Written as part of the Borderline: Through the Looking Glass blog series for Lighter-Minds mental health support.
People with personality disorders are ostracised by society.
It's time that changed.
DSM-5 lists ten specific personality disorders: paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent and obsessive-compulsive personality disorder. The phrase ‘personality disorder’ implies something wrong with the person, not a medical condition, yet this is not the case.
With numerous personality disorders out there and mental health awareness on the rise, you would assume the stigma surrounding these conditions would fade away. In actual fact, people suffering from personality disorders still face discrimination in the workplace, bullying in educational institutions and interpersonal struggles in day to day life due to prejudices by the general public.
This new series of blog posts are aimed at tackling presumptions made by people against those who face a personality disorder. Written by C.J. Appleby, owner of Appleby Ink and co-founder of Lighter-Minds UK who was diagnosed with BPD in 2019 and has suffered from symptom since childhood.
Borderline, not crazy
It’s a well known fact that early years and adolescence shapes an adult personality, behaviour habits, traits, through the network of neurological pathways adapting in the brain to both chemicals, environment and interpersonal relationships.
My diagnoses came at no great shock. Since I can remember, my mental health has been central to my life. It started as most does; during adolescence and worsened by socialisation at school.
As a teenager, I suffered multiple symptoms: extreme emotional episodes, uncontrollable anger, manic depression, panic attacks and bouts of anxiety. This led to being stereotyped as a problem child, whether subconsciously or not, by educational institutions and extended family.
Change was a concept I was uncomfortable with until I learned I myself was changing. To the right is a gallery covering 2012 up until 2020.
I did not realise it but in those eight years, and just as many hair colours, identity took shape. Both neurologically with the growth of the brain, extended pathways and an increase in chemical hormones, as well as sociologically, in how I reacted with behaviour in the specific environments I lived in.
Before I encountered my first romantic relationship I experienced something far more damaging to a child. A boy of fourteen raped me in my own home while my family slept. What made matters worse, when I considered taking the issue further I was harassed by crowds of school children from my own high school as well as his, followed home and shouted at: liar, slag, slut, skank, ho, whore, the usual spiel. People assume rape survivors should have a particular reaction to sexual assault; scream, fight, anything but freeze with fear. As a thirteen year old child myself, I seized up. Does a child know how else to behave? Read the full survivor story here.
There’s such a thing called generational trauma. Although, family medical conditions, parenting and childhood circumstances account for a lot. It’s important to remember, not everything is down to genetics just like environment cannot be blame as the sole cause for a problem.
In my case, I idealised my mother and was shielded from most negative family memories at a young age. My father has lived in Northern Scotland for well over a decade. There are mental health diagnoses on both sides but how those interlink with my own. I have an elder sister who has no diagnoses or experience with mental health (aside from unwanted side effects of pregnancy).
I grew up in a stable household after, just my mother, sibling and I. Until I was much older, I was unaware of my mother’s conditions including her physical health. There were never babysitters that I did not know because I spent a lot of time with my grandparents. My home town is Linslade, before I moved to Milton Keynes. Old photographs become the foundation for most childhood memories.
School; where I had been deemed a bad kid due to my behavioural issues brought on by mental health.
The paradoxical nature of BPD means I was incapable of regulating my emotions which led to extreme behaviour that worsened the problem.
People view BPD as a manipulative disorder in the way sufferers treat their interpersonal relationships. At the time of a trigger there is no thought process, just reaction to emotion. Afterward, the guilt settles creating a self-loathing.
At home, it became a self-fulfilling prophecy where I only met the low-standards already held for my behaviour.
Whether influenced by my sexual assault or not, I still can’t figure out, I got into a relationship with a young adult (19) while I was still a minor (14). This person coaxed me to loan them money, totalling £1,300 of my savings, encouraged me to skip school, introduced me to illegal substances and emotionally abused me. He would hide around the house and try to scare me. He would go missing for days on end. He cheated on me with multiple different women, and men. When he would turn up out the blue, it was usually drunk-as-a-skunk and ready for a fight. That relationship continued until he impregnated another woman, whom I had been friends with.
What I used to refer to as ‘the good old days’. Things were quiet in a small town. School’s a breeze. Bullying consisted of calling me the ‘Apple Lady’ or ‘Nerd’.
Since becoming a school employee I’ve seen many toddlers to pre-teens crying over things adults perceive as petty. Children are still navigating a minefield of emotions and hormonal changes. They’re expected to not know how to deal with their emotions and it’s our job as adults to advise them of the healthiest methods.
In contact, what I still call ‘the dark ages’. Not periodically when it all went wrong but the battlefield where the majority of collateral damage was dealt.
Bullying increased when I moved towns. The school systems were different. I’d been in my first year of middle school, year 5, in Linslade when I moved. I went into my last year of a primary school into Milton Keynes, moving to the high school less than a year later. For someone who was socially inept, this was straining. Crowds of children are scary enough as an adult. As a child, it’s being a lamb at the slaughter.
