I find myself in the unique position of facing the challenge of sharing my deeply personal journey, and as someone naturally inclined towards privacy and introversion, I do so not for my own sake but rather to shed light on the struggles faced by others who, like myself, have battled mental health issues. I have been a Psychiatric Out-Patient at St. Mary’s Hospital since April 2020, where I received treatment for Adjustment Disorder, Major Depressive Disorder, Suicidal Ideation, Generalized Anxiety Disorder, and eventually last January (2023), when I was diagnosed with High Functioning Borderline Personality Disorder (HFBPD).
My journey since starting treatment at St-Mary’s has been nothing short of an emotionally, physically and mentally exhausting battle that I would not have been able to get through on my own, nor would I be here today without the help of my incredible medical team (my psychiatrist, Dr. Peters, my OT Katarina, and even Debbie, (Dr. Peters’ Secretary), and today, I’m here to tell you what it’s like living with mental illness, particularly HFBPD.
Before talking about my personal experience, I’d like to give you some background knowledge on BPD & HFBPD referenced from the National Institute of Mental Health, Mayo Clinic, PsychCentral, Psychology Today & Medical News Today.
Borderline Personality Disorder (BPD) is a mental illness that severely disrupts a person’s ability to regulate their emotions and the way they think and feel about themselves and others. It leads to difficulties functioning in everyday life, such as an increase in impulsivity and recklessness, mood swings and interpersonal issues. There is an intense fear of abandonment or instability and difficulty tolerating being alone, and even though people with BPD want loving relationships, inappropriate anger, impulsiveness and frequent mood swings tends to push others away. This classic presentation of BPD involves angry outbursts and obvious and outward self destructiveness.
In contrast, High Functioning BPD refers to individuals who meet the criteria for a diagnosis of BPD but don’t fit the typical profile. They internalize their emotional turmoil, hiding it from others by directing anger, thoughts, and feelings inwards. They maintain a facade of hyper-competence and independence, allowing them to make it through the day with BPD while hiding their turmoil from others. People with HFBPD keep others at arm’s length (therefore appearing cold, distance, or aloof) in a controlled attempt to avoid conflicts and heart-breaking loss all the while suffering their raging storm in total isolation. I like to call this INTROVERTED or IMPLODING BPD, it is absolutely exhausting and distressing to deal with, and this subtype is often difficult to detect if detected at all.
BPD can have devastating consequences, affecting various aspects of a person’s life. It leads to:
- Lack of emotional control and regulation; moods changing with the slightest trigger.
- Reactions that are disproportionate to the reality of a situation and can include depression, anxiety, insecurity, jealousy, anger, paranoia, resistance, and unhealthy attachment.
- Self-injury, such as cutting or burning, and frequent hospitalizations
- Attempted or completed suicide
- Conflict-filled relationships, marital stress or divorce
- Involvement in abusive relationships
- Repeated job changes or losses
- Unplanned pregnancies, sexually transmitted infections, reckless driving causing accidents and physical fights due to impulsive and risky behaviour
- In addition, someone with BPD may have other mental health disorders, thus making BPD even more difficult to diagnose.
People with borderline personality disorder have a significantly higher rate of self-harming and suicidal behaviour than the general population, and not everyone with borderline personality disorder may experience all of these symptoms. The severity, frequency, and duration of symptoms depends on each person individually and how their illness effects them.
Since the causes of BPD are still not fully understood, we only have risk factors to take into consideration that help shed light on the disorder, and although they may increase a person’s risk, it does not guarantee that BDP will develop due to these factors.
Hereditary predisposition and Family History: People who have a close family member (such as a parent or sibling) with the illness may be at a higher risk of developing BPD.
Environmental, cultural, and social factors: Traumatic life events, such as childhood abandonment, neglect and/or sexual or physical abuse, being separated from their parent/caregiver, having parents/caregivers with substance abuse issues, and having unstable, invalidating, hostile and conflict ridden family relationships.
Medications such as antidepressants, mood-stabilizing drugs and antipsychotics, that may help with symptoms and co-occurring mental illnesses are usually provided in combination with Psychotherapy to help manage BPD. The preferred therapy being Dialectical Behaviour Therapy, which focuses on 4 key skills. Distress Tolerance, Mindfulness, Emotion Regulation, and Interpersonal Effectiveness. Mindfulness being particularly helpful, as it increases one’s awareness of the present moment, therefore allowing them to identify, label, and separate themselves from their thoughts or emotions, rather than attaching to and building them up internally. I am currently on a 12-month waitlist to get into this group treatment program.
