Cognitive dissonance

In music, consonance is when a chord or progression is pleasant to hear. It is harmonious; it sounds nice. On the other hand, dissonance is associated with unpleasantness and instability. Dissonance is perhaps when a pianist makes a mistake and accidentally hits the wrong notes. The sound is harsh and jarring.

Similarly, the term “cognitive dissonance” refers to the uncomfortable feeling we get when our beliefs do not align – when they are not in harmony with each other. Individuals that tend to think in extremes (black and white thinking, idealization/devaluation, etc.) may do so in order to reconcile their cognitive dissonance. In BPD this may occur in the individuals unstable sense of self or relationships.

For example, an individual who has the habitual belief that they are worthless or unimportant may experience cognitive dissonance when receiving compliments or while experiencing success. Their beliefs about themselves are being challenged and this makes them uncomfortable. One way the individual may try to dissolve this discomfort and sticking to their beliefs is to tell themself that these compliments were untrue or insincere. “They didn’t mean it, they were just being polite”. Another way that the individual may try to rationalize their beliefs is by downplaying their success. “I got lucky. It wasn’t that hard in the first place. Given my situation, I probably should have done even better than I did”.

These thoughts may temporarily dispel that cognitive dissonance, but the individual will experience the same discomfort again and again. The BPD individual who sees themself as “all-bad” will struggle to change their thought patterns that have been so deeply ingrained into them.

Another example is when an individual is in a relationship (platonic or otherwise). Individuals with BPD are likely to experience idealization/devaluation in their relationships, meaning they may switch suddenly from seeing their friend or partner as “all-good” or “all-bad”. Perhaps a friend cancelled plans or did not respond in a way that was expected. The BPD individual may turn to devaluation and perceive their friend as being a terrible person. They may believe their friend hates them or is trying to avoid them. However, there may be underlying discomfort because there are many other times where the friend has shown loyalty, trustworthiness, and love. In order to remove this incompatibility, the BPD individual may experience “tunnel vision” and block out any past positive experiences with the friend.

If experiencing cognitive dissonance as above, here are guidelines that have worked for me personally.

  1. Observe the discomfort. Write down the thoughts you are having. Acknowledge the judgements and assumptions.
  2. Look at the facts. Next, write down any factual evidence that supports or disproves your thoughts. Remember: facts are facts. Facts are not “probably’s” or “maybe’s”. Facts are not judgements or assumptions.
  3. Compare the thoughts and the facts. Do they align? If they do not, reconsider other possibilities.
  4. Express gratitude or acknowledge achievements and successes.

Further reading: How Cognitive Dissonance Relates to Relationships

Reconciling identity disturbances

Before yesterday, I hadn’t written in almsot a month. Partially because I have no internet at home, but also because I’m typing out long posts and then deleting them when the perfectionist in my head starts pointing out every single flaw. I’m frustrated because I can’t seem to find the words to convey my thoughts when normally it comes very easily to me. Writing was my thing – I always thought I was a good writer, but recently I’ve been really struggling to communicate my ideas.

When I first moved, I made sure to take care of my health. Being physically active was very important to me, so I was at the gym almost every day. My friend here remarked how fit and active I was (jokes on her!). Last week I was bouldering and found myself so fatigued I couldn’t even make it halfway up the wall. And it suddenly wasn’t fun anymore.  I also had a cough that lasted for about two weeks, so I would also be coughing so much I couldn’t properly breathe at times.

I am studying nutrition, so I recognize the importance of good eating, but I also feel the need to fill the role of a “nutritionist” sometimes. I cooked homemade meals every day, I packed healthy snacks, and I made sure I ate at least three meals nicely spaced out throughout the day. Recently I’ve been so busy, I’ve barely had enough time to buy groceries or cook. I’m so tired I’m scrambling to feed myself, and as a result I am grumpy and sluggish.

These areas that I identifed with are currently damaged. How can I be “fit” or “healthy” or “a writer” if I am unable to do any of these now? An unstable sense of self or identity disturbance is considered a core characteristic of BPD. In general, I don’t feel like this is a characteristic that applies to me, but I do struggle sometimes with identity. One way that my therapist suggested I reconcile these difficulties is by identifying with traits, rather than roles.

