Q. I am 26 years old and a relatively successful professional. I was diagnosed with BPD when I was 19 years old during my second of three psychiatric hospitalizations (I was hospitalized at 16, 19, and 20 for MDD and suicidal ideation’s, with the diagnosis of BPD given in the second and third hospitalizations). When I was told of the diagnosis by my inpatient psychiatrist I basically told him that he was wrong and that they symptoms he was attributing the diagnosis on were in fact an exacerbation of my MDD. (I was in college at the time studying psychology). The reality is that I have in the past displayed some classic borderline symptoms in so far as relationships are concerned, and I did have a history of self injury dating back to the age of 4 (although I am free of that behavior for several years now). I also grew up in a physically and emotionally abusive alcoholic home. My questions are...Is it possible for the results of childhood trauma to mimic BPD in the respect that the emotional instability and the instability in relationships are in fact a learned behavior in emotional and physical abuse situations? Is it possible that a four year old began to display borderline tendencies (self injury)at that age or could that be the result of trauma/abuse? I still to this day contest my diagnosis, and in depth psychological testing at the age of 20 revealed a Personality Disorder NOS, however I am troubled by the past diagnosis, and most especially of the self injury (cutting) at the age of 4.

A. Yes, learned behaviors can be mimicked in adults and children. A key difference is the presence or absence of rage and how far it goes. Dissociative symptoms such as deja vu are clues to the diagnosis. Self injury is almost always due to the BPD.

The self injury was likely a symptom of severe depression, with most likely psychotic features.

Ignore what happened at 4 regarding the BPD. The BPD is diagnosed based on what happened since early adulthood.

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