Mental illnesses are considered invisible illnesses because they don’t have a “look”, and Borderline Personality Disorder falls into this category. You can’t look at someone and know if they are struggling or not. However, If you really think about it they do have a “look”. Your symptoms present themselves outwardly a lot of the time. It is considered invisible because most people don’t understand that outward expression is a part of your illness. More often than not, these symptoms are viewed as character flaws and not attributed to something greater that they can’t see.
Borderline Personality Disorder (BPD)
My counselor walked me through the criteria and I met 8 out of 9. She read the criteria for different disorders to me and I would answer ‘yes’ or ‘no’. When we were done we would review the specific disorder and discuss it if the criteria were met.
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 5 (or more) of the following:
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least 2 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.
What It Means to Me
8 out of 9. Wow. I always thought that I was likely dealing with Bipolar when I was growing up although I was never officially diagnosed. However, BPD was one that I never gave any real consideration to.
I grew up with a sour outlook on BPD. My mom used to wave those three words around like it was a flag and an excuse for everything. I never really knew if it was something she was dealing with or not. I actually believed she just found something in a book and said “I’m going to use that one”. I’m sure you can imagine that Borderline Personality Disorder was something I hoped I’d never get a diagnosis for; just in case she really was “dealing” with it.
When I saw BPD written on that piece of paper, I felt a combination of hope and fear. I felt hope because I finally had an idea of what I was dealing with, and a plan of care. The fear was driven by my own self-doubt and knowing that there was a lot of difficult work ahead of me. Am I strong enough to do this? Becoming my mother is something that I’ve always wanted to avoid, so that has also been a huge fear of mine for as long as I can remember.
The good news is that there is hope. My counselor revealed Dialectal Behavior Therapy (DBT) to me as a treatment plan. I had always heard about Cognitive Behavioral Therapy (CBT), but never DBT.
We have just started getting into DBT during my counseling sessions. So far, I’m realizing that it’s going to be a lot of difficult work.
What is my “look like”
For me, BPD presents itself in many ways. It is a constantly changing roller coaster and every day looks different.
Some days I can be overly sensitive to everything around me. The lights will feel like too much, and normal sounds and noises seem so overwhelming that I start to get irritable (including people talking).
Other days, I question my purpose in life and doubt my ability to continue on. Then sometimes, I’m in a manic state and feel like I can take on the world. Manic episodes are where I find a lot of my motivation. I will start on all these projects and goals that I have. Ignoring the fact that I won’t be able to keep up with when I’m feeling down. The moral of the story there is I restart projects quite frequently, even though the dreams and projects are legitimate things I want to do. The upside to manic episodes is that my home usually ends up extremely clean, depending on how long the episode lasts. The downside to that is when I am not able to find the motivation to keep up with the cleaning when the episode passes, I start to feel down on myself.
Things I have Learned
When setting goals, I need to be realistic. I cannot set goals and start projects when I am in a manic state. Although that seems like the best time to get moving and get ahead, it usually leads to not being able to maintain because I did not set realistic expectations.
I also have to prepare for the worst. When I do start projects and want to be able to keep them going, I have to set myself up for success. We can use the blog for instance. In order to make sure I can keep up, I have to think ahead. This means that I need to have extra posts written ahead of time, and graphics set up for social media because I know there will come a point that I just can’t keep up. This gives me the ability to jump right back in when the storm passes and not feel overwhelmed and like I’ve failed.
I need to be self-aware. Symptoms for BPD are constantly changing. There isn’t any pattern or formula for how the symptoms present themselves. I need to be aware of what’s going on inside me and use my skills that I am learning in order to help me handle them in an effective manner. Part of being self-aware also involves me educating myself about… well, myself. I came across a book shortly after my diagnosis that I have fallen in love with. The Big Book On Borderline Personality Disorder contains so much knowledge from someone who has been there and dealt with it. It’s totally worth checking out!
Last, but definitely not least, I have learned that living with BPD is hell. In the past, and even today, it’s considered difficult to treat. It is also the only mental disorder that has suicide attempts or self-harming behaviors as diagnostic criteria. To compound things, there are typically additional mental disorders diagnosed that have an impact on Borderline. This means you not only have to treat Borderline Personality Disorder but the additional diagnosis that you may be given as well. For me, it is Bipolar I and PTSD to go along with BPD. Even though I know I’m up against a monster, and you may be too, know that there is hope. Help is available.
I look forward to continuing to share my journey.