BPD; Was I born this way?

The debate of nature versus nurture has been prevalent throughout psychological research since the concept of heritability was first understood. When you first try to understand BPD, one of the questions you’ll likely be asking your doctor, or google, is why? What has caused the personality disorder to manifest?

The answer you’re given is usually a combination of two; your genes have determined that you will have BPD since you were born, or there have been factors in your life and childhood that caused or allowed the disorder to develop as you grew. Even with my minimal scientific background, I don’t entirely understand what this means, and in particular what this means for me. Was I born with BPD?

Psychologists have tried to answer these questions by studying families where a family member has BPD, to see whether members of the same family, with shared genes, are likely to share the disorder. If more than one member of the same family was diagnosed with BPD or showed BPD like traits, this could suggest a degree of heritability. However, members of the same family tend to grow up in a very similar environment, meaning that the BPD traits could have been recreated by a similar familial environment rather than inherited.

Neuroscientists and neuropsychologists have also attempted to find out to what extent genes and biology play a role in the development of BPD. Impulsive aggression is a symptom of many cluster B personality disorders, including BPD. It manifests in people with BPD through self harm, and impulsive and aggressive acts against yourself. Scientists have found that there is a relationship between the serotonergic system in the brain, and impulsive aggression. Essentially, many people with cluster B personality disorders have low serotonin levels in the brain. A chemical difference like this could predispose someone to experience mental illness and BPD later in life. This discovery was also important because it has lead to the use of medications to help manage the symptoms of BPD such as selective serotonin re-uptake inhibitors. you can read more about my experience with this medication here.

Neuroimaging has shown that the brain of someone with BPD is significantly different to the brain of a neurotypical healthy person. These differences could be produced by either the genetic or environmental causes of BPD, because our brain has the ability to change based on how we use it. If we have learned to use our brain ‘the BPD way’ then through plasticity, aspects of our brain change in response to the way we use it. Through researching for this post, I have discovered that there is too much to talk about when comparing the brain images of healthy and borderline subjects here, so I will devote a new post to this topic in the future.

Although I feel much better informed about the known biological and genetic causes of borderline personality disorder, I am finding the information hard to relate to on a personal level. I have no family members who have been diagnosed with BPD or even experience the characteristic symptoms or behaviours on a lesser level. This makes me question whether I inherited the disorder from my parents at all. Additionally, I have found serotonin based medication fairly unhelpful. Although this doesn’t mean I don’t have low levels of serotonin, as there are many different medications available and I have only tried one of them.

It is well known among the psychiatric community that many people who are diagnosed with BPD share the same or similar negative childhood experiences. These experiences are so incredibly prevalent, it is unlikely to be coincidental.

The ‘nurture’ argument states that people will develop BPD because negative experiences have taught the child to develop maladaptive behaviours as coping skills, which are used in place of emotion regulation because the child has not been provided with the opportunity to learn this skill.

I am hesitant to create a list of childhood environments and experiences that contribute to the development of BPD, because I know how varied and individual the experiences leading to BPD are. Mind, a mental illness charity provides a simple list of reasons why a child may not gain enough experience of healthy emotions and relationships. Living with an unreliable parent, for example a parent with an addiction problem, could cause a child to develop the belief that they are unimportant, and that everyone will eventually abandon them. When this belief grows into adulthood, it could manifest in symptoms of BPD such as an extreme fear of abandonment or self harm.

Personally, I find the environmental causes of BPD easier to understand, the path from cause to result is easy to visualise and fairly simple to follow. However, I am not able to pin point an area in my childhood where I may have been made more susceptible to develop BPD. Like many children I was bullied in primary school, and my parents went through a divorce. However, the bullying was dealt with and ended when I moved schools, and the divorce was nothing special and finished while I was still young. I was not neglected or abused as a child. I had a reasonably happy childhood, and wouldn’t change any part of it. However, I do have BPD. I can understand how if I was genetically predisposed to be sensitive to the triggers of BPD, unhealthy lessons about emotions and relationships that I was exposed to in my childhood could have accumulated to affect my emotional development and behaviour in adult life.

