Therapy is helping me navigate the choppy waters of love with borderline personality disorder

Exclusive | 3 min read | Trigger warning: suicide, self-harm and disordered eating.

Editor’s note: BPD is deeply nuanced. Not all people with BPD have the same experience or symptoms. This is one person’s lived and valid experience. For more information, visit NHS or Mind. A gentle reminder that the bylines you see belong to real people so please comment and share our articles with kindness.

It is a fact I’ve long since accepted, though I don’t like it very much: I desperately crave attention and validation from any person I’m romantically entangled with.

It’s so deeply upsetting for me when it doesn’t happen, I feel entirely overwhelmed. In the spring of last year, I attempted suicide because I felt like my partner wasn’t being attentive, loving and affectionate enough. Impulsively, I’d taken a massive overdose and woke up four days later, intubated with a tube the thickness of a garden hose down my throat in the intensive care unit of our local hospital.

The emergency room doctors had prepared my family and fiancé John for the worst case scenarios. It would be a miracle, they’d said, if I lived through the night or woke without a traumatic brain injury.

Somehow, I did survived. I’d done it because I’d wanted more attention and I’d certainly accomplished my self-destructive goal, but at what cost? Nine months later, I am alive but I suffer from severe memory loss and grand mal seizures I didn’t have before the attempt I made on my life.

The driving force behind my actions? Borderline personality disorder (BPD). BPD is a mood disorder characterised by how you think and feel about others, in addition to having problems functioning in day-to-day life.

The symptoms are grouped into four main areas:

• Emotional instability – the psychological term for this is affective dysregulation.

• Disturbed patterns of thinking or perception – cognitive distortions or perceptual distortions.

• Impulsive behaviour.

• Intense but unstable relationships with others.

The symptoms of a personality disorder like BPD may range from mild to severe and usually emerge in adolescence, persisting into adulthood.

There are varying degrees of borderline personality disorder and mine teeters between moderate to extreme. I struggle with the majority of symptoms, have overwhelming issues with codependency, black and white thinking (believing something or someone is all good or all bad, with no grey areas) the need to change my self-identity to appease my partner and patterns of disturbed thinking.

Self-harm

I engage in self-injurious behaviours like cutting, anorexia, substance abuse and I often make threats of suicide when I fear rejection or separation.

I was diagnosed with borderline personality traits at just 14. I was in an inpatient adolescent psychiatric hospital at the time and almost every teenage girl had been told the same, leading me to believe it couldn’t be true.

In my late teens, my mum took me to several psychiatrists for second, third, and fourth opinions who all concluded I had depression and anxiety instead of BPD.

The stigma attached to other mental health conditions like bipolar, borderline personality and schizophrenia meant the thought of anyone finding out about my earlier diagnosis frightened me, leaving me feeling ashamed and fearful. Instead of digging deeper into whether or not I had BPD, I chose to believe I was fine. Many people suffered depression, right?

There aren’t blood tests or brain scans doctors can use to form accurate assessments about BPD. Instead, they questions, tick boxes and see if you meet the criteria for BPD.

Many people are misdiagnosed due to the fact that certain mental health disorders have similar — and sometimes the same — symptoms as one another. In the United States 40 per cent of patients with severe psychiatric disorders are misdiagnosed. In the UK, the most misdiagnosed mental health conditions are bipolar, borderline personality disorder, and anxiety.

Last year, after two weeks recovering from my suicide attempt, I was taken to a small psychiatric facility where I was held on an involuntary hold for six days. A psychologist met with me every morning for 45 minutes and concluded I had depression at all.

He said with absolutely certainty that I had borderline personality disorder. For the first time, I believed a doctor. Otherwise, who would risk dying when they didn’t actually want to, just for attention? That wasn’t someone putting words in my mouth, it was genuinely why I’d done it. Because what rational person would think: if I die, at the very least, John will cry at my funeral.

After that realisation, every relationship I’d ever had began to make sense. The way I’d threaten to break up with people if I thought they were going to leave me. That pit in my stomach when a boyfriend didn’t pay me enough attention and the way I fell in love at breakneck speed.

I’d married my ex-husband after less than two months of dating, and it wasn’t because I’d found my soulmate. I’d done it because I thought he’d be less likely to leave me if I were his wife.

Navigating love with BPD is difficult for me, to say the least. I am usually unable to self-soothe or find happiness on my own. I require validation, compliments and an excessive amount of attention. Without that, I feel unloved, empty and worthless.

Looking back

When John — or any of my past partners — mentioned finding himself a job, I boiled up inside and felt terrified about spending my days at home alone. The moment that conversation began, I was ready to manipulate him into changing his mind.

