How to be Friends with a Borderline (like me!)

Be Non-Judgemental

There are many aspects to our lives that we are embarrassed about. It takes a lot of courage to open up to someone, so if you happen to be this lucky person please don’t judge how we feel or our behaviour. If there is something you don’t understand, say that you are here and that you support us. You can research what you were told later to find out how you can best be supportive. The same goes for if you accidentally find information out, there should be no difference to how you behave. Finally, when in a group situation don’t join in with gossip or negative talk about BPD behaviours. You could be causing someone unknown in this group to feel intense pain.

Moderate Your Vocabulary

Although we don’t want you to be too precious around us, there are some things that can bring up horrible feelings and experiences. Repeatedly describing someone as crazy in a negative way, saying things such as “she really needs to get some help” makes me in particular feel ashamed and awkward. I personally don’t like it when people call themselves fat or skinny in front of me, or talk about the health quality of food that I am about to eat. I understand that everyone has their own insecurities that are completely unrelated to their opinion of me, but it still triggers unhelpful feelings and emotions. There are other obvious things that people can say that can affect someone with BPD more than an average person, for example jokes or comments around sexual violence and trauma. If in doubt try to be a little sensitive, and ask the person if anything you say is triggering.

Don’t Take It Personally

My friends all know and hopefully understand that I am not the most reliable person. If we have made plans, and I cancelled last minute, there are literally hundreds of reasons why. Anxiety, depression, and particularly violent mood swings sometimes make the prospect of leaving the house terrifying, for reasons that are hard to explain, sometimes something as seemingly silly as finding a mark on the outfit I planned last night. We are also a group of people known for snapping and being blunt with people, all I can say here is please don’t take it personally. I know it can be horrible to experience the rough side of someones bad mood, but if you can, try to ask us whether we are mad at you or being affected by something else in our lives. Simply put, it can be hard to be friends with someone with borderline personality disorder, but know that we understand this fact and we’re trying our best. I appreciate all the friends that have stuck by me, I know that it hasn’t been easy!

Listen and Don’t Steal

There have been a number of occasions where I opened up to somebody by speaking to them about something difficult, and thought that they were listening and understanding. However, down the line I noticed that they had listened to my problems and not let them go since. I don’t mean by checking that I’m alright the day after I told you I was struggling. These tend to be the kind of people that are excited by the prospect of drama. Once the conversation about my problem has ended, some people try to own the pain I have just opened up about, leading me to feel guilty and responsible for them. I don’t think that this is helpful for either party, it would be better to tell me that you don’t feel up to talking at this time, and then change the subject! If its going to cause long term problems and drama, please take a step back.

Be Upfront and Honest

This is true for friendships with average minded people too! People with BPD are often incredibly sensitive to interpersonal cues, in a way they can be paranoid. Taking any steps to hide things from them rather than manage the conflict you foresee, can make the situation worse. Feelings of deception and paranoia is often a strong trigger that is particularly hard to identify, and therefore to self manage. I would ask that you are sensitively upfront and honest about a situation which you fear would affect me, and trust me to be able to deal with it.

Think About the Situation

Some situations are more sensitive to triggers than others. I personally need to keep this in mind when planning to meet someone or go somewhere, but it would be helpful if my friends also did the same. For example, it is very easy to get someone talking after a few drinks and you may feel more confident to ask questions with a bit of a buzz. However, talking about a dark period in your life while drunk is not fun, and for someone with BPD can be very triggering. Furthermore, if your friend struggles with social anxiety and you’re planning on going to a busy event, you could ask if theres anything you could do to make it easier for them.

Compliment Kindly

Its lovely to be told that you look nice, a compliment is supposed to make the receiver feel cared for and appreciated. For me and other people with body image issues, specific comments around weight make me feel uncomfortable and ashamed. This applies to all people but when making positive comments about someone, try to think about how you want them to feel and use the right words to achieve this. There are many other ways to compliment someone other than to say that they look slim.

