Is It BPD or Autism? Let’s Talk Misdiagnosis and Stigma This BPD Awareness Week
- VHC team
- Oct 10
- 4 min read
For BPD Awareness Week 2025, we’re joining the call to clinicians, individuals, carers, communities, and policymakers to unite for systemic change. Recent Australian research shows that 1 in 10 suicides are linked to symptoms consistent with a diagnosis of Borderline Personality Disorder (BPD) (Broadbear et al., 2020). That’s a sobering reminder of why awareness and reform matter.
This year’s theme “1 in 10: Uniting for Change” - highlights the urgent need to address stigma, improve access to care, and support recovery.
To learn more we recommend heading to www.bpdawareness.com.au.
In this blog post, we unpack -
What is Borderline Personality Disorder (BPD)?
BPD is a mental health condition where people may experience intense emotions, difficulties with self-image, and challenges in relationships. It’s important to remember: BPD does not define who someone is - it’s an experience, not an identity.
We all have a personality. It’s the set of traits that make us who we are. Sometimes, these traits help us cope with life’s ups and downs. But when personality traits create ongoing difficulties with emotions, thinking, and relationships, it may be diagnosed as a personality disorder.
In BPD, people may experience:
Intense emotions that feel hard to manage
A shifting or unstable sense of self
Fear of abandonment
Challenges in close relationships
Impulsivity or difficulty with self-control
Self-harm or suicidal thoughts (higher than other mental health conditions)
Breaking Down the Stigma
Stigma around Borderline Personality Disorder (BPD) remains common - both in the community and within clinical settings. Some clinicians even avoid diagnosing BPD, thinking they're "protecting" clients from the label, but this often has the opposite effect. When stigma prevents diagnosis, people miss out on the right supports, treatments, and self-understanding.
The science around BPD is well established and recovery is possible with compassionate and evidence-based care. The biggest barriers is stigma, both in the community and within the mental health system itself.
Accurate diagnosis is an act of social justice. It opens doors to appropriate care, funding, and recovery, and says clearly: you are not too complex to help.
*If you're interested in reading more, Professor Andrew M. Chanen's editorial on Bigotry and Borderline Personality Disorder is an interesting read!
Autism and BPD Overlap, and Why Women & Gender-Diverse Individuals are More Commonly Misdiagnosed With BPD?
Autism and BPD can overlap, co-occur, or be mistaken for one another - especially in women and gender-diverse people.
Here’s what the research shows:
1 in 4 autistic adults and 1 in 3 autistic women have reported at least one percieved psychiatric misdiagnosis before being identified as autistic, and personality disorders were the most common (Kentrou et al., 2024).
37.5% of autistic individuals (47% of females and 27.3% of males) had at least one prior condition that was not maintained after they were identified as autistic, with personality disorders being most frequently no longer reported (Kentrou et al., 2021).
Research also shows that transgender and gender-diverse individuals have, on average, higher rates of autism, other neurodevelopmental and psychiatric diagnoses compared to cisgender individuals. Yet there’s limited research exploring how this impacts diagnosis accuracy and potential misdiagnoses (Warrier et al., 2020).
So, why does this happen?
Women and gender-diverse may face higher social expectations in relationships.
Masking and camouflaging Autism traits can mimic BPD symptoms.
Social challenges or preferences (like preferring fewer close friends) may be misinterpreted
When emotions run high (as they do for both autism and BPD), clinicians may get lost in diagnostic guesswork without considering the full picture.
Struggles with sense of self may come from years of masking, not BPD identity instability.
In short: what looks like BPD could actually be autism in disguise - or both.
Why Getting the Right Diagnosis Matters
When BPD is mistaken for autism (or the other way around), people often end up in the wrong kind of therapy or taking medications that aren’t actually helpful.
For people with BPD:
Theraputic approaches like Dialectical Behaviour Therapy (DBT) can be highly effective.
DBT helps with emotional regulation, interpersonal skills, and developing a stable sense of self.
For people with Autism:
Goals often focus on communication, sensory regulation, and day-to-day functioning.
Therapeutic supports and occupational therapy can help, not standard DBT.
What Should You Do if You've Been Given a Label That Doesn't Feel Right?
If you suspect you’ve been misdiagnosed, you’re not alone. Sometimes, getting a second opinion can bring clarity and validation.
At Very Helpful Chats, we recognise the nuances between neurodivergence and personality disorders, and we take the time to truely understand your individual experiences. We offer comprehensive neurodiversity-affirming assessments, mental health support with psychological therapy, and occupational therapy.
Feel free to have a read of our Autism and ADHD assessment page to learn more - https://www.veryhelpfulchats.com.au/audhd-assessments
If you’d like to learn more about our assessments and supports, please get in touch - we’d love to help!
*The right diagnosis doesn’t have to define you, but it can open the door to the right kind of support.
References
Broadbear, J. H., Dwyer, J., Bugeja, L., & Rao, S. (2020). Coroners' investigations of suicide in Australia: The hidden toll of borderline personality disorder. Journal of psychiatric research, 129, 241–249. https://doi.org/10.1016/j.jpsychires.2020.07.007
Kentrou, V., Livingston, L. A., Grove, R., Hoekstra, R. A., & Begeer, S. (2024). Perceived misdiagnosis of psychiatric conditions in autistic adults. EClinicalMedicine, 71, 102586. https://doi.org/10.1016/j.eclinm.2024.102586
Kentrou, V., Oostervink, M., Scheeren, A. M., & Begeer, S. (2021). Stability of co-occurring psychiatric diagnoses in autistic men and women. Research in Autism Spectrum Disorders, 82. https://doi.org/10.1016/j.rasd.2021.101736
Varun Warrier, David M. Greenberg, Elizabeth Weir, Clara Buckingham, Paula Smith, Meng-Chuan Lai, Carrie Allison, & Simon Baron-Cohen. (2020). Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nature Communications, 11(1), 1–12. https://doi.org/10.1038/s41467-020-17794-1
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