Living with Borderline Personality Disorder

PART OF THE “BREAKING THE CODE OF SILENCE” SERIES

In my early teens I began to experience overwhelming, unshakeable mood swings that, like a lens applied to my perspective, coloured my life. I’d feel them starting, a slow-motion crushing sensation, like being caught in an industrial compactor, and I was filled with dread.

I needed to be around people when they occurred, the places my thoughts took me to frightened me, but I was criticised at home for being moody, so I spent a lot of time alone waiting for them to pass.

 

What is Borderline Personality Disorder?

I suffer from Borderline Personality Disorder (BPD). I was first treated for depression at 15 but doctors can’t make a diagnosis of BPD on an adolescent, due to their personality still being in its formative stage. It’s a condition in which people exhibit long-term patterns of instability and turbulence in the areas of self-image, relationships and emotions.

There are 10 classified personality disorders and of those, BPD is the most common, most complex, most studied, and certainly one of the most devastating, with up to 10% of those diagnosed committing suicide. It exists in approximately 2-4% of the general population; up to 20% of all psychiatric inpatients and 15% of all outpatients.

 

How is it diagnosed?

A person is required to be exhibiting five or more of the symptoms below for a diagnosis of BPD to be made:

  • Frantic efforts to avoid real or imagined abandonment
  • A pattern of unstable and intense relationships characterized by alternating between extremes of idealization and devaluation
  • Identity disturbance, such as a significant and persistent unstable self-image or sense of self
  • Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
  • Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
  • Emotional instability due to significant reactivity of mood (e.g., intense episodic depression, irritability, or anxiety)
  • Chronic feelings of emptiness
  • Inappropriate, intense anger or difficulty controlling anger
  • Transient, stress-related paranoid thoughts or severe dissociative symptoms

 

What causes it?

BPD is thought to result from a mixture of biological, genetic, social and psychological factors. In other words doctors aren’t sure and are keeping their options open, but studies have shown a high correlation between traumatic events during childhood and occurrence of BPD. I always knew my experiences growing up and my relationship with my parents were responsible for a large part of my mental health issues and as I grew older, I tried to maintain a distance from them to help myself. But it was incredibly difficult to accept that they weren’t the supportive family I needed and every so often I would allow myself the hope that perhaps they could be. That never proved to be the case.

Thankfully, with BPD, the symptoms become less intense as a person ages and sufferers experience few of the extreme symptoms by the time they reach their 40’s or 50’s.

 

What does BPD mean to me?

borderline-personality-disorder-symptomsA diagnosis of BPD at 25 didn’t give me any great insight at the time, beyond the confirmation that I wasn’t completely to blame for my uncontrollable mood-swings and self-destructive tendencies. I was in a very dark place, frequently suicidal, self-harming and full of self-hate. It wasn’t until much later, after therapy, that I began to gain a greater understanding of myself, and even then, it could be frustratingly fleeting; a glimpse of something that resonated within me but was too intangible to pin down.

While symptoms differ from person to person, my BPD affected me in a number of ways:

  • I experienced frightening mood swings for no apparent reason, and needed company to distract me from them. It was like having a video constantly playing in your head and being unable to switch it off. I couldn’t sleep or concentrate. Sometimes I used music to escape it, as I got older I used alcohol and drugs. I used to wish I could be knocked unconscious and wake up when it had passed.
  • I had difficulty dealing with emotional reactions to things. Even today I’m not conscious of what I feel straight away, it takes a while for it to condense into something I can verbalise. I might experience extreme anger and frustration but be unable to express it – this led to me taking it out on myself by either demolishing my confidence with self-doubt or punishing myself physically through impulsive, destructive behaviour – cutting, substance abuse, starvation, binging and purging. I would feel the anger building and be scared of what it would force me to do. At times like that, calling The Samaritans helped me through. They didn’t judge, just listened sympathetically and that gave me the strength I needed to hang on.
  • I experienced Splitting, “All-Or-Nothing Thinking” where everything was either one extreme or another: good or evil, innocent or corrupt, I would put people on a pedestal only to tear them down and demonise them when I felt slighted. I would easily become paranoid and read all sorts of things into a person’s behaviour. I would over-analyse my own words and actions, terrified I had inadvertently offended someone and caused them to dislike me.
  • I had periods of Depersonalisation – a feeling of watching yourself while having no control over the situation. I could feel myself becoming distant, travelling to a kind of empty place with no feelings. I used to dream a lot about trying to say something but being unable to make myself heard, or trying to run from something but being unable to make my legs work. I felt like I didn’t exist, I was on the wrong planet; I couldn’t relate to the people around me – I looked like them on the outside but inside was an empty space.
  • One of the core areas of BPD is concerned with identity and self-image. I remember my husband telling me once that he knew me better than I knew myself. That’s an uncomfortable thing to hear. To a certain extent I had to agree with him – his logic and ability to recognise the patterns in my behaviour and thought processes enabled him a clearer view than I could ever hope for. But at the same time, I knew he was completely unaware of the intensity and nature of the thoughts that invaded my consciousness. The dark ones are too horrific to share and the light ones (I thought) just made me sound ridiculous.  It feels impossible to put them into words – like trying to catch a cloud in a matchbox.

