Poor Borderline Personality Disorder—no one wants to have it. It’s a personality disorder that gets a pretty bad rap, with many therapists claiming that it’s the hardest disorder to treat. If you don’t know what BPD looks like, you can pick up the bestselling book I Hate You, Don’t Leave Me. You can also check out the flick Girl, Interrupted with Winona Ryder (or read the book) to get a glimpse inside the mechanisms of the disordered brain.
Typically, people suffering from BPD exhibit self-harm in the form of cutting or suicidal gestures, lack of impulse control and other self-defeating behaviors like substance abuse and eating disorders. But most significantly, those weathering the storms of BPD experience extremely volatile personal relationships—be they with friends, families or significant others. Manipulation and playing the victim are tell-tale signs of the disorder, at least this is what my own therapists have told me.
Over the years I’ve convinced myself that I am in fact a sufferer of BPD. The first time I diagnosed myself with it I was 24 and having some issues with my boyfriend of three years, Justin. Looking back, these issues weren’t all that abnormal, although I will say they were more appropriate for a 14-year-old than a 24-year-old. (For whatever reason, I tend to feel like I’m ten years behind “normal” people in all aspects of my development. At 37, I’m sort of settling into the space of a healthy 27-year-old. Like the idea of settling down finally doesn’t terrify me.)
Basically, when Justin would piss me off I’d scream and tell him to get the hell out of my face, then I’d panic and realize I really did need him, terrified that he’d abandon me for good because I snapped. Couple this push-and-pull with a quasi-eating disorder since adolescence, cutting myself every now and then (a destructive habit I quit since getting sober nearly seven years ago), attempted suicide many times and I naturally thought BPD explained all of my psychological problems.
I had also been diagnosed with bipolar disorder—but there is a big overlap among the symptoms of these diagnoses. After reading I Hate You, Don’t Leave me, I was pleased to know there was a specific disorder that explained away all my behavioral problems. So I went to my next appointment with my therapist excited to tell her the good—or bad—news.
“So, I think I have Borderline Personality Disorder,” I said to Gail back in 2003.
She stared at me from that plush burgundy love seat with her legs crossed and paused, clasping her hands in reflection. Then she piped up with “Um, no you don’t.”
“But I seem to meet all the criteria,” I said. “Like poor impulse control and severe emotions…and I push and pull with Justin.”
She just wouldn’t buy into it.
“Well, Tracy,” Gail started, “if you actually had BPD you would not be worried about having it. Most people with the disorder don’t have any idea that there’s anything wrong with them at all. Denial is a big symptom.”
Well, this was interesting news.
“You may have a few traits, in fact, we all do, but you don’t display problems in the majority of your relationships—like with your friends or family. People with BPD can’t seem to hang on to friends.”
She was right about that. I’ve been fortunate enough to have few fall-outs with my girlfriends over the years. There have been one or two friendships that got strained, but almost all had to do with my drinking—friends pulling away when they just couldn’t take care of me anymore or watch me go down the tubes.
“Huh,” I said.
Later on when I attempted suicide a few times, I had two psychiatrists in the hospital emergency rooms ask me if I had ever been diagnosed with BPD because suicidal gesture is one of the key symptoms. Some argue that people with BPD make threats or attempt suicide simply to manipulate others’ emotions, but in my own experience I always just wanted to die. Furthermore, I wanted to hide the attempts from everyone if possible, including my parents or significant others. But one way or another, people would always find out. I’d come-to in the ICU or the ER and just think “Fuuuuck! I’m going to be in trouble with everyone!”
This isn’t to say that people with BPD aren’t truly suffering from their condition and don’t really want to end their suffering by ending their lives. From what I read, living with BPD is very painful. Like depression and bipolar disorder there’s no cure, but studies have shown that treatment with CBT and DBT can alleviate the symptoms. So, there is hope for the suffering. I can personally attest to the power of both of CBT and DBT to help sort my mind out.
Recently, I had another dip into suicidality, and I started questioning my mental health again since those psychiatrists in the hospital suggested I might have the disorder. Once again, I brought the idea into my new therapist to see what he thought.
“I think I might have Borderline Personality Disorder,” I told Estevan. “I’ve had two doctors diagnose me with it.”
“When was this?” he asked.
I told him the whole story, and he immediately got angry.
“It’s completely irresponsible for anyone to diagnose you with such a condition if they haven’t spent lots of time analyzing your behavior,” he said. “Furthermore, though you may have some symptoms, you don’t act like any patient I’ve had with a BPD diagnosis. Most of them are very wound-up and very hard to treat. You’re very pleasant and laid-back and down-to-earth.”
Believe me, I needed this reassurance. I did find it humorous that this was the second therapist who was certain I didn’t have the disorder. But what about the many people who do qualify? Are they hopeless? And what about the few symptoms of the disorder that I totally relate to? Like how I suffer from extreme reactions to perceived rejection in both professional and romantic scenarios. How my moods are often contingent on acceptance from others and things going well in my life: things like getting a pitch accepted to a publication, having more money than usual or getting lots of “Likes” on my Facebook posts (yes, I’m that pathetic and insecure, although I’m getting much better.) I also get super amped when things go well and, sometimes, super down when things go to shit. This is really not the same as bipolar disorder, where the swings in mood are due to natural contributors like lack of sleep or getting overly stimulated.
I’m sure there are plenty of folks in recovery who have a BPD diagnosis, and given that I identify with the symptoms, I have much compassion for anyone with the diagnosis, especially since it carries such a weighty stigma. The one piece of good news is that often people grow out of the disorder as they age.
Emotional regulation is the real antidote to the distorted thinking patterns someone with BPD deals with on a continual basis. So if you’ve got it, don’t be too down on yourself. I understand what it’s like to want to throw yourself over a bridge because so-and-so rejected you, and I understand the impulse to self-harm. Personally, I think BPD is a spectrum like all other mental disorders, including depression, bipolar and autism. I’m on that spectrum with you, but there’s hope and relief. Doing the required work has given me serious relief, and it only takes a few minutes of scribbling on CBT and DBT worksheets each day to get your head screwed on straight again.
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