- A psychologist testified that Amber Heard had borderline personality disorder during Johnny Depp’s libel trial.
- Borderline personality disorder (BPD) is often stereotyped in the media as a condition that primarily affects white women.
- Mental health lawyer Ashley Jaye told Insider that getting a diagnosis as a black woman is difficult.
Content Warning: This article mentions suicide.
It wasn’t until Ashley Jaye was hospitalized after an episode of self-harm in 2018 that she decided to seek professional help.
Until then, she had had many episodes of self-harm, suicide attempts and periods of emotional dysregulation, but she said she hid many of her attempts from others in her life. But when Jaye started working with a therapist, her initial diagnosis…
– didn’t sit well with her.
“I had no symptoms of depression, but I also felt emotionally dysregulated, and I didn’t really know how to nurture relationships or how to nurture them,” Jaye told Insider. “It was always a lot of turmoil for me.”
That’s when she decided to do a little research online. After being released from the hospital in 2018 and placed in required outpatient programs, she began to hear and learn more about borderline personality disorder and found that it matched her symptoms better.
“I said, you know, this fits me a lot better than just depression,” said Jaye, who is a mental health advocate and the creator of r/Blackmentalhealth on Reddit, Insider said.
Once Jaye told her psychiatrist about the possibility of having borderline personality disorder, the clinician admitted that they had already suspected this diagnosis. They told Jaye they kept it as a secondary diagnosis because, as Jaye recalled, “a lot of insurance doesn’t really cover BPD services.”
Jaye is currently undergoing dialectical behavior therapy, the only treatment for borderline personality disorder, and said she felt better managing her symptoms.
What is Borderline Personality Disorder?
According to the American Psychiatric Association, borderline personality disorder (BPD) is a mental health condition characterized by extreme and frequent mood swings, poor self-image, and relationship problems. guide to the diagnostic and statistical manual.
The disorder has recently come to public attention due to Amber Heard and Johnny Depp’s defamation lawsuit. A psychologist hired by Depp’s team testified that Heard suffered from the disease, as well as histrionic personality disorder.
The disease affects about 2% of the population and 75% of those diagnosed are women, according to the American Psychiatric Association (APA). People are usually affected in early adulthood.
Natalie Jones, a psychotherapist in California who specializes in personality disorders and the mental health of black women, told Insider that people with the condition can obsessively analyze and seek out the people they come into contact with. The trait crosses cultures and gender differences and also reflects how people with borderline personality disorder interact with others in their lives.
“There’s a lack of boundaries and personal space,” Jones said.
To be diagnosed, psychologists look for symptoms such as intense episodes of sadness and anxiety, risky behaviors, paranoia, suicidal behaviors, an unstable relationship pattern, and an unhealthy self-image.
The condition runs in families, and is about three to four times more common in first-degree relatives of a person with the disease. There are no FDA-approved drugs to treat borderline personality disorder, but dialectical behavior therapy can help. Therapy helps people manage their thoughts and feelings and develop healthy coping mechanisms.
“What’s misunderstood about this condition and personality disorders in general is that people can’t change,” Jones said. “And what I saw is quite the opposite.”
Borderline personality disorder can be difficult to diagnose.
BPD can be difficult to diagnose in all races because mental health professionals are reluctant to diagnose it too early, Ashley Bryant, a clinical mental health counselor knowledgeable about black trauma, told Insider.
Bryant said that while she could recognize the symptoms of borderline personality disorder in a teenage patient, she would wait until he was 18 before diagnosing him because “everything under that [age] is a little frowned upon because their brains are still developing.”
In the meantime, she said young patients could be diagnosed with oppositional defiant disorder or disruptive mood dysregulation disorder.
Jaye said that as a child growing up in a religious home, she suppressed her negative emotions and found “any kind of discussion about mental health was ignored”. Looking back, she said that as a teenager she experienced a lot of emotional dysregulation. “I never really knew how to express how I felt,” Jaye said. “I always felt like my relationships were constantly going up and down.”
Misdiagnoses may contribute to the relative rarity of borderline personality disorder, Bryant said. Mental health professionals can diagnose people with depression, post-traumatic stress disorder, and anxiety even if the person has symptoms of borderline personality disorder because they are less familiar with this diagnosis.
Fighting the stigma of the “angry black woman”.
A 2009 American Psychological Association study found that blacks with BPD experience greater affective intensity and emotional dysregulation, fewer self-harming behaviors, and more thoughts of interpersonal aggression than whites.
Often, the multicultural aspects of a patient’s history are overlooked, which can lead to misdiagnosis if a clinician misses specific symptoms that are less common in borderline personality disorder, Bryant said.
Jaye said her symptoms, which were often self-directed and repressed, made it harder for doctors to diagnose her.
“Because I am a black woman, and because I know that if I were to show my anger publicly, my life could be in danger.”
Borderline personality disorder is often stereotype in pop culture as a condition that primarily affects white women, featured in films like “Girl, Interrupted,” “Silver Linings Playbook,” “Fatal Attraction,” and Harley Quinn in the Marvel Universe.
Jaye said BPD needs to be separated from a white woman’s disease so that black women can get the help they need sooner.
“A symptom of anxiety could be like irritability, for example, but a lot of people, if they see a super irritable black woman, they just think, ‘oh, that’s the angry black woman.’ And I was like, no, she might have severe anxiety.”
In Jones’ experience, a common symptom in black mothers is a lack of boundaries between themselves and their children. Black mothers with borderline personality disorder may “view their children as an extension of them” in an extreme way, she said. Hypersexuality, another common symptom of BPD due to patients’ desire for intimacy and closeness, may also be viewed more negatively when black women display that, said Jones.
Jaye said the stigma and risks of “acting out” as a black woman can also prevent people from getting help.
“That’s why I tend to get put down about it and blame it all on myself and once I’m able to go home and lock myself in a room or a closet, it’s that’s when I have all my mood swings and all my emotions,” Jaye says.
“Because we know that any kind of maladaptive behavior that we show in public, we could probably die.”