BPD – “The Good Prognosis Diagnosis”

The following excerpt was retrieved from Wikipedia at http://en.wikipedia.org/wiki/Borderline_personality_disorder:

“Prognosis –
With treatment, the majority of people with BPD can find relief from distressing symptoms and achieve remission, defined as a consistent relief from symptoms for at least two years.[121][122] A longitudinal study tracking the symptoms of people with BPD found that 34.5% achieved remission within two years from the beginning of the study. Within four years, 49.4% had achieved remission, and within six years, 68.6% had achieved remission. By the end of the study, 73.5% of participants were found to be in remission.[121] Moreover, of those who achieved recovery from symptoms, only 5.9% experienced recurrences. A later study found that ten years from baseline (during a hospitalization), 86% of patients had sustained and stable recovery from symptoms.[123]

Thus contrary to popular belief, recovery from BPD is not only possible but common, even for those with the most severe symptoms.[121] However, it is important to note that these high rates of relief from distressing symptoms have only been observed among those who receive treatment of some kind.[121]

Patient personality can play an important role during the therapeutic process, leading to better clinical outcomes. Recent research has shown that BPD patients with higher levels of trait agreeableness undergoing Dialectical Behavior Therapy (DBT) exhibited better clinical outcomes than other patients either low in Agreeableness or not being treated with DBT. This association was mediated through the strength of a working alliance between patient and therapist; that is, more Agreeable patients developed stronger working alliances with their therapists which in turn led to better clinical outcomes.[124]

In addition to recovering from distressing symptoms, people with BPD also achieve high levels of psychosocial functioning. A longitudinal study tracking the social and work abilities of participants with BPD found that six years after diagnosis, 56% of participants had good function in work and social environments, compared to 26% of participants when they were first diagnosed. Vocational achievement was generally more limited, even compared to those with other personality disorders. However, those whose symptoms had remitted were significantly more likely to have good relationships with a romantic partner and at least one parent, good performance at work and school, a sustained work and school history, and good psychosocial functioning overall.[125]”

The following was found on the National Institutes of Health’s website athttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145201/

2000–2009—Borderline Personality Disorder: “A Good-Prognosis Brain Disease”?
The current decade has been associated with a search for the underlying etiological bases for psychiatric disorders. This reflects both a growing impatience with the extensive comorbidities in the current classification system and an excitement about the newly available neurobiological and genetic technologies.

Beginning with the stimulus given by several parent advocacy groups (most notably, the National Education Alliance for Borderline Personality Disorder, and most conspicuously, the indomitable and ubiquitous Valerie Porr) and by the establishment of the Borderline Personality Disorder Research Foundation by a bereaved Swiss family, this decade has seen the adoption of borderline personality disorder by major mental health organizations, such as the National Alliance of Mental Illness, the National Institute of Mental Health (NIMH), and, as noted at the beginning of this article, even the U.S. Congress. In this context, borderline personality disorder seems to have achieved a new legitimacy, at least as a subject for scientific study and for public awareness. Why has this occurred and what does it mean?

Two major findings have greatly affected the borderline construct, one showing that the disorder is significantly heritable and the other that it has an unexpectedly good prognosis. The confluence of these findings is all the more significant because together they seem to defy the expectation that heritable disorders should be among the least changeable. Torgersen and colleagues’ (93) finding of a 68% heritability abruptly invalidated the many theories about borderline personality disorder’s etiology that had focused exclusively on environmental causes. It established borderline personality disorder’s credentials as a “brain disease.”

Signaling the potential yield of the still very limited NIMH-funded research, this decade bore the fruits of two NIMH-funded longitudinal studies, the McLean Study of Adult Development (94) and the Collaborative Longitudinal Study of Personality Disorders (53). These studies showed that borderline personality disorder has an unexpectedly good course (Figure 3). After completing her seminal long-term follow-up reports (95, 96), Zanarini even began to call borderline personality disorder “the good-prognosis diagnosis.” This fact offered enormous encouragement to patients with the disorder even as it raised questions about how those of us in the mental health fields could have been so mistaken. When this finding is combined with the evidence of heritability, it is clear that the DSM criteria are epiphenomena.

Heard in my Psych1 Class Today – True Story

This is my first semester back at junior college after having dropped out twenty years ago. I’m studying to be a psychologist. That career decision and identity-defining choice was sort of a no-brainer for me.