Many of us, BPD or not, often define ourselves by our roles. This is why relationships can be so dangerous. My identity becomes “so-and-so’s girlfriend”. This is why I know I can’t be in a relationship right now, because I get sucked into that illusion of an identity. What happens when we break up? Who am I then?

I am proud to call myself a student and also a teacher. I am also compelled to define myself as a student and a teacher. Those are roles, though – they are not who I am. What happens when I graduate? What happens if I am no longer offered a teaching position? Who am I then? Instead, it is better to think of the traits that led me to be so successful in these roles.

I carry the role of being a friend, a sister, a person to lean on. But that is not who I am. I am empathetic (too much, sometimes), I am loving, I am protective and I am loyal.

I carry the role of being a teacher and a student, but that is not who I am. I am curious, I am creative, I am a problem solver.

I carry the role of being a writer, musician and someone who tries to be physically active and healthy (not always the case). But sometimes I sink and don’t have the energy to bring myself back up. Sometimes I can’t be a good writer. Sometimes I can’t get out of bed, never mind going to the gym for a good workout. Sometimes I don’t have the will to leave my house to get groceries to cook something healthy.

The thing is, I don’t write, cook, and workout because those roles have to define me. There’s a reason why I write, play music, stay active, and eat well – I want to recover.

I am determined.  I am strong. I am resilient.

Vulnerability factors

I am doing research abroad for half a year and I can honestly say I’ve never been happier. I left all the bad memories and baggage at home and have started over. I know this is only temporary and I will return, but I do think that I will be more at peace when I return home.

Since I arrived here, I have been happy and there has been no need for me to practice my DBT skills. After a few bumps in the road including a misunderstanding with a friend, I had some reality slapped back into me. Even when I am doing well, I still need to practice those skills. Even when I feel like I am at peace and I am “cured”, I still need to have those coping mechanisms in my back pocket.

Now I’m getting very busy with my project, and I need to take care of those pesky vulnerability factors again. For me, I need to focus on 1) eating; 2) sleeping; 3) moderate caffeine consumption; and 4) staying hydrated. Sometimes it is not possible to eat regularly with the nature of my work, and at the end of the day I feel really awful and hopeless. But all I need to do is have a good meal.

BPD is almost embarrassing in that way. Not only do I react enormously to the smallest social interactions, but I also am very sensitive to things like hunger and sleep deprivation. I joke about how “hangry” I get, but it’s something that I actually feel quite embarrassed about. Like most things regarding my emotions, the difference in my affect is like night and day.

This is something I need to be very careful of. I don’t always feel an intense urge to hurt myself, but there are little things. I don’t care about my well-being. It’s a slippery slope.

Psychosis 

Possible trigger warning – painful imagery, descriptions of injury

I was riding in the car with my family on our way to a Sunday lunch. As far as I can recall everything was fine. That’s when it hit me. I had never felt so ashamed and abnormal. I felt like a freak.

A thought crossed my mind, completely randomly. You know the feeling of having a papercut? I can’t describe it because that means I need to think about it – but I’m sure everyone’s experienced one. I thought about a papercut, but across my eyes. I winced and closed my eyes.

It was like intrusive thoughts on steroids. It kept attacking me. In mindfulness, we are told to accept these thoughts and let them pass, but these thoughts were different. I could actually feel it. I could sense the pain and felt the recoil and response a body would have to being cut.

The thought of cutting my face and small cuts against my eyes kept appearing in my brain and I felt every single sensation. When I closed my eyes, I felt something pierce through my eyelids into my eyes.

My dad stopped the car, and my mom took my sisters into the restaurant. I was sobbing and screaming, “make it stop, make them go away!” When the thoughts passed for a while, my dad and I joined the rest of my family. The thought would come in and I would shudder and wince very obviously. I must have looked insane. I felt insane. I was insane.

I ran back to the car early so I could curl into a ball. I screamed and yelled but it wouldn’t stop. How do you make something go away that is in your head? How do you get away? You can’t.

This went on for 3 days. That’s not very long, but it felt like an eternity. Was I ever going to be normal again? My parents didn’t know what to do. I didn’t know what to do. I just kept clutching and scratching at my face, trying to get the sensation of blades running across my face off. When my hands went to close to my face, I felt the sharp burning across my hands, so I recoiled. I was banging my head against walls. I was pacing in circles squeezing and hitting my head with my hands. I was humming loudly so my brain would register another sense besides pain.

