According to statistics only 1% of the population have a diagnosis of the complex mental illness that is Borderline Personality Disorder.
It is a highly stigmatised illness, even within the mental health nursing profession.
Sufferers are portrayed as being “attention seekers “, ” manipulative” or “unstable “.
But is this really the case?
One of my best friends suffered all of her life with this harrowing illness. She was classed as ” high functioning “.
In her early years she was perceived by many others to have a ” perfect life ” from the outside.
She lived in the countryside, had lots of friends and came from a large family.
However, during those early years, she was bullied by many people around her, that led her to feel overwhelming feelings of low self worth .
Because of this and traumas in her early adult life, she became very susceptible to abusive relationships.
She never learned to express her inner anguish effectively, but learnt to anaesthetise those feelings through alcohol.
As she became more dependant on alcohol, chaos ensued around her.
Her behaviour became increasingly self destructive and reckless.
She attempted suicide at 18.
She didn’t feel worthy of love or acceptance because of her previous experiences and poor treatment from those around her, so she lived in a bubble of intoxication through substance misuse.
This propelled her into her first abusive relationship that lasted 6 years.
6 years of constant mental abuse, reaffirming her beliefs of being ” worthless” and “useless ” and that nobody else would want her.
At university she struggled to feel accepted, not by her peers who she developed a good rappor with, but by fellow mentors, the very people that should have been encouraging her.
The one thing that gave her hope in the face of this adversity was her tutors at university, one of whom, in particular was kind to her and always believed in her.
On graduation from university, she decided to give up alcohol through a local support group in her hometown.
She realised she could no longer keep drinking if she wanted a chance at living a healthy and wholesome life.
As she became sober and stronger mentally, so too did her clarity become more transparent.
She removed herself from the abusive relationship and focused on the friends in her local AA group.
An opportunity arose for her to work overseas so she took it and her confidence grew. As her confidence and self belief started to grow, so too did her self awareness and desire to explore her own identity as she spent a lot of time alone on the other side of the world, travelling and meeting new people.
As her adventure accelerated, she joined a church, and was baptised as a “born again christian”.
Around a year later she moved back to the UK. However she felt deeply unsettled and restless and moved from job to job trying to find inner peace.
She maintained sobriety all in all for around 6 years, but on her 30th birthday, due to several stressful events in her life, she relapsed.
Her spiral into alcoholism began once more.
She struggled with deep anxiety which affected her eating, so she was often taunted with comments about her scrawny frame.
Coupled with intermittent bouts of alcoholic binge drinking her health began to suffer
Despite all this she managed to maintain her professional role as a nurse, trying to seek help when she could to abstain from alcohol, attending regular support for alcohol addiction.
Around the time of her 32nd birthday her lack of self worth, once again bubbled up to the surface and as she engaged in yet another poor choice of relationship, she was crippled with insecurity about who she was, constantly comparing herself to others and feeling totally inferior to everyone else.
This fuelled her anxiety and depression and despite being put on antidepressants, her inability to cope with her inner torment allowed more abuse to pour into her life from those around her who perceived her as weak, volatile or “attention seeking “.
However she was deeply troubled and this was evidently expressed through her extreme weight loss , inability to hold down a job, her volatile relationships and her destructive relationship with alcohol.
Over the next few years her addiction began to consume her and despite attending AA meetings, she looked on as friends she had made in the fellowship died prematurely as a result of the illness that gripped her whole being .
But this did not stop her, as deep down, she could not nullify her self loathing that poisoned her from within.
She tried everything to get some degree of peace within her self, seeking professional help from counsellors, addiction specialists , psychotherapists, psychologists.. but no-one seemed to be able to “fix” her.
She began to feel pressured by those around her who seemed to life “normal” lives.
Stable lives. And to her, this was all she really wanted, stability and not volatility.
She felt misunderstood and judged by many many people, including those closest to her.
My friend was getting desperate and becoming more and more hopeless as she struggled to deal with her feelings, spent all of her savings as was unable to manage her own finances due to her impulsive traits, and her actions snowballed to the point she lost everything.
Last year, I’m happy to say, my friend had a detox from alcohol, she is a nurse, so she knew what she needed in terms of medication. She attended AA and her support groups such as church and took many trips away to remote places filled with nature to gain some recovery. She surrounded herself with people she felt understood her and demonstrated warmth and compassion towards her. This was like a tonic for her and once again she gained distance from her inner demons .
However, if you don’t extract the root of a weed, it will only grow back .
So she decided to see a psychiatrist who diagnosed her with Borderline Personality Disorder and Bipolar disorder type 2, which is characterised by everything written above.
It instilled her with horror as she pondered whether or not she could ever be cured completely.
The answer was “no” but she could learn to live with her condition, understand her condition and use effective coping strategies emotionally to manage her effective mood dysregulation.
Through all of this, especially when intoxicated, she constantly fought the intrusive appeal of suicide that lived inside her head.
However medication she was placed on, therapy and her faith, her main coping mechanism brought both comfort, strength and stability back to her life.
It took approximately 18 years for anyone, including Doctors, Therapists, even the Mental health environments she worked in to recognise she had this chronic enduring mental illness.
As a mental health nurse myself this has highlighted how stigma and lack of understanding around this illness has had serious repercussions on a mental, emotional, psychological level. And it has highlighted a greater need for more insight into this illness, including education and knowledge within the medical and psychological profession as well as in schools and universities and amongst employers.
My friend had a very common symptom of this illness, as a consequence of her inner restlessness she moved around frequently so there was lack of fluidity between her own employers and those providing her with clinical interventions, which was also a contributing factor in the deterioration in her health.
My real question is, is the true population of sufferers of BPD really 1% or is it just that those sufferers like my friend are still existing in society, suffering in silence, because the medical system has failed them, just like my friend.
One of the main causes of death in those with BPD, is suicide.
I know myself, from conversing with my friend, this crossed her mind many many times, not even the thought of her family or friend would stop her.
As her life spiralled she felt purposeless, questioning the meaning of her own existence.
But her spirituality and desire to connect with those suffering on an equal level gave her hope, that through pain, comes an understanding, that creates a connection with others that recovery is possible.
My friend remains in recovery, having regular therapy and on medication to stabilise her depressive mood swings. She is learning new techniques to cope with her emotions and has aspirations to help other sufferers, particularly those who don’t recognise they are ill, such as other people who misuse substances, behave in self destructive ways, that they aren’t “attention seeking” as they may be labelled by those who have little understanding of this, but in actual fact there is a deep root, an emotional core, moulded by how others have treated them in life, or how society models success and failure, that needs both reconditioning in order to facilitate inner healing.
Education, Insight, Reflection, Clarity, Communication, Reconditioning and implementing this strategy I believe is crucial in the evolving advances of managing and treating mental illness effectively and therefore reducing rates of suicide significantly.