My psychology professor said something about borderline personality disorder at the beginning of his lecture today that really bothered me, especially since there were probably around 300 students in the auditorium. He has around 600 students total this semester. What he said was disappointing to me because I really looked up to him.

For some reason he brought up BPD, even though BPD is not discussed in any of the recent chapters we’ve covered. He said that in his experience as a forensic psychologist, the jails were filled with people with borderline personality disorder. He went on that people with BPD have little to no impulse control, that they are dangerous, and will “bash you over the head with a beer bottle if you say the slightest thing wrong. They will go off on you for nothing.”

Last week we studied biopsychology, the role of heredity and experience (nature and nurture) on the shaping of an individual’s personality and behavior. I wrote a kick-ass essay on it. So far all the work I’ve turned in has been kick-ass and my professor has generously complimented it. He has gone so far as to say it’s graduate level quality. True story. This makes me happy. I have BPD — and I’m damn smart!

Last night, I submitted my response to the weekly “thought provoking question.” The TPQ was “What forces in your life both helped and nurtured, and hurt and harmed your physical and psychological development?” I had a lot to say on this subject, as one can image. Since my professor has been so complimentary of my essays, I decided to be bold, to take a risk, and share a bit about my history and diagnosis. I’d seen other students share very personal information in their essays, which we are all required to post on our group message board, so I figured… why not.

However, I didn’t want my information out there for everyone to see. I marked my post “private” as we are encouraged to do if we want to write about something personal and only want the professor to see it. The assignment isn’t due until next Friday, but I wanted to get ahead on homework so I could have plenty of time to study for next week’s exam. I have a part-time job and I’m taking 10 units this semester. All I do is work and study. No boyfriend. It’s very healthy.

I digress. After he said what he said about BPD, I felt a little wounded, vulnerable, and yeah, even little paranoid. I regretted last night’s submission and wished I hadn’t exposed so much of myself. After all, my professor’s recommendation could have an influence on which 4-year university I get into, or scholarships that I might apply for. (I need scholarships! Badly!)

I will let the private post that I added tonight to my TPQ tell the rest of the story.

“Dear Dr. X, 

“I am the student who raised my hand in response to your question about Borderline Personality Disorder in class today. I agree that one of the many defining criteria for BPD is difficulty with or lack of impulse control, but not all individuals who have been diagnosed with BPD are violent and likely to “bash you over the head with a beer bottle for no reason.” 

“I submitted TPQ #4 on the discussion board yesterday. Even though I marked my post as private, I regret the extent of my sharing after your comments about BPD in class today. Since I’ve already posted TPQ #4, please allow me to fill out what I shared with a few more details. 

“My brother, one of my sisters, and I have all received a diagnosis of BPD. The diagnosis may be imminent for my eldest sister. While the four of us have struggled with issues of identity, emotion regulation, fear of rejection/abandonment, impulse control, and self-destructive behaviors, none of us have ever been violent towards another person. (I slapped men on two different occasions, years apart, and only after I was grabbed and shoved, so it probably doesn’t count.)” (I’ve omitted a few personal details here, as I don’t yet feel comfortable posting them on my blog.) We are all highly intelligent, compassionate, hard-working, and contributing members of society… and highly emotional. In all four of our cases, we managed to keep the intensity of our emotions hidden from public view, even from our children, and turned the rage and violence inwards against our own selves. None of us has nor ever would harm another person simply for saying the wrong thing, not even in a heated argument.

“In my future career as a psychologist, I am very determined to play a role in helping to dispel the myths and stigma of mental illness. I felt disheartened and deflated after you made that comment. Such blanket statements, especially from respected professionals and educators such as yourself, feed into the shameful stigma that keeps people with BPD (or other mental illnesses) hiding in the closet and discourages them from seeking help and support. Personally speaking, after I was diagnosed, it took 4 years for me to overcome my denial and accept the diagnosis. I did not want to be labelled as a violent person because I never was. I doubt I will live to see the day when I can tell almost anyone about my diagnosis and not have to worry about them disappearing as a result. As long as I’m breathing, I will spiritedly work towards that, for myself and for others, as much as possible. For now… I hold my secret and my heart closely. 