Avoid the Egg Shells

Or rather, don’t avoid the egg shells! We’re your friend too and we don’t want to you molly coddle us. We can cope with a lot, and we do cope with a lot. Please don’t feel like you have to not be you when we hang out, because its you we became friends with. Exercise sensitivity and we’ll be able to carry on our friendship as normal, we’ll do the same!

Look After Yourselves

Finally, we know that being the supportive and patient friend that you are can take a lot out of you. We don’t want to drag you down with us, we promise, so make sure you have your own support network if you need to talk. We also understand that you need time away from our intense relationships, and this is fine, just let us know that you’re still going to be around, and more importantly if you’re coming back! You should always put yourself first, and look after yourself as well as you look after us. If your own health is at risk because of our relationship, talk about it. I’m not holding anyone physically or emotionally hostage, and I want the best for all my friends just as most want the best for me.

Thank you for reading,

Borderline Bella xx

 

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Body Image and the Borderline

Eating disorders and disordered eating are some of the many co-morbid diseases with BPD. According to this website about BPD approximately 25% of individuals with anorexia nervosa are also suffering from the symptoms of BPD.

I have used the term disordered eating to refer to unhealthy eating patterns, beliefs and emotions around food that have not resulted in a diagnosis.

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Me and My sister on holiday age 9 (I think)

I have been unhappy about my body and my overall appearance for as long as I can remember. From the age of 5 I thought I was fat and ugly. I used to sit in the bath as a 8 or 9 year old girl, pinch the fat and skin from around my stomach and my thighs, and imagine slicing it off with a sharp knife. Although I was wildly uncomfortable with my appearance and by body, I didn’t make the connection between food, hunger, and weight fluctuation until a little later. In secondary school I knew that I needed to ‘simply’ exercise more and eat less, but I was too embarrassed to try in P.E. or jog outside. The thought of people seeing me exercise filled me with fear. I imagined that people would look at me and think ‘haha look at the fatty run’. To get around this, I used to exercise in my room in the evening. Jumping jacks and sit-ups, never too intensively and not usually for more than a hour.

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Me on my 16th birthday

I wasn’t ever more than a little chubby, but I felt absolutely huge, and thought that this was the worst thing in the world to be. I believed that if I lost weight everything in my life would fall into place; that I would find making friends easier, that my teachers would take me more seriously, that my family wouldn’t think of me as a joke. I didn’t realise at the time that my thinking was massively distorted. My weight started fluctuating, I never lost that much and it never stayed off for long. I started skipping lunch and going to the gym, obsessing about food 24/7. I tried cutting out dairy and wheat, dairy lasting the longest (which is surprising because I love cheese).

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Me at 16, spending the summer after GCSEs volunteering in Tanzania

 

In the Summer after GCSEs I travelled to Tanzania to get some work experience in a hospital there. I felt a surge in my confidence, I was around people that had never met me before and I was doing great. I started smoking, and convinced myself that the food was disgusting. I would fill my plate with, at most half of what everyone else was eating, and then pick at it until they were finished. It was hot and we were often hungover in the morning. I felt light headed and almost fainted more than a few times during the day. Im not sure whether I actually lost weight while I was there, but I had learned how to restrict my diet, and got the ‘taste’ for hunger pangs.

My new food philosophy didn’t last, I was eating normally again soon after arriving home. The difference was that now, when I would hate myself after eating something bad, or when looking in the mirror, I was able to think back to when I wasn’t being ‘a pig’ and when I felt great about myself. My diets and behaviour didn’t really escalate into disordered eating until after the summer holidays. I was starting sixth form at a new school, it wasn’t long before I started trying to restrict my food intake again. I got myself stuck into a cycle where I would try not to eat for as long as I could, mess up, binge or eat the food that I had been withholding from myself, purge, then feel so crap about myself it would all start again. I started keeping a food journal and documenting everything that I had eaten that day. It started out with fairly healthy goals, such as 1500 cals or less. I wasn’t able to weigh myself but I used clothes to measure my progress. I began reducing the calories that I was allowed, and spent every evening doing the maths of how long it would take for me to lose so many pounds if I ate so much each day. I would throw up my dinner so that I was able to keep my calories under the more and more restrictive allowance. I believe that by doing this I lost a little weight, but nothing excessive.

