Living on the borderline: thoughts on the experience of BPD

This month is Borderline Personality Disorder awareness month - and since its start, I've been trying to write something about BPD. Only whenever I do, the symptoms slip through my fingers and tower in front of me: a big ball of wrongness and fractured memories of questionable authenticity.

This is the nature of BPD. This is why it's a personality disorder. It can't be held at arm's length - unlike anxiety and depression, you can't point at a period of your life or a particular episode and say, "that's borderline." It conditions your every reaction; it conditions how you process the world, how you form relationships, how you formulate reality. It's really hard to put my whole subjective reality into words. So instead, I'm going to use the diagnostic criteria as a guide and expand on what each of them actually means, both in relation to my experience and the anecdotal experience of others.


Affective instability & emotional impermanence 

Basically, this means mood swings. Unlike bipolar, where mood shifts occur over long periods of time, a person with BPD can witness maybe 20 mood changes in an hour. You're catapulted from pseudo-manic euphoria with its delusions of grandeur to immobilising depression to rage to fear, through a whole spinning roulette wheel of unnameable emotions.

Emotional reactions are acute and overwhelming: an embarrassing encounter on the street might throw you into depression for a week; an tiny confrontation might induce suicidality that lands you in A&E; a positive affirmation throws you into euphoria that lasts all day. You are hypersensitive to an excruciating degree. As Marsha Linehan put it, “People with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement.”

Tied to this symptom is emotional impermanence: inability to recall any other emotional state than the one you're currently experiencing. It's only with the help of blog posts that I've been able to see how erratic my emotions are. When you're high, you feel indestructible, almost immortal - there's no way this won't last forever. And when you're low, there's no way out - even if that feeling only lasts for ten minutes. This makes diagnosis really hard, because people tend to present doctors with just their current emotion. It also makes for a lot of "I'm fine!"s followed rapidly by "Oh shit, not fine."
"A borderline suffers a kind of emotional hemophilia; [s]he lacks the clotting mechanism needed to moderate spurts of feeling. stimulate a passion, and the borderline emotionally bleeds to death."

Emptiness


Possibly the most common sentence uttered by borderlines is "I feel so empty". Looking through old blog posts, it's repeated again and again through the years, with no explanation. This emptiness is both emotional ("I don't feel anything") and deeper, concerning a total lack of self, a lack of permanence at your centre. The rocketing emotions, the million different personas, the dissociative clouds - they keep your head busy - but underneath it feels like a black hole. You're not a person; you might not even be real. There's nothing solid, nothing continuous that you can call a self. There's nothing there to love.


Identity instability/impermanence

The issue of impermanence goes beyond fluctuating emotions: identity is also incredibly malleable and frequently changes. Many borderlines find it difficult to consume media without taking on the persona of a character (it's very dangerous for me to watch Twin Peaks or Factory Girl). For me, I have to constantly resist the temptation to relapse into my "crazy girl self", which is the persona I had between ages 14-16, heavily informed by Effy and Cassie from Skins. This isn't a conscious reshaping of your personality to be like a character, it's an actual change, possible because your sense of self is weak or non-existent. We also tend to take on characteristics of whoever we're around- which can make us highly skilled at sensing if something's wrong. However, it's exhausting and disorientating. Many borderlines want to be alone because it's so overwhelming trying to regulate your sense of self around other people, but equally fear being alone because then they cease to exist/have to deal with the emptiness.


Dissociation (+ "transient psychotic symptoms")

last night was bad. i fell into a state that i haven’t been in for some time: crazy, pacing, hyperventilating, rocking back and forth in the corner while ridiculous ideas sprint around my head. all blood and death and darkness and wanting to run, far away from this house, this town, this body. the body that sits there in an almost catatonic stupor, unable to speak, and then twists and furiously mouths the cruelest things it can fathom, jumps up and whips around and breaks things and hurts itself. i speak of my body with passivity because when i’m in that state, i don’t even feel present. i don’t feel any control whatsoever. and when it’s over, my memories are blurred and tinged with a feeling of madness that i don’t like to examine too closely. i have no idea what triggers it or if there is something fundamentally wrong with my brain that makes me act like this.
 i feel like i’m floating, like a foot or so above a body that people describe as me. nothing is real. i just ate dinner and faye is laying out poker chips. i’m waiting to wake up.

These above are blog posts by sixteen yr old me, the first of which describes a violent dissociative episode and the second of which describes depersonalisation. Both of these are common to BPD and happen more often under stress. Last term, I was dissociating almost every day - during one episode, I poured boiling water over my leg. I missed New Years' because I dissociated on top of Primrose Hill for four hours. People with BPD can also experience psychosis, including hallucinations and delusions, particularly paranoid delusions relating to abandonment.

Dissociation can also happen on a lower level that you may not even notice: I've spent months of my life in low level derealisation, not taking anything in, terrified of sensation. Since starting anti-psychotics (magical drugs 10/10 highly recommend), I've realised that I probably spent the majority of my life in this state.


