Back to Celebrity Psychology

Amber Heard Was Diagnosed with Borderline Personality Disorder

Amber Heard has Borderline Personality Disorder and Histrionic Personality Disorder, but not Post Traumatic Stress Disorder (PTSD), says forensic psychologist.

You may have seen this story in the media (April 2022) and had at least a half a dozen questions, like:

- What about HIPAA (patient confidentiality)?
- How did the psychologist differentiate between c-PTSD and BPD?
- What is Borderline Personality Disorder (BPD)?
- What is Histrionic Personality Disorder?
- If she does have these disorders, how will she react to this information being shared all over the world?
- Will this help Johnny Depp win his case?
- Does Johnny Depp have Narcissistic Personality Disorder?
- Do Narcissists attract Borderlines?
- What treatment is available for Amber?
- Why didn't this couple's fame and fortune protect them from this? (Ah, that was a trick question. Mental health issues, substance use, and/or domestic violence crosses all socio-economic lines.)

If you haven't read any of the news related to this, here are a couple of articles:

​Psychologist hired by Depp testifies about Heard's health (abc news)

Amber Heard had personality disorders linked to violence and 'making up stories,' a clinical psychologist who evaluated her says

​Now, let's tackle those questions:

- What about HIPAA (patient confidentiality)?
Therapists, social workers and psychologists are required by law to maintain client confidentiality. In fact, we can't even acknowledge if we have ever heard of a person, let alone acknowledge that they are a client or what their diagnosis is!  How is it that the psychologist who diagnosed Amber with rather serious mental health conditions was allowed to tell the televised court room such private information?

It's called "limits to confidentiality."  According to state and federal law, there are times when a provider of mental health must break confidentiality.

Examples of these times include:

1) the client is actively suicidal or homicidal
2) the client (and in some states, relatives of the client) discloses his or her plan to harm another person or destroy property
3) suspected child, elder, or dependent adult abuse
4) court order / subpoena
5) threat to the provider and/or his or her employees or vendors
6) a demand from the federal government by way of the Patriot Act (Creepy, right? But, that's another post for another day.)

The above-mentioned reasons to break confidentiality are in addition to the more common reasons, including:
1) consultation with another licensed provider for the purposes of diagnosing and providing excellent care
2) billing insurance or another third party payor
3) coroner investigations
4) state licensing agency or insurance company audit or review 

Now, these four common reasons for disclosure are limited to the minimum amount of information necessary for the task at hand. For example, the insurance company will need to know name, address, diagnosis, date of service, and CPT code billed for that specific interaction.

- How did the psychologist differentiate between developmental PTSD and BPD?
This is a long-debated issue within the psychological community.  Trauma treatment leaders like Bessel van der Kolk have been fighting to get a new diagnosis, Developmental Trauma Disorder (DTD), in the DSM - Diagnostic and Statistical Manual of Mental Disorders for decades.  (DTD is also known as complex PTSD, abbreviated as c-PTSD), and it happens when someone was exposed to repeated or chronic traumatic situations (childhood abuse or neglect, for example).

DTD looks a lot like BPD, (and some would argue that DTD and BPD are the same thing, only with a different name).  DTD is not at the moment (April 2022) an actual diagnosis, so the forensic psychologist who conducted an extensive psychosocial evaluation on Amber would not have had to rule out c-PTSD.  But, if c-PTSD were an actual diagnosable disorder, the psychologist would have had a clinical duty to differentiate between c-PTSD and BPD. It's called differential diagnosis.

Because I am not a Hollywood fan, nor do I typically follow celebrity lifestyles, I do not know if Amber claimed that her PTSD came from her childhood, from her ex-husband, or from some other event.  In any case, your run-of-the-mill (as opposed to the "c" version) PTSD has certain guidelines that must be met before a diagnosis can be rightfully given. 

When a client or patient has enough symptoms, they are said to meet diagnostic criteria. This is often necessary to establish medical necessity for treatment when any type of insurance is involved in payment. (You didn't know you were getting a vocabulary lesson, huh?)

According to the rendering provider in this case, Amber did not meet diagnostic criteria for PTSD. In fact, Amber's exaggerated assertion of symptomology helped formulate the other diagnoses. How so? Keep reading.

