Sunday, October 23, 2011

Crossing the border with Borderline Personality Disorder

The other day I read with interest an article on Miami Dolphins receiver Brandon Marshall, a talented football player with a penchant for on- and off-field issues. His antics aren’t exactly “news,” as they seem common place for the divas that play wide receiver in the National Football League – surly attitude with the media, a “me first” disposition, arguments with coaches about how many “looks” he gets each game, and the increasingly occasional legal run-in, including domestic disputes with significant others; in Marshall’s case actually getting stabbed by his wife.



Yes, the typical ho-hum, every day story of an over-paid, pampered athlete, save one noticeable addition. You see, recently, Marshall announced he has been diagnosed with Borderline Personality Disorder.

WTF?

“Borderline” personality disorder? By name alone, it’s defined as not being a full-fledged personality disorder, or maybe not a personality disorder at all, just creeping up towards disorder, but staying tantalizingly just south of the border. “Borderline” connotes an uncertainty, a maybe it is, maybe it isn’t, and seems like the ultimate clincial hedging of bets.

There’s no “borderline” in science, outside of hypotheses being put to the test and either proven or disproven. How ridiculous would “borderline pregnant” be? Or, maybe borderline diabetic? Borderline heart disease any better?

Child, please.


Borderline Personality Disorder (BPD for those who think it actually exists) could possibly be the ultimate 20th/21st century creation designed to make people feel comfortable by shirking responsibility, blaming something, anything, even if made up on the spot, for their boorish, anti-social, uncivilized behavior. It is the euphemistic way of saying, “I’m a douche bag with no personal accountability.”

In clinical terms, “disorder” and “disease” are often used interchangeably by doctors, of which I’m not one, of course, although my hand writing and proclivities toward inflated self-worth and egotism make me qualified, if not actually board certified in many states. Neither term implies underlying causes, although “disease” implies permanence, invariance, and non-subjectivity; hence, therefore, Borderline Personality Disorder, not disease.

Disorder is the new wave term of recent popularity. Disorders relieve sufferers of the stigma of having a disease, as if having a disease made one a member of the untouchable caste. WikiAnswers will tell you that “disorders” are often used for illnesses where the origin, duration, or physiological basis is relatively unknown.

Okay, to be fair, what do I know about medicine, other than what I’ve learned from watching “House” and learning terms like “lumbar puncture?” I might not know much of medicine, but I do know about branding, and BPD’s biggest problem is branding.

The National Education Alliance Borderline Personality Disorder (NEABPD) – uh, see what I mean about a “branding problem” – is tasked with educating the public on the “disorder’ and advancing both diagnoses and treatments. In the words of the NEABPD, Borderline Personality Disorder was officially recognized by the psychiatric community in 1980 and is more than two decades behind in research, treatment options, and family psycho-education compared to other major psychiatric disorders.

You know, real disorders.

According to the organization, BDP affects up to 5.9% of adults (14 million Americans), is more common than schizophrenia and bipolar disorder, and is prevalent in 20% of inpatients at psychiatric hospitals and 10% of outpatients. Brandon Marshall himself cites research that 35% of male prison inmates suffer from it.

If the NEABDP really wants to raise the profile of BDP, might I suggest first changing the name – you got to do something about the “borderline” part. For anybody not looking for an excuse for his or her behavior, the name suggests a reach at best, a sham at worst. I mean, c’mon, if BDP was a real disorder that affected the psychological well-being of individuals, wouldn’t we have given it a way better name, something with credibility and appropriate severity, not something that just begs people to discount as a bunch of rubbish?

Moreover, aside from the branding opportunity, there’s the need for a public relations campaign to dig out of the hole BDP’s national celebrity spokesperson, Mr. Marshall, relentlessly shovels, for him and his fellow afflicted. A skeptical, cynical society – okay, forget society, it might just be me – will be prone to dismiss a diagnosis of BDP as an easy out for social misfits like Marshall to make excuses for their behavior, the safety net of “it’s not my fault, I have a medical condition, or least a disorder, or, rather, perhaps a ‘borderline’ disorder” ready-made excuse.

Brandon, regardless of whether you have BDP or not, don’t think it’s a waiver freeing you from responsibility. Excuses are like asses; not only does everyone have one, but also using the former is being the latter. What you do, your behavior, is who you are, and it’s as simple as that. The eleven calls Douglas County (Colorado) deputies made to you home between January 2006 and July 2008 gives us hints as to your character. Your five arrests and driving without a license incident, all since 2004, tell even more.

True, the world is not always black and white. But, it’s a lot more darker and lighter gray than our society often cares to admit. No “borderline” about it.

Of course, as you know, I’m often mistaken; that’s just this guy’s opinion.

Diagnose my many disorders on Twitter @RayHartjen.