Tag: NEAD

Borderline Personality Disorder: What it means to me

~ Bee x ~ 3 Comments

Borderline Personality Disorder (BPD) is a mental illness that is surrounded by stigma and considered by professionals to be a severe psychiatric disorder yet, despite the negative connotations and complexity, being given a diagnosis was in some ways a positive as it has made so many things in my life make more sense. There is so much involved in it that it simply wouldn’t be possible to fit into one post, so today we are just going to start at the beginning: the criteria of BPD and what it means to me.

To be diagnosed with BPD you must meet five out of nine diagnostic criteria (symptoms) as defined by DSM-5, and these need to have a significant impact on your life. Below we will look at them in their most basic definitions as the complexity and variety of individual symptoms and manifestations is extensive, and with each one I will include just what it means for my diagnosis and how it started to make everything make sense.

  1. Frantic efforts to avoid real or imagined abandonment.
    1. I will do anything to keep people happy, often to my detriment, and take the smallest inconsistencies as a sign that I’m hated and not wanted. I incessantly apologise and constantly need to check and validate that things are okay, people still like me and I haven’t done something wrong. This is due to an intense fear of rejection and not being good enough. All of a sudden this diagnosis made the way I behave make perfect sense.
  2. A pattern of unstable and intense interpersonal relationship characterized by alternating between extremes of idealization and devaluation.
    1. Unhealthy previous relationships and the way I go through phases of viewing the validation from certain people in my life as being of upmost importance fits into this criteria perfectly.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
    1. There are days I look in the mirror and don’t recognise who I see. I will cling to any opportunities to define myself by an activity or a relationship, just so that I have something solid that I can hang my identity onto. This criteria made me notice just how much my self-image differs depending on my mood or who I’m with, it is never consistent and that is one of the primary reasons I’ve struggled so much with my confidence.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
    1. Fortunately, this is one of the criteria I meet less but I still haven’t escaped completely. I do things to extremes – I will be compulsively saving and then sporadically become obsessed with a concept so buy everything related or try to cheer myself up by spending money I later regret. Or it will be little things like sending impulsive messages or making sudden decisions on things that ordinarily I would think through and plan. And I become easily obsessive so a substance abuse problem wouldn’t be difficult to imagine.
  5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
    1. This criteria made behaviours I’ve had since I was a child make sense – predominantly dermatillomania (compulsive skin picking). As a child they thought I had a skin condition and even tried to treat it. But now it makes sense that it is correlated to stress or low mood – it is rare I don’t have areas of skin that I am picking at especially my fingers or my head. And one of my coping mechanisms for emetophobia has always been digging my nails into my arm. Between the two I meet this criteria without even thinking about it. And, although I’ve never made any concrete plans, I do get suicidal ideation.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
    1. Mood swings. No doubt about this one – I can wake up in the morning feeling on top of the world and it takes only the tiniest trigger for it to spiral downwards into anxiety or depression or something equally as unpleasant but, on the plus side, it also means it doesn’t take a lot to trigger a good mood and bouncing back. Having a diagnosis gives some hope that, with the right coping mechanisms, I can get these triggers under control and maybe start to find some stability.
  7. Chronic feelings of emptiness
    1. Between the mood swings, depression, anxiety and dissociation sometimes the emptiness is a welcome relief but there are without a doubt days that I feel completely numb to the world and with it comes intense feelings of worthlessness and loneliness which certainly isn’t pleasant.
  8. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper, constant anger, recurrent physical fights).
    1. Of the nine criteria this is the one I identify with the least – only very occasionally do I feel intense anger and, although sometimes I can be extremely childlike in my five minute tantrum of showing it, I don’t think it is any less than anyone else.
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms
    1. I get days where I think that everyone is talking about me and looking at me, and days where I feel completely detached from the real world and like I’m in a bubble, add in the seizures which are a dissociative symptom all of their own and I have certainly got this criteria covered. But it’s such a strange feeling that dissociation will have to be covered another time. At least having a diagnosis, alongside the NEAD diagnosis, means more hope of getting it all under control.

So, that’s the basics of BPD – although there is so much more depth to each criteria and so much more that people go through alongside this. And, although I was certainly guilty of googling it prior to my assessments, it is such a complex disorder that no one should take this list as a way to self-diagnose – a diagnosis can only ever come from a medical professional.

Hopefully this has given a bit on insight into BPD and how I got this diagnosis, but please do not hesitate to comment any questions you have.

