The Stigmatization of Borderline Personality Disorder (BPD): Depp v. Heard

By Clare King

Dr Shannon Curry took to the stand in Johnny Depp’s defamation lawsuit against Amber Heard and diagnosed Heard with Borderline Personality Disorder (BPD). Many social media users have subsequently made damning associations between BPD and destructive and violent behaviours.

Stigmatization can spread through social media. Many posts referring to the Depp v. Heard trial are erroneously linking BPD to negative and violent behaviours. BPD stigma can arise out of fear: fear that individuals with the disorder are dangerous or even criminal. In actuality, people with mental illness, such as BPD, are far more likely to be victims of crime than criminal offenders (Peterson et al., 2014; Teplin et al., 2005). Individuals with BPD are more likely to be violent towards themselves than towards others. BPD is a disorder linked to self-harm and increased risk of suicide: approximately 75% of people with BPD attempt suicide and 10% eventually complete suicide (Black et al., 2004).

The consequences of stigmatization for those with BPD can be devastating. The stigmatization of BPD can be internalised by those with the condition- turned inwards against the self –  leading to depression, increased anxiety and low self-esteem. Individuals with BPD have already been found to have significantly higher levels of internalized stigma that those with other disorders (Grambal et al., 2016; Quenneville et al., 2020). Stigma can deter individuals with BPD  from seeking treatment or accessing supports, which can in turn delay improvements and recovery.

At the trial, Dr Curry also diagnosed Amber Heard with Histrionic Personality Disorder (HPD). It is not uncommon for individuals with BPD to have symptomatic overlap and co-morbidity with other disorders- though it is unusual to have comorbidity with HPD. The majority of individuals diagnosed with BPD tend to also be diagnosed with major depressive disorder – which can last a lifetime (Bateman & Fonagy, 2006; Gunderson et al., 2018). BPD itself can be lifelong and the percentage of the population with BPD may be higher than the literature suggests. BPD is often misunderstood, and therefore can be undiagnosed or misdiagnosed (Dhaliwal et al., 2020; Gross et al., 2002; Morgan, & Zimmerman, 2015; Zimmerman, 2015).

Although stigma can be permeated online, social media platforms can also be used as a tool to destigmatize. People with BPD can turn to sites such as YouTube to look for advice, share their experiences, search for information, or find likeminded people.

In recent research, I analysed 1,197 comments (approximately 55,574 words) in response to YouTube vlogs about BPD (King & McCashin, 2022). The vlogs all featured women, talking about their lived experiences of having a BPD diagnosis. Results found that the vlogs were an important force for destigmatizing BPD, and the vloggers were praised for being advocates for those with BPD. Some commenters described being comforted and others empowered by the destigmatization. The sharing of experiences helped alleviate feelings of loneliness and of being misunderstood. People gained a new or deeper understanding about BPD and with that, an increased empathy and support for those suffering from BPD and other mental health issues.

            The impact that four vloggers have had in reducing stigma and supporting those with BPD is immeasurable (the four vlogs have so far amassed over 959,000 views). Many commenters wrote of how the vlogs helped them to cope, made them feel less alone and finally understood. By sharing their stories, the vloggers humanise BPD. We can all help reduce BPD stigma by being informed and educated on BPD, as well as empathetic and respectful to those with the disorder. To destigmatise we need to humanise BPD and we can start with something simple: watching a vlogger tell their story.

The full research article available at https://doi.org/10.1016/j.invent.2022.100540

King, C. M., & McCashin, D. (2022). Commenting and connecting: A thematic analysis of responses to YouTube vlogs about borderline personality disorder. Internet interventions, 28, 100540. https://doi.org/10.1016/j.invent.2022.100540

Image credit: Photo Illustration by Elizabeth Brockway/The Daily Beast/Getty

References

Bateman, A. W., & Fonagy, P. (2006). Borderline Personality. In E. Simonsen, E. Ronningstam & T. Millon (Eds.), WPA/ISSPD Educational Program on Personality Disorders (pp. 72-83). World Psychiatric Association & International Society for the Study of Personality Disorders

Black, D. W., Blum, N., Pfohl, B., & Hale, N. (2004). Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention. Journal of personality disorders, 18(3), 226–239. https://doi.org/10.1521/pedi.18.3.226.35445

Dhaliwal, K., Danzig, A., & Fineberg, S. K. (2020). Improving Research Practice for Studying Borderline Personality Disorder: Lessons From the Clinic. Chronic Stresshttps://doi.org/10.1177/2470547020912504

Grambal, A., Prasko, J., Kamaradova, D., Latalova, K., Holubova, M., Marackova, M., Ociskova, M., & Slepecky, M. (2016). Self-stigma in borderline personality disorder – cross-sectional comparison with schizophrenia spectrum disorder, major depressive disorder, and anxiety disorders. Neuropsychiatric disease and treatment, 12, 2439–2448. https://doi.org/10.2147/NDT.S114671

Gross, R., Olfson, M., Gameroff, M., Shea, S., Feder, A., Fuentes, M., Lantigua, R., & Weissman, M. M. (2002). Borderline personality disorder in primary care. Archives of internal medicine, 162(1), 53–60. https://doi.org/10.1001/archinte.162.1.53

Gunderson, J. G., Herpertz, S. C., Skodol, A. E., Torgersen, S., & Zanarini, M. C. (2018). Borderline personality disorder. Nature reviews. Disease primers, 4, 18029. https://doi.org/10.1038/nrdp.2018.29

King, C. M., & McCashin, D. (2022). Commenting and connecting: A thematic analysis of responses to YouTube vlogs about borderline personality disorder. Internet interventions, 28, 100540. https://doi.org/10.1016/j.invent.2022.100540

Morgan, T. A., & Zimmerman, M. (2015). Is borderline personality disorder underdiagnosed and bipolar disorder overdiagnosed? In L. W. Choi-Kain & J. G. Gunderson (Eds.), Borderline personality and mood disorders: Comorbidity and controversy (pp. 65–78). Springer Science & Business Media. https://doi.org/10.1007/978-1-4939-1314-5_4

Peterson, J. K., Skeem, J., Kennealy, P., Bray, B., & Zvonkovic, A. (2014). How often and how consistently do symptoms directly precede criminal behavior among offenders with mental illness? Law and Human Behavior. 2014 Oct;38(5):439-49. https://doi:10.1037/lhb0000075

Quenneville, A. F., Badoud, D., Nicastro, R., Jermann, F., Favre, S., Kung, A.-L., Euler, S., Perroud, N., & Richard-Lepouriel, H. (2020). Internalized stigmatization in borderline personality disorder and attention deficit hyperactivity disorder in comparison to bipolar disorder. Journal of Affective Disorders, 262, 317–322. https://doi-org.dcu.idm.oclc.org/10.1016/j.jad.2019.10.053

Teplin, L. A., McClelland, G. M., Abram, K. M., & Weiner, D. A. (2005). Crime victimization in adults with severe mental illness: comparison with the National Crime Victimization Survey. Archives of general psychiatry62(8), 911–921. https://doi.org/10.1001/archpsyc.62.8.911

Zimmerman M. (2015). Borderline personality disorder: a disorder in search of advocacy. The Journal of Nervous and Mental Disease, 203(1), 8–12. https://doi.org/10.1097/NMD.0000000000000226

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