• Tag Archives mental health
  • It’s all about the BPD baby…

    EDIT – I have since had this diagnosis retracted, and have a combined Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder diagnosis. I’m leaving this post up as I felt like this at the time. It is also very common for women with ASD/ADHD to get misdiagnosed with BPD. If your emotional lability and “manipulative” tendencies only appear during depressive episodes (as is the case with myself), it CANNOT be BPD.

     

    Before Christmas, I got diagnosed with Borderline Personality Disorder (“BPD”). ‘What’s that?’ I hear you ask. It’s a mental health condition which causes a range of symptoms, including:

     

     

    • overwhelming feelings of distress, anxiety, worthlessness or anger
    • difficulty managing such feelings without self-harming for example, by abusing drugs and alcohol or taking overdoses
    • difficulty maintaining stable and close relationships
    • sometimes having periods of loss of contact with reality
    • in some cases, threats of harm to others

     

    (NHS, www.nhs.uk/Conditions/Borderline-personality-disorder/)

    This diagnosis, once I had completed my own research, doesn’t come as much of a surprise to me. I have always had (technically) unreasonable emotional reactions to things which happen in my life, from crying for over an hour solid because someone cancelled plans to have a coffee with me, to trying to kill myself because the guy I wish I was dating slept with someone else.

    What most people don’t seem to realise, however, is that I have absolutely no control over this. I can appear to be manipulative, I am extremely impulsive, emotionally labile (not just with negative emotions, I have been known to laugh until I can’t breathe at something that’s only slightly funny to most), often believe I wasn’t supposed to ever exist, and have severe rejection issues. While I know that many of these thoughts and feelings are irrational, they are all consuming and when I’m at the extremes of my emotions, it’s like another person has taken over and I’m watching from the sidelines.

    When I was working, I was the team member who, although good at their job, struggled to maintain good relationships with co-workers. I could be snappy, cried extremely easily, and often behaved in an unprofessional manner, shouting at people when I was angry, and having to run off to the toilets when I was upset. What my former colleagues won’t realise is I found all this behaviour just as frustrating as they did. I wished more than anything that I could remain in control of how I was feeling, and not be “that person”.

    I had similar experiences in school. I’d flit between social groups, never becoming a fully integral member of any of them, and with some members of those groups, loving them one minute and hating them the next. I would panic if I didn’t have plans with people for lunch, in sixth form I skipped lessons if I didn’t have a friend in them (and therefore screwed up my A-levels) because I was so scared of having to sit on my own, and was generally an emotional mess. I felt like I didn’t fit in anywhere, but was terrified of being alone. I would become extremely clingy with some people, and wasn’t able to understand why they’d want to do something without me. These are issues I still face in my daily life.

    As many as 80 percent of people with BPD have suicidal behaviours, and about 4 to 9 percent commit suicide. (NIMH, www.nimh.nih.gov/health/topics/borderline-personality-disorder/)

    I have attempted to take my own life at least six times, after each of these attempts I was taken to hospital, usually in an ambulance, always with the same outcome. My feelings were minimised, most attempts were recorded as “accidental overdoses”, and I would say anything I could to the on call psychiatrist to get them to discharge me. I also have a long history of self harm, yet after each attempt, I was just discharged without any psychological follow up.

    I have had several appointments with mental health crisis teams over the years, each of them dismissing me with depression, changing and/or increasing my medication, and basically being told to “think positively” or “think of my children”. It didn’t occur to any of the health professionals who have seen me in the past to consider that there could be more to my mental health issues than “just depression”. (Please don’t think I’m minimising depression, I have it and anxiety as co-morbid diagnoses with my BPD. Depression is crippling, there is no “just” about it, except in this case, when the recommended treatments are different, and my emotional lability can produce very different symptoms.)

    I had been doing some research regarding alternative psychotherapies, when I came across Dialectical Behaviour Therapy (“DBT”). It sounded really interesting, and looked as if it would be extremely beneficial to me as it teaches you how to regulate your emotions.

    “Dialectical behaviour therapy (DBT) reduced suicide attempts in women by half compared with other types of psychotherapy, or talk therapy. DBT also reduced use of emergency room and inpatient services and retained more participants in therapy, compared to other approaches to treatment.” (NIMH, www.nimh.nih.gov/health/topics/borderline-personality-disorder/)

    In fact, the NICE guidelines for BPD include:

    “1.3.4.5 For women with borderline personality disorder for whom reducing recurrent self-harm is a priority, consider a comprehensive dialectical behaviour therapy programme.” (NICE, www.nice.org.uk/guidance/cg78/chapter/1-recommendations)

    I thought that my diagnosis would open this door up to me, which it might, if I complete a managing anxiety and anger management course (not through mental health services) first. I then have to complete a “managing your emotions” course before I’ll be considered for the treatment that NICE clearly suggest.