“While I recognize that there is some debate over use of the terms ‘high functioning’ and ‘low functioning,’ I believe it’s important to make the distinction that there are varying degrees of BPD, just as there are varying degrees of bi-polar disorder, depression, and other types of psychological disturbances. I am hopeful that during the Module 11 and Module 14 class lectures, there will be some discussion of the varying degrees of personality disturbance and mental illness. A realistic, balanced, and compassionate representation of the mentally ill would delight me very much. 

“Respectfully yours, 

[ME]” 

I went back and later posted this information about the BPD prognosis underneath my letter.

I probably would not have felt comfortable contradicting him this way, but a woman in class today scolded him for a cartoon that she thought was sexist. The cartoon was to make a point, but she was very offended. He was a gentleman about it. I’m going to try trusting that I will be treated the same.

I’ll keep you posted on the outcome of my verbal diarrhea.

Image

Slap! A Catastrophic Epiphany – and The Stigma of Mental Illness

slapWhen the ugly truth finally pierces through the glittery illusions we have about ourselves, it is exquisitely painful. This is why we are so good at denial. It is just our nature to avoid pain, and naturally, avoiding painful truths about ourselves is part of that. We want to believe that we are good people and that we are just innocent victims and bystanders. We are terrified to face our own shadows and see our own ugliness, to fully witness the complete scope of how our choices have undermined our own wellness and hurt the people who love us. For me, it was more terrifying and more devastating to face my own shadow than to bump into a creepy stranger in a urine-soaked alley at midnight. You can run away from or fight a stranger in a dark alley. Maybe you can even kill him. I cannot run away from myself. I can’t kill myself either. It is always an attractive option, but I have to choose differently now, because too many people I care about would be harmed by my suicide.

I can’t tell anyone that I have High-Functioning Borderline Personality Disorder. The truth is, people hear “Borderline Personality Disorder,” get scared, and run away. This is not your average garden-variety depression or anxiety. This is a serious mental illness. It’s not the worst one to have because there are highly effective treatments available, but still, it’s fucked up enough. I have the scars to prove it. I don’t want this disease. I want to be awesome! I want to be strong, dynamic, successful, and admirable! I hate BPD! It feels like a curse.

Looking back, I believe the roots of BPD were laid in my childhood. I was bullied and tormented by other kids in school, had only one friend, and my mother was neglectful to the point of abuse during my infancy and most dependent years. My father is a master in the art of Catholic Guilt. My sisters tell me of incidents when my father physically abused me, but I can’t remember them at all. (My psychological defense mechanisms work a little too well sometimes.) The roots of BPD stayed mostly dormant within me for a very long time. It began to manifest in 2006 in my mid-30’s when my relationship with a man who I lived with and loved intensely began to falter. That is when the cutting started. It was a rapid descent into profound depths of self-destructive madness from there. I’ve been locked up against my will in a mental hospital four times for self-injury, suicidal ideation, and actual suicide attempts. These episodes occurred only after experiencing verbal abuse during arguments with significant others.

I am an attractive woman who attracted jealous, insecure, and pathologically narcissistic men. Most of our arguments were started by their wrongful accusations of disloyal behavior on my part. I was never a flirt or dishonest… I just try to be warm and kind to everyone I meet, young or old, man or woman. My intentions were completely misread. My partner’s perceptions of me mattered more than my true intentions. They refused to hear it. When I tried to defend my honor and commitment, it rarely went over well and the arguments often escalated into verbal abuse. If I got yelled at, cussed at, called a filthy name, angrily accused of something I didn’t do, or harangued and emotionally blackmailed into agreeing I was wrong when I truly didn’t believe I was, sometimes, though not always, something in me flipped like a switch and I would disappear into a raging, self-destructive, dissociative state. The more abusive the argument, the more likely the switch would flip, and when it did, I became a horrible scary monster. If you ask any of my ex’s about me, they would probably tell you that the authorities should lock me up forever and throw away the key. (The funny thing is, I never laid a finger on any of them. I tore up my own artwork, broke my own possessions, and cut or punched myself, but I could never harm anyone else… at least, not until recently.) Friends and coworkers who knew me when my BPD was at its worst might say that I’m a little eccentric but intelligent, spiritual, deep, artistic, talkative, compassionate, warm, funny, kind, and gentle – but they have never personally seen my BPD manifest. It has only appeared if a romantic partner was verbally abusive or physically threatening.

