WTF even is BPD??

It me.
(It’ll make sense at the end)

First of all, it’s nothing like Winona Ryder in Girl Interrupted. That diagnosis is grade A bullshit.

Second of all, this is a long ass read. But I really hope that if you choose to read it, you will understand me and this condition better.

Most of this is taken from the NHS website, because you’ve got to be careful with what you Google.
Honestly if you search for it some of the articles out there are horrible. In fact, if you Google it, one of the ‘suggested searches’ that comes up is ‘Can a person with BPD really love?’.
I mean, ew.

  • Unlovable
  • Incapable of love
  • Manipulative
  • Abusive
  • Violent
  • Aggressive

These are all common misconceptions. I’m not by any means saying they’re all lies, but I’m generally an empathic (mostly overly empathic tbh), caring, friendly individual. If you’ve met me, you’ll know I’m not a constantly aggressive, violent, selfish abuser. Sure, I’ve got a temper, but I’m not a horrible person.

Get me being all nice to myself.

Borderline Personality Disorder (BPD) aka Emotionally Unstable Personality Disorder (EUPD) is a disorder of mood and how a person interacts with others. It’s the most commonly recognised personality disorder. In general, someone with a personality disorder will differ significantly from an average person in terms of how he or she thinks, perceives, feels or relates to others.

NHS

The thing that really gets me is the fact that it’s labelled a ‘personality disorder’ – it is genuinely so fucking grim. The fact that my personality is ‘disordered’, that there is something fundamentally wrong with who I am as a person.
Once, my pals and I were playing a game and we asked whose personality you would rather have, and someone chose me. One of my other friends who was playing (they were drunk, and when I told them a few days later how hurt I was by it said it was just bantz – and I do accept that) said ‘Why would you want Lucy’s personality?! It’s disordered!’.
That cut me deep though.

What it means by a ‘personality disorder’, is that it is ingrained in my being. It is not an illness like depression or psychosis where there is some kind of chemical imbalance and there are pills that can help to fix it. In fact, there is actually no licensed medication for BPD. The mood stabilisers that I take at the moment are primarily prescribed for Bipolar Disorder (which is very similar to some extents), mainly to try and level out my moods and stop me from being so impulsive.
Because I can be very very impulsive.

BPD is a classed as a complex mental health issue, same as Schizophrenia or Bipolar.
60-70% of sufferers attempt suicide (you have probably guessed correctly that I am one of them), and 10% complete.
That’s a 1 in 10 mortality rate. That’s greater than Asthma.

The main treatment for BPD is talking therapy, learning new skill sets, and trying to change my ways of thinking. I have never had any of that input. And that is how this crisis has happened.

So in a bit more detail, what are the symptoms?
There are 4 main areas;

  • emotional instability – the psychological term for this is “affective dysregulation”
  • disturbed patterns of thinking or perception – “cognitive distortions” or “perceptual distortions”
  • impulsive behaviour
  • intense but unstable relationships with others

Emotional Instability

If you have BPD, you may experience a range of often intense negative emotions, such as:
rage
sorrow
shame
panic
terror
long-term feelings of emptiness and loneliness

You may have severe mood swings over a short space of time.

It’s common for people with BPD to feel suicidal with despair, and then feel reasonably positive a few hours later. Some people feel better in the morning and some in the evening. The pattern varies, but the key sign is that your moods swing in unpredictable ways.

NHS

Everyone has fluctuations in moods, but mine are severe. Below is a little doodle I did that I hopes explains…

The purple line is what ‘normal’ people experience. Ups and downs. (I’m not saying there aren’t moments of elation or devastation for every single human, but just take this as what happens on a daily basis).
The red line is what I feel when I’m feeling super good, the blue when I’m feeling super bad, and the green is just what can happen in general. I can go from zero to hero in literally a second, and vice versa.


This is why there’s this ongoing question of whether I have Bipolar Disorder – to be diagnosed as Bipolar you have months of feeling ‘up’ (manic – which is not happy, it is something different entirely), and then months of feeling ‘down’. This is genuinely what I experience, but it’s not something that any Drs have ever agreed on.
Regardless, my emotional rollercoaster is daily. I very rarely have an OK day – it’s either great, or shite, or ‘oh I had an amazing morning and then the worst afternoon of my life’. It’s fucking exhausting.

