Not enough treatment options

Hi Reddit,

I (19F) was diagnosed with Borderline Personality Disorder in April 2024, and ever since then, I’ve been doing what I can to seek help, stay consistent with treatment, and build some kind of foundation for healing. I’m currently on antidepressants and doing individual therapy, where we’re using a mix of approaches including Mentalization-Based Therapy (MBT).

And don’t get me wrong — I’m grateful for having any access to therapy at all. But I’m also… frustrated. Deeply, painfully frustrated. Because where I live, group therapy is the only other structured option that’s offered as additional support for people with BPD, and I don’t qualify for anything else. And group therapy just isn’t something I can do.

It’s not that I don’t want to get better — I really do. I’m incredibly self-aware, and I reflect a lot on my patterns, behaviors, and emotional responses. I understand my diagnosis, I don’t deny it, and I’m actively working through it in therapy. But because of my childhood trauma, I have an extremely difficult time trusting people. Not in a “social anxiety” way, but more like… a deep, nervous-system-level inability to let my guard down around strangers. It can take me months or even years to trust someone, even slightly. So the idea of group therapy — opening up around people I don’t know, with no real sense of emotional safety — is just not realistic for me.

But when I express this, I’m met with a shrug. Like: “That’s the only other option.” And that’s where my frustration really kicks in.

It’s like the system isn’t built for the actual symptoms that come with BPD. Like people assume we’re either too unstable or too unaware, and when someone like me is self-aware and does want to work through things, suddenly I don’t qualify for certain treatment options — like mood stabilizers — because I’m “too self-aware.” I was literally told that because I have insight into my condition, I didn’t meet the threshold for medication beyond antidepressants. Which feels… backwards? I’m not even saying I want to be on a bunch of meds, but it’s just another example of how hard it is to get the right support.

So here I am. Showing up to individual therapy. Reading. Reflecting. Trying. And still feeling kind of stuck, because the system I’m in assumes one-size-fits-all — when BPD is literally a disorder that’s rooted in individual complexity.

Does anyone else relate to this? Feeling like you’re too aware for some treatments, not well enough for others, and just kind of trapped in between? Has anyone found other forms of support — even unofficial ones — that helped?

I just want to feel like I’m not the only one who sees how broken this model is.

Thanks for listening if you made it this far.