With my fourth and final hospitalization, a hospital psychiatrist wrote “Borderline Personality Disorder” as the diagnosis on my discharge papers. I refused to buy it. I also refused outpatient group Dialectical Behavior Therapy (DBT) because I thought I didn’t need it, that I could fix myself on my own through reading self-help books, meditation, and spirituality. I have to laugh at my denial now. Of course the psychiatrist would diagnose me with BPD – during my first three days in the hospital I was punching myself in the face, screaming “FUCK YOU!” and ripping out my own hair! But I functioned too well at work and in my friend and family relationships, so I didn’t think I fit the BPD mold. I was sure it was only PTSD. My therapist thought so too. I still believe I have PTSD – but now I accept the BPD diagnosis too. NOW I understand mental illness. It’s not that I’m an evil, dangerous person. I do have a spiritual and moral compass that guides the greater majority of my life choices. I have also personally experienced the helplessness and shame of witnessing my body and brain doing harmful things contrary to the person that my conscious, higher self desperately wants to be. This is what it’s like to live with mental illness.

I find it nearly impossible to explain what it is like to be in a dissociative state or experience a psychotic episode. Sufficed to say, it’s like I am in a little boat trying to ride an endless stormy sea and I only have one oar. Terrifying emotional storms too often threaten to overwhelm and sink my little boat. Sometimes in the chaos, I get tired and give up or drop my oar. Now that I accept that I have BPD, I have a stronger grip on my oar and few navigation tools that I did not have before, but it has not made riding the emotional storms any easier. I’ve just gotten better at turning to face the waves and steering away from the whirlpools.

For awhile, I thought I was healed. I had not self-harmed or attempted suicide for four years. I had gained and lost another romantic relationship and came through it stronger and wiser, instead of winding up in the booby hatch like before. I had endured two major gut surgeries and recoveries, with no one around to comfort or entertain me during my hospital stays and for the majority of my recovery (with the exception of my sisters who each took a turn flying in from California to take care of me during my first week home after getting out of the hospital). I had bravely quit the job I’d held (and hated) for 10 years to move halfway across the country, home to California, to be closer to my loving family. I thought I was finally healthy. In reality, I had only succeeded in completely dismantling my former life and I had a lot of hard work ahead of me to build a new one. I wasn’t aware of it at the time, but my self-confidence had been dismantled in the process, so that needed work too – and still does.

Then I met a man on Facebook. Same old story… I moved in with him too quickly and he turned out to be a huge disappointment. “Mooch” (as I refer to him now) didn’t really love me. I was just a meal ticket. He took advantage of my [excessive] generosity. He could never look me in the eyes for very long. He was not very affectionate and not romantic at all. I have felt loved by men before – I did not feel loved by him. I always felt anxiously unsure of myself around him, nervously watching and analyzing his reactions or lack thereof, as I revealed and expressed my unique personality more and more. What I learned was that he wasn’t interested in me, he was only interested in his own instant gratification. At the end, I realized I could not be in love with nor even respect this man. He was lazy and self-centered.

Although I bought him three new new pairs of expensive, high quality shoes, two pairs of jeans, a nice coat, several shirts, and sheltered and fed him and his child for months, I never really felt love coming from him. I did not see it in his eyes. He was addicted to Facebook, cared only for protecting and encouraging his child’s free spirit, taking small acting jobs for no pay, painstakingly crafting his online persona, and nurturing his online friendships. Instead of putting effort into finding gainful employment to support himself and his child, I watched him waste hours every day masturbating his ego with the iPad that I had bought for him as a Christmas gift. At the very end, regrettably, my anger overcame me and I lost it.

It was my 43rd birthday and a Sunday night. By then, we had already agreed the relationship was over and it was only a matter of him finding another place to live. It was almost midnight when I got home from finishing a swing shift at my senior caregiver job. I was exhausted. I found Mooch at the kitchen table, grinning in the iPad’s glow like a man who just ate a really good steak – that I had paid for. So I plucked up the iPad off the table and trotted away. Mooch owed me more than a thousand dollars that I knew he would never repay. I took the iPad hoping I could sell it to recoup some of my losses, and in case I could not find a rent-paying roommate in time to prevent eviction.

