So your friend/partner/family member has BPD...

One thing that consistently comes up with Borderline Personality Disorder is relationships. That is, people with BPD are so difficult to be friends with. Or it’s really hard on a family when someone has BPD. Or people with BPD can never have meaningful relationships. I’m here to tell you that although relationships can sometimes be hard, it is possible to have good relationships when diagnosed with BPD!

Why are relationships difficult when BPD is involved?

BPD sufferers often have a deep fear of abandonment. This means that they are likely to be very clingy until they sense that you are going to leave. When they think you will leave, they will start to withdraw and leave first to avoid abandonment. I’ve seen it in movies a lot – girl hears that guy is going to dump her so dumps him first. It is a way to gain back some control, to avoid getting hurt. But, sometimes the sense of someone leaving is wrong. They were never going to dump her and now she’s lost the relationship just to avoid being left.

Certain behaviours can make you think that that those with BPD are horrible people. This includes things like manipulation and attention seeking. With BPD, manipulation is often used to get a need met. People remain unaware that there better ways to get a need met so resort to manipulation, often not realising that they are doing it. Attention seeking is common; it is often a cry for help or a desperate attempt to get someone to pay attention. For me, I often look for attention when I feel unloved or unheard. Making me feel loved and heard counters the need for destructive, attention seeking behaviour.

There are people who really love the intensity of emotions from people with BPD. My partner loves how passionate I get and how much I care about other people. However, it is understandable that this intensity is not comfortable for everyone. If I am your friend, I will constantly tell you I love you and I will worry about you and want to spend a lot of time with you. This is common with BPD. Therefore, if you feel like this would be too much for you and you like your friends more aloof and less emotional then BPD friendships probably aren’t going to be suited to you.

If you are finding it difficult to be in any sort of relationship with someone who has BPD then here’s some advice:

• Reassure them. Tell them that you are not going to leave them even if things get difficult.
• Do not make false promises. Never ever do this. Breaking a promise is never a good thing but when someone is particularly insecure then it can be very damaging.
• Talk to them. It is common for people with mental illnesses to isolate themselves; sometimes just a text letting someone know you are thinking of them will make so much difference.
• Do not make plans with all your friends and exclude someone, even if it unintentional, it is still hurtful. When you have BPD and you feel excluded, your mind enters the ‘everyone hates me, no one wants me around, I might as well be dead’ state which is never fun. Invite them to events, even if you think they’ll say no. Being invited to things is nice and reinstates the thought that you want someone around.
• Do not let them push you away. “I hate you, please don’t leave” is a common BPD trait. This means that I will probably tell you that I hate you and I’m doing it to test our relationship. If you stay despite me being awful then all is well but if you leave then you were just like everybody else who left before. I am not excusing being mean to people/testing people’s patience in this way however, if you understand the thinking behind it then it softens the blow.
• Be open and honest. Lying does not sit well with BPD. Finding out you have lied is horrible and for me, it makes me start questioning everything about you.
• Learn all you can about BPD, ask questions about it, try to understand it as much as possible. This means a lot with any mental illness. Showing that you care enough to go and find out about it is important and it will be useful for you.
• I have already mentioned this but again, reassurance is so helpful. Tell them you love them and that you care about them, that you are here to stay. It is all nice for anyone to hear but more so when you feel like you are inherently unlovable.
• If you believe that you cannot deal with the intensity of a person with BPD among other things, then do not enter a relationship with them. Do not become their friend or partner if you know that you will find it difficult. It will be much easier to have someone walk away early on. Going into a relationship knowing you will eventually leave is unfair.

A lot of this might seem obvious. However, they are all things that are commonly forgotten about in relationships and make a huge difference if someone has BPD. It can take more work when BPD is involved, but all relationships require some effort from those involved. If you are willing to do small things like offer reassurance and send a message every other day then a relationship involving BPD can be just as wonderful as any other.

Everyone is different, these things help me but ask the person with BPD what specifically helps them. Communicate your worries, be open.

BPD & Stigma

I’ve decided to explore the stigma attached to it here and why this is so damaging and often unfair.