If you feel a particular way about whether your BPD was more influenced by genetics or your environment I would be really interested to know, please get in touch!

Thank you for reading,
Borderline Bella xxx

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New Year, New Crazy Me; My first inpatient experience

I was really struggling to find a way to describe the experience of my first day at the priory retrospectively. I found it not only hard to remember the facts, but also remembering how I felt at the time was incredibly difficult. I couldn’t convey the experience truly through my normal style, so I decided to write it as if it was an ongoing inner monologue from 2013. You can read this article here. The process of writing it and the feedback I have received made it a therapeutic and cleansing experience, enhancing my connection to and understanding of my younger self.

I stayed at the Priory Hospital for 2 weeks. During this time I explored some of the therapy groups, beginning to recognise the same people day after day. There were many staff members that I encountered daily, the majority were not in my favour. I have to emphasise that I hated the staff and the therapists because of where I was standing mentally and emotionally. I later discovered that they are all caring, kind and supportive people who are brilliant in their fields of work. One staff-patient confrontation sticks in my mind. Months before, my family members had booked a trip to the theatre. For some reason, I believed that I would be and should be allowed to go even if it was only two days after my admission. Numerous emotionally heated conversations culminated in a one-to-one meeting with the ward manager. He told me I would not be allowed to leave the ward, and I replied with nothing less than raw, unfiltered anger and disgust. It was so bad that I wasn’t able to properly look at him for the rest of this or any of my other visits.

I remember having an influx of visitors, almost every day. They bought chocolate and clothes and anything else they imagined would make my experience better. I feel like both parties in these meetings were ignoring and denying the blatant fact of where I was and why. Jokes were made (mostly by me), I would dismiss the importance of everything that was happening there. Although I was grateful for the company and the distraction, this probably wasn’t the best line of attack for two weeks in a psychiatric hospital, and maybe contributed to my lack of immersion in the therapy offered. During my second admission a while later, I put some boundaries on who could visit and how often.

I met my doctor after my first weekend; Dr Woolley. I wasn’t entirely sure what to make of him, a middle aged man with facial expressions and a demeanour like an awkward teen boy, but with marks of his age on his skin. He had a way of talking and looking at me like he was observing a dangerous animal, but with fascination rather than fear. At the time it is likely I was misinterpreting interest and concern. We talked with, and without my mother. I sat up straight with my hands neatly folded in my lap, nodded and smiled where appropriate and answered all questions with a considered and clean cut response. During my time in therapy I frequently confused observations about my detached demeanour and apparent logic based ideology as complements. I distinctly remember a point in one of our early meetings when Dr Woolley said something along the lines of ‘you appear rigidly rational’, my instinctive response was to politely say ‘thank you’ and smile, returning my gaze to my hands. This moment stuck with me because I found his response intriguing; he was quiet, looking invasively at me, amusement visible on his face. He asked why I assumed it was a compliment, I don’t remember my response.

I spent a lot of time watching Breaking Bad and reading the books family members had brought from my bedside, but at least 2 times a day I was expected to attend group therapy. Group therapy at The Priory involved sitting in a cold and slightly damp room, with paint or wallpaper peeling from the wall. Chairs were placed in a circle around the edge of the room, just the normal plastic chairs usually found at schools. Most of the rooms had a flip-chart whiteboard in one of the corners, rarely used, with the same old scribbles never wiped or cleaned away. There were rules for the groups, such as no leaving once the session had started, no talking over people and no hot drinks. Mostly the same people would talk each session, possibly the most confident or veteran patients in the hospital. It sometimes felt like you had to search really hard for something to share on topic, just in case they picked on you and thought you weren’t cooperating, when actually you couldn’t think of an example to share. During this first admission I found group therapy boring and pointless, and usually too early in the morning to fit in with my sleep schedule.