All those horrible depictions of mental illness and psychosis you see on tv was my reality for those few days. You see people screaming and hitting themselves and scratching away at their face and it’s horrifying. You think it’s horrifying to watch? It’s even more horrifying to experience.

It hasn’t happened again since, but now I have a wider understanding of what others may go through. I can’t imagine going through that every single day. I don’t think anyone could.

I always say this: people with mental illnesses are having normal reactions to an abnormal situation. If any “normal” person was hearing voices, feeling sensations that weren’t there, or having visual hallucinations, I don’t think they’d fare too well either.

Where I went wrong/ A girl on fire

Where I went wrong:

  1. I wasn’t open and honest because I was happy and didn’t want to risk losing anything. I knew there was a really good chance it would blow up in my face, but I opted to deal with the consequences later. I forgot that I don’t quietly implode. I’m a ticking time bomb and everyone around me is hit by the shrapnel. That’s really the main thing.

If Borderline Personality Disorder (BPD)  was a person, I would say they are extremely clever and cunning. Really, everything just works out perfectly in their favor. (Note: I am not blaming my actions on BPD. They are still my actions. But my emotions and thought processes are due to some fucked up circuitry in my brain, and I still haven’t quite figured out how to handle them.)

I have real, valid, understandable worries and fears that are amplified beyond comprehension to others. Does anyone watch Community? There’s this one scene where Troy is brought into a secret initiation into Air Conditioning Repair school. The room includes ridiculous figures such as an astronaut cooking paninis in one corner and “black Hitler” in the other corner. This is to ensure the potential recruits don’t tell anyone about the school, and even if they did, it would be too ridiculous to believe anyway.

That’s what I feel happens to my emotions. At the seemingly smallest events, I react enormously, to the point where others think I am being childish or purposely difficult. And then the emotion dies and I’m 100% reasonable and calm. Absolutely ridiculous.

I have talked about stigma that we carry, including being ‘crazy’, ‘manipulative’, and abusive. I don’t intend to do so, but I do come across as being all those things. I hope you all don’t think that I think I’m a perfect shining example of recovery and strength. I certainly have moments of great improvement, but I’m far from perfect.

You say I’m self-centered, manipulative, controlling but I’m really not. Well, no, I suppose I technically am self-centered because I am so extremely preoccupied with my issues that I forget that people around me have problems too. Though, when we think of a self-centered person, we think of someone who doesn’t care about others and who thinks they are entitled to all your time and attention.

I hope you know in your heart that that is not me. I am not dramatically weeping and wondering why you aren’t paying attention to me like some diva. Rather, I am running around like a chicken with its head cut off because my kitchen spontaneously erupted in flames, but as I’m trying to put out the fire, my room erupts in flames, but then I realize I’ve actually been on fire the whole time.

This is why I believe it’s better to talk over the phone rather than texting: it is easy to detach yourself from the person on the other side of the screen, so their demeanor and intentions are all up for interpretation. I get the sense that you might think I’m sitting around pouting and rolling my eyes, when the reality is I’m in sheer panic mode. I am very worried about what you might say next.

It is not malicious and calculated. It is panicked and out-of-control. That doesn’t make it any more okay, I know that, but I think it’s good to understand the nature of the beast.

We can talk about mental illness and how tough it is for the people struggling, but that’s really not the whole picture. That really doesn’t fully capture the devastation that mental illness leaves in its path. I wrote a piece called Termites, in which I expressed my fear of spreading my “disease” around to my loved ones. Honestly, it is not a completely unfounded fear.

I am a girl on fire. I know that I burn everyone I come in contact with; some more severely than others. I cannot expect my loved ones to hurt just because I’m hurting. When the fire temporarily dies down, I’m left aching and raw, and as the smoke clears from my vision, I can see the damage I’ve caused. I’m sorry I burnt you, I really am. But please don’t forget that I was hurting too.

You might think I’m a manipulative, cruel, monster, but the reality is that I’m a good person who is struggling and in immense pain. The reality is I’m still hurting you, another genuinely good person, and pulling you down with me just because you cared enough to lend a helping hand. I get a sense of burning guilt and helplessness as I watch the situation unfold. I can’t ask you to stay with me or change in any way. In the end it is my struggle to deal with.

