What Are Borderline Traits And Why Are Therapists Reluctant To Diagnose BPD?

QUESTION:

Dear Dr. Heller,

My wife committed suicide in 1999 after a lengthy bout with several issues including what I believe was Borderline Personality Disorder (one of her several therapists' notes referred to "borderline traits", I'm not sure what that means), what I believe was Muenchausen by Adult Proxy (controlling mother kept her life completely screwed up to the point of creating overwhelming anxiety throughout her life), Hypothyroiditis, and eventually, Burning Mouth Syndrome.

I have a couple of questions: First, are therapists reluctant to diagnose Borderline Personality Disorder?  If so, why?  Their notes generally mention "Severe Personality Disorder." (What is that?)

Lastly, is it at all possible, or even likely, that her Burning Mouth Syndrome (Glossodynia?) could be tied to her Hashimoto's Thyroiditis?

Thank you in advance for your response.

ANSWER:

Borderline traits are signs that are consistent with the BPD.  If an individual has 5/9 BPD criteria he/she has the BPD.  Therapists are often reluctant to diagnose the BPD because of the erroneous belief that borderlines never get better, and are reluctant to "label" someone with this diagnosis. 

Severe personality disorder means a significant problem with the individual's personality, without naming specific personality disorders as outlined in the DSM. 

There are many possible causes of burning mouth syndrome, but clearly stress can play an enormous role. 

Hashimoto's thyroiditis is a viral infection of the thyroid gland that temporarily causes an elevation in thyroid levels, subsequently resulting in low thyroid.  Low thyroid (hypothyroidism) can cause many symptoms and diagnoses, and burning mouth might be related.  Low thyroid can also cause depression.  "Hypothyroiditis" is not a medical term.