Adding to the long list of symptoms that come with BPD is a deep stigma attached to BPD. Not only by the general population but specifically by mental health professionals. I personally work in the mental health field and the amount of negative comments I have heard from people is sickening. I have heard that:

“BPD can’t be diagnosed properly because they’re (those suspected to have it) all liars and attention seekers.”

“Ugh people with PD’s are so fucking difficult.”

“People with personality disorders are usually the ones who end up as criminals; real psychos.”

“I reckon my old boss had BPD, she was so manipulative all the time.”

These are completely unfair and unfounded accusations. Like people with mental illnesses do not have it hard enough, putting these negative labels on them further increases belief that being around us is impossible. Treating those with BPD badly like people often do only furthers our self-destructive behaviour. If you tell me that I must be an attention seeker and liar because of my diagnosis, I will believe you and I will hate myself even more. That is why it is so vital to spread understanding of mental illness; the stigma is so harmful to those with mental illnesses who are already vulnerable.

There is such a strong negative attitude towards those with BPD and is often because it is so difficult to treat. Do you know what will make it more difficult to treat? Making assumptions about the people who are being treated. This is a crass analogy but if someone assumed that a car worked in a certain way because they had been told this, they would then struggle to fix the car if it in fact did not work in this way. Someone who attempts to treat a person with BPD while believing that they must be manipulating you is completely irresponsible.

If you know someone with BPD then you will know that while they experience negative emotions intensely, they experience positive ones like this too. A person with BPD is not always in a state of anger/depression/anxiety and difficult to be around. They can also be fiercely loving, loyal and friendly. Please refrain from judging someone because you are scared that you will be unable to deal with their feelings. That is horribly selfish. You do not have to experience life like this, the least you can do is understand and show some empathy rather than passing judgment based on what you have read/been told.

People with BPD can be manipulative. This does not mean that everyone who is manipulative has BPD or vice versa. Being manipulative is often the only way that borderlines understand that will help them get something they need. It is unfair to think of manipulation in a wholly bad way. Manipulation does not make someone a horrible person.

Further to this, it is widely believed that everyone with BPD is violent. This is due to the knowledge of anger management being a common difficulty with the diagnosis. True, some people with BPD can have violent tendencies. However, it is much more common for someone with BPD to physically hurt themselves rather than others. Again, the strong belief in this from so many people leaves those diagnosed with BPD being feared. This would be detrimental to anyone’s well-being, more so when that person has a mental health issue.

Now comes the worst thing I have heard about Borderline Personality Disorder is something which I get angry just writing about. There are some psychologists out there who felt it would be beneficial to diagnose Hitler with BPD. Getting a mental illness diagnosed is hard enough but finding out that someone who was so beyond evil is suspected to have the same mental illness makes it terrifying. However, diagnosing historical figures is often highly inaccurate so please remember that. To any professionals, please stop adding to the already existing stigma surrounding this condition.

The important thing to remember is that Borderline Personality Disorder can be treated. We are often led to believe that having a mental illness is something that is awful and long lasting and impossible to overcome. This simply is not the case. There are medication options, therapy options such as DBT and mentalisation and lots of other things out there to help. I wish that access to these services was easier because I know how hard it is to live with this. However, it is possible to live with it and have healthy relationships and function despite what people might have told you. You do not and should not feel ashamed if you have BPD. The stigma is based on ignorance and misunderstanding.

Living with BPD; the highs, lows and madness

Trigger warnings: self harm, suicide

I was diagnosed with Borderline Personality Disorder last year. For me, the diagnosis was extremely helpful. The word ‘borderline’ with this does not mean almost a personality disorder as many assume. I wanted to share some thoughts on living with BPD and hopefully help some people feel less alone and offer a little bit of hope.

First and foremost, BPD leads to people feeling extremely intense emotions. Here’s a recent example of this from me: I got upset because I was unable to go out with friends and did not want to miss out on anything. It is natural to be upset. But, this quickly became an intense sadness that completely took over and resulted in self-harm. Rationally, I know that this was not helpful and frankly, an overreaction. At the time, I could not contain the sadness that turned into anger and self-harming was my way of relieving some of this intense emotion. 