As I was admitted the Friday after boxing day, I spent New Years as an inpatient. New years eve was a strange event to experience in hospital. I did not want to leave my room and ‘celebrate’ with the other patients in the common room, despite the repeated invitations and coaxing from staff members. Not because I thought myself better than they were, I wanted to be on my own, I suppose to allow myself to forget where I was, but also out of some misguided protest. Speaking to friends on New Years, happy and drunk from the parties I should have been at, was the only memorable experience from that night. The few friends who knew the truth about where I was showed a great deal of love and patience by speaking to me that night. I was bored, angry and frustrated, and coming to terms with the fact that I would simply have to drop out of university. I stayed up late into the early hours of the morning, reading books, magazines and listening to music. I didn’t want to sleep, in hindsight the symbol of waking up in a psychiatric hospital on New Years Day was probably too much to handle.

 

Two weeks after my arrival at the Priory, my doctor and I had agreed about my withdrawal from university and my discharge from the hospital. The plan was to continue as a day patient, I was to be under the hospital care during week days in order to undergo therapy. I left that day still detached and in denial, remaining a day patient for 5 weeks before my second admission.

Thank you for reading,

Borderline Bella xxx

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

 

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

BorderlineBella Vs Freshers; Round 1

Hello everyone and welcome to BorderlineBella!

I have decided to start a series of posts that tell my story from the beginning. I hope this will be somewhat enjoyable to read, and that it will provide an understanding of the kinds of treatment you receive when you have a mental illness. If you are worried about triggers around mental illness, self harm activities, and suicide I advise that you don’t read posts in the ‘My BPD Story’ category. This particular post has a trigger warning for suicide and overdoses.

Under Pressure

For as long as I could remember, I wanted to be a doctor. I was pretty obsessive about it, putting extremely high expectations on my grades from GCSEs and felt devastated when I got 2 less A*s than the school had predicted. I wanted to prove to everyone that I was clever and that I was going to be successful, I suppose because I didn’t feel like I would ever be pretty or popular, it was extremely important to me to achieve highly.

After quite a long fight, two interviews and one offer, I did much worse than anyone expected in my A Levels. I might have been over stressed and unhealthy but I don’t know for sure. This meant that I had to put this dream down and apply for clearing places. I was lucky to get into Newcastle University to study Biology and Psychology, however there were not enough places in halls, so I ended up in a shared house with 6 other people who had also come through clearing.

3 Trebbles for a Fiver! (your dignity, reason, self control.. and a fiver)

It became very obvious pretty soon that I was not well, university was not what I expected it to be and I was having problems bonding with my new housemates. I frequently felt anxious about the future and thought that I would always be alone. When we went out together I frequently drank too much or created drama. At this point I didn’t really think that I had a mental illness, I just thought that people didn’t like me. I believed that everyone had the problems I did, but nobody talked about it. Eventually, the first semester culminated in me stealing one of my housemates medication and taking it all, then pretty much immediately calling a housemate to tell them. There was no real danger to my health, but we went to the emergency department for observation. Nobody from the psychiatry department questioned me or my housemate that accompanied me, even though I was clearly trying to tell people that something wasn’t right. I was ignored by the NHS. Unfortunately a few days later I took a more serious overdose, and at this time unlike before, I truly believed that I wanted to die.

“It will be the best time of your life! Make the most of it!”

Moving to university is an extremely hard time for everyone, and this was enough to trigger the start of an illness that would effect me quite extensively, and probably will for the rest of my life. I was showing signs of being unwell from the start of the first semester, but other freshers like I were not and should not have to be equipped with the knowledge and ability to know what to do in this difficult situation. Shame and embarrassment stopped me from telling anyone from home about what I was going through, which was a massive mistake. I did not want to admit that university wasn’t ‘the best time of my life’ as everyone told me it would be.

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Me at Carnage Newcastle dressed as a cat or a leopard or something. See the whiskers? I coped by drinking too much and partying all the time, I wanted everyone to see that I was just another normal ‘fresher’, when in reality excessive drinking was just making me more unwell.

