For me, everything is black and white. Some mornings I can wake up at 6am and feel on top of the world, happier than I’ve ever felt in my entire life, but within the hour I could suddenly burst into tears during a meeting at work or on the Tube. I spend this time in a disconnected reality, wondering why I’m alive, threatening to leave my job (or actually leaving my job, as I have in the past), fighting the urge to make myself sick after a black coffee, spiralling deep into a recurring hole of self-hate, unable to distinguish if I’m actually awake or having a nightmare. And then, 30 minutes later, I’m back at my desk counting my blessings and smiling. This is what life is like with borderline personality disorder – or "BPD", as it's often known. As defined by the NHS, the symptoms of borderline personality disorder can be broadly grouped to four main areas: emotional instability (a psychological term for this is affective dysregulation), disturbed patterns of thinking or perception (psychological terms for these are cognitive or perceptual distortions), impulsive behaviour, intense but unstable relationships with others. The range of symptoms can make the disorder hard to diagnose; according to the Royal College of Psychiatry, 40% of people with BPD have previously been misdiagnosed with other disorders such as bipolar disorder or clinical depression. Bipolar disorder can be characterised by manic and depressive episodes, similar to BPD in the intensity of the extreme mood swings. Clinical depression is a more severe form of depression, also known as major depressive disorder. It draws parallels to the mind-crippling lows felt in the depths of both bipolar and BPD. Misdiagnosis was very much the case for me, as it is for many people with BPD. Unaware that this disorder existed, I was tried and tested for various mental health issues since I was 14 years old, yet doctors could never quite place what was “wrong” with me. Then, when I was 16, more tests concluded I was in fact somewhat "normal" and they put my experiences down to “teenage hormones.” A year later, I was diagnosed with post traumatic stress disorder and, in my late teens, bulimia nervosa.
It was only in November 2015, after nine years of experiencing the various symptoms of BPD, that I was finally diagnosed correctly. I was 23. As I walked into the psychiatry unit, feeling like an extra from a scene in Girl, Interrupted, I could sense something was up just from the overly-sympathetic smile on the doctor’s face. He handed me a booklet exploring borderline personality disorder. I remember what he said next like it was yesterday: “You can also refer to it as emotionally unstable personality disorder, if that makes you feel any better?”
We discussed my options. I would begin a therapy practice named Mentalisation. The overall aim of Mentalisation Based Therapy, or "MBT", is to learn to manage emotional states, but with less emphasis on past relationships and the meaning of specific life events than other types of therapy. The therapist trains me to focus on understanding my own intentions and the actions of others without over-analysing. Instead of focusing on how I “felt” at a specific point in my life, MBT allows me to remain open to the present time, which when paired with Sertraline – a popular anti-depressant to lessen the effects of anxiety and impulsive behaviours – should gradually reduce severe outbursts of emotion.
Alongside a mindset overhaul I began practicing meditation for ten minutes a day and keeping a regular work out routine, even if I can only squeeze in 15 minutes of yoga before I leave for work. They are small steps that help me stay on a level – although I can admit I am still a far cry from feeling totally balanced. Sertraline might be a daily crutch – and one that I can one day hopefully rid myself of – but, in the mean time, a very supportive group of friends and my therapist are also helping me to turn things around. The best advice my therapist has given me lately is to “start with simple things such as being able to accept compliments by saying 'thank you'". She reminded me that I am not my diagnosis; “You are actually a person and beginning to distinguish between the two is very important”. Another great piece of advice my therapist gave me, was to surround myself with positive people. Throughout my university years, I lived in a flat share with three girls I counted as best friends. As soon as one girl left the room it became routine to talk about her; “She’s so ugly, she’s really fat, and why is she wearing that dress?” After four years in this environment my insecurities were at a peak and I started to rely on bulimia to get myself through months of living in such a hostile environment. I didn’t want to burden other friends with the endless tears and stories, mainly because I didn’t want to play the victim or admit how bad the situation really was. Instead, I shrunk into myself and became more and more reclusive, isolating myself in my room. Since then, I have learned to cut out the bad people in my life and focus on building positive relationships with those who love me – good day or bad. It is very true that having positive people around you and people who understand what you're going through is imperative and helps you create a sense of self-worth and value.
Looking back over my experience learning to live with BPD, what leaves me the most frightened is the concept of my misdiagnosis, which was only solved after nine long years of pushing for an answer. Sure, statistics from The Royal College of Psychiatry prove one in 20 patients will receive the correct treatment to support how they are feeling, but I continuously wonder how many slip under the radar and get defined as just another over-emotional millennial or angry teen. Perhaps, through raising awareness of less known mental health issues such as BPD, we might better be able to self-identify, or identify in the people close to us, those instances when things are more serious than the doctor can spot in a quick, ten-minute appointment. For more information on Borderline Personality Disorder, visit the Mind website.