Since a young age I haven't always been "normal" or "sane." I was always the overweight child that would run around the playground by myself, with no friends or no one to hang around with. I find it very difficult to show who I actually am instead of how my mental health wants me to be. I am sharing this, not only for myself, but also for others who find it hard to express themselves in the way they want to. For me, people understanding all types of mental health illnesses is important, to show that we aren't "lazy" or "crazy."
So people ask all the time, what is BPD? Well let’s start off by saying that BPD stands for Borderline personality disorder. While the name of this disorder is vague and sometimes misleading, BPD is “a serious mental illness marked by unstable moods, behaviour and relationships."
People with severe BPD sometimes have psychotic episodes, which can be caused by many different things. Personality disorders have more than often been mistaken for other mental disorders, making BPD one of the hardest mental illnesses to diagnose.
Most people who have BPD suffer from:
- Problems with regulating emotions and thoughts
- Impulsive and reckless behavior
- Unstable relationships with other people.
Self harm and Suicidal Tendencies
People with these disorders also have high rates of other disorders that coincide BPD. These include depression, anxiety, substance abuse and eating disorders, alongside these are self-harm, suicidal behaviours and also completed suicides. The main issues here are the self harm and suicidal tendencies. I will say this once and once only, people who say that people are "attention seekers" or "selfish" for doing these two things isnt ok. In fact you're only making things worse for the person who is carrying out these actions.
A staggering 80% of people suffering with BPD have suicidal behaviours, and about 4-9% actually commit suicide. This may seem like a call out for help or a selfish act, however I can guarantee that 9 times out of 10 the sufferer actually wants to die. This isn't always necessarily because the sufferer hates their life or they don't love their family, its more than likely because they cannot live with demons inside their head anymore. The tormenting thoughts that go on in their mind the majority of the time. Now this is where things get difficult for people to explain, especially for family members and all loved ones. I will tell you my point of view on the suicidal tendencies I have had for 2 whole years, and how it effected my family.
Now, from the age of 9 I knew that something wasn't quite right in my head. My thoughts weren't normal and the actions I thought of were worrying. However I kept it in, I thought that me keeping all of my thoughts and problems in my head, would be better for my family and friends. I never really thought about suicide until the age of 13 however I carried on causing myself harm from a very young age. To me self harm wasn't about the cry for help or the attention; It was about how that small amount of pain made me feel something and how it helped with my overall thoughts. This helped maybe once a month for a few years, until it was too late. The cutting became an addiction, worse than anything you could ever think of. Waking up in the morning - it was the first thing on my mind. Throughout every school day or weekend - it was on my mind. I had to deal with the worst addiction ever. It wasn't about the release anymore, or the small amount of feeling; it turned into a lot more of an uncontrollable must do. I didn't want to do it anymore, but the burning I felt in my chest was unbearable if I didn't do it. Then people started to see it, thats when people made it impossible for me to stop. It became an everyday routine, just like brushing your teeth or eating your food. What started as small "cat scratches" ended up being life threatening and started becoming a routine for me to try and commit suicide.
Unlike suicide, self-harming does not come from the desire to die. However some self-harming behaviours may be life threatening. Self-harming linked with BPD can be anything from hitting, scratching, head banging, hair pulling burning or cutting, and any other harmful acts. People with BPD may self-harm to help regulate their emotions, to punish themselves or to express their pain.
PLEASE REMEMBER SELF HARM AND SUICIDE IS NOT THE ANSWER AND IT DOESN'T HELP YOUR PAIN GO AWAY. IF YOU NEED HELP CALL THE SAMARITANS ON 116 123, THIS NUMBER IS FREE TO CALL. IF THEY DO NOT ANSWER STRAIGHT AWAY KEEP CALLING UNTIL THEY ANSWER. THIS MAY FEEL ABANDONING AND LIKE NO ONE IS LISTENING BUT I PROMISE THEY'LL ANSWER AND HELP.