I am hurting and hurting others, but people still stick with me. This is a bittersweet realization. Thank you for burning a little bit with me. Thank you for telling me you need space. Thank you, and I’m also very sorry. This is advice I know you’d give me, so I’m going to give it back to you. Please don’t stress over me; first and foremost, take care of yourself.

We set the wrong course
and headed due North
That’s where we went wrong

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The lotus flower 

The lotus flower is sacred to many cultures and religions including Buddhism, which is what dialectical behavior therapy (DBT) is heavily influenced by. We see the use of the lotus flower becoming more popular – tattoos, yoga studios, jewelry etc. Why is it such a revered plant? It has to do a lot with the context that it grows in.

Lotus seeds plant in the bottom of shallow, warm, murky waters. The plant grows upwards towards the surface, seeing nothing but the muddy waters around it. Despite being surrounded by nothing but this dark, ‘impure’ environment, the lotus plant flowers above the surface of the water, in vibrantly beautiful colors. The petals rise above the water, and are hydrophobic – meaning water slides right off of them. They bloom in the morning towards the sun. They are resistant to cold, so they don’t bloom in winter. However, they always return when the weather is warmer. 

We too can be like the lotus flower. We can grow to be beautiful and bright despite our pasts. We can interact with but still be separate from our emotions, letting them slide off our petals. We may wither in the cold, but we can be resilient enough to return in better weather.

Scientists against stigma!

I have no training in neuroscience from my undergraduate degree, so it was probably a little ambitious and maybe also a little stupid of me to add a neuroscience component to my PhD dissertation. Luckily, my supervisor is a superstar and I have excellent mentors (psychologist and neuroscientist) on my supervisory committee. The only reason why I’m surviving at all is because I have a personal interest in my topic. I have been diagnosed with borderline personality disorder (BPD) and depression, and it’s made my life pretty difficult at times, so I’m trying to understand it and tackle it from within.

I’ve said it once before and I’ll say it a million times: the best weapon against stigma is education. I really believe that studying the development of and the internal workings of mental illnesses and certain behaviors can be that weapon. Individuals suffering from mental illnesses hear it all the time from people who are healthy. Just get over it! It’s all in your head! Everyone else goes through tough times, just suck it up! I personally think these people need to learn a lesson or two in empathy and respect, but if we can’t convince them otherwise, maybe hard, scientific evidence can.

Now that I have a bit of a better understanding of the brain and processes of behavior, I’m a lot more forgiving towards myself. After an emotional outburst or a depressive episode, instead telling myself I’m weak, stupid, or crazy, I’m a lot more understanding. While understanding the chemical and biological processes behind the mental illness is important, this does not mean you surrender all responsibility for your behaviors and actions. Oh no, I think this gives you even more responsibility. I like to think of myself as an exasperated mother or an owner to a bunch of particularly rowdy dogs. Like, ‘well crap, my amygdala is acting up again so I’ve gotta go take care of myself until it calms down’. Or, ‘my medial temporal lobe is being a little brat and refusing to make neurotransmitters, so I’m gonna go refill my prescriptions’.

Other sciencey ways I use to validate myself that amuses me include:

  • Being exasperating with my limbic system
  • Thinking, that the amount of pro-inflammatory cytokines and cortisol pumping through my blood must be through the roof
  • “The cognitive distortion is real af today” (credit this one to my sis)
  • My mind is ruminating, brb as I calm it down
  • Hang on, I’m trying to listen to what you’re saying but anxiety is being a little shit and screaming at me, so why don’t we talk later
  • Yes, yes, depression I know you think I have no friends and I’m worthless, you tell me only all the time but can you just sit down it’s getting old
  • Oh come on, we’ve been through this! I’m counting to 3 and you’d better come back here. *indistinct grumbling* (as I watch my mind jump to conclusions)

I’m not saying you should always just downplay your pain and brush it off. I still experience the extreme emotions/pain and suffer, but this just helps me get through it a little more. Keep pushing and fighting back, everyone 🙂

Related reading: The Neurobiology of Borderline Personality Disorder

Idealization/devaluation

This post is dedicated to you. Not the post you probably even wanted, but it has the explanation you deserve.

