Apologies in advance for the long read. It is optional
Boy, is it an intimidating diagnosis to digest!. My initial reaction was initially relief, actually, because I already knew what my experience was, but didn’t know what it was called or how to live with it. Then came the feelings of “whoa, this feels like a lot to carry.” I still feel like that now, though just a bit less so, now that I’ve learned things here and there to help manage it.
I know what you mean about just taking a fistful of pills! If only it were that easy. I’ve been put on all sorts of meds in doctors’ efforts trying to help – antidepressants, anxiolytics, mood stabilizers, antipsychotics, you name it. Some people get partial relief of some symptoms with medication, but lots don’t, and it’s not a fix anyways. In my case, meds didn’t help with BPD at all. They did help manage my anxiety disorder and ADHD, which helped indirectly, but I also didn’t need them.
From a healthcare standpoint, the treatment that ended up helping me a lot was what you mentioned: individual therapy, course work, and support groups. My course work and support groups weren’t BPD specific, but as there’s a lot of overlap between management of various mental health conditions, they still helped. Mood regulation, CBT, mindfulness and other coping skills, and interpersonal effectiveness were especially relevant to me as overlap topics. I also got a couple of workbooks on DBT that I worked through on my own. DBT was modified from CBT, was designed to treat BPD, and has been especially helpful to me.
I do comparatively little formal treatment these days for it, at least not with classes and groups. I just keep practicing the skills I picked up in classes and therapy in an everyday setting. I’m still in therapy, though that’s down to once a month or so now. I think I’ve basically learned what I need to as far as book knowledge, I just need to get better at putting it in practice. And every day, all day, 24/7 is practice. Especially in precisely the times you want to just lose it and not think about practicing! With repetition, though, the work becomes more automatic and less work. And as much as it is hard work, I really look forward to therapy. I really feed off of knowledge, and I learn so much from those sessions.
I also found that it took a long time for some techniques to start working. It was months before CBT started helping me, it made sense in theory but not when I tried to apply it. A lot of what I learned felt artificial, silly, and pointless to start. A key realization I had was that a lot of coping skills they teach you aren’t actually even necessarily to make you feel better as their primary purpose. They’re just healthier, more constructive and less destructive ways, through the same emotional minefield. A lot of the time they do make it easier, but we all know sometimes something just sucks, no matter what you do.
I’ve come a long ways in a relatively short period of time. I used to be in and out of the psych ward a lot, up to a month at a time, and some of it involuntary. Suicidal ideation and self harm was regular. I readily formed interpersonal relationships that were practically the definition of unstable and intense, putting myself into patently unsafe situations in some cases to do so. I felt desolate and panicked when I didn’t. I whipped back and forth on how I viewed and treated people in my life, because my view of the world did so. I’d handle some things like a model adult, and melt down over trivial or imagined things.
That has all but stopped. My last psych hospitalization ended last spring. I’ve distanced myself from unhealthy relationships, and started repairing the rest. I don’t self destruct like I used to. With a lot of help and wisdom from my HP and community, I don’t drink or self harm anymore. It’s mindboggling to me how both my past behaviour and my behaviour now are both from the same person, me.
But that’s not because BPD stopped. A lot stayed the same. My emotions still surge to baffling heights and depths at the drop of a hat. I still struggle to feel valued, valuable, or wanted, to the point of despair at times. I still deal with high levels of impulsivity. The identity thing is still unclear. I still get suicidal thoughts and I still dissociate, though less often. In fact, that #9 symptom perfectly describes an unsettling experience I had a few weeks ago (that I won’t get into just now).
The difference is that I have gained control over my behaviour. And it’s a life-changing difference I’m grateful for. If I remain diligent in improving my management of behaviour, I do believe that I can experience better relationships, get and keep a good job, etc., while not setting my world on fire. This behavioural management part is the part that all that treatment stuff helps with.
The experience itself, though, the feelings and thoughts behind the old behaviours… this part is hard for me. I wonder to what extent, if at all, I’ll ever be able to feel and think in more palatable ways. Am I always going to feel this way and live a normal life in spite of it? Or will this too, ease with time? For me, it’s too early to say. I’m basically only a couple of years into BPD recovery. The question is really heavy though, and it can really get to me. I just remember “one day at a time”, and try to avoid getting upset over things that haven’t happened yet.
I’m also still finding it really tough to accept how my life is currently affected by my mental health in general, between BPD, ADHD, and anxiety issues (I’m still waiting for a doctor to just pick one anxiety disorder and stick with it!). I have come a long ways, but I still have a long ways to go. I still want to come off disability, get back to my career, do more than I’m doing now, and not feel so limited. But there are reasons for where I’m at and the timing of it, so now I’m learning patience and persistence.
Today was a day where I felt like giving up on all the improvement stuff, but I didn’t. I literally got nothing else done that wasn’t on my very short to do list, but I did get that done. Even after the accomplishment, and victory over the mental struggles of the day, it still feels like a crap day. I keep comparing myself to a version of myself who resembles what “normal” is, someone who would have knocked off those tasks before lunch without a sweat. But right now, today, I was the person who spent all the hours of energy and effort on the other things. Lifting myself out of the emotional pit I woke up in, getting stuck in obsessive thoughts when I want to do something else, calming down after the trip to the grocery store, coaxing myself into necessary chores, chasing the whirlwind of thoughts I get when I’m at a keyboard communicating with humans, and so on.
I’m embarrassed at the slowness and difficulty I experience for these simple matters that sometimes end up taking all day. But I’m doing it better now than I did a few weeks ago. I’m doing it much better than I was doing it a few months ago. I wasn’t doing it at all a year ago, or I was causing destruction in the process. I just do the best I know how with what I’ve got. I get good and great days along with the bad. Keeping perspective and holding on to hope is my lifeline in this process. And engaging with others, not doing this alone, is a crucial part of that.
This is lacking a proper conclusion, but there’s my honest, raw experience, my friend. It’s been tough but doesn’t deny me a full, fulfillling life.