    While I understand that there is a lack of funding, and they’re hoping that the other therapies will provide me with enough coping strategies that I don’t require the DBT, there are very few other conditions that this same logic would be applied to. It’s like telling a type one diabetic that trying to control their blood sugar levels through diet alone is sufficient, unless they nearly die. In no case would that be suggested. They’d be put straight onto insulin (the recommended treatment) and be reviewed on a regular basis by their medical team. There wouldn’t be any arguing “well, there are other people with unmanaged diabetes who have your symptoms, but when they follow a good diet, they go away.” It would be accepted that type one is very different to type two, and although they can initially present similarly, type one is significantly more deadly if it is not dealt with correctly. BPD is significantly more deadly than anxiety, perhaps being told to go on a course for people with anxiety isn’t going to be the long-term fix that is so needed.

    “Community mental health services (community mental health teams, related community-based services, and tier 2/3 services in child and adolescent mental health services – CAMHS) should be responsible for the routine assessment, treatment and management of people with borderline personality disorder.” (NICE, www.nice.org.uk/guidance/CG78/chapter/Key-priorities-for-implementation)

    I got discharged from mental health services in the same sentence that contained my diagnosis. I have been told that if I am in a crisis, I will have to contact my GP, get an appointment, see them to get referred to the mental health team, and wait for an appointment to be sent through the post. During my last major crisis, I took 16 paracetamol in the time it took to have two swigs of cola. I wish I could say I was surprised to be discharged, I’m not. Mental health services in this country are in a dire state and I am by no means the only person in this situation. What isn’t considered by those in charge of the distribution of money is that someone with a diagnosed mental health condition who is not able to contact the crisis team directly when they are in crisis are going to be seeing (potentially) GPs, A&E staff, In-patient psychiatric staff, Police, Social Services, or maybe even a Mortician. I’m sure these services are far more costly (and overworked/understaffed) than what it would take to be kept on a database which allows you to directly ring someone who may actually be able to help.

    It’s taken me over a month to write this post, and I wouldn’t consider it to be my best piece of writing either. It’s a bit of a jumble of emotions, thoughts, and frustrations which I needed to get out. I congratulate you if you have read this far, and have only one request: please try to understand I don’t mean to be so emotional, and I am trying to get it fixed, it’s just going to take some time.


  • Home

    When I think about the mind, it reminds me of an old house, dark and decrepit. The paintwork on the façade is cracked, peeling, scorched by the sun, and battered by the winds of the past. It is uninviting, but somehow draws you in, like a moth to a flame.  You can’t help but walk up the splintered steps to explore the inside.

    The heavy wooden door is slightly ajar. You feel your heart quickening in your chest, the blood pounding in your ears like a beating drum. You struggle to catch your breath; you want to turn away and flee like so many others before you, but you know you must go on.

    The corridor is long, dark, and dusty; a path which hasn’t been walked for a long time. Your footsteps echo as you go forward, dust billows behind you, and cobwebs snatch at your face like ghostly fingers. You see movement ahead, you slow your pace in trepidation, yet you know you must continue.

    Two figures appear in the dark, shadowy and sinister. As you approach, you notice that one figure is cowering low to the floor, hands raised as a shield, to protect itself from the words spouting from the other. The figure doing the talking is tall, and menacing. It has no face, yet words keep coming from the place where its mouth should be. You hear it calling the quivering figure weak; telling it that it is worthless, stupid, and unloved. It spews out nothing but hatred, every vile insult sparks something inside you, and you break into a run determined to protect the whimpering figure on the floor.

    As you get closer, you hear more of the bile; you see clearly the figure on the floor. Realisation washes over you as you see that the frightened figure is yourself. You are naked, vulnerable, and uncomfortable. You hear what is being shouted by the taller figure, and realise it’s every worry, every self-doubting moment you have ever had. You stop, and realise the figure is the part of your brain which feeds all of your self-doubt, your fears, and your anxiety. You stare at the figure, and notice that as you do, it begins to become smaller. The realisation that it is a manifestation of your fears rather than an entity which can cause harm makes it seem less frightening.