In my last post I explored my tendency to resort to all-or-nothing thinking. I am aware that this is a huge problem I have and am usually hyper-vigilant about it. The problem is, I will either drift off into either extreme (which is still better than racing there full speed) or I will become overwhelmed at times, thus reducing my ability to regulate my tendency to split.

Here is a recent example of this. Idealization and devaluation are common defense mechanisms in individuals with BPD.

From the day we met, I was very careful not to let myself fall into this cycle with you. And I was doing a great job, considering you consistently challenged everything I had previously known. There are countless instances where I braced myself for the worst and nothing happened. So really, your biggest character flaws here are:

  1. Not being so insecure that you have to put me down
  2. Not being so insecure that you feel entitled to have control or power over me
  3. Not playing games and
  4. Not taking me for granted.

In other words you were a decent human being. How dare you.

I was really worried I would start idealizing you while you were here, but I can honestly say I didn’t. I will give myself props for staying level-headed. Whenever you proved another fear wrong, I truly appreciated it, and tucked it away to create new positive memories I could look back on. This whole situation was so encouraging because it showed me that all my hard work I have put in for years was paying off. It also showed me that good people do exist and that I should never accept anything less ever again. 

Then you left. No matter who it is, I always take goodbyes very hard. This goodbye was definitely extra difficult, though. After you left, stress started piling up slowly but steadily with school, other friends, people reappearing from the past, and my health. 

I had also been preparing to move overseas (which will be in less than a week). It will be the first time I will live away from home, my family, my support system. Sure, I’m only gone for 6 months, but understand that that is a really long time to go without therapy and support. I relapsed and overdosed last week, and this made my stress about moving skyrocket even more. I’ve been given this opportunity that will be amazing for my career, something that I’ve dreamed since the start of my graduate studies. I didn’t even think it was a possibility until after my PhD, and even then I was doubtful. But here I am, in my first year of being a PhD student, being given my very own project with this lab I admire so much as part of my dissertation. Despite all of this, I sometimes seriously consider backing out and not going because I don’t know if I will be able to make it.

Before, your validation was like a little treat. I didn’t need it, but getting it was always nice. When I began drifting back into a depression, I clung to anything that could lift my mood. 

I started thinking of you as the most amazing person who could fix everything and anything. I’m not trying to downplay how much you have supported me, my point is I was starting to rely on you too much, which is something you had noticed and pointed out too. Talking to you made me feel better, getting a message or one of your stupid snaps made my day and distracted me from the other stresses. All that hard work I had put into trying to prevent idealizing you was out the window.

My expectations of you had become too much by this point. I relied on you too much. And then things that never would have bothered me before became overwhelming. If you didn’t respond in a way I expected or didn’t respond at all, I was thrown right into devaluation – and I did not land gracefully at all. That’s it, he hates me, he’s horrible, he doesn’t care about me, I never want to talk to him again. This would happen multiple times in the span of a couple days. Sometimes you would be my favorite person ever in the morning and by night I was convinced I was through with you forever. 

The last straw was the day that I stumbled across the fact that you were connected to a painful piece of my past. What are the odds? My handle on the idealization/devaluation scale felt shakier and a lot more out of my control.

After this, everything became more confusing and tiring. My emotions became so big and out of my control, I felt like I was being whipped around incessantly. With each flip, I was hit harder and harder. It’s tough for me to know what to do when I feel such extreme emotions on both sides of the spectrum. It’s difficult to know how to weather the storm once I’m already caught up in the middle of it.

Eventually the painful moments overshadowed the good and I decided I had had enough. I cut our connections and told you I didn’t want to be your friend. My perception of our relationship was skewed because I was so overwhelmed, so tired, and I just wanted the pain to stop. I said a lot of things that were true but worded harsher than they needed to be. I said some things that echoed how I was feeling at the time, but definitely not throughout the majority of our time knowing each other. Honestly, I believed I would never talk to you again and after distancing myself I felt better. Then 12 hours passed and I realized that was not what I really wanted.