Disturbed patterns of thinking

Different types of thoughts can affect people with BPD, including:

Upsetting thoughts – such as thinking you’re a terrible person or feeling you do not exist. You may not be sure of these thoughts and may seek reassurance that they’re not true.

Brief episodes of strange experiences – such as hearing voices outside your head for minutes at a time. These may often feel like instructions to harm yourself or others. You may or may not be certain whether these are real.

Prolonged episodes of abnormal experiences – where you might experience both hallucinations (voices outside your head) and distressing beliefs that no one can talk you out of (such as believing your family are secretly trying to kill you)

NHS

I don’t hear voices, and I don’t see things. But I do have really disturbed patterns of thinking.
I will often (if not always) think of the worst case scenario, and genuinely convince myself that it’s true. After one of my miscarriages I believed that there was this conspiracy against me to take away everything I loved, and that’s what got me basically sectioned, but that’s probably a story for another day.
For now, I have considered all kinds of possibilities about what’s going on with life outside of the psych ward. Even before that, I was doing it outside the ward though (which is why I got here I guess).
On the night my crisis began (January 31st) I sent the following texts to my boyfriend…

‘I phoned the Crisis Team but they’re too busy’
‘There is no one around’
‘Is everything OK? Has the world stopped? Did Brexit kill everything? No one’s answering. Did we get bombed?’
‘Did we get bombed?’
‘Are we dead?’
‘I’ve just looked at the news. There’s this virus. It’s like the zombie apocalypse. We’re all going to die. Unless we’re dead already?’
‘They’re still not answering’
‘Are you there?? Is everything OK?’
‘I’m scared’
‘Are you there?’
‘Please help me’
‘I am fucking terrified, what’s going on?’

Then he texted me back, and let me know that everything was OK. That neither Brexit nor Coronavirus had ended the world, but I just didn’t believe him. He said I should call an ambulance, but I said there was no point because there was no one out there.

You get the picture.

When I’m really stressed, I also experience what are called Dissociative Episodes.

If you dissociate, you may feel disconnected from yourself and the world around you. For example, you may feel detached from your body or feel as though the world around you is unreal.
Dissociation is one way the mind copes with too much stress, such as during a traumatic event. Experiences of dissociation can last for a relatively short time (hours or days) or for much longer (weeks or months).
You might experience dissociation as a symptom of a mental health problem, for example post-traumatic stress disorder, depression, anxiety, schizophrenia, bipolar disorder or borderline personality disorder.

Feeling like you’re looking at yourself from the outside
You might:
feel as though you are watching yourself in a film or looking at yourself from the outside
feel as if you are just observing your emotions
feel disconnected from parts of your body or your emotions
feel as if you are floating away feel unsure of the boundaries between yourself and other people.
A doctor or psychiatrist might call these experiences depersonalisation.

Mind

I sometimes get gaps in my memory when this happens, like what has happened wasn’t real. This is often when really bad shit goes down, and I can do really stupid things. These are the worst times.

Impulsive Behaviour

If you have BPD, there are 2 main types of impulses you may find extremely difficult to control:
an impulse to self-harm – such as cutting your arms with razors or burning your skin with cigarettes; in severe cases, especially if you also feel intensely sad and depressed, this impulse can lead to feeling suicidal and you may attempt suicide
a strong impulse to engage in reckless and irresponsible activities – such as binge drinking, drug misuse, going on a spending or gambling spree, or having unprotected sex with strangers

NHS

This is what I take my medication for. The first one is rare tbh, but it’s why I’m here now. The second one however… my oh my…

Oh I’ve done some really impulsive shit.