I was also very angry that Mooch had been living on my dime for five months, contributed nothing to the rent or utilities, worked on average only one or two hours a week as a massage therapist in the Napa/Sonoma area, and no longer had his own car. His neglected piece-of-shit car broke down and he didn’t have the money to fix it, and it would have cost more to repair it than it was worth, so he gave it away to someone for free. This meant he drove my car to work, 45 – 60 miles each way. In the year that we were together, he put 10,000 miles on my car and never once took it to a car wash or put a single penny into its maintenance and repairs. I paid for it all. I also often paid for the gas so he could drive my car to his appointments and transport his child to and from school. In spite of this, he never once helped with our rent or utilities. Sometimes he paid for our dinners out or bought some groceries, but that was all. I paid for 95% of our mutual expenses for six months, which wiped out my life savings. I had warned him several months prior that if he didn’t get a job or at least show that he was trying, that it would damage our relationship. He didn’t seem to care. I was angry at myself for trying to buy his love and angry at him for selfishly taking all he could get with no concern at all for me or my future. Like the volcano in a nightmare I’d had a week before, I exploded.

After I took the iPad off the table, he chased me around the apartment, grabbed my arms, and wrestled it away from me. I screamed and raged and called him names like Mooch and Deadbeat and Loser. When the altercation went physical, I went into fight-flight-freeze mode. Hello, PTSD! This is the moment when people can snap – and I did. This time, instead of taking my anger out on myself, I took it out on him. After he succeeded in overpowering me and pried the iPad out of my hands, he stood in my bedroom doorway with the iPad tucked under his arm, smiling victoriously, smugly. I never had a conscious thought about hitting him. I don’t want to or like to think of myself as a violent or abusive person. I try so hard to be a gentle human being. It just happened. And there it was. My arm launched up and I slapped him across the face – hard. He just looked at me, stunned. His cheek bore a red mark where I had struck him – where I used to kiss his handsome face affectionately and often. I was stunned too.

I could no longer deny that I have Borderline Personality Disorder.

I really wanted a classy, gracious, peaceful ending. I failed once again. Mooch had to call friends to make arrangements for emergency shelter because he no longer felt safe under the same roof with me. He kept saying, “Who are you?” and called me crazy. He referred to my round of rageful verbal abuse, the slap, and my wailing and crying as a psychotic episode. He was right to. I was not in control and I knew it. I was so scared, ashamed, and humiliated. I kept thinking to myself over and over, “I didn’t want it to end like this. I didn’t want it to end like this…”

In the midst of my episodes, other men have asked “Who are you?” or have said that my face looked as though I were possessed by a demon. More than one man had said the same exact thing. Aha, a pattern. Yep. And dammit!

In the hour after that slap, it all collapsed in on me. All of the stupid shit I had done to myself and all of the lousy choices I had made in the last 10 years bubbled to the surface of my consciousness. I had simply thought of myself as spontaneous and adventurous – but in reality, I was mindlessly impulsive. I always thought that I was just a sensitive person and that maybe I experienced emotions a little more strongly than other people. I knew I was different somehow, but I could not accept a diagnosis of mental illness. The night of the slap – my 43rd birthday – there was no denying the diagnosis anymore. Lucky me. I got Borderline Personality Disorder for my birthday. Yay.

I fell to Mooch’s feet and crawled on the floor, sobbing my heart out and begging his forgiveness. I was terrified he would call the police and have me arrested for domestic violence. People would believe him and not me, because I am a nut job with a Mental Health History. Everywhere we went, we bumped into people who knew Mooch and greeted him warmly (and there were many). They described him as “such a good guy!” He was well-loved, if not adored by his friends and family. No one in my new home of Sonoma County really knows me. I had set myself up perfectly to be a pariah. Might as well tattoo a big red letter “C” for “CRAZY” onto my chest. My crawling on the floor, sobbing, and begging for forgiveness only further convinced him that I was crazy. He boasted that he recorded my entire psychotic episode on his iPhone. I was shattered with humiliation.

I smoked a bowl of weed to calm myself down but sobbed and wailed until well after 2:00 AM anyway. The next morning, I started my brand-spanking-new job. I cried as I got myself ready for work that morning. I hoped my new boss wouldn’t notice how red and puffy my eyes were. To put on a smile, to act upbeat and confident, and focus on learning a new job after such a catastrophic epiphany was the hardest thing I have ever done. Even giving birth, boot camp, and running a marathon was more fun than that first Monday.

