselves from them. With a constantly cluttered mind and dysregulated emotions, they are like a time bomb waiting to explode any second into impulsive behaviors galore. 

We see insanely high rates of hospitalization from this group of mental health patients. They make up 9% of all psychiatric emergency room visits in the US. (Hong 2016) Despite being stigmatized, these individuals still seek the care of emergency providers. It may seem counterproductive to do this, but the answer is depressing, but unfortunately true. These people have absolutely nowhere else to go when they NEED help. The critical emotional state that BPD sufferers are internally capable of reaching is very dangerous. While in this state, they can and will make very impulsive decisions. This can include sex, rampant drug use, or even attempted suicide. They can’t be trusted to be left alone. For this very reason, they need to be observed, protected, and controlled for the time that they are hospitalized. This makes the stigma they receive almost unavoidable, which makes a double edged sword: Go to the ER to protect your own life while being treated like a nuisance, or stay home and risk hurting yourself or even others.

One of the reasons that ER staff become so irritated, annoyed, and tired of borderline personality disorder patients is due to the frequency of visits, comorbidity of symptoms, and their attitudes. According to Victor Hong MD’s journal Borderline Personality Disorder in the Emergency Department: Good Psychiatric Management, “High rates of comorbidity (mood disorders, anxiety disorders, substance use disorders, and eating disorders) among BPD patients further complicate matters. BPD patients are often advised to visit the ED when in crisis and when safety is in question, but experiences in the ED can damage the patient and undermine treatment progress.” BPD related visits often end up becoming seriously complicated due to either misdiagnosis, or other conditions presenting themselves. BPD sufferers often present symptoms of various other mental health conditions. This includes Obsessive Compulsive Disorder, Chronic Depression, and Attention Deficit Hyperactivity Disorder. This can make treatment and diagnosis very tricky and complicated for doctors.

BPD patients are also very frequently showing up to the ER. BPD remains one of the most common hospitalized mental health conditions. Those with BPD have a very hard time functioning on their own, and need to rely on emergency services when they need it. Symptoms of BPD fluctuate in severity from patient to patient, but anyone who is previously untreated is going to have much more intense and prevalent symptoms than someone who has been in therapy before.

In author Cameron Hancock’s article The Stigma Associated with Borderline Personality Disorder, he claims “Individuals experiencing BPD are also frequently labeled as “treatment resistant” and dropped as patients. But when this happens, it reinforces the common misconception that reaching out for help is hopeless. It can also intensify symptoms that caused an individual to seek help in the first place…” Knowing this, it makes it no surprise that sufferers keep coming back for more. BPD patients go to the emergency room when it is absolutely necessary for their survival. This means that they are in an emotionally vulnerable state in every single way possible. They already have a hard time communicating when they aren’t even necessarily in crisis, so this is magnified by a considerable amount when they are barely hanging on to their lives. This can make it very difficult for doctors to help them, as they might try and refuse help from the doctor. At some point, the effort might seem meaningless or futile to a doctor and he/she may just give up on the patient. “The emotional dysregulation and hypochondriasis so common in BPD patients can lead to hostility and dysregulation in their mental health providers. The often inadequate interview spaces, lack of appropriate disposition options, and limited time with which to assess patients in the psychiatric ED only heighten the tension.” (Hong 2016) Doctors can also end up even being hostile towards patients. Not only is the BPD patient feeling potentially hostile, but this can spark that behavior in the doctor out of pure frustration. This dynamic can be very dangerous physically, mentally, and emotionally. From this situation, the displayed behaviors from the patient will only escalate further and further. In their most critical time, they are expecting to be given tender and gentle care to help get them back to health. When a doctor responds in such a hostile manner, it can seriously damage the patient’s ability and willingness to continue with the given care.

Even if this is wrong from a professional or moral perspective, it does make sense. Possibly the worst part of these situations is that it just reinforces the BPD sufferer’s distorted worldview of perceived abandonment, making them even harder to treat in the future. This cycle continues to repeat, doctor after doctor, until the person in question has absolutely no idea of where to go from there. With clear causes identified as to why BPD patients are stigmatized, we may be able to begin to help both doctors and patients find a healthy middle ground when it comes to treatment.