Secrecy, Shame and Suicide

I did not tell anybody from home what had happened. A day or two after I arrived home for christmas I took a much more serious overdose that required an admission to hospital for treatment. I was so confused about what was going on with me, I didn’t know why I felt the way I did and needed to do the things I was doing. My family were completely shocked when they found out. I had climbed out the window in my pyjamas in a panic, realising the seriousness of what I had done. I knew that I would become extremely unwell and eventually would die if I didn’t get treatment (what I thought I wanted) but I would have to look my family in the eye and behave normally until then, and I didn’t know if I was able. I called an ambulance to pick me up from the street away from my house and thought up a plan of how I could get treatment and back to my house without my family realising that I had gone. This included calling a friend from home in the morning and asking them to pick me up, and waiting until 7am to send a text to my mum telling her I had gone out for a run and didn’t know when I would be back. I called pretty much everyone I knew that had a car, I can’t remember exactly what I said to all of them but luckily I told one or two of my close friends the truth. Together, the people who knew what had happened told my mum to find me in the hospital. I felt so ashamed and embarrassed for putting my family through this. They were all so awkward, and obviously had no idea what to say to me, or ask me. Everyone was in shock and confused, including myself.

Attention Seeker

About 30 hours after I had arrived in the emergency department I was physically healthy and discharged from medical treatment. I was seen by the psychiatry department and didn’t know what to tell them. I just wanted them to stop asking questions. My mum and I waited hours to see another psychiatrist but there was nothing helpful that they could offer. Again I felt let down by the NHS and their lack of care for mental illnesses. I was wrongly referred to the CAMHS (child and adolescent mental health services) which shouldn’t have happened because I was 18 at the time.

I’m Fine, I Promise

I was in complete denial about the seriousness of my health at the time, to the horror of my family I went out drinking with my friends almost the night after I was released. I thought that everyone around me was over reacting. I now know that I was dissociated; I had split from my emotions and reality, nothing felt like it was really happening, essentially I was detached from my surroundings. I didn’t feel depressed or anything really, I mainly just felt ambivalent about my life.

I attended a short meeting with CAHMS and was asked questions that were so transparent I could have easily decided what diagnosis I wanted and answered accordingly. It was frustrating and a waste of time. At one point the psychiatrist told me to make a cup of tea next time I felt sad. This is patronising advice that belittled the struggle I was going through. They gave me some contacts including a crisis team number, which I was informed would not be operational 24h a day because it was short staffed over christmas. The next time I was in crisis was boxing day night, I did not make a cup of tea and I did not call the probably unavailable crisis number. All the signs pointed towards me being unsafe and confused about what was happening to me, but nobody acted on these signs. No healthcare professional took me seriously, I was frequently asked if I hurt myself because a boy had broken up with me and silly things like this. They didn’t see a woman who needed help, but a stupid little girl who wanted attention.

Luckily I had and have a strong family around me, that were able to get me the help I needed, but this wouldn’t be until one more crisis. I am grateful for everyone who helped me through this stressful and scary time.

My next post will talk about how I ended up in a hospital for mental illness, and started on a 6 month long journey to a diagnosis and stability.

Thank you for reading

BorderlineBella xxx

Hello Everyone!

Hello! My name is Annabel, AKA BorderlineBella. Thank you so much for visiting my new blog. As my name suggests, I have Borderline Personality Disorder which will be the main focus of this blog. I hope to document my everyday experiences and coping mechanisms, and review the different forms of treatment I have embarked on.

The reason I have started a blog now is that I have experienced discrimination at Newcastle University, leading to my withdrawal and my new goal of raising awareness and reducing stigma for this diagnosis.

I enjoy meditation, smoothies, reading (Margaret Atwood is my favourite) and skiing. On an average day you could find me snuggled up on the sofa, drinking strong black coffee from my favourite Star Wars mug. Im incredibly introverted and dyslexic so I apologise in advance for any awkward and misspelt posts!

You might enjoy reading this blog if you or someone you love are new to the diagnosis of Borderline Personality Disorder, or if you are a veteran and also looking to reduce stigma! There will be a little bit for everyone.

IMG_1519I will begin with documenting my experience of discrimination at Newcastle University, keep you up to date with the complaint procedure, and the context around me feeling forced to withdraw from studying there. I feel that my story is one that needs to be heard, as in my experience there is an extreme lack of compassion for people with mental illness at university.

I am embarking on a new journey in my life, leaving university and trying to find my place in the world. I will try to keep it light hearted and fun, I hope you will come on the journey with me!

BorderlineBella xxx