Three months later, I am still struggling with my confidence and social anxiety to a greater degree than I ever have before. I have never felt so low. I know what it feels like to experience ego death. It was not a peaceful ego death, like the kind that comes gracefully to Buddhist monks after months or years of devoted meditative practice. My ego died fighting with gun drawn and boots on.

Unfortunately, mistakes will be made when learning a new job. It’s just part of the learning process. My boss isn’t abusive, but he demands a very high standard of excellence and supplies constructive criticism… most generously. He tries to keep it balanced with some praise and encouragement too. I take his criticisms very seriously and beat myself up hard for my mistakes. I know I shouldn’t be so hard on myself, but the mistakes and the criticisms hurt a lot. I find it hard to believe that his praise is authentic. At times I sensed that he was angry at me, or maybe that’s just my fear talking. I don’t know. I don’t know that I can trust my own thoughts anymore. But I do know that my boss is protective of his business. Of course he is – his business is his baby. And I feel vulnerable, like I could be fired any second… I fear that he will see through my facade, that he will sense my craziness and be done with me. When I make a mistake and he corrects me, I am devastated. I cry in my car on the way home and I cry at home. I want to give up and die, but I can’t, because I would hurt too many people who love me if I offed myself. When I’m not making mistakes and I’m enjoying rare moments of connection with other people, I feel great! The second I make a mistake, I feel like the biggest piece of shit ever to stink up this beautiful planet. I constantly doubt and second-guess myself and my every thought, word, and action. I lie in bed awake worrying about how things I said during the day could have been perceived by others. All I know for sure is that I have a mental illness – that my intentions and the person I try so hard to be – my actual behaviors – do not line up, and I feel so powerless about it that it scares me. I feel so fragile and vulnerable. What happened to my confidence? Where is my mojo? Gone.

Somehow, in spite of my dead ego and vanished mojo, I’m also going back to school in the fall to work towards my degree in Psychology. I’ve been interested in Psychology since high school, studied it with rapt interest in junior college, and my interest has grown into passion in the process of trying to understand and heal myself for the last decade. It just makes perfect sense. Recovered addicts make the best addiction counselors, and I guess it probably takes a crazy person to understand and relate to another crazy person. The catch is, I have to find my way out of this craziness so I can show others the way out too. I can’t imagine that everything I have been through has been for any other reason. It can’t all be for nothing, anyway. Something good has to come out of it, or I might as well just blow my brains out right now.

Although Mooch committed his share of selfish wrongs in our relationship, I knew that none of it would have ever happened if I had loved and respected myself enough to set limits and say no, and if I knew myself well enough to know and respect my own limits. I was so hungry for love that rather than wait to be sure he loves me before supporting him financially, I just trusted that he was going to love me and be good to me because I was so good to him. I know now that I am not a victim. In many ways, I brought it upon myself. Now, Mooch gets to be the victim. I begged him not to tell anyone what I did. I knew that he would not represent himself and his own behavior truthfully, that the whole thing would be about the slap and only about the slap. I was right. The things he has said publicly have trickled back to me. Now all I can do is hope that I never cross paths with him or anyone else he told my secret to. I don’t want to be seen as a crazy, violent person, as someone to be feared. It was one slap. It was bad, it was wrong, but I keep telling myself the slap wasn’t the sum of my entire life, it doesn’t represent all the good I have accomplished or all the effort I put into being good. Telling myself that doesn’t make a difference, though. I know what people would see when they look at me if they knew about my BPD. They would not see all the good I’ve done in my life. They would see someone to fear, someone to run away from – not someone they’d want to get to know, and certainly not someone they could love.

Ironically, all of the stupid shit I did over the last 10 years was because I was starved for love and attention but didn’t love and respect myself enough to be more patient and selective about where I get it from. On the other hand, all of the stupid shit itself is just plain irrational, insane, and self-destructive, and only took me further and further away from the possibility of ever finding and being in a healthy, lasting romantic relationship. Now, my baggage is so stuffed with damaged goods that I can’t open up and show anyone the truth about me without scaring them away. I can’t ever pull down my pants for a man without telling him my history, because there are too many obvious scars. How could I ever be intimate with a man without telling him about where the scars came from? Wouldn’t that be dishonest? And how can I ever be honest without scaring a man away? I don’t think I could ever get to the point of pulling down my pants for a man if he knew the truth about my past… unless he is as crazy as I am or only cares about getting in my pussy. So – relationships are really out of the question, at least for a long time. Maybe forever. It makes me cry to think too much about that.