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Me at 17, at the end of a restrictive week. I was pale and tired, but hadn’t lost very much weight.

Half-way through year 12 I went on a ski trip, which was fairly out of character because I didn’t know how to ski and only one of my close friends was also going. It was another one of those situations where you could get away without eating very much and exercising all day. My eating patterns aroused the suspicion of the 3 girls I was sharing a room with. I can see how my odd behaviour would annoy them to no end. I look back on this trip fondly, as its where I learnt to ski and I had fun with my friends.

For the next half of the year I had moments where I was losing weight to my satisfaction. I was managing to reach my weight and clothes goals, and getting away with eating under 400 calories each day, sometimes nothing. I was binging less frequently and going to the gym fairly regularly. The only time I really purged was when I had to eat with people, or something that I didn’t feel comfortable eating. I knew that it was wrong to do, that it was rude and antisocial, especially as people started noticing. I would start to get incredibly anxious about even the thought of food, and would write mantras and phrases in my diary reprimanding myself for giving in to food. I would use my friends and my social life to get away without eating, by not eating much while out I could lie to my parents at home.

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Me at 17, probably at my highest weight immediately after exams.

I remember at one point during the summer between year 12 and year 13 when my aunt and my mum confronted me about my bulimic behaviour. My mum said something along the lines of ‘you’re not bulimic are you, you know better than that’ and frequently (unsubtly) checked my knuckles for scars. My aunt said something like ‘you’re not spreading pesto on toast and then throwing up are you?’, I said no. I got more secretive and better at hiding my behaviour, they never brought it up again. I was stuck in a cycle of feeling happy about my progress and hating my body. Comments from family members about my body or my weight were never welcome, even if positive. I began to hate other people who talked about diet or food or weight or bodies, especially while eating. My heart would pound and my face would blush if someone said a food I was supposed to eat was ‘naughty’ or ‘bad’. I managed to lose a little for year 13 leavers ball, but not enough.

When I moved to university I had the freedom to eat whatever I wanted. I began to lose weight by eating tiny portions or not at all, but quickly began purging again. I was getting more and more unwell, staying up late at night to binge and purge. It got to the point that everything I ate had to be purged. I was too scared to do a food shop so I ended up eating the weirdest things, such as raw oats.

Since then I have been through stages that last anything from a week to months. My weight doesn’t often move above or below two numbers, no matter what my behaviour is. The common denominator for all my eating habits is poor body image. I don’t believe I’ll ever be able to not want to lose weight. In a way I am lucky that I cannot stick to the same routine for more than 2 weeks, this way I never get really unwell due to diet. My battle with body image and self esteem, and to be honest, weight goes on.

If you think you, or another person is showing signs of disordered eating, please speak up in a calm and understanding manner. It is incredibly important not to be judgemental, and not to ambush the person. You could send them retreating further into their developing illness, and make it harder for them to end the damaging cycle before it takes over their lives. People with disordered eating need support and help, and in particular they need to be taken seriously. It is often a sign of other underlying problems, and problems that they could face in the future. Just because someone struggling with food is not underweight, or even if they are overweight, doesn’t make their problems any less serious.

Thank you for reading
Borderline Bella

My BPD Medication

When I was first admitted to hospital I frequently refused the offer of medication. I believed that there was nothing medically wrong with me, and the only way I could prove that I was not unwell was if I wasn’t taking meds. I eventually folded to the necessity of sleeping pills, mainly because sleeping in hospital is not easy. I also began taking a benzodiazepam, simply because I could. My experience with medication has been very mixed and incredibly stop-start. For varying periods of time I have taken all 4 of the medications I talk about below (actually a low number for many people with mental illness), as well as different combinations. I have learnt that (for me) sometimes medication can help, but also sometimes its okay to take a break and re-stock. In the past I have decided to take these drugs in order to make the people around me more comfortable, in the hope that they would find me more agreeable if I was medicated, and in some cases sedated. However, I am happy with who I am. I can manage mood swings and can enjoy the variation in my personality and even sometimes mood.