 

I still don’t have a clear sense of who I am. If asked to describe myself, I have to consult other people. On one level, I know I have opinions, likes and dislikes. I HATE mushrooms and I know the difference between right and wrong, but there seems to be something in me that is very impressionable. Every time I watch a film I come away identifying with some aspect of a character and wondering if that’s who I am. For a while, my thoughts and behaviour might change, until the influence wears off and I’m back to being a blank canvas again. I feel as though I have some definable “pieces” but they’re not enough, or don’t fit to make a whole person.

 

Learning to live with it

I was treated with medication to get my head into a better place and I had Cognitive Behavioural Therapy to help me deal with my triggers. I discovered the thought and behavioural patterns I had become enmeshed in and worked hard to undo years of ingrained habit. It was slow and difficult work. I would get so frustrated when I could identify my problems but my habitual response would automatically kick in. Knowing the problem was one thing, but fixing it was another. It was particularly difficult to deal with people who triggered my symptoms but I eventually faced them and voiced my feelings. Doing this, in spite of my fear, gave me strength in the face of their denial and helped to give me another tangible “piece” of Me to fit with the others.

Hard work and persistence won out in the end. I wanted to change things, and with support from my husband and mental health team I did. I finally received confirmation from The Priory that I was in good mental health and no longer required treatment. That was some years ago now. I still have difficult times, but I know that if I dig deep, I have the tools to get through them. Thankfully now those times are few and far between.

 

Linking up with the Love All Blogs Mental Health Blog Hop.

Promoting BlackDogTribe

 

Author’s note, June 2014: Since the time of writing I’ve been re-diagnosed with Aspergers and Bipolar II. I no longer meet the criteria for BPD and given the existing cases of Aspergers and bipolar in my direct family I have to admit this re-diagnosis seems a more accurate explanation for my symptoms. Oh, the beauty of hindsight… 

 
 

22 Comments

  1. I for one am very glad you persevered and found a way through your illness. I think it’s great that you’re being so open in this series and helping to show other people that there is hope and support.

    Reply
    • Thankyou Julie. I very nearly didn’t make it. The quality of care for people with problems like mine is patchy and society’s general view is that you just need to knuckle down and get on with things. There needs to be more education available in parenting classes/books, leaflets and advice in public places like libraries, schools and community buildings and a more caring and understanding attitude put forward by the media when covering mental illness. There is support out there, but it’s not always easy locate and organise it when you’re in the grasp of a bad episode.

      Reply
  2. we got a phone call at 4am this morning to go to help a very special girl who has this problem. this time last year she would have tried to kill herself but this time she went to the doctor got valium and has gone to ground in her room. she will return to the ‘normal’ world when she can all we can do is hope and wait and let her know we are there for her. she lives with her very ununderstanding (i know there is no such word, my brain is asleep it is so late) parents who have gone on holiday today. abandonment definitely triggers hers. thanks for this info really helps. we are also looking after someone with psychosis and abnormal paranoia. she has been hospitalisied . stressful time all around

    Reply
    • Get some sleep while you can. You do something that has a big effect on those you care for. You’ll never know how big a difference you make, but rest assured you do. What a wonderful way of using your knowledge to help others. I’m so proud of you! xxx

      Reply
  3. You write so well and make what you have been through so easy to understand. I can’t empathise with all that you have been through, but I do empathise with the feeling of being a ‘blank canvas’. When I was first diagnosed and had the Crisis team in they kept asking ‘who are you’ and I just couldn’t answer as I don’t know. I also often identify with film or book characters.

    What you are doing is great, helping people understand Mental Health issues in a very easy manner with no jargon.

    Take Care x

    Reply
    • Thank you for the compliment. You are doing a fantastic job over on your blog, shedding light on the lonely experience of Post Natal Depression. Depression has a funny way of just robbing you of your human-ness. You really do lose sight of who you are and become a shell or automaton – only functioning because it is expected not through any personal drive. You take care too xxx

      Reply
    • Personally, I don’t see it. But thanks anyway :-)

      Reply
  4. That was a fantastic post for a condition that is still little understood. I absolutely agree that it probably has its roots in trauma at a formative age – when we are trying to find an ego sense of self which trauma can fragment into many pieces and effects the wiring in the brain. This of course can be healed. Also its not a case of you have BPD or not – its a spectrum of which many of us can relate to the symptoms – I know I certainly do. Having BPD is only a sum of the part – not the whole person. This is why I think the categorisation of the personality via the DSM can be unhelpful in so many ways. Also EMDR therapy is a very powerful trauma focused psychotherapy which has been proven to be very effective in finally laying the emotional and behavioural residue of trauma to rest once and for all – by allowing the ‘live’ memory of the trauma to be stored in the correct part of the brain – trauma has a way of not allowing the memory to get processed properly by the brain hence all the symptoms. EMDR has also been very effective for BPD.

