Let’s talk BPD

I have spent the last hour browsing different Borderline Personality Disorder (BPD) articles online while Benidorm plays in the background. It’s rare I learn something new in these, but today I did, not particularly about my illness but about raising awareness of it. Apparently, May is Borderline Personality Awareness month.

I haven’t blogged on here for a while, mainly because I write more when I’m struggling as a way to process what’s going on and recently, for a while now (luckily) things have been pretty stable. When I read it was BPD awareness month I thought about how if I’d know i’d of written something new each day on statuses to explain what BPD really is but seen as I missed the majority of the month I thought I’d take to the blog again.

Here are 31 things about BPD, one for each day of the month. Some are specific to me, some are general facts and some are things I wish people knew.

1 – There are 40 different terms that are used when talking about BPD which all mean BPD, some of these are BPD, emotionally unstable personality disorder, emotional disregulation disorder and complex developmental trauma.

2 – These different terms make it harder for clinicians and patients to understand what is been talked about and diagnosed, BPD is still the most commonly used name despite the official name of the disorder changing to emotionally unstable disorder several years ago

3 – There are 9 diagnostic criteria for BPD, a person who has 5 or more of these can be diagnosed however all the criteria are blanket terms which branch into different issues, meaning a group of people with BPD could sit together and not one of them experience the same symptoms

4- The only symptom all people with BPD share is emotional intensity/instability

5- BPD is normally comorbid with other mental illnesses, the most common of these are depression, anxiety, substance misuse and eating disorders

6- It is common, in times of emotional stress to experience psychosis and disassociation.

7- Disassociation is difficult to describe, the best thing I can compare it with is being in a dream like trance, you’re on auto pilot, you don’t know what’s going on around you and things done feel real, but somehow you can still do things

8- People with BPD can experience flashbacks

9- No one is really sure what causes BPD, it has been suggested that it is a mixture of genetics and traumatic experiences

10- BPD is highly stigmatised, people with BPD are labelled manipulative, attention seeking, not worth the effort and hopeless cases, this stigma has caused funding to be withdrawn from treatment plans

11- the emotional extremes of BPD are not triggered by huge events, one word can trigger severe depression, one tiny change to a day can trigger mania

12- this emotional unpredictability has been classed by professionals as “unbearable” and “too much to handle.”

13- BPD has one of the highest suicide rates of any mental illness. 70% of people diagnosed will attempt suicide, 10% will succeed.

14- For people with BPD suicide and self harming thoughts can become obsessive and intrusive

15- Over 40% of people diagnosed with BPD are initially misdiagnosed with something else first

16- BPD can have some strange symptoms caused by the umbrella diagnostic criteria, these include

17- Oversharing

18- Emotionally shutting off / refusing to have close friendships or relationships

19- Appearing emotionless or cold hearted

20- being tired or physically ill

21- People with BPD diagnosis’s make up at least 20% of patients in inpatient units in the UK

22- People with BPD make up almost 10% of A and E presentations

23- BPD is classed as a sever mental illness which needs long term treatment, group therapy, one to own therapy and crisis management. There are currently 3 places in the Uk which offer this, despite 0.7% of the population having this diagnosis, that’s 448,000 People.

24- BPD and bipolar are often confused as the same thing but they are very different, the key difference relates to how quickly moods and emotions cycle and the thought processes behind these

25- there are no medications specifically to treat BPD

26- Splitting or Black and white thinking is a common and misunderstood symptom of BPD An explanation of what this is can be found here

27- the focus of BPD treatment is not how to get rid of it but how to learn to live with it having less of an impact on day to day life

28- personality disorders are there own category of mental illness, they are not mood disorders, anxiety disorders or psychotic disorders by so share some of the same symptoms

29- People with BPD share some positive traits, it has been proven that generally they are more creative, expressive, compassionate and can pick up on others emotions easier than neurotypicals

30- early 20s are the most common time to be diagnosed

31- Despite the common myth, it is possible for people with BPD to go onto live a normal life with the right treatment and support

If you are worried about you or someone you know having BPD Click here

If you want to learn more about BPD, try this amazing explanation Video

If you or someone you know are in crisis call 116 123

If you or someone you know is an immediate risk to themselves or others dial 999

What it feels like to be signed off work for mental health reasons.

I have been declared unfit for work due to my mental health numerous times. Sometimes I would be signed off, go back to work and be signed off again after one shift. That was in my last job, a job I enjoyed but didn’t really care about. It meant nothing to me to miss a few weeks or months and then go back. Around 18 months ago, after just graduating university and after a crazy (quite literally) year I landed a new job. A job that I cared and still care about. In those 18 months I have phoned in sick twice, only one of those times was mental health related and it was just after my dad passed away so I kind of let myself off for that, and, even then it was only a couple of days, not long enough that I could no longer self certify.

A few months ago, maybe more than that my mood took a turn for the unstable, I was carrying on as normal and keeping myself on track enough to still be working. Then I wasn’t. In mental health world theres a fine line between struggling and in control and struggling and no longer in control. Right now, I find myself in the latter part. I may be in control of my actions but I am completely out of control on an emotional stability level. It started to effect me at work and a few weeks later I found myself declared unfit. It hit me hard, I didn’t ever expect to be back in that place again. Lets talk about the issues and the positives that come with being signed off shall we?