Works Cited

Hong, V. (n.d.). Borderline Personality Disorder in the Emergency Department: Good Psychiatric Management. BPDcommunity. Retrieved March 28, 2021, from

Sheehan, L., Nieweglowski, K., & Corrigan, P. (n.d.). The Stigma of Personality Disorders. BPDcommunity. Retrieved March 28, 2021, from

The Stigma Associated with Borderline Personality Disorder. (n.d.). Retrieved from

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2 Responses to Causal Rewrite – iwantpopsicle

  1. davidbdale says:

    Before we get started on your argument, Pop, I notice a few quick things.
    1. Your list of references at the bottom of the page, in APA style, should be called References, not Works Cited (WC is the MLA version).
    2. We don’t do parenthetical citation tags such as: US. (Hong 2016)
    Delete them and . . .
    3. Instead, we follow the In-Text Citation style model we studied in class the day we covered this:

    APA Citation

    You’ll be including the authors’ names in your In-text citation, so there’s no need to tag them afterwards in parentheses.
    4. The Hong, Sheehan, and Hancock articles are just that, articles, not Journals, so they need to be represented in your text with quotation marks, not italics. So, for example:
    In author Cameron Hancock’s article, “The Stigma Associated with Borderline Personality Disorder,” he claims, “Individuals experiencing BPD . . . .
    5. INSIDE the Hancock quotation, which is already flanked by quotation marks, there’s another set of quotation marks around the phrase treatment resistant. THIS is the only time to correctly use single quotation marks (when a quote is contained within a quote).
    For more on this Rule, see:

    Fails For Grammar


  2. davidbdale says:

    Now for the argument:
    (You didn’t ask for feedback, so I’ll do as much damage as I can in around 15 minutes.)

    —You say “this affliction” without antecedent. You can’t assume in this brand new essay that readers know what you’re talking about. And you’re not allowed to use your title as part of your paragraph either. So, name the affliction.
    —You mean it doesn’t exist without cause. If there were a REASON for the stigma, it would have a purpose. You mean it didn’t appear out of nowhere; it’s the RESULT of lived experience.
    —People can’t be incessant. Their actions can be.
    —You’ve combined two very different claims with an AND, Pop. They seek attention AND they are rapidly discharged. I think you must mean they seek attention and THEREFORE are rapidly discharged.
    —Your last sentence confirms my conclusion. Revise to make your logic clear. Your focus should be causal.

    Good stage-setting but it could benefit from a citation. Any of your sources weigh in on the badly-mixed cocktail of psychological factors always present in the heads of the BPD sufferer?

    —Not a good idea to wave around the “insanely” modifier in an essay about mental illness. It’s distracting.
    —No need to delay this explanation:

    Despite being stigmatized, these individuals still seek the care of emergency providers because they have absolutely nowhere else to go for help.

    —You mean “impulse sex” or “unsafe sex” or “sex with random partners.”
    —You could so easily follow up your remark about seeking help at the ER with the comment: “And it’s a good thing that they do.”
    —That little remark would set up what follows: the dangerous emotional state, the list of risky behaviors, their untrustworthiness, need for observation, etc.
    —You have more than two edges to your sword, Pop. Stay home and be a self-hazard. Go to the ER and face reluctant treatment. Be ejected from the ER too soon and hurt oneself or others.

    It’s a rich paragraph that deserves clear logic and rhetoric.

    —A “reason” is never “due to.”
    —And if you’re going to name THREE reasons, you should avoid starting your sentence with One of the reasons. You mean:

    ER staff are sick to death of BPR patients who visit too often with their comorbidity symptoms and bad attitudes.

    —Your quote comes along at the right time to confirm your broad claim.
    —Let’s get rid of another clumsy “due to.” (You NEVER actually have to use that phrase.)

    BPD-related visits are often seriously complicated by secondary conditions or misdiagnosis.

    —You list a bunch of co-presenting conditions, but several parallel what Hancock has already named (mood disorders, anxiety disorders, substance use disorders, and eating disorders). You may want to acknowledge that TOGETHER with Hancock’s list, there’s no wonder staff have a hard time diagnosing accurately.

    Time’s up. I hope this has been helpful, Pop. I’ve graded this post at Canvas as if it were already in your Portfolio. The next step is for you to reply and acknowledge your appreciation for your feedback, then make significant improvements to ALL your paragraphs and ask for a Regrade Please. You may also ask specific questions for additional feedback.


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