Schools have evolved since my time, even though to some that seems fleetingly short in comparison to their own, when suffering from ill mental health it is unsurprising not all people hand it elegantly. I’ve been egged on, singled out, shouted at, you name it… A PE teacher -not my own- stated I needed anger management in front of a class.
Another would give me a word of the day to recite in his maths class after questioning the definition of his archaic language while struggling to understand an advanced statistics class.
Teenage girls are mythical creatures, a bit like mermaids lulling their sailor victims to their watery deaths with sweet songs that turn out to be venomous lies. Children cannot be blamed for their behaviour solely – it’s learned. Everyone’s bullied or been bullied. Some of us have done both. It’s a cycle.
My circle of friends wasn’t so much a circle. I have the same best friend now at 24, that I did when I moved to Milton Keynes. Apart from her, I was more of a social butterfly; unable to interact with groups people for longer than a few minutes at a time. I would flit from table to table, keeping positive acquaintance with most but usually ending up alone in the library.
Displays of imbalance were clear: throwing a chair at a teacher, suspension for slander, inability to work with others, smoking cigarettes at on the sport’s field, physical fights outside school property and truancy for almost half of my final school year.
Breakdowns were a regular part of the morning routine. Mass anxiety over untamed hair, a missed alarm, a scheduled exam.
Things improved at college. Moving away from the school I spent five years at to a campus where nobody knew me increased motivation to study. I left college with 12 GCSEs and 3 A-levels. For some mad reason they even put my picture in the MK newspaper.
Initial diagnoses and treatment
Initially, my mother took me to a doctor who diagnosed me with anxiety and depression at 15 years old. I was put on citalopram, an anti-depressant/anti-anxiety medication which I stayed on until I was 19. At the first appointment, I’d refused any referrals for therapy.
At college, that changed. I began participating in cognitive behavioural therapy. To date, I have completed 5 different sets of 12 hours of sessions with the NHS. I also had counselling at university, and a mental health mentor throughout my postgraduate degree.
The first incident that saw me in A&E at 22 was a mental breakdown shortly after I returned from studying an undergraduate degree.
This led to an emergency intervention where I was finally assessed by a psychologist and a psychiatrist. During this time, I was also diagnosed with a chronic neurological pain condition: fibromyalgia.
I had another 6 sessions of CBT where my therapist pushed my GP and the hospital to get me a real diagnosis for proper treatment.
The day before Christmas eve 2019, they diagnosed me with emotionally unstable personality disorder.
Tailored BPD treatment
The proper treatment for BPD is dialectical behaviour therapy. Since my diagnosis, I have been unable to secure proper treatment. In Stockport, I was offered dialectic community therapy through Stockport Healthy Minds. It was a democratic group for personality disorders and emotion dysregulation. As a council worker in a school, I couldn’t take 2-3 hours off work each week during school hours and there was no alternative times.
I am on different medications. Amitryptiline 30mg first prescribed as a nerve blocker but also treated my anxiety attacks. Sertraline 50mg to start, now 150mg, an anti-depressant that has been the first step in emotional stability.
Once I’ve moved and settled into Tameside, I’ll try another GP referral to see if DBT therapy is available in my new area.
I cofounded Lighter Minds UK as a mental health support group for any and all conditions as a self-help resources for both my local community and myself.
Using podcasts, YouTube videos, internet resources and charities, I have been learning the DBT techniques to practice in daily life. Self development and progress can be made without medical intervention if you have the determination.
- the present
- your awareness in the present
- your emotions, thoughts, and sensations
- separating emotions and sensations from thoughts
- balancing rational thoughts with emotions
- using radical acceptance to learn to tolerate aspects of yourself
- taking effective action
- using mindfulness skills regularly
- overcoming sleepiness, restlessness, and doubt
Emotion regulation skills help you learn to deal with primary emotional reactions before they lead to a chain of distressing secondary reactions. For example, a primary emotion of anger might lead to guilt, worthlessness, shame, and even depression. Teaches you to:
- recognize emotions
- overcome barriers
- reduce vulnerability
- increase emotions that have positive effects
- be mindful of emotions
- expose yourself to emotions
- avoid giving into urges
- solve problems
In times of crisis, you might use certain coping strategies to help you deal with your emotions. Some of these, like self-isolating or avoidance, don’t do much help, though they may help you temporarily feel better. Others, like self-harm, substance use, or angry outbursts, might even cause harm. Helps to:
- distract yourself until calm enough to deal with the emotion
- find ways to improve the moment despite pain or difficulty
- compare coping strategies by listing pros and cons
Intense emotions and rapid mood changes can make it hard to relate to others. Interpersonal skills help you be clear about. These skills combine listening, social, and assertiveness training to help learn to change situations while remaining true to values.
- objective effectiveness, learning how to ask for what you want and take steps to it
- interpersonal effectiveness, learning how to work through conflict and challenges
- self-respect effectiveness, building greater respect for yourself
This series of blogs will cover how I tackle self-development using cognitive and dialectical behavioural therapy techniques which I will cover in more detail; things like mood journals, mindfulness, self-soothing and radical acceptance. Therefore, it may include triggering material as it covers the causes, symptoms and responses to personal triggers.