Borderline Personality Disorder – getting a diagnosis

Black Dog Tribe logo

Black Dog Tribe logo

This is just a short post to let you know about a piece I wrote recently for Black Dog Tribe, a website launched by comedian Ruby Wax with the aim of providing a sympathetic user-generated community for those affected by mental health issues.

Websites like Black Dog Tribe have an important role to play in overturning the stigma surrounding the subject, raising awareness and giving contact details for those seeking help.

Editors note, August 2015: As the piece is no longer available on the Black Dog Tribe site, I’m re-posting it here in it’s entirety.


Coming in from the cold

At 26 I was diagnosed with Borderline Personality Disorder after more than a decade of unsuccessfully seeking help.

I first mentioned it to my family doctor when I was 15, but it started when I was 12; recurrent crashing mood-swings – disastrous extremes of outlook and reason so intense they altered my perception of the world around me. It was impossible to stabilise myself when everything shifted so radically, like being tossed about in heaving seas with no buoy to cling to. I’d feel the fog descend and be gripped by fear, knowing I’d face hopelessness and suicidal thoughts alone. My parents called me moody and told me to “snap out of it” or keep to myself until I’d cheered up – I was selfish for inflicting my moods on everyone else. As if I chose to feel that way!

My family GP was a warm and caring woman who ran her surgery from home. I told her about my feelings, although, with the misplaced discretion familiar to many sufferers of abuse, I couldn’t bring myself to mention what went on at home: my father’s unpredictable violence, my mother’s stinging put-downs and insensitivity, the physical, verbal and emotional attacks. They’d done such a good job of convincing me I was the one to blame, I felt ashamed.

She asked me if I took any illegal drugs, I didn’t. She said she didn’t think I was the sort of person who felt comfortable giving up their self-control in that way. She was right. Later I learned it didn’t matter what I took, I couldn’t escape my own self-hatred. Like someone with a balloon-phobia trying to escape one tied to their wrist, I could never outrun my sense of inadequacy. It bobbed along with me wherever I went, bumping me in the face if I changed direction sharply, letting me know it was still there, shadowing my every move.

She prescribed counselling, but it was a limited course and despite providing slight relief, I was no nearer to understanding my problems. I felt a failure for being depressed – other people worse off than I managed to function. I didn’t realise the validity of the difficulties I had to deal with at home. I was so inured to it I had no idea people would have been horrified my father strangled me, or that my mother told me she never wanted children. Deep down, I thought I was the cause of incidents like these, and that telling anyone else would only cause them to hold a low opinion of me too. When I turned seventeen my mother threw me out and my focus shifted from getting better to survival. Your mental health takes a back seat when you’re homeless.

As the years passed things got consistently worse. I developed anorexia then bulimia, practiced substance abuse and self-harm. I tried to put myself through university but dropped out after two years, exhausted from working three jobs and totally demoralized. I found a good job as a civil servant but after a few months my manager took me aside and asked me to see a doctor – it was clear to everyone but me I was slipping.

The doctor signed me up for antidepressants and off work, and as the months crawled by I became withdrawn and agoraphobic, ducking instinctively whenever someone passed outside my window. I hitchhiked alone, called the Samaritans to distract me from suicidal thoughts, and was stitched up in A&E. Someone called an ambulance when I passed out in the street from a cocktail of alcohol and anti-depressants.

I swung between numbing the pain and numbing the numbness, not caring if I lived or died. I hated myself for inconveniencing everyone – in my mind I was worthless and I believed secretly they thought so too. Every birthday wish was the same (immature I know, but worth a try): I wished to be happy. Every birthday I thought “Maybe this will be the year I gain the maturity to understand it all and make something of myself” Every year that passed I felt I’d failed – again.

A string of medical practitioners as jaded as me seemed bent on medicating my problems away. Journaling and over-thinking, I battled to get to the root of them, to understand why they were happening in the first place, but my limited energy was sapped by poor and ineffectual treatment. One psychiatrist I saw responded to all my requests for feedback and guidance with, “What do you think?”

I was going nowhere.

Time and time again I was referred to someone new. I’d recount my story, plundering the box of tissues on the table as I shared painful memories, but I never got closer to a solution. All the rooms began to look the same: the chairs artfully arranged so you didn’t need to make a choice, the Kleenex box sitting expectantly on the table, the desiccated spider-plant high on a shelf by the window…

Twelve bleak and lonely years of searching finally led me to a mental health team who recognised my problems and swung into action. I got a diagnosis, a referral for Cognitive Behavioural Therapy, was taken off the drugs that worsened my suicidal feelings and offered advice about financial help I qualified for. Resources were made available to help me integrate and socialise and I was appointed a key-worker who I met weekly to discuss my progress and who encouraged me to stick with it when things were tough.

Everything happened so quickly. All those years spent slogging away at the unyielding rockface of mental health treatment and suddenly, instantly, I was winched upwards. The fact that I needed a lot of work didn’t fill anyone with exasperation, my diagnosis of Borderline Personality Disorder meant there was a possibility I’d be difficult to treat but no one made me feel like I was the obstacle to my recovery.

At the time, BPD didn’t mean much beyond having my feelings legitimised – for me THAT was the big deal. I began to glimpse I wasn’t to blame for feeling the way I did, that my difficulties weren’t my personal failing.

Slowly I learned to manage my condition better. It was difficult and frustrating, especially when I knew where I was going wrong but couldn’t stop my automatic reactions, but in time I finished my therapy and started building a life on my own terms. I still struggle with negative thoughts and volatile moods, and I experience anxiety that makes my hands shake and my heart race, but I keep pushing on. I discovered mindful meditation and it made a HUGE difference to my relationship with myself. It seems I had time and compassion for everyone but me.

Since my treatment, I’ve married, learnt to drive, become a mother to three amazing children, trained as a teacher, emigrated to Canada and carved out a career for myself as a freelance writer. I’ve finally come in from the cold.”



Related Links:

Social networking can lighten the darkness of depression – The Guardian


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… 


Whitby Shores, Whitby, Ontario

By Aisha Ashraf

An autistic Irish immigrant in a cross-cultural marriage, Aisha Ashraf is the archetypal outlander, writing to root herself through place and perspective. Published in The Rumpus, The Maine Review, River Teeth, HuffPost and elsewhere, her work explores the legacy of trauma, the nature of being an outsider and the narrow confines of belonging. She currently lives in Canada.


  1. Fantastic post:-) and I’m amazed about the many parallels to my own history. Resisting the temptation to begin to write about those, since this is my first visit here, and I don’t want to overwhelm with long personal comments. Anyway your writing style is fantastic, …and book-worthy.

  2. I’m just astounded by how much of your blog I’m relating to. My parents have never abused me even if we don’t always get along well, and I’m so sorry you went through that. But the bit here I recognised was the BPD, I was originally sent to my current therapist by my parents for self harm and by the second session she seemed to have come to the conclusion that I had BPD, she didn’t say so until I confronted her weeks later but she went through asking me the entire DSM-v criteria in order, I guess she didn’t realise what I meant when I said I liked psychology. Anyway, when I confronted her she said I was “borderline borderline” but too young (15) and lacking abandonment issues and impulsiveness to really fit the diagnosis. So she just left me with the labels Neurodiverse, Paranoid, Persistent Depressive Disorder, and anxious.

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