One of my fave instances was when I went for a night out in London and ended up in France.
I have bought all kinds of random stuff (like the other day I was feeling sad, so I bought a pink bicycle, oh and a website domain).
Drinking – obvs.
Drugs too. Not that pretty much anyone knew that until now. And let’s be honest, secret drugs are way worse than drugs with pals.
And obviously, the top one being shagging someone I barely knew, which was the catalyst for me leaving my husband of 7 years (partner of 10). Within a week, I’d got myself a new flat in the city centre. I left all of my belongings and my cat, and just started a brand new life. I mean, as it turns out that one was actually for the best. I didn’t love him, and we were super unhappy. But still – one of the most impulsive things I’ve ever done. The kind of life decision that I probably should have given proper thought to.

Unstable Relationships

If you have BPD, you may feel that other people abandon you when you most need them, or that they get too close and smother you.
When people fear abandonment, it can lead to feelings of intense anxiety and anger.

You may make frantic efforts to prevent being left alone, such as:
constantly texting or phoning a person
suddenly calling that person in the middle of the night
physically clinging on to that person and refusing to let go
making threats to harm or kill yourself if that person ever leaves you

Alternatively, you may feel others are smothering, controlling or crowding you, which also provokes intense fear and anger. You may then respond by acting in ways to make people go away, such as emotionally withdrawing, rejecting them or using verbal abuse.
These 2 patterns may result in an unstable “love-hate” relationship with certain people. Many people with BPD seem to be stuck with a very rigid “black-white” view of relationships. Either a relationship is perfect and that person is wonderful, or the relationship is doomed and that person is terrible. People with BPD seem unable or unwilling to accept any sort of “grey area” in their personal life and relationships.

For many people with BPD, emotional relationships (including relationships with professional carers) involve “go away/please don’t go” states of mind, which is confusing for them and their partners.

NHS

This is where it gets really painful.

I am so so afraid of being abandoned, but I also really like to be left alone, but then I feel abandoned, but then I really want to be left alone.

My frantic effort to not be left alone is what drove my love to say that he didn’t think he could cope anymore, and as a result we’re currently not in contact.

I don’t see relationships in black and white as in ‘I love them/I hate them’ (for instance, I could never ever hate my love – he is a beautiful person in every single fucking way), but I do see my relationships in a way of ‘it’s wondeful’, or ‘it’s doomed’. Not even necessarily romantic relationships, but friendships too.
This is where my turmoil is coming from at present. At the moment, my romantic relationship is not wonderful, nor is it necessarily doomed, but I can’t cope with that. I keep flipping between the two, because it has to be one or the other – it can’t be this uncertain shade of grey.

This, to me, is the most damaging symptom, and the one that I am most determined to change.
I have never felt determination like it.
I know I can do it.

Why Do People Have it?

No one really knows. Many potential reasons listed on the NHS website…

  • Genetics
  • Problems with brain chemicals – most notably serotonin
  • Problems with brain development
  • Being a victim of emotional, physical, or sexual abuse
  • Neglect from parents/being exposed to long-term fear

Honestly, with me I think it’s probably a mix of brain chemicals (thinking about it since I’ve been here, I’ve always been better on anti-depressants – which help to increase the serotonin levels in your brain – but I fucking hate the side effects… probably time to just suck it up and surrender to my fate though), and all the fucked up shit that’s happened to me (sexual, emotional, physical abuse, being screwed over, loss, miscarriages).
My dad (the ex-consultant psychiatrist, lol) thinks it’s super weird that my self-harming symptoms didn’t manifest properly until my 20’s, but the rest of it was all there.
Definitely there.

One thing I want to be super clear on, is that my parents were great, and still very much are. I was not neglected or abused by them in any way.

All of the shit I went through has never really been addressed, so that’s something I really need to work on.
Need to rip the weed out by the root, else it’s just guna grow back.

How is it Diagnosed?

Internationally recognised criteria are used to diagnose BPD.
A diagnosis can usually be made if you answer “yes” to 5 or more of the following questions:

Do you have an intense fear of being left alone, which causes you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody (but not including self-harming or suicidal behaviour)?

Do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they’re wonderful to hating that person and thinking they’re terrible?

Do you ever feel you do not have a strong sense of your own self and are unclear about your self-image?

Do you engage in impulsive activities in 2 areas that are potentially damaging, such as unsafe sex, drug misuse or reckless spending (but not including self-harming or suicidal behaviour)?