Signs and Symptoms
In most cases for someone to be diagnosed with Borderline personality disorder, a person must show ongoing patterns of behaviour that includes AT LEAST five of the following symptoms:
- Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived
- A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
- Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices)
- Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
- Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
- Intense and highly changeable moods, with each episode lasting from a few hours to a few days
- Chronic feelings of emptiness and/or boredom
- Inappropriate, intense anger or problems controlling anger
- Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.
These symptoms may be caused by extreme events.
People with BPD often feel targeted by loved ones or even strangers. Sometimes when people looks angry or depressed they will immediately think their issue is about you, and take it very personally. For example, if someone I care about is upset I will automatically feel like I am the cause of their distress, making me overthink and sometimes blame myself.
Unfortunately, BPD is often underdiagnosed or misdiagnosed.
A mental health professional experienced in diagnosing and treating mental disorders—such as a psychiatrist, psychologist, clinical social worker, or psychiatric nurse, can detect BPD based on thorough interviews and many files of paperwork. A careful and thorough medical exam can help rule out other possible causes of symptoms.
The mental health professional may ask about symptoms and personal and family medical histories, including any history of mental illnesses. This information can help the mental health professional decide on the best treatment. In some cases, co-occurring mental illnesses may have symptoms that overlap with BPD, making it difficult to distinguish borderline personality disorder from other mental illnesses. For example, a person may describe feelings of depression but may not bring other symptoms to the mental health professional's attention.
Women with BPD are more likely to have co-occurring disorders such as major depression, anxiety disorders, or eating disorders. In men, BPD is more likely to co-occur with disorders such as substance abuse or antisocial personality disorder. According to the NIMH-funded National Comorbidity Survey Replication—the largest national study to date of mental disorders in U.S. adults—about 85 percent of people with BPD also meet the diagnostic criteria for another mental illness. Other illnesses that often occur with BPD include diabetes, high blood pressure, chronic back pain, arthritis, and fibromyalgia. These conditions are associated with obesity, which is a common side effect of the medications prescribed to treat BPD and other mental disorders.
No single test can diagnose BPD. Scientists funded by NIMH are looking for ways to improve diagnosis of this disorder. One study found that adults with BPD showed excessive emotional reactions when looking at words with unpleasant meanings, compared with healthy people. People with more severe BPD showed a more intense emotional response than people who had less severe BPD. - source from NIMH.com
From my personal experience, my final diagnosis took around 6 months. My disorder was first mistaken for "bad periods," "bipolar" and "severe depression." This was very hard for me as I felt like no one was quite understanding me, and misdiagnosing me was really tough, to the point that it actually made my moods worse. For me I did not want a diagnosis, however I wanted someone to believe in me and believe that I wasn't just a "freak."
Like myself I was told that my BPD was difficult to treat. However, after a year of hard work and talking about things I was finally treated effectively, and now my treatment has been highly effective for my disorder.
BPD can be treated with psychotherapy, or "talk" therapy. In some cases, a mental health professional may also recommend medications to treat specific symptoms. When a person is under more than one professional's care, it is essential for the professionals to coordinate with one another on the treatment plan. - this for me was the hardest part of therapy and "getting better," talking about my school life, and the events that went on in my life was difficult, however I finally realised that it was helping and it was making me happy again. Talking isn't for everyone, just as medication isn't. however these two elements have helped me greatly and still carry on doing so.
Tips for Communicating with Someone With Borderline Disorder
Now for me this is the most important part of this post. I know this is long but this is the part that people will hopefully listen to so they can help and understand there loved ones.
1. Be realistic. You will not eliminate another person's borderline behavior, no matter how well you communicate. Only that person can do that. Your goal is simply to communicate in a way that respects you and the person with borderline personality disorder.
2. Leave if necessary. You do not have to tolerate physical threats or emotional or verbal abuse. So leave. But know what they are saying or doing is invalid and they do not mean even a small part of it.
3. Simplify. When speaking with them, especially about sensitive issues, remember emotion is likely to be so strong that neither of you can do high-level thinking. Make each sentence short, simple, and direct. Leave no room for misinterpretation.
4. Separate the person from the behavior. Make it clear to them that when you dislike behavior, you do not dislike the person. You may have to reinforce this often as the sufferer will think you dislike them as a person.
