My Last Night

The night before I left the hospital was the most surreal night of my life. It had been a full 24 hours since I found out I had Borderline Personality Disorder. I still could not believe it. I had carried the handout the social worker had given me everywhere I went. I looked at it constantly. It was as if I had stumbled upon this perfectly written, inspiring bit of poetry. It had ignited a fire within me I thought would be extinguished forever.

Tomorrow, I was being released to what I hoped would be a normal life; whatever that is. My suitcase was packed with almost all of my confiscated items, since Dr. Eaton had deemed me stable enough that I wouldn’t try to get drunk off of my shampoo. My shoes still needed laces, but everything else was in its place. In a lot of ways, being released this time would seem no different. Like before, I had gotten the annoying permission slip saying that I was stable enough to return to the college. I was a liability. With this note, they would not get sued had something happened. This sure made me feel supported; they were so concerned with protecting themselves. And like every other time I would be released only to my school counselor. This was always a bit awkward. I would almost have to fake that this deep epiphany had been realized; that God Himself had saved me. Some of the administration and faculty at the college totally believed I was depressed because my relationship with God was distant and fuzzy at best. So praising God never hurt.

This time, however, there was a huge difference. I was armed with a more accurate disorder: I have BPD. And there is hope for me. And more importantly, I would get better, so Tim and I could be friends again. ‘Okay, I will give him his space,’ I thought. ‘And then after Christmas Break, when we’re both rested and I’m “fixed,” he’ll see that I’m no longer annoying. Sure things won’t be the way they were before… But at least we’ll still be friends forever. He promised we would. I care about him and so I will do this for him.’ I would learn however that this was something I needed to do for myself, and that denial would be the first step in grieving the loss of our friendship.

I woke up more than once during the night, wet with sweat. I was nervous. I was scared… so scared… I had messed up so bad. I wanted to be able to say goodbye to Tim, and yet I feared he wanted nothing to do with me. I had thrown everything away that semester… I mean EVERYTHING! I wanted so desperately to be able to go back in time, do things differently, say things differently. There was nothing I could do to take the pain away. The pain I had caused Tim was unforgivable. I couldn’t graduate with my friends anymore. The college was making me medically withdraw. I’d be left behind. My mom had called me many times while I was in the hospital. She had no trouble letting me know what she thought of everything, how I was a loser, how she kind of expected me to fail. She was right. She was always right. I wondered if her opinion of me would ever change. I wondered if Tim would ever forgive me. I wondered if I would ever forgive myself.

I had just finished writing this all in my journal when the buzzer went off. It was breakfast time. I got dressed and sat in the line to have my vitals taken. ‘This will be the last time I’ll ever be in a place like this!’ I vowed to myself. ‘It just has to be!’ I knew today would be a difficult day. Being discharged always was. Not only did I have to wait until after 5pm for the college counselor to come sign me out, I had to find a ride. It was another one of the college’s liability rules – she wasn’t allowed to drive me. Since I was considered a patient until she showed up, I still had to attend all the required meetings. It was also the Monday before Thanksgiving. So a lot of my friends had gone home early since some professors canceled classes. Finding a ride would be difficult. I missed my cell phone. I don’t know how I ever lived without text messaging.

After breakfast, I had my daily meeting with Dr. Eaton. We discussed my discharge plan. My goals were always the same: 1. Be free of suicidal thoughts. 2. Respect others’ boundaries. 3. Be medication compliant. This time however, there was a fourth goal: 4. Find a Dialectical Behavioral Therapy Program. “A what?” I asked. My mouth couldn’t even begin to repeat the tongue twister. He chuckled, his eyes smiling. “This is a form of therapy”, he explained, “that involves meeting with a personal therapist, as well as group sessions. This form of therapy focuses specifically on treating your Borderline Personality Disorder. The cool thing about this is you will have the opportunity to meet others with BPD. It’s a great way to find support and to support others.” I would need proof of participating in such a program so I could return to school.

Finally, I was able to find a ride. My suitemates, who had supported me fully by visiting me, were more than happy to pick me up. They were even going to take me to Ihop to celebrate. I had the best suitemates ever! Hands down! After signing the piles of paperwork I was given the okay to leave by the counselor. I said my goodbyes and gathered my belongings. The night air was crisp and beautiful. Never had ozone and car exhaust been so comforting! At Ihop, we did a ceremonial cutting of my hospital bracelet while waiting for our pancakes. Our waitress happily provided some scissors and snapped pictures of the event. What she must have been thinking, I don’t know. The bracelet didn’t flash “mental patient” in florescent orange or anything, so she probably thought I had undergone some surgery that had prevented me from eating solids for a week.

We finally arrived on campus. I nervously opened the door to my dorm room. It was a mess. There were piles of clothes strewn all over the floor. My bed was unmade. My computer was open on my desk, still on. My PS2 controller was uncoiled on the floor. It was as if life had completely stopped for a week. Was it all a dream? The only thing that was neat in my room was my beta fish tank. My roommates had taken care of them while I was away. They had even given them creative names that I wish I had written down. I had to get everything that wasn’t owned by the college packed up tonight. Tomorrow I would have to go to Admissions to get the paperwork, get signatures from all my professors, meet with the Dean, and be completely moved out of my room, all by 5pm. Only then would the medical withdrawal be official. Tomorrow was the beginning of Thanksgiving Break, and no one was gonna wait around for me. I looked at my alarm clock. It was 9pm. No way could I get all this done! Tomorrow I would have to say goodbye to my friends for who knows how long. They had been my family for the past four years! And besides, I had just been released from the hospital! I started to panic. I took a deep breath and thought for a minute. Surely they’d let me leave my things over the Christmas Break. I would be, I was convinced, coming back in January for classes anyways. So I left it all and went to the student center for what would be the last night with my friends.