So, before I get into the issues, here are the positives that I can think off.

  • Being signed off gives me more faith that my doctors know my illness. They know when its time to say stop and time to say go. My doctor advised I be signed off a few weeks before I was, he left it with me and I was adament I wouldn’t do it, but on my next visit and the worsening of my symptoms he took the option out of my hands. Looking at the situation that was the right call, and that helps me trust the system a little more.
  • Being signed off takes some of the pressure out of day to day life. For now I don’t need to think about going to work and functioning on that level. I have time to focus on keeping myself safe and that can be full time job in itself.
  • I have the time to work out an updated plan for keeping myself well. The last one I did was a couple of years ago and included things such as ‘go out of the house at least once a day’ and ‘make sure you at least shower.’ Those things are no longer an issue for me now I can swap them out for skills that help me in my higher functioning lifestyle. In looking at those plans I can also appreciate how far I’ve come, and praise myself for it. Like, at one point I was that unwell I couldn’t function without hospital stays and friends monitoring me and actually one hard time in 18 months is fucking good going. Recovery is never a straight line.

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Now lets talk about the challenges, and to do that lets start at the beginning of the being signed off process.

Firstly is the visit to the doctors, I don’t have a massive issue with this, I’ve always trusted my doctor, more than mental health professionals in some cases, but it can be daunting for some people to go to there GP and tell them there mental health issues.

The next thing is one which I struggle with, the dreaded phone call to work. Like hey, I know I’m meant to be on shift tomorrow, I know I’m screwing you over massively and someones going to have to work extra hours but I can’t come in tomorrow, or for the next 3 weeks. I had so much anxiety over doing it, and it makes me feel like the biggest dick on the planet, but truth is it’s better that I do that than come in in the non functioning state I’ve found myself in ( I should also add that if you have a good employer there shouldn’t be 20 questions or any guilt led by them, luckily for me I am in that position). Currently Ive been signed off for a week longer than expected with a note on my sick note saying I need to be reassessed at the end of the two weeks. That scares me even more, because once again in 2 weeks time I may have to ring in again saying I’m not going to be back in at the last minute, leaving me with the, you’ve just screwed everyone over once again feeling.

Then theres the ‘I feel emotionally naked’ feeling, I am open about my mental health but theres something really degrading to me (and I’ll admit its my issue) to hand in a sick note that discloses my biggest secret, the thing I try hardest to hide.

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An issue I faced today was the wording of my sick note, which just says ‘depression’ when I actually want to explain. Yes depression is an issue for me, but right now its instability which means depression, hypermania, impulsivity, anxiety, inability to function in relationships, flashbacks, addiction,dissasociation and so much more. My doctor always puts the least possible on my sick notes because of confidentiality but sometimes it feels more of a hinderance than a help.

Then theres the actual time off. 

How do I explain to the people around me that Im not working for the next couple of weeks? To my mum (who I now live with) I’ve gone down the line of stress. Theres a lot the older generation don’t understand about mental health, my mum falls into that category, which I don’t blame her for at all. She actually tries really hard to understand and support me but I can see the panic and confusion when she tries to talk about it, I think thats a problem with the education in mental health rather than her, but still its there. So for now I’ve gone with stress, then theres the rest of the family, they understand a lot more, but do I change my story to them and risk exposing myself to my mum?

What am I meant to do with my time?

Theres something about being crazy that turns you into a child, like have a spent the last week doing jigsaws and puzzle books just to keep myself distracted? Yes. Have I being spending 18 hours in bed? Yes. Have I been painting and colouring? Yes. There is another panic, what if when I get back to work someone asks me what I’ve been doing? When I answer it won’t sound like I’ve been ill, it will sound like I’ve had a bit of a jolly, but actually I’ve being doing those things to distract myself from my own thoughts and pain.

I 100% don’t want people to know that I’ve spent the first week of my time off reliving every moment of my last 2 weeks at work questioning every decision I’ve made whilst at work. Like have I fucked everything up. When I said that, was that me or my mental illness. When I snapped at that co-worker, was it justified or was that my illness. Then theres the bits I don’t need to overthink, I know I fucked up because of my mental health and I feel guilty 97.34% of the time.

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Being off work means any small amount of motivation I had to keep it together has gone. Like, do I want to start drinking as soon as I wake up? fuck it theres nothing to stop me now, do I want to stay in bed all day? Yes and now theres nothing to make me get up… I was going to make more examples but I’ve reconsidered in case they disclose to much, sorry about that I guess. Truth is in the job I work, it would be selfish of me to carry on going in, barely aware of reality just to keep myself going.

And lastly, you’ll be glad to hear, heres my massive concern, what will people do when I get back? Will everyone treat me like normal and pretend I was never off? I hope so. Will people ask me if I’m Ok? please no, because lets be real, I’ll be better, I’ll be functioning and I’ll be back to doing my job, hopefully well. Will I be OK? probably not, just better.  Worst off all, will people question my ability to do my job? Will I be seen as less? Will my time off be judged? With everything I’m hoping the answer is no. But thats part of the issue with mental illness isn’t it? If I was signed off sick because of a stomach bug, or the flu, would I have the same issues, the same questions?