To someone without BPD, emotions come and go and intense emotions are often a result of an intense situation. For those with BPD, emotions are often intense and lasting. While this means anger and sadness can be dangerous emotions with BPD, it also means that people with BPD tend to be very enthusiastic and friendly and fun to be around when emotions allow it. This shows that BPD does not have to be all negative all the time and it is possible to enjoy the company of someone with BPD.

Due to experiencing such intense emotions, it is very common for people with BPD to shut down. It is like a huge build-up of pressure in a container and we know it will soon explode so we just turn it off. We have difficulty regulating our emotions and so feeling nothing is better.

On top of all of this, people with BPD also experience mood swings very often. These often involve depression, anxiety and anger. There can be no obvious trigger to these mood swings and take it from me, they can be exhausting!

Another thing I would like to mention is feelings of shame. Before my diagnosis, I had noticed that feeling embarrassed or humiliated had a profound effect on me. If I was embarrassed by something, I would still be playing it over in my head and hating myself for it years later. Turns out that this is common with BPD.

Borderline Personality Disorder is often accompanied by substance abuse. For me, it was alcohol. At the time, I was unaware of BPD but I did know that alcohol numbed emotions for me. When sober, I felt everything all the time and it was draining. Having a drink would stop me thinking and feeling anything deeply. Obviously, alcohol is a depressant so in the long run is very damaging for someone with a mental illness.

BPD is also commonly joined by eating disorders and self-harm. These are other things which I have personally experienced. For self-harm in particular, I have always used it to relieve emotions. I get really really angry so I cut myself and feel better. Feeling better is fleeting though because then comes along the guilt and shame. In the moment, it feels as though nothing else will help but in the long run, it harms more. A pretty vicious cycle, right? While harming oneself might seem counter intuitive to mentally well people, it is very common among those with BPD. It provides relief from intense emotions that we have no other way of dealing with.

On to a topic that anyone close to me understands well, relationships with others. Before my diagnosis, I was very aware that I was clingy and insecure in friendships and romantic relationships. No matter how hard I tried to stop this and change the way I was around people, I could not do it. I still have not managed to do it but knowing it is part of BPD eases the self-hatred relating to it.

I have always been sensitive to rejection. Any of my friends will tell you that if I ask them to hang out and they say no, I will not react well. I will either believe that they hate me or will isolate myself from them so they cannot leave me. I am insecure and people often find it annoying that I need constant reassurance. Luckily, I have found friends who are willing to give that reassurance. It does not stop the insecurity but makes it more manageable. It is very easy for me to think that everyone I know hates me and will leave me because I hate me so much.

It might seem that being friends or in any relationship with someone with BPD is difficult. It can be at times, yes. But, if you take the time to understand the illness then it gets easier. If you know to offer reassurance and not be dismissive etc. then it will be possible to have a good relationship. This idea that people with BPD cannot have healthy relationships is bullshit. It is more difficult but it is not impossible. See here for an old post about my relationship before I knew we both had BPD!

One of the symptoms of BPD that is often misunderstood and unfairly focused on is manipulation. I hold my hands up and admit that I can be manipulative. Until recently, I would beat myself up about it. That was until my therapist asked me why I was being manipulative. People manipulate in order to get a need met. I do not manipulate people to hurt them, I rarely do it consciously. It is often very subtle but I do it because there is a lack of something which I need. My way of getting it just happens to be manipulation because expressing that I need something from a person is difficult for me.

Self-harm and suicide attempts from those with BPD are often thought to be part of their manipulation. Sometimes they are but that is not to be quickly judged. Imagine what someone must be going through to think the only way they can get love or attention is to hurt themselves. When I first realised that I had self-harmed in order to get attention from a friend who had been ignoring me, I was horrified with myself. I was about 16 and upon realising what I had done, I immediately started thinking that I was the worst person in the world. 

We are constantly getting sent the message that anyone who hurts themselves for attention or validation is bad. This is not true. They are often hurting and scared and do not know what else to do, it is a desperate act. It is damaging to assume that any self-destructive behaviour is only used to manipulate others into responding in a certain way.  