5. Address feelings before facts. In ordinary conversation, we put facts before feelings. We assess facts and react with our feelings to them. But people with BPD often reverse this process. They have certain feelings—such as the fear that a partner will abandon them—and so they change the facts to match their feelings.
For example, their partner isn't going to the grocery store; he is walking out on the relationship. A non-borderline confronted with that accusation may want to try to point out the facts (he's taking a grocery list, there is no food in the refrigerator, or so on), but in the sufferers emotional state, that will be irrelevant. Instead, the non-borderline may get farther by acknowledging an empathising with their borderlines feelings (not facts) rather than discounting them.
For example, "You sound really upset. I would be upset too if I thought you were walking away forever. However (however is better than "but") I'm just going to the store and I'll be back in an hour."
6. Keep focusing on your message. Ignore our attacks or threats or attempts to change the subject. Stay calm and reiterate your point. If you're feeling attacked, calmly say that things are getting too hot and you'll be back in an hour. Then leave.
7. Ask questions. Turn the problem over to the other person. Ask for alternative solutions, by saying, for example, "Where do you think we should go from here?" Or "I'm not able to say yes, and you seem to really want me to. How can we solve this problem?"
8. Remember the importance of timing. There are good times and bad times to bring up certain subjects. An incident that may make the sufferer feel particularly vulnerable—the loss of a job, for example—could lead him or her to feel rejected, abandoned or invalidated. Your conversation is likely to be a lot more difficult. Postpone it if you can, or at least take into account the BP's greater vulnerability at this time.
9. In the midst of an intense conversation that is escalating and unproductive, practice Delay, Distract, Depersonalize, and Detach.
Delay. Tell the other person, "Why don't we think about things and talk about this later?" or "Give me some time to think about what you're saying." Speak calmly and in a way that affirms the other person as well as yourself, without necessarily confirming their claims: "I'm feeling upset right now. Your feelings are important to me and I need some time to understand them."
Distract. Suggest, for instance, that the two of you run an errand together.
Depersonalise. Throughout, you will do better if you remind yourself frequently that harsh criticism of you is not real, but still feels very real to that person. Don't take the other person's comments personally, however cutting or cruel they may feel to you. This is the nature of the disorder.
Detach. Remove yourself emotionally from getting caught up in the emotional whirlwind. Resolve to yourself, "I'm not going to get so involved in this."
This is especially true not just in moments of high negativity, but in moments of high positive emotions. Impulsivity is a key trait of people with BPD, and while it can show up in negative actions—like throwing something through a window or telling you you're a monster and they never want to see you again—it can also show up in positive actions: Telling you they adore you and wants to get married, right now or tomorrow. A positive impulsivity can be very seductive. Detaching yourself can help you guard against it.
The emotional cycle that a person with BPD goes through can be compared to a row of dominos. One trigger, one push of the first domino, and the entire row falls in rapid succession. Your job is to try to remove your own "domino" from the row. You can also learn what makes the dominos fall. Pay attention to your experiences and anticipate ways to keep things calm. If you can calm yourself, the adrenaline doesn't flow through your system, and you can begin to try to steer the volatile relationship into less stormy seas.
It may help if you remind yourself, "I can't help that person's splitting. I can't help that person's shame. I can't help that person's fear. I can't control those things. What I can control is how I respond. And if I respond calmly, not impulsively, perhaps I can lower the temperature and help us find new ways to respond to each other and manage the BPD."
This doesn't mean caving in, however. Simply adopting a "whatever you say, dear" is not good for your own mental health, and it's not good for the person with BPD, either.
I would like to thank anyone for reading all the way through this, I know it was very long. However these small pointers could save someones life and could help save a relationship or friendship. I would personally like to thank my family and those small amount of friends who have helped me in the past three years. I have been an awful person and the horrible words I have said have never meant anything. I am lucky to be a survivor of this illness and I will carry on fighting for the rest of my life. Please feel free to ask any questions you may have and I will try and answer them, honestly and supportively.