You may have heard that May is Mental Health Awareness Month, but did you know it’s also Borderline Personality Disorder Awareness Month?
A few months ago I was sitting in my psychiatrist’s office and said something to the effect of “well they didn’t think I was good enough” there was a pause, and then my psychiatrist looked at me and said: “I feel like you may have Borderline Personality Disorder, have you ever considered that?” I was stunned, I had heard of BPD before and had met a few people with it in psych hospitals, but I had never considered myself to fit that profile. I asked him why he would say that, and he said: “you externalize everything, it’s always about other people, not you.” He could probably tell I was getting all stirred up as I clenched the bottom of the chair angrily asking what else had I done to make him think I had borderline. He gave me a few more examples that only made me angrier and told me that my behavior and mood patterns over a long period of time met the criteria, but it was tough to say if 2 of my other disorders were presenting like BPD when combined or if I had BPD in addition to those. He said I “should focus on treating the symptoms and not worry so much about the label.”
In that moment I felt like a mirror shattering, could I be that toxic person I feared? My anger rapidly cycled through rage, heartache, fear, and numbness before I even had time to outwardly express them. Our appointment was over; I got up, took my prescription sheet, thanked him, and softly went out the door. I was numb; in shock, there was no way I had borderline personality disorder; I wasn’t one of those people.
I drove to the pharmacy to drop off my prescription. When I got to the store, I realized I had no recollection of getting there. My brain seemingly turned off for half an hour, and this frightened me, I had severe issues with dissociation while under stress in the past, but after hearing I might have borderline it felt more intense. I texted a friend (who is technically an ex, but it was like a six-week volatile “relationship”) and told them that my psychiatrist just told me I might have BPD. I expected them to ask why or validate my feelings of denial. That’s not what I got; their response was “haha, I can see that.” I sent them a text back pretending I was laughing along with them, then I set down my phone and just stared out at the parking lot with my thoughts racing. “Could this be true?” “Could everyone see me as borderline except me?” “Do I hurt people all the time?” “Am I manipulative?” “Will I really never be freed of my symptoms?” I felt my heart sink, I was terrified and heartbroken.
I went into the pharmacy with a flat expression, I wasn’t feeling much anymore. I got to the counter and the woman who always looks and talks like she’s 5 seconds away from a nervous breakdown puts my information in the computer. She looks a bit stunned and says, “you’re picking up nine prescriptions? Does that sound right?” I didn’t look up from my wallet as I was pulling out my debit card and ID as I flatly replied “yep.” She responded in her shaky voice, “Oh, ok, I’ll go get those for you” I stood there and thought “nine prescriptions, almost all of them being psychiatric, God, could I be more of a fucked up person?” for a moment my emotions remained flat but then suddenly I was filled with rage, I was angry at my own mind for being the way it was. I grabbed my prescriptions and stormed out the door and sped home to call my therapist.
When I got home, I was enraged, then denying it, then I was crying. It was like I was repeatedly experiencing all the stages of grief within the span of 5 minutes. I pulled out my phone and called my therapist, I knew I’d get her voicemail, but for some reason this angered me. I was trembling with anger with tears running down my face screaming things like “will I ever be ok?” “how can [my psychiatrist] just drop that on me!? He said it as casually as if he were telling me the weather!” “What’s wrong with me” “That’s not who I am!” “[My psychiatrist] is an asshole, I never want to see him again!” Among other frantic and rather unstable things.
What I didn’t realize at that moment (or when I started writing this nearly a month ago) was that I was expressing those rapid mood swings and black and white thinking that is common in borderline personality disorder. I didn’t really know anything about the disorder except for the fact that every teenager on Tumblr claimed to have it. I had met a few people in psych hospitals with it and had read the Wikipedia article about it, but that was the extent of my knowledge. Based on the Wikipedia article, I didn’t consider myself to have BPD, sure I had some of the symptoms, but I didn’t think I fit the profile I gave people with borderline personality disorder.
That night I watched a really long video about the disorder, and how it had 9 “traits” or diagnostic criteria, and a diagnosis requires that at least 5 of 9 specific criteria be met. Upon hearing the longer explanations of the criteria, I started to be able to relate. With each trait they explained my heart sunk deeper and deeper into my chest, I was checking off so many of them.