Lorazepam

Lorazepam is a benzodiazepam normally prescribed to patients with anxiety or sleep problems. It is also used as a muscle relaxant in hospitals when somebody experiences a seizure. Gamma-Aminobutyric acid (GABA) is a chemical neurotransmitter in the brain. Its role in the central nervous system (CNS)  is to reduce excitability of the neurons, which leads to a reduced CNS response. When your CNS response is reduced, your heart rate slows down and your blood pressure lowers, essentially you relax. Lorazepam blocks the breakdown of GABA to that the concentration of this calming chemical increases, and that you can feel the relaxed effect. Once you have taken lorazepam, you can feel the effects very quickly. I found this drug incredibly helpful, to stop or reduce the effects of a panic attack or situational anxiety quickly and easily. However, after taking it for 4 or 5 months, I began to accidentally overdose when also drinking alcohol. My dose was increasing, and as alcohol is also a CNS depressant this mixture caused some problems for me.

Zopiclone

Zopiclone is the sleeping pill my doctor first prescribed when I was an impatient to help me get to sleep. It didn’t knock me out, in fact they were shocked that I didn’t sleep for about two hours after taking my first dose. Zopiclone boosts the effectiveness of the chemical GABA by attaching to the receptor sites in the brain where it normally works. Although the package clearly says that you shouldn’t take this medication for more than 2 weeks at a time, I was taking it for about 8 months. It was the last thing I decided to stop taking but I don’t necessarily think that it was helpful. Unfortunately they prescribed it to ensure that I would sleep through the night in hospital, however I didn’t suffer from a sleep disorder before. Once you’ve started taking sleeping pills, its really hard to sleep without them. I wouldn’t recommend this medication for the treatment of BPD unless you also have insomnia.

Citalopram

Citalopram is a type of anti-depressant called a selective serotonin re-uptake inhibitor. This means that the removal of serotonin from your brain is reduced, increasing the concentration of serotonin. Serotonin helps to regulate mood, appetite and sleep, and is used as an antidepressant as it brings about feelings of wellbeing and happiness. I was first prescribed citalopram upon my second admission to hospital. It had become apparent that I could no longer put off the use of medication, therefore my doctor and I agreed that an antidepressant would be the least invasive and could really help my depression. I have taken it for short periods of time since then, but I don’t really notice much of an effect. It might increase my general happiness and reduce my impulsivity, but not enough to notice on myself. I might talk to my doctor about trying a new anti-depressant.

Quetiapine

Quetiapine is an atypical antipsychotic medication. It is usually prescribed as a mood stabiliser for people with bipolar or mania, or as an antipsychotic for people with psychosis. However, there has been a lot of research recently about the effectiveness of quetiapine for the management of BPD symptoms, and it looks promising. Quetiapine works by blocking dopamine receptors in the brain, reducing the effect. Dopamine is involved with motivation, emotions, behaviour and perceptions. The reduction of dopamine in my brain caused me to feel overly tired and uninterested in activities. It also lead me to gain weight (a common side effect) which I did not enjoy. The sedative effect helped to stabilise my mood and keep me stable, but having stopped taking it now, I believe that for me and my disorder, quetiapine is not the right drug.

I have taken some information from wikipedia and some from the website headmeds which I really recommend for information about medication and illnesses.

