Healing from Borderline Personality Disorder is not something that happens overnight. And, “healing” will mean something different to each person who reads this post. For me, the healing process has been about not allowing the symptoms of BPD to control my life any longer. It’s not that I am completely symptom-free or that I never react to the symptoms, but I’ve built up an overall sense of mastery in my capabilities to tolerate the distress they generate and the skills to take care of myself until emotional storms pass.
- Frantic efforts to avoid real or imagined abandonment
I used to become so debilitated when my significant other would leave on business or even just when he would go to work. I’d often end up in the emergency room, exhausted and anxious to the point where I couldn’t sleep. I took every nuance — a facial expression, a change in a tone of voice, etc. to mean that a person I cared about no longer loved me and would leave me. (I write about this extensively in my book, Healing From Borderline Personality Disorder: My Journey Out of Hell Through Dialectical Behavior Therapy.)
These days — and I never thought I’d get to this point — I actually enjoy some alone time. I still get uncomfortable, sad, and sensitive when I must part ways with loved ones, but I estimate that my reaction is only moderately more intense than that of any other person who doesn’t want to be away from a person.
- A pattern of unstable and intense interpersonal relationships characterized by extremes between idealization and devaluation (also known as “splitting“)
In job after job, I would show up and quickly become the ideal employee. I’d bond with coworkers and bosses and become very attached to them. Because I didn’t have the skills yet to engage in healthy boundaries and to handle the intensity of the emotions that would arise within me, I’d often feel like I “loved” the people I worked with and expected the same from them — even after only a month’s time.
I quit jobs left and right, and never without a huge scene or crisis of some sort. I ended up in the hospital after many job quits. I’d see my coworkers and bosses as so ideal, but if they seemed to not care about me or not respond in ways that I expected or wanted, my perception of them would quickly change, and I’d come up with all kinds of reasons for why they were “no good” and that I “needed” to quit. I justified my actions a lot like this. I talk about this pedestal phenomenon in my book as well.
I also did the same in my early to mid-twenties in romantic relationships. In this area, I would describe myself as having been “out of control,” though, I look back on that “young me” with compassion, as she honestly was doing the best she could with the tools she had, and where she was. I hadn’t yet been officially diagnosed with Borderline Personality Disorder yet, and I (as well as random health professionals who I would sporadically see over the years) inaccurately presumed I might have been bipolar.
- Identity disturbance: Markedly or persistently unstable self-image or sense of self
This was absolutely, positively one of the most distressing symptoms of BPD that I experienced, and it is what ultimately led to my diagnosis. I talk in detail in the book about the emergency room visit and IOP (Intensive Outpatient Program) stay where it was finally determined, through my willingness to openly disclose my struggles around identity (in combination with many other symptoms) that I was diagnosed with Borderline Personality Disorder.
One of the things that I discovered early on was my inability to conceive of a sense of self when no one else was around. If my significant other was out of town and no one else was home with me, I’d have episodes of sheer terror. I’d literally cry hysterically and rock myself on the floor. I’d make myself sick sometimes by being so sad and distraught from the intolerable feelings of loneliness and a sense that I didn’t exist, that I couldn’t sleep or eat. These episodes often led me to go to the emergency room. This happened at least a couple of times a year. I haven’t been back to the emergency room for psychiatric issues since June of 2011.
A huge part of this has been learning who I am through DBT, and it’s why I included a huge section on Dialectical Behavior Therapy in the back of my book as a resource for others who are ready to learn and apply these potentially life changing skills.
- Impulsive behavior in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
I had many impulsive behaviors prior to being diagnosed as well as early on in my recovery during treatment. Most of my impulsive behaviors revolved around not putting time and space between the uncomfortable (and seemingly intolerable) emotion I would experience in reaction to a situation. I’d act right away, often to my own detriment.
This showed up as hobbies that turned into charges of hundreds (to thousands) of dollars on my credit cards (because I couldn’t just explore whether I liked beading — I had to buy every bead and every accessory they had because “this” was going to the hobby that would stick — only to have this happen again, and again, and again.)
Impulsive reactions to emails at work have caused me many problems. I have learned to put time and space between my initial reactions to upsetting emails, but this still remains a challenge from time to time, as does reckless driving.
- Recurrent suicidal behavior, gestures, or threats, or self-harming behavior
I often felt distressed from my emotions that I just wanted to escape. I wanted to be locked up in the hospital. There was some part of me that knew I needed to hold on — that suicidal thoughts were not “normal,” and that I had to push through. I knew somewhere in my heart that I didn’t really want to die — I just desperately wanted to feel my emotions less intensely or to feel something altogether different than what I was experiencing, because it was too much. Once I learned the skills to help me tolerate such situations, my threats of suicide went away. I learned ways to express my feelings of desperation in ways that were safe, and I learned how to even tolerate them and reduce them.
- Emotional instability in reaction to day-to-day events (e.g., intense episodic sadness, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
The frequency and intensity of my mood swings were rediculous. My mood was so unpredictable and caused upset for me, my significant other, and others in my life. I could go from happy to severely depressed with little warning and seemingly for no reason. Through DBT, I’ve learned that “everything has cause.” This means that everything that has led up to this moment was influenced by a chain of events before it. Even if we don’t know why our mood has changed, we can rest assured that there is a reason, via memory, subconscious, biological shifts, etc. Just knowing this has helped me to handle mood swings better. I know longer panic and become immensely dysregulated when I notice a shift in mood. I just notice it, accept it has cause, use my skills to soothe myself or distract, and remind myself that it will pass. This has been huge in terms of my ability to follow through on commitments even when I “don’t feel like it,” and to wait out uncomfortable moods rather than acting impulsively to try to feel better.
- Chronic feelings of emptiness
For me, this aspect of BPD was hugely tied into a lack of identity and feeling like I didn’t exist when others weren’t around. These days, since I’ve been working on discovering and living by my values (through DBT) and consciously working on building a life worth living, I rarely feel empty. The space that felt like a void is now being filled with pieces of who I am as well as interests that I am now sticking with.
- Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
For me, the anger outbursts were similar to the suicidal threats. I didn’t know how to manage my emotions. I was terrified and tried to convey this, often in unintentionally but very dramatic ways, such as outbursts of anger.
When I began to apply to concept of “cause” to anger when it would show up, I began taking better care of myself and became better able to de-escalate anger episodes and not take out my emotional discomfort on others.
- Transient, stress-related paranoid ideation or severe dissociative symptoms
I still notice these symptoms sometimes, but far less often, and only when feeling extremely overwhelmed, usually by multiple stressors simultaneously. For the paranoid ideation, I would imagine that my coworkers were “all against me” or talking behind my back and deliberately excluding me.
I’d think my significant other was cheating, based on no evidence other than my own insecurities and paranoia.
I’d dissociate often. It was my brain’s way of “checking out” from reality when it became too much. I’d drift back to a younger age or feel as if I wasn’t really in my body. Through mindfulness exercises in DBT, I’ve learned to ground myself and, amazingly, to even be able to identify the dissociative state and help myself “come back.”
You may also enjoy reading my post Emerging from the Oppressive Symptoms of Borderline Personality Disorder.