One that really stood out to me was “unstable sense of self” while they were explaining it in depth I couldn’t understand it. What do they mean by “at the end of the day I know I’m me”? What do they mean by having a consistent sense of self? This is something I don’t understand, I thought everyone’s views of themselves and who they were as a person came from the outside. Are other peoples’ sense of self really not affected by outside influence? How do you know who you are without external influence? If you never had anyone tell you anything about yourself, would you know who you are? I’m genuinely asking because this is something I can’t wrap my head around, and no matter how much googling I do I still can’t find something that explains sense of self in a way I can understand. I guess I don’t have one? I really do externalize everything.
This felt similar to a few months back when I was in a DBT treatment program, they were talking about values. They went around the room and asked: “what is something you value?” I was the first one up, and I said “everyone’s right to free speech” – that’s a value, isn’t it? It’s really important for society in my eyes. But as they went around the room, every single person said something more internal like “my creativity” “love” “my sobriety” and so on. I guess I didn’t understand the question or what a value is. We were given an exercise to prioritize our values, as I read each of the pieces of paper I thought: “yes, these are things I care about, but are they values?” Maybe it’s because I’ve never had a value of this nature explained to me or it’s just one of those ASD things that is difficult to explain to me. Throughout the exercise my choices kept changing based on other people’s answers, more externalizing, yet my answers were nothing like the rest of the group. Since it was a DBT group, I know some people in there had BPD, so maybe it is an ASD thing. I felt so estranged from the group.
Here’s how I answered part way through the activity, left is most important, and right is less important. This is after we discarded maybe 10 others.
When we narrowed it down to one mine was “safety” if you were curious.
So let’s go over the 9 diagnostic criteria [source]:
1. Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behaviour covered in criterion 5.
Check. If this isn’t me I don’t know what is. I’ll do crazy things in efforts to keep people close to me when really most of the things I do are probably driving them away. Abandonment is my biggest fear, I know it’s to an irrational level but I can’t help but feel it. At one point if Phil so much as didn’t respond to a text right away I’d snap and be convinced he didn’t love me and I’d beg him not to leave or worse, I’d get angry and yell about how much I hated him. I’m getting better about this though.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Check. Talk to literally anyone I’ve dated.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
Check. See above.
4. 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.
No. I may have a history of substance abuse, but it wasn’t impulsive, it was thought out and intentional. I’ll explain this fucked up thinking in a later post, but I planned my substance abuse since I was probably about 10. I’m really paranoid when driving and super careful, budget like mad, never gambled and don’t really care to, and have the exact opposite problem as binge eating.
This is the trait of borderline personality disorder that always made me feel like I didn’t have it, everyone I knew with it was incredibly reckless and I’m not. I didn’t realize this wasn’t a required criterion to have BPD.
5. Recurrent suicidal behaviour, gestures or threats, or self-mutilating behaviour.
Check. Yeah, let’s not go into how often I say I want to kill myself. I Always Want To Die (Sometimes)
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).
Check. See this?
I spin it like a goddamn prize wheel.
7. Chronic feelings of emptiness.
Unsure.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Check. I don’t get into physical fights, but man do I have anger come out of nowhere. I am getting better about controlling it through DBT and EMDR, but damn.
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.
Check. Stress can make me lose all touch with reality and I’ll disassociate so badly I won’t know who I am, where I am, or what’s going on, then I likely won’t remember it. This has gotten significantly better recently, but after I was re-traumatized (post on that coming soon) I was disassociating probably daily, if not multiple times a day.
So 7.5 out of 9, I don’t know what that means. I could have borderline personality disorder, or I’m just really traumatized and autistic as fuck … or all 3! Yay!
I’m working through my symptoms with lots of therapy (I have 3 therapists at the moment), DBT, and EMDR. I don’t want to be a toxic person to those I love anymore. I really don’t want to have borderline personality disorder. My fiance won’t be visiting me in a couple of weeks as planned due to my intense mental disturbance he’s had to deal with his last 2 trips. I couldn’t be more heartbroken, I understand, but I’m still deeply hurt. I just don’t want any of this to be true, and reflecting on my behaviors makes me angry at myself.
