When I was 12, I started cutting myself. I couldn’t explain why, other than it just felt good to feel something, like I was releasing something from inside myself. I’d take apart my step-dad’s disposable razors, hide the blade in my pencil case and excuse myself from class under the pretence of going to the toilet, so that I could go somewhere and draw the blade across my skin, knowing exactly how hard to press so that the damage was superficial. I can’t remember how I got found out, but I ended up in therapy for the first time and being told to follow a book called “Ten Steps to Happiness” in my free time.
If you looked at my medical record since then, you’ll see several references to depression, anxiety, mood instability and other non-specific mental health issues over the 20 year time period. You’ll even see a reference or two to substance abuse and eating disorders. There’s also the words “bi-polar” in there about eight years ago, although that didn’t come to much and I was never formally diagnosed.
Just recently, though, I decided that my mental wellness needed a lot more of my attention.
Last summer, I sat in my car talking to my Husband about the fact that I felt like I wanted to die. I wasn’t suicidal, I didn’t want to actually kill myself, I just felt like I wanted to be dead. I didn’t want to be away from him or my kids, and I didn’t want this to be the end, but I also just felt like it wouldn’t really matter if I were to quietly shuffle off this mortal coil and cease to exist.
I went to my GP and asked for help, and they referred me to a counselling service. Once a week for six weeks a nice woman would ring me on my mobile and spend an hour asking me how I felt about certain things, on a scale of one to eight.
“How many times in the last week have you thought about ending your life?”
“One a scale of one to eight, how much care would you say you’ve taken with your personal hygiene since we last spoke?”
“How often, with one being never and eight being constantly, would you say you’ve felt worthless in the last week?”
I’m sure it all looked good on her worksheets, but it did fuck all for me. I wasn’t allowed to talk about any traumatic events in my childhood in case it triggered a negative reaction and the counsellor wasn’t physically present to help me, and I didn’t learn anything which felt even close to being able to help me with my issues.
In the meantime, things were getting worse at home. Husband and I were arguing constantly, and it seemed like one minute he was my favourite person in the world and the next I’d be accusing him of trying to take the kids away from me, or trying to manipulate me. All the while, he was trying to reason with me and make me see how irrational I was being. My mind felt like a really hostile place to be and the feelings of anger, emptiness and paranoia just weren’t going away.
So I decided to look at things for myself. A bi-polar diagnosis really didn’t seem to fit, nor did the “general anxiety and depression” label. PMDD was an option, but my ‘episodes’ weren’t always in direct correlation with my cycle.
Then, by chance, I happened upon the term ‘borderline personality disorder’ and it was like something clicked into place.
I read every article and blog post I could find, watched YouTube videos of university lecturers talking about BPD, borrowed books from the library and the more I read, the more I was convinced this is what I had. There are 9 criteria for diagnosing BPD in the Diagnostic and Statistical Manual of Mental Disorders:
- Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
- Identity disturbance: markedly and persistently unstable self-image or sense of self.
- Impulsivity in at least 2 areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.
- Recurrent suicidal behaviour, gestures or threats, or self-mutilating behaviour.
- Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).
- Chronic feelings of emptiness.
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
- Transient, stress-related paranoid ideation or severe dissociative symptoms.
Borderline Personality Disorder sufferers are diagnosed if they fit five of the nine criteria. On a good day, I display 7.
The road to diagnosis hasn’t been straightforward; I went back to my GP, who listened to me, agreed with my self-assessment, and happily referred me to a psychiatrist. However, with the NHS under as much strain as it is, my referral was rejected because I apparently didn’t qualify for help. The best they could offer was more telephone counselling and that wasn’t even close to being what I needed. Fortunately, my Husband pays for discretionary healthcare, which means that we can go private for diagnosis and they agreed to cover a session with a private psychiatrist.
I spent an hour telling her about my childhood, the sexual abuse I’d suffered, my lack of stable parenting, the fear of abandonment, the mood issues I struggled with, the cutting, the emptiness, the occasional recklessness, the binge eating, the issues with my relationship and she confirmed exactly what I’d suspected. I had BPD. She said that the fact that I’d been married for 12 years and had the same job for 8 years was fairly remarkable, so I was probably what they’d called a “high-functioning borderline” and didn’t need any medication, but starting a programme of dialectical behavioural therapy could be hugely beneficial.
I’ve spent my life being accused of being ‘too sensitive’, but it turns out, that’s the BPD.
I read a description of BPD which is that it’s like going through life as a burns victim; you don’t have your skin to protect you from the pain of the world, and that felt pretty profound for me, as have many other things I’ve read since discovering BPD.
Getting the diagnosis was a double-edged sword, in some ways. When you say “mental illness”, it’s the same as any other illness, and sounds like an affliction, something which happens TO you. When you say “personality disorder”, it makes you feel broken, like your whole personality is just ‘out of order’. The relief at knowing what’s going on is sometimes overshadowed by the thought that this is just WHO I AM, not something I suffer from, or that maybe I’m just a massive arsehole.
That’s not helped by the fact that I really struggle with my perception of other borderline sufferers. I joined a bunch of support groups on Facebook and Reddit, but I spend half of the time cringing at the pictures they’ve post of themselves crying because someone has upset them somehow. I seem to be a self-hating borderline and worry that I appear like a whingy baby to the world, just like how I see other borderlines.
If you’ve ever seen Girl Interrupted, Crazy Ex-Girlfriend, Silver Linings Playbook, or Fatal Attraction, you’ll have seen how the media portrays BPD, and it AIN’T flattering. Anything from unhinged bunny boilers to self-obsessed weaklings, and I don’t see much of myself in any of it. Sure, not everyone is the same, but it galls me to think that people could make an assumption of a person suffering from BPD, based on these portrayals. To be fair, Crazy Ex-Girlfriend is considered to be a pretty good depiction, but only really show the more extreme side of BPD.
My main focus, going forward, is to insulate the kids from this as much as possible; children who spend significant amounts of time around adults who can’t regulate their emotions have a higher chance of developing Borderline Personality Disorder (although it’s usually also related to trauma) and I sure as hell am not going to inflict this upon them. My husband has been amazing, doing his own reading and learning as much as he can about coping mechanisms for when I have an episode (I hate calling it that, but I also don’t know what else to call it…), and now that I’m a “self-aware” borderline, I’m finding it easier to talk myself down from the proverbial ledge.
I’m hoping that my diagnosis means that I can now access the therapy I need on the NHS, but as with everything, the services are limited and the waiting times are long. I’ve been trying to learn mindfulness on my own, but the process can be tricky, especially without someone guiding you. The fact is, though, I’m trying and I do feel like things are getting slightly better, even if it’s only by a fraction of a percent each day. Admitting that you need help is often the hardest part of dealing with mental illness and disorders, but once you do it can change your life.
If you’re struggling with similar issues or recognise yourself in any of the criteria above, I strongly recommend pushing for help. Below is a list of resources which can be helpful.
Image credit: Gif by Libby Vanderploeg