I haven’t written much about my diagnosis of Borderline Personality Disorder, even though it’s a diagnosis that means a lot to me. It was hard fought: when my psychiatrist didn’t believe me, I presented him with all the research I could find to prove to him that it was at least worth considering. He both apologised and admitted that he was wrong, and it wasn’t long before he bestowed the diagnosis upon me. It was confirmed later that year when I got my Autism diagnosis.

The name Borderline Personality Disorder is not a clear one. People assume that there’s something wrong with your personality or that you only just have a personality disorder. Both of these assumptions are incorrect. The word ‘personality’ in personality disorder refers to the patterns of thoughts, feelings, and behaviours that are individual to each of us and the word ‘borderline’ relates back to early uses of the label, when it was thought to be a condition ‘on the borderline’ between neurosis and psychosis. Even though that has since been disproven, the name hasn’t changed although that is a popular idea. Suggestions include ‘Emotional Intensity Disorder’ and ‘Emotional Regulation Disorder.’

The symptoms include:

• Intense fear of abandonment
• Intense, unstable relationships
• An unstable sense of self
• Impulsive, self damaging behaviour
• Suicidal ideation and self harming behaviour
• Intense, unstable moods
• Feelings of emptiness
• Intense feelings of anger
• Paranoia or dissociation when under stress

I related to a lot of this: the intense emotions, the fear of abandonment, the shifting sense of self. But on the other hand I’m too anxious to be impulsive or get angry with someone. There were enough connections to keep investigating though and that’s when I discovered the quiet presentation of BPD. Where the classic presentation lashes outward, quiet borderlines internalise, blaming or harming themselves. Their fear of abandonment can make them people pleasers and they struggle with feelings of isolation and loneliness, at a higher risk of depression than the classic borderlines. This discovery changed everything; I related to almost every experience I read and that gave me the confidence to pursue it as a diagnosis.

Despite the considerable stigma around BPD, I’ve had a really good relationship with my diagnosis. After so much anxiety and uncertainty, it was empowering to have a name for my struggles and it allowed me to get the support I needed. I’m aware of how lucky I am to have found the right people but that wouldn’t have been possible without the diagnosis.

Having said all of this, my diagnosis has been causing me a lot of anxiety of late. At the end of a session, my psychiatrist made what was probably, to him, an offhand comment about my collective diagnoses, that I might not need the BPD label anymore. I was too overwhelmed by a torrent of emotion to respond before the session was over – even a short session can take me days to process – but then the anxiety began to sink in. The idea of losing it – this necessary, hard fought piece of my identity – was terrifying. Is terrifying. This label explains a big part of my daily struggles and revoking it would be so invalidating, like saying that it isn’t happening, like my difficulties aren’t significant enough to even earn themselves a name. That thought of that happening is devastating.

The symptoms still feel very present to me. I feel things so intensely; they’re like physical forces acting on me. If I’m happy, sunlight is bursting out of me; if I’m sad, my ribcage is collapsing and I can barely breathe for the pain; if I’m angry, I feel like it’s strong enough to bring down buildings. They crash over me like waves and I’m overwhelmed by this panic to get back to the surface. It’s very stressful. I read somewhere that people with BPD are constantly in crisis and I definitely relate to that. Every emotion flares with life or death situation strength and it happens over and over again. They can swing so violently that it makes me physically sick and it can feel like there’s no solid ground to stand on. It’s exhausting. I also feel the emotions of other people, particularly sadness or pain, and it can take hours or days to recover from them.

“Borderline individuals are the psychological equivalent of third-degree-burn patients. They simply have, so to speak, no emotional skin. Even the slightest touch or movement can create immense suffering.” – Marsha Linehan

I’ve talked about self harm a couple of times on here (here and here) and this is my best description of it:

“One of the biggest things about self harm is the release you get from doing it. My emotions get so strong sometimes that I feel like there isn’t space for anything else in my body, in my brain. There isn’t the space for my lungs to expand; I can’t breathe. It almost feels like the emotion is crushing me and the only way to survive is to open up my skin so that it can escape. It’s like a pressure valve. Once I’ve done it, I feel like everything stabilises and I can think more clearly. If there’s a problem, I can deal with it and if there isn’t and it’s just an overload of emotion, I can take care of myself a little better than I could if I hadn’t.” (x)

Another example of overwhelming emotions…

The fear of abandonment is ever-present, willing or unwilling. The thought of it causes me to spiral into panic so intense that I’m unable to function. Indefinitely. I’m always running, running away from this black hole that’s trying to pull me in. Past abandonments have left me unable to talk or eat or do anything for weeks and it’s taken years to recover from them fully.

I struggle with a deep feeling of emptiness and I sometimes feel like my soul is empty, which feeds into the feeling of having no idea who I am. I feel like I have no real sense of self that’s mine: who I am seems to change according to who I’m with. I take on the traits of others, becoming loud and joke-y with one person and quiet and introspective with another. I don’t know what is actually me. I know small things, like ‘I like flowers with symmetrical petals’ and ‘comedies make me strangely sad’ but I don’t know the big things, like whether I’m a good person or a reliable person or an extraordinary person. If anything, I feel like a child, like I’m stuck as a child while all my friends turn into adults. I can’t cope on my own or look after myself reliably. I feel so intensely sensitive, like I’m too vulnerable for the world I live in and I get too overwhelmed to function properly.

To take this diagnosis away would be to say that this is normal, that I have to just live with it, regardless of the pain it causes me. To take this diagnosis away is to say that I don’t need support and that I should just ‘get on with it.’ That is so invalidating and so upsetting that just writing it brings tears to my eyes. That is why this diagnosis is so important to me and why taking it away would be so traumatic.

All of this is very scary to put out into the world but I feel like the only way to make progress and move forward is to put it all out there and be honest. It’s almost painful, like removing armour that I’ve been wearing so long that it’s fused to my skin and I’m peeling it off with my fingernails. But it feels like the right move. Maybe, in doing this, I’ll start to see change.

“People with BPD are doing the best they can, and they still have to change.” – Marsha Linehan

There’s more information about BPD here and some excellent accounts of Quiet BPD here.