My Life:
In regards to the contributing factors in my life, I grew up in a volatile home environment experiencing neglect, psychological, verbal and physical abuse from either of my parents and various other family members (although improvements have now been made later in life). My name was not Jennifer, but rather fatso, tub-a-lub and beluga. My mental capacities and physical appearance were constantly picked apart by family members, being criticized over and over, and made to feel embarrassed about my mental “slowness” and sudden weight gain at the age of 9.5 (that I later found out by the age of 24 was due to undiagnosed PCOS and hypothyroidism.) I felt alone, alienated and isolated, and by the age of ten I started having suicidal thoughts, truly believing that no one in my family loved me or even cared for me. I was bullied in school, having had snow, ice and dirt thrown at me (or sometimes even rubbed right into my hair and clothes); I was intimidated and physically attacked, I was called names such as beast, man and Sasquatch, I was gossiped about, false rumours were spread about me and expletive slurs written onto bathroom walls. I truly felt I had no one to turn to and nowhere safe to go.
My harmful thoughts and feelings only progressed the further along I got into my life; struggling with self-esteem and life purpose, finding myself in relationships that would become abusive, fearful while dealing with abusive employers, unable to keep an employment long-term, pushing myself to psychological and physical extremes (to the point of injury and sickness) to prove my self-worth, and disordered eating and self-harm when I couldn’t control what was going on internally or in my external environment. Every single part of me was held together by one thin thread, and I kept repeating these cycles in an attempt to prove to myself that I was smart, that I was capable, that I was good for something, that I was good enough. Not only did the cruelty that I experienced influence how I looked at and felt about myself, but it also influenced how I interacted with others and let people into my life. I was scared of talking with people, with becoming friends with them and with trusting them. I was always terrified that they would see all the same things in me that those family members and bullies had seen in me, that I wouldn’t be able to hide what was so obviously wrong with me, and that they would end-up treating me the very same way.
To this day, these life experiences are extremely painful and shameful for me to talk about, and this is only a fraction of them. When people try to get to know me, asking me questions about myself, I usually find a way to turn the conversation back onto them. Unlike how proud they are to share so many of their positive and happy memories, my memories are all mainly toxic and I wish I could forget them because even now as they come to mind while talking, I can easily dwell and start to ruminate, which can then send me spiralling into a depression that could take anywhere from hours, to days or even weeks to pull myself out of.
The impact this has had on my life has been a delay or even absence in such life experiences as making real friends, traveling, finding my career, getting married, having children and buying a home; often times leaving me to feel unaccomplished, alone, very lonely and not enough to live for.
Recovery:
Like all mental illnesses, BPD is a life-long Disorder, and although most people will improve considerably with treatment, struggles with some symptoms of BPD may always exist. There may be times when symptoms are better or when symptoms are worse, which can be utterly discouraging to deal with. Recovery takes time! Learning to manage emotions, thoughts and behaviours takes time. Learning and applying DBT skills takes time, but treatment can significantly improve one’s feelings about themselves and their ability to function.
Getting a diagnosis has been a relief for me. It has allowed me to understand that there is a reason for my thoughts, feelings and actions. When things get out of control for me, rather than criticizing or blaming myself as to why I can’t handle something that everyone else can, I now know to say to myself that I can’t handle it because BPD causes me to be this way. This understanding helps me stop myself from behaving impulsively and acting on my initial emotions, which also helps me work on my internal critic and irrational thoughts to prevent rumination.
Dr. Peters warned me that because I’m so introverted and used to having to depend on myself, it is easy for me to close myself off from others, however that will only continue to make me feel more isolated and alone, making it even harder to pull myself out of an episode or depression.
In January, my father told me, “You need to change your perspective. Go take a walk.”, and when I responded to him through my tears saying, “I can’t take a walk. I’m too exhausted to take a walk, I’m already crying and I’m going to cry even more if I go for a walk alone. I don’t want people to see me crying.” He pushed me and continued, “Even if you go for a walk around your block. Not far. You just have to change your perspective to help you get out of your mood.” Something so totally against my natural inclination; forcing myself out of my quiet and solitary little bubble, was the largest and most painful step in my road to recovery. I went for a walk that day, right to the corner of my street where there’s a dog park. Probably no more than 5 minutes there and back. I had achieved something I had never achieved before; doing something I would never typically do to help my mental health; pulling myself OUT of isolation, and this was paramount in how I proceeded with my home treatment.
