First published by Vice, 10th August 2015
In the summer of 2010, just before I turned 19 and in my first year of university, I attempted suicide with a month’s supply of my antidepressants and ended up in intensive care, breathing on a machine. By my second year, my good-time friends had had enough of me. I was no longer invited out, and became very isolated and increasingly unhappy. I got into an abusive relationship and attempted suicide another two times. I was also bulimic – vomiting everything that touched my lips.
During the first year of my undergraduate degree I reduced my calorie intake to 250 a day – about two and a half slices of bread or five medium apples – and started to go slowly insane. I drank, took drugs and went to clubs with a religious fervour. My body started to cave in. I was starving and my hair started to fall out. My nails went blue. My skin turned to flaking scales. I once ate a burger after a night out and forced myself to run up and down the stairs until I actually passed out to “make up for it”. I went to my campus GP and told him I needed help. At five and a half stone, he said I wasn’t sick enough to warrant eating disorders treatment, and Borderline Personality Disorder was never even mentioned.
People couldn’t keep up with my impulsive behaviour, the manic phases and the fits of crying. The labels of “drama queen”, “attention seeker” and “total fucking mess” followed me around like a bad smell. I tried to conceal it, but being called those things hurt. I didn’t know how to explain that all the stuff I was doing was an attempt to manage my out-of-control emotions, because when I’m going through a bad patch it feels like being on a sickening rollercoaster – only, I can’t get off.
Stephen Buckley, Head of Information at the mental health charity Mind, describes BPD as “a very broad diagnosis that can include lots of different people with very different experiences”. He told me that BPD can involve experiencing a number of symptoms for extended periods of time, including “feeling worried that people might abandon you; feeling very intense emotions that are also very changeable; feeling like you don’t have a strong sense of who you are; finding it hard to make and maintain relationships; acting impulsively; having suicidal thoughts or self-harming; feeling angry; feeling paranoid, having psychotic experiences; feeling numb; or feeling empty or alone a lot of the time”.
To me, it was more like going from feeling suicidal and totally despairing, to reasonably positive within an hour. The intense mood swings were terrifying because they were – and still are – coupled with impulsive urges to harm myself or do things I know I’ll later regret. The negative emotions I have are immobilising. They crash over me like huge waves, knocking the wind out of me and forcing me underwater. It means living with a devious voice in my mind that whispers ugly thoughts and orders. It tells me that I’m a shitty person, don’t deserve to exist and that my life is meaningless.
Author, pictured right.
According to the NHS, personality disorders often become apparent during a person’s teenage years and are commonly associated with childhood trauma, with eight out of ten people with BPD experiencing physical, emotional, or sexual abuse during childhood, or parental neglect.
I wasn’t neglected by my parents. I had a very happy childhood up until I started secondary school. It was the kind of school that concerned middle-class parents tend not to send their kids to. Discipline in classrooms was practically nil and I was bullied badly, branded a “lezzer” and a “dyke”, greeted with laughter whenever I entered the room, pelted with chewing gum, dismissed by boys as a “rat” and a “dog” that “no man would ever want to touch”. Girls would pretend to be scared of me in the swimming pool changing rooms because I hadn’t realised, age 11, that I was meant to shave my legs.
This continued for about two years, and by the time I was 14, I’d become completely disconnected from myself and overwhelmed by feelings of worthlessness and anger. This was when my impulsive behaviour kicked in, and I started self-harming, drinking, taking drugs like cocaine, mephedrone and speed, and looking for attention from dubious men. I didn’t know what Borderline Personality Disorder was. I began limiting myself to 1,000 calories a day and visiting pro-anorexia websites. I told myself that I’d feel calmer and people would like me and the raging hurt would leave me if I just became thin enough.
It wasn’t until the end of my second year of university – when I was finally accepted on to an eating disorders treatment programme – that I was finally diagnosed with Borderline Personality Disorder. I did a course of Compassion Focused Therapy, which is designed for people with high levels of shame and self-criticism. I learned more about how to navigate my overwhelming emotions, and not listen to the hateful voice that pushed me to starve myself and hurt my body. The therapy was coupled with medication to help me sleep and negate some of the crushing depression that so often accompanies BPD.
Some BPD sufferers hear voices outside their heads, usually with instructions to harm themselves or others, and at the more extreme end of the spectrum, some sufferers also experience prolonged delusions or beliefs that they cannot be talked out of. Others – like Rachel Rowan Olive, a girl I talked to who also suffers from BPD – tend to disassociate or shut down when their emotions become too difficult to deal with. “BPD is hard to describe to someone who doesn’t have it. I never liked the label ‘Borderline Personality Disorder’. It’s the kind of term that makes people back away slowly. I used to think that a lot of the criteria for BPD didn’t apply to me, but as time has gone on, I can connect things that have always been part of me to the diagnosis.
“My main problem is self-harm and that’s the most outward and obvious symptom of my BPD. I experience a lot of anxiety, so I feel like if I’m going to be frightened anyway for absolutely no reason, I might as well make myself frightened of something that’s real and within my control. I experience a level of emotional dysregulation, where I end up feeling really empty a lot of the time. I think a big part of it for me is finding it hard to tell the difference between my emotions and other people’s. I notice it even with fiction – if I’m reading or watching TV I can end up getting panicky because it’s like I’m feeling what all the different characters are feeling at once and I don’t know which emotions are mine any more.”
Nowadays, I try to keep my environment as calm as possible, and use distracting and soothing techniques to mitigate the effects of bad episodes. Most of the time I keep my emotions under control, but there are still times when I swing between crying and not being able to get out of bed, hyper productivity and manic states where I’m tempted to be super-impulsive.
I still have a hard time forming long-lasting friendships. The majority of my friends from school and university are no longer in my life. Part of BPD is forming intense relationships that don’t last very long, and the illness ends up being very isolating. My emotions are so overwhelming that other people find it hard to understand why I’m laughing and bouncing around for no reason, and then suddenly in floods of tears. I don’t usually tell people that I have BPD because I’m afraid they’ll judge me.
Managing Borderline Personality Disorder usually involves a combination of medication and talking therapy. There’s no drug specifically licensed to treat BPD but mood stabilisers, antidepressants and antipsychotics (all of which I take) are commonly used. Rachel uses Dialectical Behavioural Therapy to manage her BPD, coupled with art therapy at a studio in Hackney. She will also plan her week out in advance to give herself a sense of structure and control.
The stigma that surrounds all mental illness is vastly unhelpful, does much to damage sufferers and can prevent them from getting help. As a “personality disorder”, BPD gets more than its fair share of social stigma. People with BPD aren’t cold and emotionless, as Rachel felt others perceived her to be, or attention-seeking and deserving of social isolation, as I was dubbed at university. They are merely trying to manage an illness that’s every bit as real as a physical condition, with the tools they have at their disposal.
It’s very easy to succumb to feelings of frustration and hopelessness when you’re stuck on a waiting list and it might be six months to a year before you even get an assessment appointment for any kind of therapy. Despite this, it’s essential that anyone experiencing BPD-like symptoms informs their GP. No one should have to get to such a breaking point with their mental health that they try to end their life. It’s five years since I was unconscious in intensive care, unable to breathe, with a nurse washing my hair because of all the sweat that had run into it. I owe it to my partner, my parents, my sister and myself not to end up back there.