We all sat in front of the TV, not really watching it, but not really saying much either. We all knew this wasn’t goodbye, and yet now I believe we all knew we wouldn’t see each other for years. Awkward jokes and laughs were exchanged as we reminisced about the semester. This was supposed to be a joyous occasion, in which we were grateful we had survived another round of classes and bad cafeteria food. And yet, we were somber. I was exhausted. Tomorrow would be a rough day. And so, reluctantly, I headed back to my dorm. I began to cry as I climbed into bed for what would be my last night on campus.

Borderline Personality Disorder: An Overview

What is Borderline Personality Disorder? According to WebMd.com, it can be defined as “a mental illness that causes intense mood swings, impulsive behaviors, and severe problems with relationships and self-worth” (1)

There are ways that Borderline Personality Disorder, or BPD, is diagnosed. Psychiatrists follow a guide called the DSM IV which lists every mental health condition, their criterion and their treatments. According to the DSM IV, BPD is characterized by: (2)

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts:

1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3. identity disturbance: markedly and persistently unstable self-image or sense of self.

4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

7. chronic feelings of emptiness

8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

9. transient, stress-related paranoid ideation or severe dissociative symptoms

It is important to mention that someone may possess one or more of these nine criteria and not have Borderline Personality Disorder. These would be the result of other conditions. A person diagnosed with BPD must, as the DSM VI states, have a “pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts.” (2). This is what makes BPD harder to treat than other mental health issues.

In my experience, BPD can be very scary and almost euphoric. I can think back to many relationships that I’ve “messed up” and for the longest time I didn’t know why. My moods were always up and down; always intense and hard to control. I felt out of control. In my worst moments, it was almost as if I was having out-of-body experiences where I wasn’t myself. It was more than not thinking before speaking; I knew exactly what I was saying and thinking, and at the time, the most horrible things seemed more than plausible. I would be the most vicious with those I loved the most and were closest to me. I deeply loved them one moment, and hated them the next, most of the time because I felt abandoned. This abandonment was imagined, and yet I was without a doubt in my mind being abandoned. I would do anything I could to avoid this abandonment, which seemed unavoidable.

There was something wrong with me. I was feeling worthless and helpless. How could anyone love an emotional freak? I did everything I could to change who I was, but nothing seemed to work. There was something wrong with me, but I didn’t know what. I turned to things like pot and sex to cope with my emotions. I also was trying to be someone else. I was trying to be the person others thought I should be, or at least what I thought they wanted me to be. Then the pot and sex turned into unhealthy ways to cope with everyday life. I knew that these things weren’t effective. I even felt worse after doing them. And yet they offered the temporary relief I so desperately wanted.

I’ve been in the hospital four times total, as a result of suicidal thoughts. I didn’t really want to die; I just wanted a way out. At the time I had already been diagnosed with depression, but I knew there was something else seriously wrong. No one would help me. They didn’t want to help me. I know now that this wasn’t the case. On the fourth and final hospital visit I was talking with the social worker. I remember trying to explain the reasons for my actions. And yet I didn’t even know what they were myself. She then told me that I have Borderline Personality Disorder. I was scared at first. BPD for many years has had this stigma attached to it, simply because we have only just learned how to treat it in the past 20 years. People with this disorder were labeled untreatable in the psychology realm, and were considered outcasts in society. When the social worker handed me some information however, I became extremely relieved. I read the DSM IV, and for the first time I wasn’t a freak. I knew what was wrong with me and that there was hope. I would be okay!

I enrolled in BPD-specific therapy known as Dialectical Behavioral Therapy, or DBT. This was developed by Marsha Linehan, a professor at the University of Washington. It consisted of one-on-one therapy with a counselor and group therapy. I was in the group portion for about a year, and have been seeing my counselor now for three years. She is a blessing in my life and I don’t know what I would do without her! I will be starting up a more advanced version of the group therapy in September.

This is just an overview of what I have experienced over the past four years. I will continue to post more experiences and daily accounts as a way to cope with my BPD, educate others and offer comfort to others with BPD.

~ Allyssa

Note: I would like to thank cbtish of cbtish.wordpress.com for reading and commenting on my post. She pointed out that I had missed an essential component in the definition of Borderline Personality Disorder. According to the DSM IV, in order for one to be diagnosed with BPD, they must possess all nine of the criterion. This is important because if someone were to have one or two of these nine, they would be caused by other conditions which are easier to treat. Thanks again to her contribution! I would also like to give a shout out to her blog: http://cbtish.wordpress.com/ She blogs about mental health in the UK and offers very interesting incite. ❤

Bibliography and More Info on BPD:

(1) http://www.webmd.com/mental-health/tc/borderline-personality-disorder-topic-overview

(2) http://www.borderlinepersonalitytoday.com/main/dsmiv.htm

Reader’s Note

Reader’s Note: This blog is a personal account of my life with Borderline Personality Disorder. I am writing to educate others and give others hope. It is not intended to diagnose, treat or cure anyone of any mental illness. If you think you or a loved one may have a mental illness, or you or a loved one are having thoughts of self-harm or suicide, please contact your primary care physician, or go to the nearest emergency room.

Some names have been changed to protect anonymity.