I considered everything we talked about and realized I had done that thing where I drifted off and started subconsciously splitting. I reevaluated and changed my expectations back to where they were initially. In the previous link, see the list of words that indicate splitting:

  • Always
  • Never
  • Impossible
  • Awful
  • Perfect
  • Ruined
  • Terrible

I think I said ‘I don’t think we were ever on the same page’, which is essentially another way of saying ‘never’. Other than that I think I did an alright job of not using too many dramatic words.

I think you’ll understand that I’m not asking you to condone my behavior – I want you to understand what was happening behind the scenes. I want you to know that I’m grateful for friends like you, who call me out and make me realize when I’m being unreasonable. These are the people who push me to become better.

Before, I was rambling and asking why you’d want to be my friend. Asking, ‘what have I ever done for you?’ I intermittently have these moments where I feel completely indebted to my friends because it feels like they are saving me and making such a big impact on my life, whereas I feel I do little to nothing for them.

In the end, I know that other people can’t save me or fix me. Any progress is my own doing; a result of my own hard work and resilience. And out of big moments of crisis and pain like this one, emerges a smarter, wiser, more determined version of myself. I am doing my best to build myself back up. There are people who love and care for me, and when I am in a healthy state of mind I definitely do not forget this. This has been a particularly large bump in the road, but I’m getting back on track. I will not make the same mistakes again. I would like things to go back to the way they were, and this time I’ll know how to diffuse the situation if things go south. However, I’m afraid that the damage has been done, so I will take a deep breath, back away, and give you (and I) some space.

Stigma hits like a ton of bricks

Warning: mentions of self-harm and suicide

Stigma surrounding mental illness can lead to devastating  consequences. People have lost their jobs, been shunned by their loved ones, or abandoned. Me, being as naïve as I was, thought that stigma was mainly an issue in the general population. Silly me, thinking that doctors would be trained in treating various medical problems in an unbiased manner.

2 years ago, I was woken up by my mother one morning. She told me that my cousin and best friend (basically my sister) was in the hospital because she had attempted suicide. Fortunately, she got the help she needed. I was angry. Really angry. Not at her, of course. Angry because this was another reminder of how things could have gone for me, if the stigma wasn’t there.

Similarly, about 5 years ago, I also landed myself in the hospital. When I finally got to see a doctor, the first thing I remember was him asking general questions about my life and how I was feeling. He seemed a little rushed and abrupt, but still nice enough. I was already on edge, and feeling uneasy. I remember thinking, there are actually people dying and seriously injured and I’m wasting his time. I need to get out of here. Why am I even here?

He asked me if I had an “official diagnosis.” I told him I was diagnosed with depression… oh, and also that other thing – borderline personality disorder. The second that came out of my mouth, I knew something was wrong. I froze over as I watched his demeanor completely change. He gave me a smug smile that will unfortunately always be branded into my memory and asked, “do you agree with that diagnosis?”

Excuse me? I was completely taken off guard, I didn’t even expect being asked that. I didn’t even really know much about it. When I was initially diagnosed, I latched onto the diagnosis of depression because I knew what it was. So truthfully I didn’t know much about BPD. I didn’t even know what stigmas were associated with BPD.

When I gave him a hesitant “yes”, he began interrogating me. “Are you sure? Do you even know the symptoms of BPD? Do you agree with the diagnosis?” I just kept saying yes, hoping he’d let me go. He laughed. Then he said, “huh, that’s really funny. People with BPD usually don’t agree with their diagnosis.”

At this point I was overwhelmed and confused and I was sobbing and I kept saying to him, “why are you saying that?! What are you doing? Do you think I’m lying? What do you want me to say?”

He called me melodramatic. He downplayed my self harm scars. I felt trapped by this doctor, who seemed to want nothing more than to prove that all my problems were trivial.

I don’t even know how long I was there, but by the end I felt like I had aged. I felt a little more weary, and a lot more broken. At the end he knelt down so he was eye to eye with me, and said, “now, we aren’t going to see you back here again right?”

No. I’m not coming back next time. Next time I’m suicidal I am definitely just going to kill myself. That’s for sure.

And that’s what I really felt. The hospital was my last resort to save myself and this interaction proved that people like me, people with BPD, apparently do not deserve that treatment. Thank goodness my parents arrived. Thank goodness they are as supportive as they are. Thank goodness they acted quickly and put my mental health first. They hid away all my pills and sharp objects. They watched me day and night. I am so grateful.