Borderline Bella

A Day In The Life Of BB; Waking Up In The Priory

I wake up from a long deep slumber, I’ve been sleeping in a large comfortable double bed. I’m not at home because my room is only home to a childlike single. The room I’m in is similar to a medium starred hotel room, the kind I imagine that business men and women crash into after a long day of city work. It has a desk and an ensuite, and a beautiful large window. Theres not a feel of ‘ikea’ about the furniture, so it must be a nice place. I didn’t sleep well, and feel quite drowsy. Frequent interruptions from the staff disturbed me at regular 30 minute intervals. I soon learned that this inevitable annoyance was less invasive if I slept with my face uncovered by the blankets and facing the door. This way had the downside of the hallway light hitting my face every time the door opened, but at least the stranger night staff felt no need to gently peel the cover away from my face, and peer their own right against mine. I did consider whether I would rather have a pulse monitor on, at least then the rhythmic beeping would announce my ‘aliveness’ for me, and I might be disturbed slightly less. However, this is not a hotel, or even a hospital with heart rate monitors. I am sitting in a private psychiatric hospital called ‘The Priory’.

Evidently, I have slept passed breakfast, but this causes me no disappointment. I am thankful that the nurses allowed me to sleep in as I have very little motivation to leave the bed, let alone the room. I faintly remember being roused in the morning at the change of shift, to ask what I would like for breakfast. I replied nothing, I wanted them to stop waking me up and disturbing me. Beside me, rather disturbingly on the bedside table furthest from the door, is a tray. There is a banana, an apple and a pastry. I don’t remember anyone bringing this. It feels violating that anybody and everybody can walk into my bedroom. I make a point to remember where I am and try to forget the idea and the comfort of personal privacy.

I am nervous to go to the bathroom, as I haven’t yet checked whether there is a lock on the inside. I also must time my shower perfectly. Based what I learned about the staff behaviour last night, I doubt anyone would think twice about barging in while I am in the shower, and I am not sure whether a verbal affirmation would convince them that I am, indeed still alive.

I walk back into my room and change as quickly as a pubescent high school student in the filthy crowded P.E. changing room. I wish people would knock. I make my bed. I don’t eat the food, but contemplate what I am supposed to do with it, would the mystery room service person return to take it back? I am not smoking at the moment, currently I cannot remember what drove me to stop as there is nothing I wouldn’t do for a cigarette right now.

The day is passing slowly, nothing eventful occurs. I am beginning to recognise the faces that pop through my door, there appears to be a repeating pattern. A few of them make half hearted attempts to rouse me out of the door, to meet the other patients. I have no interest in doing so, I would not know how to behave around them. I am not depressed, I am disgruntled at being here. A nurse comes in to visit me and have a little chat. Ive been having a lot of those over the past couple of days. He’s a middle aged man, with a face that I cant read. His lips are slightly too large for his mouth and it affects his London accent more than mildly. Im straining to understand the questions, but he seems friendly if not a bit patronising. The conversation is inconsequential. My doctor is not working this weekend and nothing about my treatment and care can be changed until he returns. I am not allowed to leave for any reason.

There is nothing to do here, I have spoken to my mum, or she came to visit. There really is no difference. I could get my books out and start revising, but i’m not in the right mind set. I’m agitated and stressed, this would all be a lot easier from home. Lunch has come and gone, I snuck downstairs and picked at a salad. I sat on my own and exuded no signal of wanting the people around me to join. Dinner is going a similar way. The food hall has such a mixture of smells it’s making me feel unwell, like all the bright and beautiful colours mixing together to form sludge. Nobody stays here for dinner unless they are inpatients. There is a long table opposite me, reserved for the eating disorder patients. Its empty, but I am here early. There are small bundles of people who appear to know each other, some are talking and some are simply using other peoples company to guard themselves from prying eyes and loneliness. Its not busy here, and mostly women. There are a few people who visibly appear unwell, through the pain on their faces and the outfits they have managed to put on, but mostly the people here appear like I do. Entirely normal.

Theres a television in my room that I am looking forward to getting back to, so I eat my meal quickly with my head down and make my way back to Upper Court, my ward. In order to get inside I have the press a button on the intercom, and wait while it makes the most grating and inconceivably annoying noise. Eventually the noise will stop and I will step inside, turn up the stairs and then into the first door on the right. My room. I am lucky that I don’t have to walk past the nurses station, or any other door in order to get back, I do not want to talk to anybody. Not today.

My first day has ended. How many more?