    You stand and watch, listening to the figure and realising that although it may say things which are hurtful, you can choose how you react to them. You approach your trembling self, and hold out a hand. It places its hand into yours, and you stand united against the negative thoughts and feelings. Together you watch the figure twisted in its hatred, and choose to let the words wash over you and away. In the same way that no two drops of water are the same in a waterfall, no two thoughts are the same, and they will pass quickly. The figure continued to shrink, and as it did, the house began to fill with light. The corridor widened, and the cobwebs vanished. Warmth spreads throughout the house and you walk back towards the open front door. As you look back, you see yourself sat peacefully in the warm light, and you know you are free; you finally feel at home in your own mind.


  • 2014 – The Summary

    How much can happen in a year?

    As it turns out, lots. Lots of things can happen in a year. 2014 has been… eventful and that’s putting it kindly. If I’m truly honest, it has been one of the hardest years of my life. It has also been a year of self-discovery, and I know I am exiting the year a stronger person than when I entered it, the journey however, has been a bitch of a ride.

    2014 marked the beginning of my life as a full time carer/stay at home mum. Since my eldest son was born, all I ever wanted was to be able to stay at home with him, to do all the school runs, to bake cakes, go to the park, play board games, have his friends over for dinner, become a member of the PTA, the list goes on. Unfortunately, reality doesn’t tend to match ideals. The sole reason I became a stay at home mum, was due to my eldest son requiring enough extra support, compared to other children his age, he qualified for DLA. My dreams of PTA meetings had turned into hospital appointments and SENCO meetings, trips to the park were few and far between, and during those trips I spent most of my time calling out to him to “stop licking the railings” or to “please come back, you’re too far ahead” and “put your bottom away, nobody wants to see that”. All pretty normal for a toddler, right? Except he isn’t a toddler, he was 6 in April of this year. He also has an Autism Spectrum Disorder diagnosis. This year I also got diagnosed with Coeliac Disease and my youngest son has issues with hypermobility, however he proved his physiotherapists wrong and started walking this year just before he turned two. Unfortunately his Geneticist found he has a heart murmur and has referred him to a cardiologist, we should know more about that in the New Year. Medically, this year has been an eye opener, at least we are better prepared for what the future may hold.

    The biggest shock to me was how much I missed working. I knew I liked my job and I also knew I was good at it, however I never thought that being employed was such an important part of my identity. I have recently started doing some freelance work as I needed to do something to protect my mental health as I had felt like a drain on society since I stopped working full time and felt like I had lost a big part of who I was. I don’t, however, make money from it.

    I also realised early in the year that throughout my adult life, I had changed myself to be the person I thought everyone else wanted me to be and I knew I had to make big changes in order to start bringing myself out of the depressive cycle I had been in since I was a teenager.

    The first step was being completely honest with my husband about how I felt, including informing him I didn’t think our relationship was going to work. I’m not going to dedicate much time in this post to the separation, however I am grateful that we have come out of the other side amicably, I would consider him a friend. There were very low points during the transitional period, particularly when I felt like an awful person for not wanting to be with him when he still wanted to be with me, however he has met someone new and I wish them all the happiness in the world. He deserves to be happy, as do I.

    At around the same time, I spoke to my mum about my childhood. I feel we now have a much more open relationship than we ever had in the past, although I still very much revert back to a child-like state around her. I also went back to my GP to talk about how low I was feeling, they increased my dose of antidepressants and referred me to Primary Mental Health, who did precisely nothing.

    During the separation and the period of talking about the past for the first time in many years, I started self-harming for the first time since in many years. I would cut or burn myself on my arms as a way to release some of the pent up emotions, and to also make sure I could still feel something other than sad and despondent. At this point, I lost many of my friends and family members who couldn’t handle me at that time. While I appreciate everyone has their breaking point, these were friends of over a decade, “best friends”, the godparents of my children, the bridesmaids from my wedding (okay, I know that the marriage didn’t work out, but you understand how close we were). There are a list of people who this time last year I would see nearly every day, who have completely disappeared from my life. I have been blocked on social media, texts are not answered. Tonight, at midnight (or there about) will potentially be the last time I attempt to contact them. I will wish them and their families a happy and healthy new year, and if I still don’t get a response, I will give up and stop allowing myself to ruminate about what went wrong and get on with my life. (Although I also know that’s easier said than done.)

