'I'm ruined': Young people's and their mothers' experiences of living with, and receiving a diagnosis of, borderline personality disorder: An interpretative phenomenological analysis.

Background: The adolescent borderline personality disorder (BPD) diagnosis has been widely debated for many years. Strikingly, young people's experiences of both receiving a diagnosis of BPD, and of living with BPD, are largely under-explored. The current study seeks to address these gaps in the literature in a multi-perspectival design utilising young people-parent dyads.

Methods: Young people (aged 16-18 years) with a diagnosis of BPD (n = 5) and their mothers (n = 5) were recruited from two NHS Community Mental Health Services in the West Midlands and participated in semi-structured interviews. Data were analysed using interpretative phenomenological analysis [IPA].

Findings: Analysis identified two superordinate themes with five subthemes: (1) The "ugly" reality of living with BPD (providing a stark insight into what it is like to live with the unpredictable nature of experiences labelled as BPD), and (2) The diagnosis that dare not speak its name (highlighting the complexities of how the diagnosis itself is experienced by participants as a symbol of personal and permanent defectiveness and danger).

Discussion: Findings highlight a clear commonality of experience centred around the intensity of the young people's emotional distress and the accompanying pressure on parents to keep young people safe, both of which services must strive to do more to contain. Ultimately, the costs of receiving a BPD diagnosis appear to outweigh the benefits, and this paper adds support to calls for change in respect to how we conceptualise difficulties labelled as BPD and how we communicate about these difficulties, in order to avoid causing harm.