BPD often leads to difficulties having a strong sense of self; people tend to have difficulty knowing what they like or value or struggle with setting any goals. This is something which leads to a lot of indecisiveness, something I have trouble with on a daily basis. I am also prone to adopting attributes of characters in film, tv and books. I do this because I often doubt myself and everything about me. By turning myself into someone else that obviously knows who they are, I then feel a stronger sense of who I am. Obviously, this is not the healthy way to develop knowledge of you but it stops the fear and empty feeling.

People with borderline personality disorder often struggle to concentrate. This is hardly surprising considering all the stuff going on in our heads on a daily basis. The lack of concentration can often lead to dissociation, a type of “zoning out.” It is often clear when someone is in this state as their face and voice might become expressionless. Dissociating is the mind’s way of avoiding intense emotions or painful memories. This can be helpful until it starts to happen with normal, every day emotions which everyone should be able to experience.

There you have it. I have, by no means, covered everything but this gives a bit of an overview of what it is like to live with Borderline Personality Disorder. Next blog post about it will focus on the stigma attached to the condition.

Mentalisation

I am currently taking part in some group therapy as treatment for my recently diagnosed Borderline Personality Disorder. This therapy is mentalisation based… sounds a little pretentious doesn’t it? I have actually found it really helpful and I still have 4 weeks left. Not many people have heard of mentalisation so I thought I’d try and explain what it is.

What is mentalisation?

Put simply, mentalisation is about being aware of what is in our own minds and the minds of others. “Holding mind in mind” is a common phrase used in therapy. But more than that, mentalising is about not making assumptions about things and being open to alternative possibilities.

For example, whenever my friends reject my invitation to do something, my thoughts immediately turn to “they’re going to leave, they hate me, I am an awful person.” With mentalising, it is about opening up, thinking that maybe this is not the case, maybe they really are busy or they have their own stuff going on.

It is something that everyone does naturally, a skill we develop as infants. If you have ever thought “why did I do that?” or “maybe what I said has upset that person” then you were mentalising. You were thinking about your own feelings and those of others. However, some people find it easier to do than others which is okay because it is a skill that can be practiced.

Surely thinking too much is not good?

It is not about the quantity of your thinking but the quality. This sounds strange but, usually thinking too much is quite negative. We tend not to ruminate on good things that happen, it is usually the bad stuff. Mentalising asks us to think about things in a more open way. This means that while we might be thinking a lot about feelings, the thoughts will not be damaging but helpful.

Back to the rejection example. If I were to over think it, I would constantly go round and round thinking that everyone hates me. But, mentalising is about stopping that and thinking differently.
Failing to mentalise can lead to difficult relationships. If we are always sure that we know what others are thinking, this can be very damaging. If you think that every time your partner talks to another woman, they are thinking about cheating, you will become distrustful and paranoid. Yet, if you think about why you believe this and other options, communicate this to your partner… well, it would make the whole situation a lot less horrible!

How am I supposed to mentalise if I am really angry?

This is probably the most difficult thing when it comes to mentalising. When our emotions are heightened, it is much harder to stop and think about anything. The best mindset to mentalise in is when our emotions are balanced – we are not completely numb and we are not feeling everything at once. How do we get there?

Stop and take a step back. Whenever you feel yourself getting to the point of extreme rage, for example, take some time out, move away from the situation until you feel calmer. Then do some thinking and go back into the situation when you feel ready.

If you cannot do this because it’s really difficult then that is okay. Because it is possible to mentalise about the past, present and future. We can look back on situations, as we all do, and think that maybe the person we were interacting with was having a bad day and that caused their angry behaviour. This is still an important thing to do as it allows us to see things in a wider perspective.

Who can use mentalising?

Everyone! It is a really useful skill that can improve our relationship with ourselves and others. It is particularly good for those with mental health problems.

So hopefully this hasn’t been full of too much jargon and has helped you understand mentalising a little and why it is so useful. Personally, it has been hugely beneficial for me so far. If you would like to have mentalisation based therapy as you think it would be useful, talk to your GP about it.