    Having said that, I have also met many wonderful people this year all thanks to me meeting up with the most amazing person in the world. I knew him from school, life happened and we didn’t see each other again until 2013 at a mutual friend’s wedding. We reconnected on social media, although this year, in around March, we re-met for coffee and quickly became best friends. He has saved my life on more than one occasion and has been, and will continue to be, my most favourite person on the planet. Thanks to him I have seen live bands performing for the first time since I was in high school, I discovered Aeropress coffee and started to have private counselling for my depression.

    As he is so awesome, he also knows a lot of awesome people. Throughout the year, these people have transitioned from being acquaintances through my best friend, to being my friends. They have welcomed me into their lives with open arms, are funny, kind, honest and more supportive than people I have known for years. This year would have been unbearable if I didn’t know them. Unfortunately, two of the friends I met through my best friend I have also lost within the year, I obviously haven’t quite cracked this “people liking me for who I am” malarkey just yet, however I’m sure with practice I’ll get better at it. I’m not saying I expect people to never call me out on my wrongdoings, in fact, please do call me out on them so I can learn from my mistakes and grow as a person, however the two people in question did the same disappearing act my long-time friends did so nothing can be learned, nothing can be changed, I am in the dark with only my rumination to keep me company.

    Due to the separation, my ex and I sold our marital home and I moved to another area of Cardiff to live on my own (with the children) for the first time ever. While I still love having company, I have realised this year that I am more than capable of being on my own, I don’t need people I want people. They are two completely different things and I’m glad I can now make that distinction. I will admit, however, this is a very recent realisation. I struggled greatly with the transition to single life, missing the knowledge that there was someone else in the house. It was due to missing a presence that I got my cat. He is both lovely and evil, he has a Jekyll and Hyde personality and I wouldn’t trade him for the world.

    I started to fill my evenings with hobbies, mostly reclaimed from my youth. I started playing computer games again. I soon realised that gone were the days of DOS and Duke Nukem 3D, no longer was Doom (the original) an option and Tomb Raider had received a major facelift! With a lot of help from my best friend (and parts from my ex), I built my gaming rig and installed Steam, which is both one of the best and worst things I’ve done this year. I love that I’m playing games again, that I can get lost in another world (sometimes for too long, thank you Skyrim), however the Steam sales are dangerous! I now have more games than I know what to do with and need to stop buying until I have played them all.

    I have read more books this year than in the past 10 years combined (this is possibly an exaggeration, however I know I have read a lot). I do, however, find it strange that I did as for many periods of the year I simply didn’t have the concentration span to read more than four pages at a time. I didn’t give up though and have read some absolutely fantastic books as a result. It was thanks to two of these books that two big events happened; I started practicing Mindfulness meditation (although I will admit I’m not very good at keeping up the momentum) and, after going on a dedicated weekend retreat, I had my first fully lucid dream. For anyone who hasn’t tried to dream lucidly, I would recommend Charlie Morley’s book “Dreams of Awakening” and implore you to give it a go. It’s absolutely fantastic and a wonderful way of confronting the deepest darkest areas of your subconscious.

    This year, I also hit one of my lowest points and took an overdose of sleeping tablets. I’m still not entirely sure what my thought process was at the time, all I knew was I was really sad, and desperately wanted to go to sleep. I had intended on taking the correct dose and going to bed, I ended up taking two diazepam and eight over the counter sleeping tablets. I knew that it wasn’t a lethal dose, and that wasn’t my intention in the first place, but still I confessed what I had done to a friend. She called for an ambulance and I was taken for an overnight stay on the poisons unit. Ironically, I didn’t really sleep that night. I did feel drowsy, particularly in the ambulance, but the inability to fall asleep when I’m really sad still won. I knew I couldn’t do anything like this again and ensured I told my counsellor and my GP what had happened. Ironically, even though the psychiatrist I saw in the hospital said it was likely due to me being overtired, overwhelmed and in need of support, that support (from external agencies and/or people who could really help out with having the children more) never materialised. I am very lucky to have friends who help support me emotionally and, when they can, practically.

    2014 was also the year in which my faithful car finally died a death. Thankfully, as all the debt accumulated while I was with my ex had been paid using the house sale proceeds, I was in a position to buy a new one! I’ve wanted a new car for years but was always too scared to buy one. I thought I needed to justify why I wanted one, I felt I had to seek permission from other people, particularly my parents to do it. I have since learned that I don’t need other people’s permission to buy things, as long as I have the money, I can spend it how I choose.

    So, that was my year. It’s been very hard, stressful and eye-opening. The people I have in my life at the end of 2014 saved me this year, one way or another, I owe a lot to them. Thank you from the bottom of my heart for all your support, kindness and time this year, I love each and every one of you.