Have you made repeated suicide threats or attempts in your past and engaged in self-harming?

Do you have severe mood swings, such as feeling intensely depressed, anxious or irritable, which last from a few hours to a few days?

Do you have long-term feelings of emptiness and loneliness?

Do you have sudden and intense feelings of anger and aggression, and often find it difficult to control your anger?

When you find yourself in stressful situations, do you have feelings of paranoia, or do you feel like you’re disconnected from the world or from your own body, thoughts and behaviour?

NHS

You probably get the picture by now. The answer for me is ‘yes’ to pretty much all of them.
(Except for the sense of self one. I fucking know who I am. Doesn’t mean there aren’t many facets of me, but that’s just who I am.)

How to Treat it?

Input from the Community Mental Health Team (CMHT) – nurses, psychologists, social workers (if applicable), occupational therapist, overseen by a psychiatrist.
I DO NOT HAVE THIS.
I see a nurse prescriber every couple of months to keep an eye on my meds, and maybe mix them up. I have not seen a psychiatrist since my diagnosis 18 months ago.
This is how I know I can get better. I am going to get the correct support now.

Psychotherapy.
I DO NOT HAVE THIS.
I had some person centred counselling after my miscarriages, but she just kind of sat and listened. And a lot of the stuff that has happened since then, or well before then, I’ve never even talked about until this blog.
This is how I know I can get better. I am going to get the correct support now.

Dialectal Behaviour Therapy (DBT).
I DO NOT HAVE THIS.
I have a self-help book for this, which I recently began to tackle. But this is the most specialised type of therapy for BPD.

Dialectical behaviour therapy (DBT) is a type of therapy specifically designed to treat people with BPD.

DBT is based on the idea that 2 important factors contribute towards BPD:
you are particularly emotionally vulnerable – for example, low levels of stress make you feel extremely anxious
you grew up in an environment where your emotions were dismissed by those around you – for example, a parent may have told you that you had no right to feel sad or you were just “being silly” if you complained of feelings of anxiety or stress

These 2 factors may cause you to fall into a vicious cycle – you experience intense and upsetting emotions, yet feel guilty and worthless for having these emotions. Because of your upbringing, you think having these emotions makes you a bad person. These thoughts then lead to further upsetting emotions. 

The goal of DBT is to break this cycle by introducing 2 important concepts:
validation: accepting your emotions are valid, real and acceptable
dialectics: a school of philosophy that says most things in life are rarely “black or white” and that it’s important to be open to ideas and opinions that contradict your own

The DBT therapist will use both concepts to try to bring about positive changes in your behaviour.
For example, the therapist could accept (validate) that feelings of intense sadness cause you to self-harm, and that behaving in such a way does not make you a terrible and worthless person.
However, the therapist would then attempt to challenge the assumption that self-harming is the only way to cope with feelings of sadness.

The ultimate goal of DBT is to help you “break free” of seeing the world, your relationships and your life in a very narrow, rigid way that leads you to engage in harmful and self-destructive behaviour.

DBT usually involves weekly individual and group sessions, and you’ll be given an out-of-hours contact number to call if your symptoms get worse.
DBT is based on teamwork. You’ll be expected to work with your therapist and the other people in your group sessions. In turn, the therapists work together as a team.
DBT has proved particularly effective in treating women with BPD who have a history of self-harming and suicidal behaviour. It’s been recommended by the National Institute for Health and Care Excellence (NICE) as the first treatment for these women to try.

NHS

It is my understanding that this is what I’ve been on the waiting list for for pretty much 2 years, and I am now at the top.
This is how I know I can get better. I am going to get the correct support now.

SO THAT’S PRETTY MUCH IT.

If you made it this far, well fucking done. I’m aware this is a proper wordy bastard.

I just want people to understand. I am not scary. I am just hurting. Pretty much all the time.
Where some people have a thick skin, I have no skin. Like, literally no skin. I am the woman at the top of this post. Can you imagine living your life with no skin? Everything would hurt so much, to have all your muscles and your nerves exposed. Every little prod or poke would hurt so much, even sitting or lying down would hurt, and all you would want would be for something to cover you up to stop you getting hurt.

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