Where my story begins would mean having to go back a few decades or so, and trudging through a lot of unnecessary and sometimes repetitive stuff. So for the sake of time, and boredom, I’m going to start my story from several months ago, August of 2016, to be exact. This feels like a good place to start since in a number of ways I am at the beginning of new things, namely my diagnosis but my treatment as well. The diagnosis I’m speaking of is Borderline Personality Disorder. At first I wasn’t sure this diagnosis fit, and even my psychiatrist wasn’t a hundred percent about it either.
Now I can’t speak for my doctor’s reservations about confirming the diagnosis but I can tell you for me the term itself conjured an image of a hysterical woman with erratic thoughts, and erratic behavior, and even erratic hairstyle (I went full out for this image). I imagined this desperate woman who seemed constantly on the edge with periodic bursts of hysteria coupled with complete confusion and the underlying concern of never being too sure what this woman was really capable of.
I can tell you that my psychiatrist was leaning more to whether or not I fit the criteria but in my head was this erratic, hysterical, unpredictable woman, and my first thought was ‘that’s not me’. Now as it turns out, it was actually a little closer to me than I originally realized, or cared to admit, and the diagnosis itself wasn’t too far off the image either, minus the hairstyle, which you can have if you want, but it isn’t mandatory.
I have travelled down Diagnosis Road before, and over the years have mostly whittled it down to two or three that I continue to struggle with to this day, and a couple that fell off the map long ago, having never really fit me in the first place.
In no particular order, I have been diagnosed with generalized depression, mild to severe depression, severe depression with suicidal tendencies, bipolar disorder (later changed to bipolar episodes…whatever that means), generalized anxiety disorder, panic attacks, mild agoraphobia, mild social anxiety disorder, attention-deficit disorder, and last but not least, binge eating disorder.
It has been a long, long road, so you can understand my initial hesitancy at this new diagnosis of Borderline Personality Disorder, or BPD.
Thankfully, before my doubts and fears, and this colourful image of a hysterical woman could really take off, my psychiatrist pulled her big blue copy of the DSM (Diagnostic and Statistical Manual of Mental Disorders) off her shelf and went over the criteria with me.
To meet a diagnosis of Borderline Personality Disorder under the DSM-V, you must show “a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning in early adulthood and present in a variety of contexts, as indicated by five (or more) of the following”:
- Frantic efforts to avoid real or imagined abandonment
- A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
- Identity disturbance: markedly and persistently unstable self-image or sense of self
- Impulsivity in at least two areas that are potentially self-damaging (e.g., substance abuse, binge eating, and reckless driving)
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
- 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)
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
- Transient, stress-related paranoid ideation or severe dissociative symptoms
At first, it seemed that I only met 5 of the 9 criteria however after some further investigation into what each criterion meant, it turns out I actually met 8 of the 9 criteria. The sole criteria that I didn’t connect with was #8 – Inappropriate, intense anger or difficulty controlling anger. I personally actually avoid anger at all costs, mine and other people’s. But my anger issues will be for another time. My point is the diagnosis of BPD was starting to fit, and slowly a lot of things from my past, as well as current events, started to make a lot more sense.
Hmm. Well played, doctor.
It was at this point that my doctor suggested I look into DBT. For those of you not familiar with it, DBT stands for Dialectical Behaviour Therapy. It was developed by psychologist Marsha Linehan in the early 1990’s especially for those struggling with BPD, and it was and remains the most effective form of non-pharmaceutical treatment for BPD to this day. Further details of what DBT is will be covered in the next post.
The unfortunate part for those suffering with BPD, is that right now DBT it is not as widely available as one might hope. Major cities tend to be the richest source at this time but for those in rural areas, please don’t despair. DBT is becoming increasingly popular, especially as the treatment continues to prove its high success rate in allowing Borderliners to finally gain control of their emotions, manage their stress and their relationships, and more and more professionals are being trained in the treatment of DBT. Hopefully it won’t take long for DBT-trained professionals are able to be found across the country in every city, region and town, no matter where you are. There are several good books out, that I will suggest in a separate post shortly, including the bible of DBT by Marsha Linehan that are available for purchase that can be of some help in the meantime. They by no means can replace what a professional can offer but it is a good place to start.
I was absolutely fortunate that I was referred to a DBT group that had just opened their acceptance and waitlist, for ONE WEEK!, and I was able to apply and get in. I give oodles of credit to my social worker and psychiatrist for all their efforts and getting me access to the waitlist in the first place. It is a year-long program where I attend one group therapy session and one individual therapy session every week.
I have just started the course, and will share what I am learning, and hopefully my progress every week here.
NOTE: If anyone, at any time, has any questions regarding the modules, the treatment, or needs clarification of anything, please feel free to ask. I may not have all the answers but I will do my best.
Lastly, for anyone struggling with BPD, or if these criteria sound like you, then I urge you to please speak to a professional, and do some research to try and find a DBT course, or a DBT-trained professional in your area. If you aren’t able to access one at this time then I urge you to speak to a therapist regardless and maybe check out a few of the DBT books on your own. Either way, to any Borderliner, diagnosed or not, I sympathize. I know living with BPD is hard, and can take over your life. My own life has been quite the struggle too.
I wish all Borderliners out there the best of luck.
As for me…here’s where my BPD and DBT journey begins…wish me luck!
See ya soon!