After this happened, I immediately began researching more about BPD. I found so many heartbreaking posts. “Borderline Personality: The Disorder That Doctors Fear Most” published in TIME magazine. Individuals with BPD are “manipulative” or “drama queens”. They ruin the lives of everyone around them. People in relationships with them need to be saved. They are lost causes that can never be helped.

Borderline personality disorder (BPD) is often viewed in negative terms by mental health practitioners and the public. The disorder may have a stigma associated with it that goes beyond those associated with other mental illnesses. The stigma associated with BPD may affect how practitioners tolerate the actions, thoughts, and emotional reactions of these individuals. It may also lead to minimizing symptoms and overlooking strengths.

Source: Borderline personality disorder, stigma, and treatment options. Aviram et al., 2006.

There has been incredible progress over reducing stigma surrounding depression and anxiety. There are a lot of people speaking out, celebrities and role models speaking out. But we don’t have that for BPD. I don’t have someone I look up to who has gone through BPD. Whenever I read on forums where people discuss relationships, do you know how disheartening it is to read comments like, “what a fucking psycho, she definitely has BPD”?

Like I said before, when I looked into my BPD diagnosis, a lot of things fell into place. I was mistreated because the doctor made assumptions about me, my motives, and my character based on the stigma surrounding BPD. These stigmas are not me. But because they exist, I was stomped on by a healthcare system that was supposed to save me.

Depression and that other thing

Warning: mentions of suicide, self-harm. 

Disclaimer: I am expressing myself creatively here, but I want to make it very clear that I am not romanticizing mental illness or self harm. 

What if I told you I have been diagnosed with an illness that kills up to 1 in 10 of patients? That’s an alarming statistic. If I told you it was some sort of congenital disease or cancer, you would see me as someone who is a fighter; someone strong and determined. Unfortunately, it’s a mental illness and apparently we don’t care about those as much. Unfortunately, my illness is so lethal because it drives patients to complete suicide. Unfortunately, no one cares like they would if it were a physical illness.

I feel like I’ve always had this eerie aura following me around as long as I remember. When I was 7, I would lie in my bed and worry about people who were sad or suffering. I cried because all I wanted was to be able to take everyone’s pain, hide it inside of me, and disappear. When I was 12 I would write exams or finish projects and wonder, what’s the point of this? I’ll probably kill myself before I graduate high school. I went through a large part of childhood waiting for my inevitable suicide. It was almost like a weird ironic safety blanket I always held with me.

Through high school and university, the blanket became larger and larger until I realized I was suffocating. The depression became less of a wave in the background of my mind and more like sharp, jarring lightning bolts. It was an exhausting roller coaster, to say the least. Some days I would be overcome with intense suicidal thoughts for an hour, sometimes even less, and then be perfectly fine after. The lightning bolts were so intense and fast that I didn’t even have time to figure out a coping mechanism. All I could do to cope was numbing and dissociating. The lightning became more intense and more frequent. I had panic attacks in fear that I would be struck at any moment.

The lightning would disappear as quickly as it appeared, but the numbing and dissociation lingered. Eventually I felt constantly separate from my body. I went from feeling too much emotion all the time to feeling nothing. I started cutting to bring myself back to reality. Sometimes reality would be too overwhelming and then I would cut to distract myself from reality. I kept falling from one lose-lose situation into another. There would be days where I would lay in bed, unable to move, afraid of what I might do to myself.

I was already diagnosed with depression and borderline personality disorder. The latter I completely ignored because I felt like “depression” was a good enough explanation and BPD was never really explained to me anyway. This ignorance didn’t do me any good. I started thinking how this didn’t feel like depression. I tried searching for answers and started losing my mind. I don’t think I have depression. I think I’m just crazy. What the hell is wrong with me?  The answer was right under my nose. Once I realized that, everything fell into place.

Borderline personality disorder (BPD) is a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships. A person with BPD may experience intense episodes of anger, depression, and anxiety that may last from only a few hours to days.

Some people with BPD also have high rates of co-occurring mental disorders, such as mood disorders, anxiety disorders, and eating disorders, along with substance abuse, self-harm, suicidal thinking and behaviors, and suicide.

– NIMH website