I have doubts about everything I think except that fact that I’m no good to anyone if I can’t be good to myself. I know I have to be alone for now. This doesn’t mean that I don’t feel lonely. I still ache for a warm, strong pair of arms around me, a fuzzy chest to rest my cheek on, and to see eyes full of love looking into mine. When I can look in the mirror and see love for myself in my eyes, maybe then I can look for love with a man.

I find it impossible to explain my behavior (the “stupid shit”) because in my heart of hearts, I want so badly to be a good person and to live a life of loving and conscious contribution. I try so hard to be gentle, generous, accepting, and kind – to be towards others all that I wish others would be towards me. I want so badly to be normal and I put a lot of effort into appearing normal, although I no longer have any idea of what “normal” even looks like. I feel extremely self-conscious of how every word and every action will be perceived. I have social anxiety like I never had before 2006. I hide in my apartment every chance I get. I go to work and the grocery store only because it’s necessary to my survival. (I should be grocery shopping right now. Instead, I’m writing. I think I’ll order a pizza online and live off that for the next two days.)

The great challenge that I face every day living with High-Functioning Borderline Personality Disorder is that like all human beings, a person with BPD needs love, affection, acceptance, and a sense of connection and feeling valued by others. At the root of everything I have ever done, good and bad, to myself or others, is a deep need to love and be loved. The sad irony is that my BPD behavior keeps love away. Perhaps that’s only partially true. I give love everywhere I go to everyone I meet. I give it to my seniors at my caregiver job, to the store employee checking out my groceries, to the bedraggled mom standing in line in front of me, the pizza delivery guy, my coworkers at both jobs, even to my boss. No judgement, no blame, no eye-rolling… Just love and compassion. I get plenty of love from my family, but I don’t get to see them nearly often enough. How am I supposed to heal and be healthy without love? Is giving love away ever going to be enough? Water, water everywhere! But not a drop to drink.

I can never leave my past behind me and I am so ashamed of it. There is no burying it. There is no going back in time to undo it. All I can do is keep my secret and keep to myself. I do have to give myself a little credit, though. While thoughts of cutting and suicide enter my mind a lot more often than I would like, at least I have not acted on any of those thoughts. No New Scars. That is my mantra.

I am starting a brand new life in a new city, two new jobs, and going back to junior college, with no health insurance and no way to afford therapy or medications. Marijuana is my medication for now. Nothing seduces me out of a dangerous funk more quickly or reliably. I smoke 2 – 5 bowls a day and worry that I’m smoking too much… It enables my strong hermit tendencies and hermitting myself away at home usually only makes matters worse, so I have to be wise and careful about when I choose to smoke. (I plan to write a blog post in the near future about the many ways in which marijuana has awakened my consciousness and helped me survive the last few years.) For now, the only resources I have are my sisters, one of whom also suffers from BPD, and the free self-help resources I can find online. I’m on my own here. (Yes, I think I’ll smoke my first bowl today and order a pizza.)

Although my rational mind knows that I am not my scars or my past, that there is a lot more to me than my mental illness, I can’t get close to anyone without feeling dishonest somehow because I have this huge secret to keep. The alternative is isolation, shame, and being the subject of cruel gossip. I cannot be authentic and this feels like such a heavy burden on my soul. It is hard to look people in the eyes without fearing they will intuitively perceive the monster in me. I can only work on my monster in my daily life privately and blog about it anonymously. I can only hope that all this mental and emotional energy and the words I write and publish online do a little good for someone else who might be struggling, like me, to find a way to survive and thrive within a judgemental society, in spite of having a mental illness.

Please let something good come of all this… Too much has happened and it is too much a part of me now. There is no pretending none of it ever happened. This is who I am. I have only two choices now – turn the shit over and compost it and use it to grow something beautiful, or roll around and die in the stinky filth. Today, I say – hand me a shovel! …and I pray for the strength and courage to make the same choice tomorrow.