Can we allow luck and zip code to decide the treatment of those with a personality disorder?
We need national guidelines for personality disorders. Patients quickly become «swing door patients» and are meet with ostracism rather than help. To ensure early and correct treatment, there is a need for a substantial quality boost.
There is a well-founded treatment optimism for personality disorders. Still, many patients are ignored. The name of the diagnosis gets the blame for lack of knowledge, unstructured treatment plans and, bad attitudes. It is a paradox that disorders that require so many resources and so many lives remains an unprioritized group in our health care system. Now, we need to establish national professional guidelines to ensure equal treatment. Regardless of zip code.
I won the psychiatric lottery
I was the problem child that teachers warned about. In a free fall, on the road to disability aid, imprisonment or early death. I reached rock bottom as I was evicted by my landlord, who was tired of the constant ambulance visits. There and then, I decided to move back to a place that was willing to help me. New zipcode replaced the ambulance, rejection and, risk with respectful treatment, recovery and future hope. Without a good treatment plan, I would at the very best only be unable to hold a job.
The diagnosis of personality disorder is associated with stigma and is for many patients synonymous with closed doors, unnecessary suffering and, an uncertain future. I was there for a long time. In a constant worsening state. My resources used against me, as an argument to «get a grip.» In the end, I´d gone through all available survival strategies and me staying alive was mostly based on luck.
Thanks to a knowledge-based approach, I went from costing the Norwegian government one to two Teslas a year to become a taxpayer and business owner. Most important of all, I went from survival to living. From eternal loneliness to life with healthy relationships. Over ten years were lost. It is pointless to wait until someone’s life has been destroyed before offering proper treatment.
The myth of treatment resistance is dead
Personality disorders were for a long time seen as chronic – the patients considered as without potential for recovery. The closest hope they got was learning to live with the symptoms. This idea is refuted. Expired knowledge becomes a quagmire for those who are fighting for a better life. Treatment works! Studies with up to 16 years follow-up time have shown great recovery potential. Captivated early and treated correctly, the diagnosis can be regarded as something passing by.
People with personality disorder are as different as the rest of the population. The diagnosis doesn’t say anything about who a person is or their future. It gives a direction for some problems one can struggle with to a greater or lesser extent.
The idea that one can fix themselves out of a personality disorder is as unenlightened as yelling at a cancer patient who doesn’t respond to the first treatment attempt.
It is never too late
Correct treatment will help more people experience an increased quality of life. It can help more people contribute to society within years. Discontinued treatment or inadequate treatment may lead to the frequent use of emergency services, costly hospitalizations or over-medication. Lack of treatment can cause negative effects.
When life consists of weekly retrieval of ambulance, rejection and, distrust, it seems like a utopia to recover enough to cope with small daily tasks. Support and proper treatment becomes a necessity. It is absurd how grateful I am for «only» losing 10 years. Offers for early and good treatment should be available for all in our welfare society. Increased quality of life for the individual will be beneficial to all involved.
Zip code and luck influences as a future predicament
Today’s quality of diagnostics, investigation and treatment options vary significantly across the health regions.
Patients want treatment, but many experiences that there are coincidences of whether they are taken seriously. Or diagnosed correctly and get structured, thoughtful treatment. Therefore, we need national guidelines. Guidelines will help more people get help. A joint understanding in touch with updated knowledge will be beneficial to all involved. Too many feel their diagnosis is a tattoo in their forehead, rather than a ticket to receive proper treatment.
At my worst, I understand that faith in my future easily evaporated. That’s precisely why an evidence-based approach was so important. An intensive and predictable treatment plan provided the necessary stability for me to meet my challenges head-on. The combination of individual and group therapy helped me experience and learn the importance of relationships and secure attachment. I was seen, supported and challenged. The therapists stood by my side when the chaos and my darkness were at its worst. Together with these people, I learned to understand myself and others better. It has led me to live a good life, even when the hard realities of being human comes smashing against me.
It worries me that I can feel a winner in the psychiatry lottery. It’s time to make knowledge-based treatment available to all.