Impulsivity
THE IMPULSIVE BEHAVIOURS OF BPD ALL HAVE COMMON ELEMENTS. THEY ARE IMMEDIATELY GRATIFYING AND ARE PRECEDED BY A BUILDING OF TENSION, WHICH THE IMPULSIVE ACT RELIEVES. THEY ARE USUALLY RISKY, AND THERE IS LITTLE CONCERN FOR NEGATIVE CONSEQUENCES IN THE FUTURE. THEY ARE OFTEN RITUALIZED, WITH A STEREOTYPICAL PATTERN FROM ONE TIME TO THE NEXT. THEY MAY SEEM IRRESISTIBLE, WITH TENSION MOUNTING TO AN INTOLERABLE DEGREE IF THE ACT DOES NOT OCCUR. THEY ARE FREQUENTLY FOLLOWED BY FEELINGS OF REGRET OR REMORSE.- Richard Moskovitz, Lost in the Mirror: an inside look at borderline personality disorder
The diagnostic criteria says: "impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating)". This doesn't include self-harm or suicide attempts, which get a criterion all of their own. This is your basic off the rails stuff. You go out alone at 1am, get drunk, go home with a stranger, take drugs without knowing where they're from or what's in them. You put yourself in danger - probably because you hate yourself and lowkey want to die or just because you don't feel like a real person or maybe because you're verging on manic and nothing can hurt you. And then, because of the whole OTT emotional reactions bit, you spend weeks or months or years in remorse. You avoid people altogether or you hate yourself so much that you go out and do it again, spinning into a self-destructive spiral.


Splitting

You've probably gathered by now that the BPD world is one of extremes. The world is black and white, all or nothing. "Splitting" is a term used to describe what happens when black turns to white or vice versa; when a shade of grey enters our worldview and shatters it. Splitting can particularly impact relationships: when we meet a new person, we tend to idolise them. They go up on a pedestal and become the best person to ever exist. We remake ourselves in their image. And then they reveal a very normal, human flaw - and suddenly they are the worst person in the world, they are irredeemably evil, we hate them and hate ourselves for associating with them. In most instances, this means the relationship gets cut off for good - we draw a line in the sand and move on to the next glorious, perfect person. Sometimes, splitting happens again and again in a relationship, the person ricochetting between good and evil. All of this makes for incredibly unstable relationships, and is the main reason that people with BPD have such a terrible reputation. There's no doubting that we make for difficult partners and friends. But splitting can be improved massively in therapy and it's something I've already worked on a lot since being diagnosed. Just being aware of what your brain is doing can sometimes give you the tools to fix it.


Self-harm and suicidal behaviour, gestures, or threats

Not everyone with BPD self-harms, but enough of us do (
around 70-80% of us, to be exact) that it's become an issue in psychiatry that people who self-harm are automatically assumed to have BPD. Additionally, around 75% of people with BPD will attempt suicide at least once. Between 5-10% of those with BPD complete suicide, making up 7-38% of all suicide cases. [The Borderline Personality Disorder Survival Guide]. Many of these attempts are impulsive, "ambivalent" suicide attempts, where the person seeks to put themselves in danger of dying but not guarantee it. I've overdosed four times, taken myself to hospital three times. Each of these have been responses to being acutely upset and not seeing any possible solution. One of these has been in response to a perceived threat of abandonment.


Fears of abandonment (real or perceived)


This one took a long time for me to come to terms with. None of us like to see ourselves as needy or codependent, and I've always prided myself on my total independence. When I fell over as a child, I would refuse help, determined not to be seen as weak. But I've also been crying and hyperventilating on the kitchen floor at 3am with a bottle of whisky because my girlfriend's phone died and she stopped replying to my messages. I've had delusions that all my friends secretly hate me and been so convinced of them that I've tested them, lashing out at them to see if they'll show their true colours and leave. When my ex-boyfriend went on holiday, I saw it as an abandonment and turned to hating him as soon as he was on the plane.

There are some more symptoms, scattered around and vaguely related to the above. Irrational "rages" are common, as is sensory overload and object impermanence (people and other bits of reality existing a little less when they're not with you). Many people with BPD are torn between feeling like frauds for identifying with the diagnosis - even if professionally given - and feeling like they need to be sicker. Lots of people with BPD don't experience all of the above symptoms, so if you have BPD and didn't relate to one or several, don't worry. This is also v much informed by my subjective experience of the disorder.


There are positive symptoms too: we are highly perceptive, creative, adept at empathy, incredibly self-aware and therefore ideally suited to recovery. Always experiencing the world at top speed can be a gift when it's not trying to kill you, and having an emotional range greater than most people can be glorious as well as dangerous. Impulsivity can bring benefits: I wouldn't have had half the defining experiences of my life without the impulsivity that drove me to move to London at 16 or to book a train to Paris with no money and nowhere to stay.


BPD can be hard and horrible - for the people around us as well as ourselves. But it shouldn't be the case that you can't look for resources to help you manage a relationship with BPD without finding a dozen articles on how to "deal with" your borderline significant other, all of which tell you to abuse them by invalidating their feelings or run away as fast as you can. We are not inherently abusive; 75% of us are survivors of abuse. Personality disorders are not hallmarks of bad people. What they are is complex and in need of more attention. Treatment programs are scarce and underfunded - and the intense stigma around personality disorders allows this to continue.

3 comments

  1. I am fairly new to the BPD dx and these articles explain so much. I also have Bipolar Disorder. BP since a child and I think the BPD is thanks to trauma from my ex-husband. The more I read the more it makes sense.

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  2. It is incredibly important and helpful for people to come forward and describe experiences of living with borderline personality disorder, both to help other borderline folks see the possibility of wellness, and to explain things to non-borderline folks. Thank you for this.

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    1. We're going to have to fight the stigma ourselves if there is ever to be more emphasis on BPD research. Hopefully enough of us will get our doctorates :)

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