May is mental health month in the United States. It is also borderline personality disorder awareness mnth. BPD is my current diagnosis. I have written a few posts on this condition already, but most required some previous knowledge of BPD or mental illness in general. In honor of mental health month and BPD awareness month, I am going to write about my experiences with mental illness in this post and will share facts along the way.
I have always struggled with rapidly shifting emotions and mood swings. If it had been popular at the time and my parents had sought help for me, I might’ve been diagnosed with a childhood-onset mood disorder. I do not have bipolar disorder or major depression now, but these conditions are thought to affect children differently. In the current edition of the psychiatrist’s manual, the DSM-5, there is a diagnosis for children with severe mood swings, dysphoric (sad or angry) moods and extreme temper tantrums. This disorder is called disruptive mood dysregulation disorder. It is thought not to be lifelong, as it can only be diagnosed in children under age eleven.
I remember as a child of about nine already experiencing suicidal thoughts and making suicidal threats, particularly during meltdowns or tantrums. This is not necessairly a sign that the child is going to attemtp suicide – I never did -, but this is also not just “attention-seeking”. It is, in fact, a sign that a child is in serious distress.
Making repeated suicidal threats or attempting suicide is one of the core symptoms of borderline personality disorder. It is commonly thought that most people with BPD only threaten suicide and “aren’t serious about it”. In fact, however, about ten percent of people with this diagnosis die of suicide.
As a teen, I started self-injuring. Self-injury is also a core feature of BPD. This may have many functions other than “attention-seeking”. Of course, some people with BPD do not know how to ask for attention and instead use self-harm as a way to get it. Even then, attention is a human need and withholding it altogether will not usually solve the problem. Other functions of self-injury may include to express pain, to numb out feelings or conversely to feel something when one is feeling empty or numb.
Chronic feelings of emptiness are another symptom of BPD. Generally, a person with BPD is somewhat depressed or numb. This feeling of numbness is also common with major depression, post-traumatic stress disorder and dissociative disorders, all of which commonly co-occur with BPD.
Dissociation is the feeling of being disconnected from oneself, one’s thoughts or feelings or one’s surroudnings. Symptoms of dissociation, particularly depersonalization (feeling “unreal”), are common in many mental illnesses. The most well-known specific dissociative disorder is dissociative identity disorder, also known as multiple personality disorder. My former therapist, who diagnosed me with BPD, believed that BPD and DID/MPD are on the same spectrum.
Paranoia is also common in people with BPD. However, as opposed to people with schizophrenia or related disorders, people with borderline personality disorder experience paranoia only briefly when under stress. For example, when I am overwhelmed with eotions, I tend to mistrust people and situations, while I am not usually paranoid.
Lastly, people with BPD have difficulties in relationships. Firstly, they often have an intense fear of abandonment and go to great lengths to prevent people from leaving them. Some may push people away (“I abandon you before you can abandon me”). Others, like me, are excessively clingy. People with BPD may also alternate between idolizing and devaluing the people who are important to them.
No two people with BPD or any other mental illness are alike. For a diagnosis of borderline personality disorder, you only need to meet five out of nine criteria. I meet between six and eight depending on how you look at it.
Borderline personality disorder bears similarities to post-traumatic stress disorder, dissociatve disorders and mood disorders, particularly bipolar. However, the difference between bipolar and borderline personality disorder is that people with bipolar disorder experience long-lasting mood episodes, whereas people with BPD have rapidly-shifting moods. BPD cannot be diagnosed in children, although of course they can have mood swings. They may then be diagnosed with disruptive mood dysregulation disorder. Psychiatrists are beginning to diagnose BPD in adolescents starting at arund age fifteen. This is good, because, the earlier someone gets treated, the more likely they are to reach recovery.