Early Prevention and Detection of Borderline Personality Disorder is Important. Emily* and her parents spent years looking for appropriate treatment.

It’s been a long, hard road to diagnosis for our 15 year-old daughter Emily* and us. It would have been better if it had come sooner.

Emily’s behaviour went from sensitive, engaged and happy to challenging, angry and selfdestructive when she was 7 years old. Unbeknown to us, she had experienced sexual abuse by a male peer and relative. I spent years seeking help for Emily. I felt betrayed by the ‘system’ for taking so long to name what she was going through. No-one warned us about what may be happening to her; what her behaviour could mean for her. I often felt blamed as a mother, incompetent, destabilised and exhausted.

Emily would act out towards us and was almost ‘street angel/ house devil’. She had difficulty with relationships and perceived injustices, later regretting her behaviour and feeling hatred towards herself. She eventually began self-harming. My husband and I employed different approaches – but neither of them worked. We focused on keeping her safe and alive and learning skills to manage her distress.

Our relationship and our relationship with others suffered. Our other children were affected as well. We felt isolated; grieving the loss of who she had been. I sought help and support with parenting courses and counselling. No-one ever mentioned BPD; despite research supporting a strong link between trauma such as sexual abuse and BPD.

Finally, Emily was diagnosed with ‘emerging traits of BPD’ by an emergency mental health clinician. She was relieved to have an explanation for her feelings and behaviour and started telling people. We didn’t expect the stigma. I started using the term ‘emotional regulation difficulties’ instead of BPD. I felt if Emily had been diagnosed with a physical illness there would have been a lot more emotional support, concern and kindness. Instead, we often encountered ignorance, fear and blame. Some people told me they did not approve of early diagnosis and ‘labelling’ my daughter. Yet it seemed to me that it was this attitude perpetuating the fear and the stigma more than the diagnosis itself.

I often felt unheard or actively blamed. Everyone had an opinion. I was told that my fear and reactivity were causing Emily’s behavior. However, eventually I did get help and met some supportive clinicians, and police. I also had the support of a psychiatric registrar for 12 months which helped with my wellbeing and with keeping our family together. I maintained a good balance in life between caring for Emily and outside interests, for my own survival. My role as parent to Emily became that of carer. I began working as a volunteer counsellor which also helped me to come to terms with my own sense of grief and loss.

There has been little acknowledgement of the impact of the sexual assault on Emily. Both children are considered victims because they were under 10 years old, yet the effect on our daughter has been devastating and lifelong. I’m telling our story because early detection of BPD is essential, especially when a child discloses sexual assault. As distressing and devastating as this was, the added trauma from the inability or reluctance to name the behaviour as possibly BPD was almost fatal in our case. It’s absolutely vital BPD is identified early and talked about so that appropriate support can be found and treatment can begin.