BPD and relationships

I have been with my boyfriend for a year now, we've just moved in together and are very happy. Our relationship didn't start in a conventional way... I was in an episode of mania due to a screw up with medication dosage and he was off his medication. So it was a bit of a whirlwind. But it settled and although our relationship is not perfect, we're very much in love and happy. I'm not just writing this to make all you singletons feel bad! I'm writing this because my boyfriend also has Borderline Personality Disorder and this is often said to make relationships difficult. I want to give an example of someone with BPD who is in a healthy relationship to show that if someone you like has this illness, it can work!

What exactly is BPD? Well, it's a mental illness with a wide range of symptoms. It's a mood disorder which also affects how someone interacts with others. Some symptoms include feelings of anxiety, depression and anger. Those with BPD often abuse drugs or alcohol or use self harm to manage their feelings. BPD sufferers can also experience hallucinations and hearing voices. It often results in impulsive behaviour such as self harm or binge drinking. So it's a lot of horrible stuff that those dealing with BPD have to cope with. I am going to focus on relationships here though.

BPD can often make it difficult for a person to maintain a relationship. Those diagnosed sometimes have a deep fear of abandonment so they will appear to be very clingy, perhaps they will constantly phone you or not want to leave your side. Those with BPD tend to experience moments of 'leave me alone' towards their partner followed by 'please don't leave me.' People with BPD have very black and white thinking, there is no grey area to them. Either a relationship is wonderful and perfect or it is terrible and will fall apart.

All of this unfortunately can lead to break ups and there are many comments across the internet warning people not to start relationships with someone who has BPD. However, relationships with a BPD sufferer can still be great! How is this? Well, it takes a lot of work but here's some advice:

1. Understand the condition.
Learn to identify the symptoms in your partner. Know everything you can about BPD, its causes and treatments. The internet is full of information and if in doubt, talk to your partner about it. But, do not constantly remind them of their problems. They are aware of them and think about them every day. Do not point out every time they act in a way that reflects their BPD.

2. Encourage your partner to get treatment.
If they are not already, treatment will be necessary for them to live a fulfilled life. Go with them to the doctor, be there every step of the way. Medication or therapy, just reassure them that you will be there to help. With treatment, their condition will be easier to manage and so will your relationship.

3. Tell them you love them every day.
People with BPD often need a lot of reassurance. Something as simple as 'I love you' could calm their fears that you are going to leave them.

4. Know that sometimes they do not mean what they do/say.
This is the case with many mental illnesses. A person is more than their mental illness, much more. But sometimes their illness might take over and someone with BPD could, for example, be quite aggressive when shouting at you. They will feel terrible afterwards. Accept that it is not their fault, talk through it and move on.

5. Talk to them and be honest.
Communication is so important with BPD. Letting a partner know how you are, that you care about them etc is important in any relationship but particularly those with BPD. They may often feel worried and anxious that the relationship is going badly, talk things through with them no matter how difficult it might be to understand. If they have done something to upset you, do not just tell them it's okay because they have mental health issues. Be honest with them about it. That will help them learn what others see as right/wrong.

6. Keep your promises.
If you tell them you will do something or be somewhere then do it! If you don't, that person will find if difficult to trust you in the future. A lot of mentally unwell people are like this but it is more extreme for those with BPD.

7. Let them be an adult.
Many symptoms of BPD like anger fits and acting impulsively may seem quite child like. However, you should not make the mistake of treating them like a child. They are still responsible for their actions even if it was their BPD symptoms taking over. If they smash a door, they sort it out. If you always fix things like a parent/child then they will not see a reason to change.

Also, there are some great things about having a partner with BPD:

• They can love fiercely and completely
• They are passionate
• They have been through difficulties so will understand yours

Basically, it is possible for someone with BPD to have a good relationship! Do not think that because the internet is full of horror stories that your experience will be the same. It could be amazing. We should not be teaching people to avoid relationships or friendships with those suffering from mental health problems. Relationships are something which both people have to work on together. This is just advice for anyone who is in a relationship with a BPD sufferer to let you know it does not always have to be bad. Mentally ill or not, those in relationships of any kind deserve mutual love, care and respect.