A Letter From A Disgruntled BPD Sufferer To His GP

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An open letter (although names have been redacted to preserve anonymity).

Dear Doctor ****

Thank you for seeing me on Friday. At the end of our consultation, I asked if I should make another appointment and you said, ‘No, just touch base.’ I was not sure what you meant by this (finding the comment ambiguous) so I thought the best thing to do was write. I will keep it brief as I can so as not to tale up too much more of your time.

First, allow me to place this letter in context :

As consultation of your notes will no doubt confirm, I have a diagnosis of BPD. This, of course, is a very serious condition. Indeed, the best research indications are that 10 per cent of BPD sufferers will eventually die by suicide. I do not know if this statistics is reflected by your practices own statistics, or even if it records such data.

Despite this alarming statistic, you may also be aware that, according to several studies published in academic journals of high repute, there exist within the medical profession many negative attitudes towards BPD sufferers

However, there is now overwhelming body of evidence suggesting that the disorder is related to abnormal brain development brought about by developmental trauma (i.e. trauma during childhood, particularly early childhood).

Furthermore, specialists in the field are of the view that of all psychiatric conditions, BPD inflicts the greatest mental pain and anguish on sufferers.

Anyway, that’s the conrext of the letter set. I now turn to a consideration of the consultation you were kind enough to provide me with today.

Because I am acutely aware of time restrictions in consultations, I came prepared with a list (though by no means an exhaustive one) of some of my main symptoms. Obviously you cannot be expected to recall the symptoms this list and I am not sure whether or not you kept a record of them. Therefore, to refresh your memory, I reproduce the list below :

1) Severe sleep disturbance, including extremely frequent waking, extremely disturbing nightmares / vivid dreams and thrashing about in sleep (sometimes tesulting in knocking things off my bedside tabe).
2) Frequent exteneded periods of hyperventilation.
3) Severe head pain / feelings of profound psychological distress the nature of which is difficult to articulate.
4) Periods of feeling extremely on edge / hypervigilant / overloaded by feelings of stress
5) At other times, periods of such deep exhaustion and lethargy that I stay in bed for 20 hours at a time but only sleep very fitfully and shallowly or else am in a state of that feels like a kind of very unpleasant, semi-conscious delerium.
6) Distressing intrusive, circular and ultimately futile thoughts and negative ruminations.
7) Concerns about the possible effects of many years of severe chronic stress on my physical health (e.g. excessive cotisol production and inflammation) particularly when one also takes into account my inability to stop smoking, tendency to try to calm myself with carbohydrtaes, and possible detrimental biological effects of anti-psychotic medication ; as you know, I already have diabetes.

I suggested I see a sleep specialist or neurologist but you doubted this would be helpful or even possible. 

I also suggested I was suffering from Complex PTSD and explained that I have reason to hold this view, in large part (though other factors of course will have been of play), because I suffered severe developmental / childhood psychological trauma This, however, did not appear to be a theory you were keen to pursue (although I accept this might have been due to time pressures).

After our discussion, the treatment you did recommend was the joining of an exercise and wellbeing class that I think runs on Friday afternoons. I have not yet signed up for this but thank you for idea which, as I said to you, I thought would be of potential benefit.

However, I seem to recall from a while back that during an appointment with Dr —— it was suggested that I might be able to obtain EMDR therapy on the NHS (even though there would inevitably be a long waiting list. I wonder if this is still available. Alternatively, can I obtain dialectical behaviour therapy, mindfulness-based CBT, cognitive analytic therapy or biofeedback training on the NHS?)

As I alluded to above, I am aware of various peer-reviewed studies published in academic journals that suggest there can be a certain level of prejudice, within the medical profession itself, towards those who have been diagnosed with BPD even to the extent that it can lead to deliberate avoidance of BPD sufferers, deeming them unworthy of help and admitting to not acting in their best interests ; if you have reason to concur, or feel I might be subjected to such discrimination in the future, I would appreciate your support.

Because I have mentioned Dr ——- in this letter, I shall, as a matter of courtesy, send her a hard copy of it. For the surgery’s records, I shall also send a hard copy of it to your Practice Manager.

Thank you again for seeing me and for your offer to join the Friday exercise class.

Yours sincerely,

P.S. When I told you about my negative ruminations, you responded that cows ruminate but only because they don’t have digestive systems. I am still pondering the relevance of this enigmatic observation.

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About David Hosier BSc Hons; MSc; PGDE(FAHE)

Psychologist, researcher and educationalist.

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