    Reply
    • Had a quick look at EMDR, seems like a mixture of hypnosis, free association and desensitization. Intriguing, will have to read more. Thanks for taking the time to comment so comprehensively.

      Reply
  5. This is such a powerful piece, Aisha. Your descriptions are heartwrenching, save for the fact that I know you are so much better now. And I think THAT is why your writing about your experiences, and some of the others commenting about their own situations, is so important. Setting aside the horrible parents mentioned in a comment who chose to go on vacation while their daughter suffers, most people would read, learn, care, share and possibly be moved to action. You really do have a knack for explaining complicated terms and symptoms in simple yet eloquent terms. Who could read this and not be affected? Such a powerful, powerful piece.

    Reply
    • Wow! Thanks Linda. I don’t know what to say, I just try to describe how it feels so I’m glad that translates into something helpful to others. I rely on comments to give me an idea of how successfully I convey it, because it’s so subjective for me – I’m immersed in the feelings, and simultaneously desensitized to them. After the prolonged exposure I had it was the only way to stop them totally engulfing me. The objective assessment of my descriptions provided by comments is invaluable.

      Reply
  6. Just so wonderful to read Aisha, you really write so passionately and I for one am glad that you have made it through thus far. And that’s from another lady who has Borderline Personality Disorder.
    How are you finding writing about all this? I know it can be therapeutic but also initially very emotional – are you doing ok? x

    Reply
    • What wonderful compliments, thank you! A fellow “Moody Mutha”, lets unite and form a band – hold on, it’s years since I played guitar; second thoughts lets stick to blogging! BPD has done nothing to diminish your creativity, I LOVE your style and wish I was a little more like you – I’ll keep working on it ;-)

      It’s very kind of you to ask how I’m doing. To tell the truth it’s a bit of a rollercoaster at the moment, and me being me, I chose to put it down to the weather, while your speculation is much more realistic. Everything comes down to balance, and while writing about these things has given me greater insight and enabled me to like myself more and blame myself less, it also kinda gets on top of you, especially when you’re tired. Some early nights and some sunshine will help to keep me on the rails. Big hugs to you, you amazing lady! :-)

      Reply
  7. It is such a shame your parents were so destructive towards you at a time when you needed their love and understanding the most. No wonder you felt confused and depressed.
    However, no one I’ve met is completely happy or fulfilled, not even me. It’s how we recognise our dark moments, deal with and move on that counts. Inner peace brings an inner strength :)

    Reply
    • Wise words… are you really Master Shifu?
      In seriousness though, you are right – everyone’s misery and difficulties are relative, as is the strength it takes to overcome them.

      Reply
  8. Thank you for this wonderful article. I am going to use it as a teaching text for my students, since it demystifies BPD and makes it seem human and real.

    Reply
    • Thank you Rachael! I hope your students find it helpful and I’m grateful for any opportunity to increase awareness and understanding.

      Reply
  9. I have BPD and major depressive disorder. Its been 15 years since I was diagnosed and I still struggle daily. I’m in DBT and have been in DBT in the past several times(but never finished it due to multiple hospitalizations) and I’m at a point where I’m not sure there is such a thing as getting better. I was wondering if you knew of others with BPD who have not been able to overcome it/get better like you have? It takes someone special like yourself who can change your way of thinking and make a better life. I’m not sure I can do that and I truly believe that if I can’t change despite medications and lot’s of psychotherapy that it will ultimately result in a death sentence.

    Reply
    • Hi there,
      I was sorry to hear about your struggles. BPD sometimes seems like a life sentence of agonizing, monumental effort – so unfair when everyone else seems so effortless. I don’t see it as being about getting better; that implies something is damaged or broken. This is who I am, my brain is wired in such a way that I’ll always have a natural melancholic inclination, but I’m definitely getting better in terms of understanding myself, having compassion for myself and managing myself.
      It’s funny, we put so much effort into training our bodies, but so little into training our minds. I’m proud of my mental dexterity, my ability to see the fine-print and my strength in enduring its emotional legacy.
      Like you, I have my days when the will to keep pushing through deserts me, but I know all I need is time, patience and kindness – if not from others then from myself.
      I do talk to others who struggle and doubt themselves and I think the key for all of us is to take it a day at a time. The future will take care of itself, we can do without the extra pressure.
      Maybe what really needs to change is your perception and that of those you surround yourself with.

      Reply

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