My New Diagnosis and What It Means for Me
Personality disorders have got to be one of the most stigmatized mental illnesses in today's day and age. When I say personality disorder, the first thing you probably think of is multiple personality disorder. What you probably didn't know is that there are at least 10 known personality disorders. What you also probably didn't know is that there is really no such thing as multiple personality disorder these days because it is now known as dissociative identity disorder, which is typically brought on by trauma. I have a minor case of this disorder. But that’s another topic for another day and another post. I however haven’t had much of a problem coping with that diagnosis.
But then there's borderline personality disorder aka my new diagnosis.
During my time in the psychiatric unit, I was terrified that the psychiatrist there was going to give me another diagnosis. But my assumption was that he would misdiagnose me with bi-polar disorder; which is something that I do not have, but is something that many people believe I must have only because it seems to be so common these days. He told me that all of the diagnoses that my current psychiatrist of 7 years has given me are spot on. Although, he stated that he felt strongly that I had borderline personality disorder, and felt that if I speak to my current psychiatrist about it, he would probably agree. The only reason my current psychiatrist has never given me the diagnosis is because he's never performed an evaluation for it; which is something that must be done upon diagnosis of BPD.
Before we go any further, I'd like to say something about labels. Many people consider a diagnosis a label, something that can be dangerous, because these days, there is a label for anything and everything. If I were evaluated, I would probably be diagnosed with another 5 mental illnesses. But I don't need a diagnosis for every single little behavior or emotion in my life. However, I will admit that having this new diagnosis has helped me tremendously because it's a very unique disorder. It has very unique characteristics and behaviors. Many of which I have, but for a long time, none of it made sense. I wasn't educated on BPD, so it wasn't something I ever thought of. But there are so many things in my life that make perfect sense now, and I am so thankful for that.
Now, borderline personality disorder is defined as a pattern of feelings and behaviors that seem appropriate and justified to the person experiencing them, even though these feelings and behaviors cause a great deal of problems in that person’s life. It typically includes several symptoms like, inappropriate or extreme emotional reactions, highly impulsive behaviors sometimes associated with inappropriate and intense anger, and a history of unstable relationships. Other symptoms which aren't as common, include, frantic efforts to avoid real or imagined abandonment, 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, having stress-related paranoid thoughts, and having severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.
I'd like to walk through each symptom and explain what each one is like for me personally, as this disorder varies so much from person to person.
Inappropriate or extreme emotional reactions
Upon explanation by the psychiatrist, I learned that this does not always mean that I'm going to lash out and react like a 5 year old; screaming at the top of my lungs because I was told no. He explained that it also means that I am highly sensitive and react with great emotional intensity. My feelings and emotions related to my interpersonal relationships are very intense, so when difficulties and conflict surface, it can cause me to feel extremely anxious, angry, or sad. In my case, I feel more anxious and sad more than I feel angry. During these conflicts, I begin to feel extremely overwhelmed very easily, and the intensity of my emotions feels much greater than normal. As a result, my anxiety becomes much greater and I have a very difficult time trying to calm down once I am upset. However, there are also times where I can do a complete 180 and instead feel disconnected, empty, detached, or numb. I have yet to figure out why it is that I can feel one way during some conflict and the complete opposite during other conflict. The psychiatrist also explained that different types of self-injury are common during the times of feeling numb. I haven't cut myself in years, but I have an extreme addiction to food, so a lot of things about my eating disorder make a lot more sense now.
Highly impulsive behaviors
Most people with BPD find themselves in fights, extreme conflict, or verbal arguments. They do not act before they speak, and it can often land them in jail or the hospital. I do not have those kinds of impulsive behaviors, thankfully. But the psychiatrist did explain that my addiction to food is all based a lot on impulse. Impulse occurs as a reaction to an event that has caused you to have an emotional response. My eating disorder is often triggered by specific events, causing me to have an abnormal emotional response. For some people, impulsive behaviors can include spending sprees, unsafe sex, reckless driving, and substance abuse.
A history of unstable relationships
The psychiatrist explained that the abusive relationship that I endured is a perfect example of this symptom. People with BPD often intentionally - but sometimes subconsciously - pick fights with the people close to them. This can lead to abusive relationships, and extremely rocky friendships. Someone with BPD will sometimes intentionally pick a fight to "test" the person. They use those fights as a way to see if the person that claims to love them will actually leave them or not. While I was not the abuser, I did instigate a lot of the fights to see if he would actually leave me. This is where I have a hard time with guilt. Because I instigated a lot of it, I feel as if I asked for it to happen.
This symptom stems into;
Frantic efforts to avoid real or imagined abandonment
Someone with BPD experiences intense fear of abandonment. A good example of this symptom in my life is when someone is only but a few minutes late to plans that we have, but my immediate thought is that they forgot about me, hate me, or had something better to do. The longer I wait for them, the more intense the thoughts get. The read recipients setting on the iPhone is my own worst enemy. If I am in the middle of an intense, emotional, or in-depth conversation, and the person clearly reads the message but takes a few minutes to respond, or doesn’t respond at all, my immediate thought is that they hate me and can't stand to continue the conversation. In my mind, the "abandonment" implies that I am bad; almost as if the abandonment is my punishment for being bad.
Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
This is where part of me feels as if I've had BPD since my childhood or teen years. One symptom does not mean I've had it all along, but this particular symptom was very dominant for me for many years. Along with my unstable relationships, and extreme emotional reactions, I would not be surprised if I've had BPD for years without knowing it. I began cutting myself at the age of 14. Almost immediately, it became a full-blown addiction. I'm talking about the kind of high that drug addicts experience, I experienced. Not from the drug itself, but from the psychological high. It has been scientifically proven that the same hormones and chemicals that are released in your brain during a drug high are released when you cut yourself. It became an everyday thing for me. It was almost as if I HAD to do it. It wasn't even a choice at that point. Eventually, I began having extreme suicidal thoughts and a few tendencies as my depression got worse. Because I was hospitalized only a week ago, it is clear that my suicidal thoughts have not subsided. Even after being discharged, they seem to be recurring.
Intense and highly changeable moods, with each episode lasting from a few hours to a few days
This is a big one for me. Everyone experiences changes in their mood. Sometimes they'll last for a few hours to a few days, just like someone with BPD. But the one thing that sets those people apart from those of us, who have BPD, is the fact that the mood swings don't usually interfere with their everyday life. A person who does not experience other symptoms of BPD, can still generally function during a mood swing; they can still interact with their family, go do to work, and still be successful. For those of us with BPD, the mood swings can interfere with every single aspect there is in life. What defines this symptom, according to John Cloud from an article in TIME Magazine, “is the sufferers' inability to calibrate their feelings and behavior.” I am unable to adjust my feelings and emotions - and sometimes even actions - to properly fit a reaction to a "normal" situation. I have days where the mood swings feel so intense that they feel uncontrollable. I have called into work because the mood swing I experienced that day was much too intense, and I just couldn't bring myself to function correctly.
Chronic feelings of emptiness
For those of you who read my previous post about my time in the psychiatric unit last week, you will recall that I talked about the void, and how I felt this overwhelming feeling of nothingness. Nothingness - to me - also means emptiness. When something is empty, you have nothing. This is exactly where I feel my feeling of reaching the void came from. The void is what caused me to have suicidal thoughts to begin with. So when I was told that I had BPD and the psychiatrist explained all of this to me, it made perfect sense as to why I felt that overwhelming feeling of nothingness.
Having stress-related paranoid thoughts
We all hear that stupid saying of "You're so paranoid. Stop it." Trust me, you would know it if you were paranoid. And trust me when I say that you would not throw that phrase around if you really knew what it was like to be paranoid. I personally feel like this symptom and the symptom of abandonment go hand-in-hand. Paranoia is usually only brought on during times of stress for people with BPD. Whereas people with schizophrenia or paranoid personality disorder experience paranoia to the extreme; i.e. belief that the government is listening in on your phone calls, or that your spouse is having an affair. Paranoia related to BPD is very different. A good example would be if you were in a store and ran into some people that you know. You have a brief conversation with them and then say your goodbyes. For someone with BPD, that's a stressful situation alone. But then you suddenly hear them laughing as you walk away, and you immediately feel paranoid that they are laughing at something you said, something you're wearing, or by the way you walk. This causes you to feel as if they are belittling you or are planning to humiliate you the next time that they see you.
Having severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality
For years, I have associated my dissociation with my PTSD/panic disorder because it is brought on by trauma. Within the last year, the dissociation has become much more frequent and much worse. While it still is associated with my PTSD/panic disorder, I had no idea it could be associated with BPD until I began my research, just as I do whenever I receive a new diagnosis. Dissociation is my least favorite thing about PTSD and BPD. Everything feels unreal. I could be at home or somewhere that is very familiar to me, and everything will still look strange, feel strange, or seem unfamiliar. I often have a "zoned out" look that I feel sometimes makes me look psychotic, even though I'm not. Dissociation is defined as a disruption of the normal integrated functions of your consciousness, identity, perception of the environment, or memory. There are several different dissociative identity disorders which is another topic for another day. Dissociation is often used as a coping mechanism to cope with past trauma. But the dissociation associated with DID and BPD differ because of the severity levels. The dissociation found in BPD is not as severe as that found in DID, which explains lot for me.
They say that the name for borderline personality disorder is misleading. I agree, to an extent. But in a way, it also makes sense because so many things about the disorder are borderline to other things. If I have learned anything by receiving new diagnoses, it's that I cannot allow the label to become my identity. BPD is not my identity, but it surely brings a lot of things to light, and so many things make sense for me now. Mental illness is confusing. I am not the kind of person who can be diagnosed with something and move on from it. I have to know about the diagnosis, I have to know the ins and outs of it. I have to understand something before I can move on from it. This post is mostly for my own understanding, unlike most of my other posts. This illness is still new and fresh to me, and breaking it down bit by bit for myself helps me to understand why I am the way that I am. But my hope is that this will also help others. Borderline personality disorder isn't very common. But it's common enough that you likely know one person with it. The best thing anyone can do for someone like me is to learn why I am the way that I am. Being educated on mental illness is the best way to learn.
The symptoms listed in this post should not be used for self-diagnosis. The only way to be diagnosed with borderline personality disorder is to see a mental health professional and undergo an evaluation.
If you or someone you know needs support right now, call the Suicide Prevention Lifeline at 1-800-273-8255, or text START to 741-741
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