Christmas, a Sharpener, and a Pair of Hospitals.

In the past week I had spent a day and night at hospital on a drip, talked to a handful of psychiatrists and revealed my struggle to friends and family. What happened next was the beginning of a journey that put me on the path to recovery. I have been avoiding writing this part of my story, concerned about the reaction of my friends and family who were involved at the time. I have written about the suicide event in a fair bit of detail and therefore it would be triggering to read for anyone with a history of self harm or suicide attempts.

Merry Christmas, and Goodbye!

My family has always had the tradition of alternate christmases, each year we would spend the real christmas day with either my mum or my dad, and usually a ‘fake’ christmas with the other. For christmas 2013 we had boxing day celebrations with my mums side of the family. My memory of events here is a little blurry, but the day involved dinner and drinks, everyone was having fun, although my recent stint in the hospital had everyone a little on edge.

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I went to bed that evening fairly drunk. I was also quite frantic, the thought of how low I was and how hopeless my prospects were came into my head very suddenly. I remember considering my options, landing on cutting my wrist, and then trying to find an implement in my room without disturbing anyone. I found an old pencil sharpener and used tweezers to pry the blade out from the plastic. I don’t know how I managed to get so far, I don’t remember really feeling any pain or distress. I was disconnected from my surroundings. I had a blanket on my lap to reduce the amount of mess I would make and listened to music through my headphones. Writing this down I realise how far away I was in my thoughts. At the time I honestly believed that I was acting completely logically, but the series of events I have just written are not the actions of a girl behaving rationally, instead of a girl who was confused by and lost in her own mind. I’ve also just noticed how fast things seemed to escalate, it reads blunt and shocking, but as thats how it occurred for me I cannot find another way to write it. For some reason, my mum came into my room to check on me, it must have been after 2am. She walked into my bedroom. I had placed the blanket over my arm to hide the blood while I was playing angry birds on my iPod. I think I was just waiting for something to happen. I must have looked very strange, as she lifted up the blanket and immediately ran into my sisters room to wake up my Uncle and his girlfriend who are police officers. They talked to me while my mum called an ambulance.

Just Another Emergency Department

The ambulance arrived and luckily didn’t wake up anyone else in the house. They put my arm in a sling and let me change into clean pyjamas. My mum and I travelled to the hospital in the ambulance while my Uncle and his girlfriend followed behind. The emergency room was empty, it was early in the morning over the christmas period and it seemed like a small hospital. A doctor gave me stitches and I was moved to a bed to sleep and wait until the psychiatric consult was available. I remember my mum asking whether it would scar, and finding it a ridiculous question. How could a scar effect me if I was dead? I remember my mum being incredibly distressed and upset, but I didn’t feel the same way. I didn’t really feel anything about the events that had just occurred. The talk with the psychiatric consult was much the same as before, I was asked the same questions and pretty much gave the same answers. During this time, my mum was on the phone to a psychiatric hospital in London called the Priory. She got the hospital to refer me there, with the intention to travel immediately. I insisted on first going home to have a shower and change. I didn’t want to go.

Welcome to The Priory

I arrived at the Priory wearing a jumper I had opened as a christmas present only days ago. I had chosen it because I wanted to appear to all the staff as a young girl who had her shit together and didn’t need to be there. I wanted them to think that I had over protective family, and that I was just going to stay there while I continued to work towards my exams in order to make them happy. The building was beautiful but scary. There were locked doors and people all around me that I didn’t know. My bag was searched when I arrived, my chargers and glass makeup containers were removed. I was interviewed by a nurse and then a health care assistant, and then left to settle in. I stayed in my bedroom pretty much the whole time I was there, I didn’t want to be there and behaved accordingly. My mission was to get out and convince everyone around me to let it all blow over, to essentially get over it and let me carry on the way I wanted to. I left the Priory a fortnight later to continue as an outpatient.

My next post will talk about the two weeks I spent at the Priory during this first admission. I imagine that I will take much less time to write it as the worst part of the story is now over.

Thank you for reading
Borderline Bella xxx