It’s irrational, no good for him and I’m acutely aware of that. But it’s a reaction I’m unable to control because of all the worry I feel. What if he finds someone else while he’s working? What if the job becomes more important than me? How can I prevent this?

You can see how a personality disorder such as mine might cause such troublesome — and sometimes toxic — relationships. While there isn’t much research on the causes of BPD, genetic predisposition, brain abnormalities, sexual assault and trauma are the known, leading theories for why or how it begins.

Medication can’t outright treat this disorder and can sometimes make it worse, with therapy considered the gold standard of treatment. But with all the misdiagnosis that happens, it can be years before the correct talking therapy is prescribed. And even then, it can take years of speaking with a professional who specializes in this area, before substantial changes are felt.

Psychiatrists occasionally prescribe medication to treat specific symptoms (depression, mood swings, anger), but they cannot treat the disorder as a whole, chemically

My BPD isn’t as extreme now in my 30s as it was in my teens and early 20s as I’ve learned a lot through painful trial and error. I know if I self-harm in order to scare my fiancé into staying home when he wants to go out, I run the risk of losing him altogether. I work hard to avoid taking these drastic measures to satiate the empty feelings that raise up inside me.

I’m in control of myself more now, and I’ve learned to act ‘normal’ in many situations, despite my impulses telling me to act jealous, manipulative, more sad than I actually am or angry for attention.

Moving forward

I’ve observed how other people communicate for so many years that I’m capable of emulating the way couples act in healthy relationships, for the most part.

There are times when I’m better at asserting myself than people without BPD. I can calmly express how I feel when I’m upset or disappointed. But, I still feel the same fear, jealousy and emptiness on the inside. I’ve simply mastered hiding it.

I used to act before thinking and ruined a lot of relationships with my anomalous behavior. Many of my exes couldn’t handle my frequent, erratic reactions. It’s hard to blame them. Imagine coming home to your loved one screaming, crying and throwing her phone across the room in a fit of hysteria — and you’re not even sure why? I’m surprised they didn’t leave sooner, and I’m surprised too that John is still here.

Supportive

But he tells me about all the qualities he loves about me: being an honest person, highly intelligent, empathetic, loving, nurturing and non-judgmental.

Six months ago, I began having weekly therapy along with monthly psychiatrist appointments for medication management and psychotherapy. I voluntarily sought treatment because I don’t want to act and feel this way for the rest of my life.

Since I also suffer from anorexia nervosa — eating disorders are common amongst folks who have BPD — my mental health professionals treat all of my diagnoses. I’m prescribed medications that ease impulsivity and anxiety. These are both symptoms of borderline personality disorder.

Last week, I asked my therapist if she thought I, or anyone else for that matter, could fully rid their life of the symptoms of BPD. She thought for a moment and said it was dependent on how much work I put in.

I’m not convinced personality disorders are curable. However, I do believe therapy can bring a much better quality of life, and less intense, less frequent symptoms that are easier to cope with.

Realistic

I’m working on feeling comfortable being alone so I won’t always need my fiancé to uplift my mood, or stay home with me every hour of every day, as well as learning to set healthy boundaries and understand what behaviours are acceptable in relationships.

I wish I could say that I’m recovered, cured or ‘fixed’ but I’m not. At times, I still manipulate my partner and act out for attention. I can’t seem to change my black and white thinking, no matter how hard I try. I’m not giving up, though, and I think that’s what matters most.

I’ve made good progress in therapy. I am able to go to the grocery store with my mum and leave John at home. In the past, I needed him to come with us and be by my side 24/7.

Now, I can read books, write articles or practice yoga while he plays video games on his phone. Two years ago, I couldn’t. If we didn’t sit together on our couch and talk or watch television all day, I thought I wasn’t being given the proper amount of attention.

I’m learning, slowly but surely. I’m correcting the unhealthy attitudes and behaviors I once thought were necessary to maintain happiness.

I feel positive about the future. I am not a lost cause by any means. I’m tackling each symptom of BPD one by one, taking steps in the right direction, until I’m healthy.

Above all, I’m hopeful. I know I’m capable of doing better in romantic relationships than I currently am. Mine might not be a story with a perfect and fairytale happy ending, but it’s real life - my life - and I’m doing everything I can to get better. And that is enough.

• For mental health help and support in the UK, visit Mind. For information stateside, visit Mental Health America. If you are feeling suicidal or worried you may harm yourself, dial 999 (UK), or 911 (US) for urgent help.

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