PTSD and Borderline Personality Disorder: A Gendered Divide in Diagnosis?

white male solider and black woman split image

As with many types of traumatic or mental disorders, certain criteria must be met to receive a diagnosis. Following the structure of these guidelines is meant to allow for an accurate and unbiased determination. However, when it comes to the differentiation between Post-Traumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD), the question of whether men and women are diagnosed differently has been raised.

According to NAMI, the National Alliance on Mental Illness, an estimated 1.6% to 5.9% of adults in the U.S. have BPD. And of those actually diagnosed, 75% were women, despite the fact that men are just as likely to display symptoms. A non-profit organization, PTSD United, found that roughly 8% of Americans have PTSD. Additionally, 1 out of 9 females in the U.S. have PTSD, while the rate for males is about half that. These statistics alone call for us to question whether there is a divide in diagnosis based on gender. Before we can safely address the issue of gender, though, it’s important to look at the symptoms and characteristics that are used to diagnose both Borderline Personality Disorder and Post-Traumatic Stress Disorder.

For a mental health professional to diagnose a patient with BPD, they must display at least 5 of the qualifying symptoms. These include unstable relationships altering between idealization and devaluation, frantic efforts to avoid social abandonment, a distorted self-image that affects emotional stability, impulsive behaviors, suicidal and self-harming behavior, periods of depression, irritability, or anxiety that last between a few hours to a few days, chronic boredom or feelings of emptiness, uncontrollable anger, and dissociative feelings. Most psychological research indicates the causes are genetic, environmental (from the experience of a traumatic event), neurological, or a combination of the three. Continue reading PTSD and Borderline Personality Disorder: A Gendered Divide in Diagnosis?

The History of Hysteria: Sexism in Diagnosis

vibrator ad cosmopolitan magazine

The female body has long been misunderstood. Women are often misdiagnosed by doctors, either due to the belief that they are over-dramatizing symptoms or because of a lack of adequate research on illnesses predominantly faced by women. As frustrating as this is, it’s no new phenomenon.

Dating back to 1900 BC Egypt, an ancient medical document known as the Eber Papyrus contained references to hysterical disorders thought to be caused by abnormal movements of the uterus. In the 5th Century BC, Hippocrates was the first to coin the term “hysteria” and agreed with his predecessors that this so-called condition — attributable only to women — was due to a “wandering womb,” believed to be caused by sexual inactivity. Recommended cures were, naturally, that women should increase sexual activity within the bounds of marriage. This diagnosis was not founded in science or medical research (though that may seem obvious now), but in gender bias against women and their experience of emotions and the perceived lack of sexual interest.

As currently defined by Merriam-Webster Dictionary, hysteria is, “behavior exhibiting overwhelming or unmanageable fear or emotional excess.” An alternate, psychiatric definition is, “a psychoneurosis marked by emotional excitability and disturbances of the psychogenic, sensory, vasomotor, and visceral functions.” While the definition of hysteria might seem broad, it has also altered over time. While medicine and mental health have changed a great deal over the centuries, hysteria is a historically gendered diagnosis that often served as a catch-all when doctors couldn’t identify another illness. It was extremely common to find women labelled as “hysterical” defined more by their stature as women than by their symptoms. Continue reading The History of Hysteria: Sexism in Diagnosis