I’ve been to see my new psychiatrist. There were two doctors and they did a huge, comprehensive assessment with me that included a lot of grilling and difficult questions. I was relieved that they were both quite personable and really listened to what I had to say. They then went away to discuss me, and came back with a new diagnosis; BPD.

I’ve been treated by my old psychiatrist for almost a year now, with the diagnosis of major depression. Various therapists have also highlighted my PTSD symptoms, which I’ve been aware of for some time. So I was surprised when they told me they think I have Borderline Personality Disorder (or Emotionally Unstable Personality Disorder as it’s also known). I’m concerned about this change and what it might mean; primarily a new course of treatment and different medication.

I went to the Mind website and did some reading. It’s a great source of basic info on all things mental health. I found quite a bit of it fitted, but at the same time, those symptoms are common to a lot of mental illness.

What is BPD?
Borderline personality disorder (BPD) is a type of personality disorder. Personality disorders are a type of mental health problem where your attitudes, beliefs and behaviours cause you longstanding problems in your life.

What are the symptoms of BPD?

• You feel very worried about people abandoning you, and would do anything to stop that happening.
• You have very intense emotions that last from a few hours to a few days and can change quickly (for example, from feeling very happy and confident in the morning to feeling low and sad in the afternoon).
• You don’t have a strong sense of who you are, and it can change depending on who you’re with.
• You find it very hard to make and keep stable relationships.
• You act impulsively and do things that could harm you (such as binge eating, using drugs or driving dangerously).
• You have suicidal thoughts or self-harming behaviour.
• You feel empty and lonely a lot of the time.
• You get very angry, and struggle to control your anger.
• When very stressed, sometimes you might:
  • feel paranoid
  • have psychotic experiences, such as seeing or hearing things other people don’t
    feel numb or ‘checked out’ and not remember things properly after they’ve happened.

To be honest, I’d not read much about BPD previously, and I know it has a very negative reputation. I have always heard people say that BPD is permanent, it is who you are. Therefore it is lifelong and treatment only manages it. I was frankly quite horrified at the idea of having a condition that I am always going to have to manage.

But then I thought about it differently. Because all mental illness is about managing. It is always something that can resurface, at times of stress or illness for instance. Depression is by no means any different. Studies show that treating it adequately when it is acute and learning how to manage life in healthier ways significantly reduces the chance of relapse. And BPD is just the same. Nobody is saying, ‘this is your personality, live with it’.

Personality is just a cluster of traits, behaviours and preferences. It isn’t fixed and finite. We all change as we go through life. Yes, we are predisposed to certain behaviours through genetics, but I don’t believe any of these qualities are impossible to change. The human brain has incredible plasticity, and every experience changes how we think, even if only in the most minuscule way.

So even if that is my diagnosis, I’m not going to give up on everything I’ve fought for over the last year. None of those struggles are insignificant. I’ve had days when I felt like every hour was harder than the last. I won those battles. I’ve had time to really examine myself and what sort of place I’m looking for in the world. That stuff matters. Not symptoms. Not labels. Not terminology. The fabric of who we are is so very much more than that.

Image from Creative Commons, courtesy of Neil Conway.