- What is Borderline Personality Disorder (BPD)?
BPD is a grouping of symptoms that cause distress in several domains of a person's life. People with BPD are often erratic (hot and cold); prone to emotional outbursts; take things personally; are easily offended; seem to change their mind a lot about things like sexuality, religion, style, and occupation; and have an all-or-nothing mentality - especially in relationships. 

A couple of hallmark symptoms with BPD are frantic attempts to avoid real or imagine abandonment and attempts at self-harm, including suicidal ideation and/or attempts.

Someone who is in a romantic relationship with someone with BPD would notice that he or she was very passionate and exciting (at first), then turned critical, suspicious and clingy (out of fear of abandonment). Relationships with people who have BPD are very volatile. 

The people in the person with BPD's life feel as if they are walking on eggshells all of the time, "waiting for the other shoe to drop" as they say. In fact, BPD is called Emotionally Unstable Personality Disorder (EUPD) in the UK.  This name gives a better indication of what might be going on with the person.

For the diagnostic criteria based on the DSM, go here.

- What is Histrionic Personality Disorder?
Histrionic Personality Disorder is marked by an exaggerated need for attention and an extreme focus on personal appearance or image. They can be charming, and often use their social skills to woo and manipulate others. The person with this disorder is also often overly sexualized (think Marilyn Monroe).

It has often been speculated that almost *everyone* in Hollywood has this disorder as evidenced by the need to be in front of fans and cameras, endless self-glorifying selfies on social media, and the general, overly glamorized celebrity image.

Typically, people who suffer from HPD are not able to form or sustain meaningful, long lasting relationships.  It is difficult for them to be vulnerable and authentic, yet they will often believe that relationships are more intimate than they actually are.  

For diagnostic criteria, go here.

- If she does have these disorders, how will she react to this information being shared all over the world?
Sadly, this puts her at risk. Not only is her mental health at risk, her very life is at risk by the very nature of the disorder.  I am hopeful that the rendering psychologist has initiated precautionary safeguards as appropriate. 

On the other hand, this media circus could be fuel to her fire. She could use the publicity as an attempt to gain sympathy and support, or as "proof" of her victimhood. I say this recognizing that she most likely IS a victim- of the disorders, if nothing else.  Possibly also a victim of her former spouse, or at least the victim of a toxic dynamic between them.

- Will this help Johnny Depp win his case?
Only time will tell.  It is possible that his mental disorders or other personality issues will soon be revealed.  That being said, if Amber is the only one who presents with a diagnosis, it is possible that she will either be seen as the "bad guy" or as the weaker one who has a disorder she can't control.

In any event, having disorders like this never looks good in family court while dealing with custody matters. 

- Does Johnny Depp have Narcissistic Personality Disorder?
Well, I'm just going to leave this one for Howard Stern's speculations right now.

- Do Narcissists attract Borderlines? 
Yes. And Borderlines attract Narcissists. Read more here. There is also a ton of other information on this classically toxic pairing online. Just search.

- What treatment is available for Amber?
​The most successful form of BPD treatment is widely believed to be DBT, Dialectical Behavioral Therapy.  DBT was created by Marsha M. Linehan, who struggled with BPD herself.  DBT includes coping skills, mindfulness, and radical acceptance. 

Other treatments may involve talk therapy, CBT, and/or medications (usually for anxiety, depression, or impulse control).

We wish Amber and Johnny the best, including any appropriate treatment, as they move through this season of life.

​Back to Celebrity Psychology 
​

​Thank you for stopping by!  You can find out more about our Therapy Team and Services offered by following the links. Be sure to stop by our growing Online School to see if we offer any trainings that could enrich your life and relationships.

​
​
tags
#amberheard #johnnydeppvsamberheard #istandwithamberheard #johnnydepp #justiceforjohnnydepp #bpd #ptsd #npd #narcissistic #domesticviolence #therapy #destigmatize #celebritypsychology #celebritymentalhealth #richandfamous #mentalhealth #mentalhealthawareness #selfcare #selflove #anxiety #love #mentalhealthmatters #depression #motivation #health #wellness #mindfulness #healing #fitness #life #loveyourself #therapy #inspiration #happiness #mindset #positivity #positivevibes #quotes #meditation #mentalillness #psychology #wellbeing #recovery #instagood #happy #canwetalk #healplaylove
​
photo credit: Associated Press / AP
​