- Bree Conklin was diagnosed with borderline personality disorder when she was 27-years-old.
- It wasn't until 5 years later when a different doctor suggested she might have autism instead.
When she was 27, Bree Conklin was diagnosed with borderline personality disorder (BPD).
The male doctor who diagnosed her while she was working in Germany said it was the cause of her meltdowns, self-harming behavior, and suicidal ideation. According to him, Conklin was also "seductive" and "manipulative" because she dated several men at once.
Conklin, however, didn't feel like she was intentionally misleading anyone. "Looking back now, I take things kind of literally, and I thought you can date several people at the same time and then decide which one you would like to be in a relationship with," Conklin, now 39, told Insider. "I would go on three or four dates in a day because I thought that's what adults are supposed to do."
After she was diagnosed with BPD, Conklin developed an intense interest in the subject, and bought several books on it. But after reading more about the mental illness, the diagnosis confused her even more.
BPD is characterized by a severe fear of abandonment, mood swings, and patterns of unstable relationships, according to the Mayo Clinic. While Conklin identified with some symptoms like extreme mood swings and instability, she struggled to relate other ones. Many of the books also cited a lack of empathy and frequent lying as characteristics of the disorder, which she did not relate to.
Still, she stuck with the diagnosis for years, telling partners and friends that she had BPD and was seeking treatment for the disorder.
She was prescribed medication that made her symptoms much worse
To address her symptoms, Conklin was prescribed Abilify, an antipsychotic medication used to treat disorders like BPD and schizophrenia. But she said it made her experience frightening side effects.
"I didn't leave my house for three months, and I was convinced that if I ate anywhere, people were trying to poison me," she said. It wasn't until she got off the medication and started cognitive behavioral therapy that she felt better.
Her relationships suffered during this time period, too. She broke up with a partner of three years while she was on Abilify. Additionally, she said some people in her life kept their distance because "they would never put themselves in a position with borderline people ever again."
All of this made Conklin feel shame and guilt around her diagnosis. "I felt like I was being punished and that I didn't deserve to be around people, and I almost didn't want to because I didn't want to hurt anybody," she said.
It wasn't until five years after her initial diagnosis that she first learned she might be autistic — a moment she said made "everything fall into place."
She realized she might be autistic when she was pregnant
During her second pregnancy, Conklin began seeing a therapist who was puzzled by her BPD diagnosis. Instead, noting Conklin's sensory sensitivities, the therapist wondered if Conklin might be autistic. Conklin also had PTSD and trauma from her past, which the doctor thought might be making her symptoms worse.
At first, Conklin didn't know much about autism. But when she did her own research, she realized the symptoms explained everything she'd been going through.
"A lot of the classic BPD symptoms actually make a lot of sense when you see them through an autistic lens," Dr. Megan Neff, a psychologist who also was diagnosed with autism in her 30s, told Insider. For example, both BPD and autism symptoms include emotional dysregulation and mood swings.
Conklin also finally had an explanation for some of the symptoms that didn't seem to fit into her BPD diagnosis.
When alone, she often rubs her fingers together or makes "weird noises," something known as "stimming," as a form of self-soothing. She also noticed her moods dramatically worsened around her menstrual cycle, which is common for autistic people.
It took her two years of being on a waitlist to get a formal diagnosis. But Conklin described that time in between as life-changing.
"For once in my life, I felt like being kind and compassionate to myself," she said. She even encouraged another friend who was diagnosed with BPD to seek out another opinion — and that friend learned that she actually had autism and ADHD.
The experience made her realize how much stigma there is for both conditions
Neff said that both autism and BPD have stigmas, albeit very different ones.
Misdiagnosed autistic people continue to be judged and unsupported, which can lead to depression and suicidality. "Suicide rates and self-harm rates are much higher among the autistic population," Neff said.
Additionally, autistic women and gender-nonconforming people are more likely to be misdiagnosed. Neff said gender bias plays a huge role: Autistic men are more often depicted in media and stereotyped as scientific geniuses.
Meanwhile, for people who have BPD, there is also a lot of stigma. "Even within the mental health world, you'll still hear therapists say 'I don't want to work with someone with BPD,'" Neff said.
Conklin's experience made her see how differently people treated her with each diagnosis. The German doctor, for example, saw her as flirtatious and disingenuous because he thought she had BPD.
Conklin said being formally diagnosed as autistic improved how people treated her, compared to when she was diagnosed with BPD. After trying to get disability benefits for years when she said she had BPD, she was finally granted them with an autism diagnosis.
She also said her ex-husband stopped pursuing full custody of their son once he learned she was autistic and started expressing more patience with her as well.
On the flip side, people knowing she's autistic leads to her feeling infantilized. She recently had to get a colonoscopy done and the doctors wanted to "strap her down" before the procedure — something she said would only make her freak out more.
Conklin said her experience not only made her feel a lot of empathy for misdiagnosed autistic people, but also for people with borderline personality disorder.