Arguably among the least understood and most stigmatised Mental Health issues, Borderline Personality is an extremely complex illness and I am here to share my experience, my learnings and finally how I am navigating through to acceptance.
Borderline Personality or BPD as it is known is most often confused with Bipolar Disorder, and often misdiagnosed as the same. In truth, it is common that years of treatment can go by, or no treatment at all, before the condition is finally diagnosed. In my example, I wasn't properly diagnosed until I found myself in my mid-thirties.
A significant personality trait that I have is a kind of OCD about learning a particular topic. I research and watch everything I can until the topic is exhausted and I move onto the next. Over the years this became a blessing and a curse. On one level I learnt an awful lot about random topics and on the other, I kept researching various Mental Health conditions, desperate to find an answer for why I felt the way I did, and still do to a certain extent.
What I read on Borderline Personality Disorder was fairly grim, but I kept coming back to it. I had to be careful that I wasn't diagnosing myself by being so desperate for an answer that I would kind of slot myself into the symptoms without realising. But I knew, intellectually, that I fitted all the criteria, but at that stage was still very naive in my own ownership of my illness and eventual treatment strategies.
I was around 28 at this stage and living in Scotland. This was when my health deteriorated significantly for the first time that required a Hospital stay. I felt like I was in a never-ending cycle of GP visits and every time I would go they would just change my Anti Depressants and I would be back a few days/week later, once again throwing myself at their mercy. I will never forget, the same GP I had seen a fair few times, took out his book and said: "Well I don't know, what do you think we should try?". Having zero insight into the inner workings and traps of Mental Health, I felt my heart sink. Then he followed up with "other than that I would just suggest joining the gym". Bear in mind by this time I had been on Anti Depressants for around 8 years and had progressively gotten worse. I remember walking outside the Doctors Surgery and just falling to the ground crying.
How could I possibly feel this bad and be told: "just join the gym". I felt helpless, not for the first time in my life and certainly not for the last. I started researching my condition myself because if I wasn't going to get the help I needed then I knew I needed to start trying to piece things together myself.
Absolutely, I knew that my Sexual Assault was something that I was continually struggling with. My self-esteem was non-existent and the level of anxiety I was feeling daily was excruciating. Although I had my two closest friends there with me in Edinburgh, I still vowed I would never tell a soul about the assault because it would feel like opening Pandora's Box and I didn't feel like I could face that as well.
In the end, the best decision was to come back to Australia and take some time out to recover and go from there.
There are so many points in time in my story that I wish I could go back and tell myself one thing - Kyle, you HAVE to go to therapy, not just a chit chat once a week, but proper psychodynamic psychotherapy. Well, that is the benefit of hindsight and a hell of a lot of incompetent GP's.
I was formally diagnosed with Borderline Personality Disorder after several years of therapy. To meet the diagnostic criteria you have to fall under the following categories;
A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) or the following:
1. Frantic efforts to avoid real or imagined abandonment
2. A pattern of unstable and intense interpersonal relationships characterised by alternating
between extremes of idealisation and devaluation
3. Identity disturbance: markedly and persistently unstable self-image or sense of self
4. Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating)
5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
6. 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)
7. Chronic feelings of emptiness
8. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper,
constant anger, recurrent physical fights)
9. Transient, stress-related paranoid ideation or severe dissociative symptoms
Of course, I actually qualify for all 9 of the criteria, lucky me huh?
What really helped me is that I truly believe in any situation that knowledge is certainly power and that the more I read about the recovery aspects of BPD, the less scary it would feel. I trawled the internet and found a site that popped up on Facebook called The Mighty. It is an amazing community of people with a wide range of health issues and gives people the opportunity to be part of something. The more I read about BPD the more connected I felt because of one of the classic symptoms being that I had no sense of my place in the world and thought I was the only one feeling this way. Suddenly I felt a little less like an Alien.
I am what is called a "quiet" Borderline, which sounds a little creepy at first. What it means is that the anger and rage aspects of BPD are all directed inwards at me. I constantly berate myself for every tiny little thing and over time I started to display more and more symptoms. I actually cannot count the number of times I have been in Hospital now, mostly it feels like a massive fog and I can't see properly to put things in order. It is so chaotic in my mind that at times I am just sitting trying not to explode.
BPD is a lonely disease and because of such a negative stigma around it, I shy away from telling people that I have it. Usually, people just put it in the same category as Bipolar, simply out of pure lack of education on what very clearly separates the two illnesses. It is very common that a patient will go either untreated like I did, or diagnosed with Bipolar because of the intense mood swings which exist in both illnesses.
The best way I can explain what it feels like to have BPD is like constantly being on the outside of a snowglobe. Inside is the world, swirling around in colours and joy but I can't break through the glass to be part of it, so instead, I look through from the outside, never really getting to experience all the things happening inside the globe.
I would look at people on the street laughing and smiling and think to myself "how are they doing that?" or "fuck you for being happy", depending on the mood I was in. I started to see the world as malevolent and so self-isolation became a huge issue for me. After so many years of fighting every day, I had run out of energy. I needed to heal and the best way to do that was to sacrifice my life in Sydney and come home close to my parents and sister so we could work out a plan.
There is certainly hope for my future, I just have to stay as determined as possible to stay on track. The most effective form of treatment for BPD is called Dialectical Behavioural Therapy, or DBT. Mental Health loves a good acronym for everything.
DBT is a totally different type of therapy, it involves both group and individual sessions. The significant difference with DBT is that it is almost entirely skill based. The world's leading expert, Marsha Lineham developed the technique from her own experience with BPD. There is lots of evidence to show DBT as the most successful treatment plan and the outcome being that a patient can go on to live a healthy and happy life. This gives me and a lot of other people hope, that my world could become less insular and be connected to something.
Although having BPD scares me a lot of the time, I also know it is part of me and has made me who I am today. I have such compassion for people suffering from Mental Illness that I have dedicated my whole life to finding ways to reach people and to help them feel less isolated and alone. It is a tricky journey to make because in committing to writing honestly about Mental Health means admitting some pretty serious stuff, but as I say, if one person reads my work and feels a tiny bit better then it is more than worth it.
My journey to recovery is not over and won't be for a very long time, but I have the power of knowledge and support to know I will get through. One day I will finally make it inside the Snow Globe and be immersed in the world around me rather than seeing it as strange and foreign and always from the outside.