My maternal aunt would check in with me daily either by phone call or text to make sure I was okay, and made it clear to me that no matter how often or what time of day, I had to call her if I was struggling; she is my emergency contact, and she told me not to worry about how exhausting or burdening it might be for her. For two months, a dear friend of mine would call me every single morning on his drive into to work, just to check on me, cheer me up and encourage me with helpful advice and knowledge. Words of wisdom, validating opinion, and references to multiple multiple YouTube videos and streams “I should watch” that taught me how to deal with certain symptoms such as catastrophizing and rumination; techniques that I later discovered were DBT skills.
I couldn’t just be expected to patiently wait for 12 months while I was struggling to survive. I had to take my treatment into my own hands. I became a YouTube and Podcast consuming junkie during my recovery; watching anything and everything that made sense to me and that helped me make sense of myself. On Instagram and Facebook, I started following motivational speakers to the likes of Jay Shetty, Andrew Heuberman, Lewis Howes, and Steven Bartlett, and motivational, inspirational and manifestation accounts, to the point that my stream would be flooded daily with positive and educational messages pushing out any triggering thoughts and forcing me to remain mindful. Since I couldn’t control what people were posting and saying online, I wanted to give myself as much control as possible over what came up in my feed that could possibly trigger me. I got an agenda and I started writing down every single thing I did each day that was positive for my mental health, whether is was the bare minimum of making my bed in the morning, to making sure I ate supper that night. I would write them down in pink ink and highlight them in orange, so that I could open my agenda to any page and see all the work I was putting in to making sure I took steps to becoming healthy.
My recovery hasn’t been perfect. I still battle internally to share what’s going on with me, because I don’t want to burden and overwhelm anyone with my thoughts and emotions, I don’t want anyone to be scared of me, and because I don’t know how to explain that I can be seemingly “fine” one day but then in tears and calling TRACOM crisis line the next. The shame that I feel for being this way and the embarrassment when others find out, I just want to hide from everyone so no one ever finds out, gives me uncomfortable looks or makes comments that are too uncomfortable for me to deal with. The stigma is REAL. The prejudice is REAL. I still get discriminated against whether it’s knowingly or not, by friends, family, colleagues, employers and strangers. At times it leaves me wondering if being more open is really worth it; it makes me want to retreat back to my old ways, but I have to remind myself of the progress I’ve made, because I worry about how difficult it is for others in similar situations to mine.
Life Regrets:
It is said that we shouldn’t regret anything in life. Every experience, decision, and encounter is meant to teach us valuable lessons and guide us along our predestined path.
I understand that I shouldn’t have regrets, but as someone with a mental illness, my brain continually reminds me of my mistakes, missteps, failures, and regrets. These reminders can be fleeting moments or intense feelings. Sometimes, they trigger paralyzing bouts of depression, while at other times, they create a bombarding stream of thoughts in my mind, even while I may appear to function normally on the outside. From obsessively dissecting past conversations, to my parents divorce and my upbringing dictating my decision to not get married or have children of my own.
I can’t change what has happened, but I have now learned how to be forgiving towards myself about these things because I was doing the best I could while dealing with an undiagnosed mental illness. Despite this understanding, the struggle can still be overwhelming. When negative thoughts and emotions are triggered, I never know how things are going to go for me; I apply my DBT skills as much as possible even when they force me out of my comfort zone, I hold onto myself tight, I tell myself I just have to make it past this, and I weather the internal storm.
If my openness about my private struggle can help even ONE person who feels hopeless, like they’re falling to pieces or like they’re on the verge of taking their life, my struggle and my regrets have now become a blessing because what I’ve gone through is no longer in vain, but can serve as tools to offer insight, education, and guidance to others and shine a light on the often stigmatized realm of mental illness.
@jasontylermclean posted a video to instagram, and in his video talking about suicide. He said, “If you thought about ending your life this year and you didn’t, your courage deserves to be celebrated. Surviving when you want to give up is one of the hardest things to do.” I immediately bursted into tears because I have wanted to give up since 2019. I ended-up at St-Mary’s because I wanted to give up but I’m trying not to. He continued, “Even thought you might not feel strong, you are one of the strongest people in the world. I am tremendously proud of you. I am so happy you are still here. I hope the heavy thoughts become lighter. You deserve to feel peace. You deserve a better life. You deserve to be alive… You are not alone”.
No one has suicidal ideation or decides to attempt suicide because they they think it’s a normal belief to have or decision to make. No one actually wants to have that feeing inside of them; there is so much shame tied to it because we inherently know it’s not okay to have those feelings or beliefs. It is a sickness. When someone has suicidal ideation or attempts suicide, their brain is working against them, convincing them to think that way regardless of how hard they try to fight it.
Thank you for taking the time to read my very personal story. ??
Jennifer
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