Bee x

My Mental Health Story: Leading up to a diagnosis [Diary Extract]

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After the SSRI triggered hypomanic-type episode (here, if you want an excuse to chuckle at me) things were up and down – I still had days with the warm bubble of over-enthusiasm where I knew I was edging on too high, and day’s that I felt like I was going to crash I wanted to go to the psychiatrist with as much information as possible so I kept track of it all in this record I kept between the episode and the day I got my diagnosis:

23/03/2018 – after the few days of hypomania I woke up feeling fuzzy and butterfly-ey still but this began to dissipate and I started to feel calmer, although the world still did not feel normal. I met my parents at the pub that evening and my mood was still elevated, racing thoughts and chatty.

24/03/2018 – 27/03/2018 – over this period I felt very up and down, between feeling quite hyper and up and a bit lethargic. The first few days were considerably more up than down, this balance then shifted as the week went on and I felt more levelled out. Extremely embarrassed and anxious over my behaviour on the previous days, however, I did feel closer to normal than I had done. I still struggled with my appetite and did not feel overly hungry.

  • 25/03/2018 – decided I wanted to get certificates so looked online and found courses that were officially certified and proceeded to buy 3 (spent over £100 but was also extremely pleased due to the savings which is another thing I am easily obsessed over). These were in subjects I am interested in but have no use for currently. I then became obsessive about completing the first one for 4-5days before losing motivation.
  • 26/03/2018 – had a doctors’ appointment first thing and then went shopping with my mum at an outlet shopping centre. I had already been thinking for a while that I needed a new purse and, when looking round, found a designer one I liked. Whilst in the shop I also saw a bag I liked and impulsively bought it – spending more than I could justify on the bag and purse. Normally I would weigh up the cost implications of this, thinking about it whilst shopping further and returning to the store, but I spent this money impulsively without much consideration, especially as it was a good saving. I also did the same thing with a pair of shoes.

28/03/2018 – 30/03/2018 – although I did not feel normal, with still feeling up and down, I did feel a lot more normal than I had done previously and the changes were not significant enough for me to actively notice.

31/03/2018 – continued to be very mixed in my moods. I was fairly content when I woke up, but then had a period of being sad and anxious in the afternoon where I questioned a friend over concerns that no one would turn up to my funeral. Attended wedding that evening which I found difficult as I had a previous failed engagement and this wedding was with friends that would have been attending ours. I had a period of intensely over whelming sadness when everyone coupled up to join in with the first dance and you have a recipe for disaster. I had 2 glasses of wine however felt the effects of it far more than normal, and I was being more outgoing than usual; I even asked a cousin of the bride, who I had never met before, if he fancied going out for dinner which is extremely out of character for me. This is the last thing I have recollection of…

  • Information gathered from others due to no recollection: When I was sat down (approx. 22:00) I was talking to a friends’ partner who then went to get her as I was apparently no longer making any sense when I was talking. They then removed me from the room and led me down as I began to have what they believed to be a tonic clonic seizure (two friends at the wedding that looked after me are both in a medical field). I was incontinent of urine at this point so they borrowed spare clothes. I was not particularly responsive, and when I was it did not make sense and I may have had further seizures during this time. They got hold of my parents and drove me to my parents’ house – arriving at around midnight – in the car I was ‘twitchy and kicky’. Once at my parents I was sat on the sofa, but still unresponsive and not very conscious, I then slid off the sofa and was incontinent of urine again. At approx. 1am my parents rang an ambulance as I was still not regaining much consciousness. The ambulance took me to RHCH, in which I had a further event where I made a lot of faces, with my tongue going in and out of my mouth, and my legs shaking and kicking. The ambulance did nearly put oxygen on but we then got to the hospital as they were considering it. In the hospital they did bloods which confirmed my alcohol levels were not overly high and that there were no other substances present. I then became quite agitated and aggressive – taking three of them to put a cannula in, which I later tried to pull out, and I was put on fluids overnight. I do not have any recollection of any of this and my memory does not kick back in until I awoke at around 6am on 01/04/2018, this felt like I was just waking up as normal, except for the confusion about where I was and how I had got there from being in the middle of a wedding. I was discharged from hospital and stayed at my parents – I slept for a large proportion of the day and struggled to eat initially.

02/04/2018 – I felt extremely up and down during this day, feeling fairly content and then very irritable and low. This continued throughout the day.

03/04/2018 – 11/04/2018 – on waking up I felt extremely low and tearful, which continued for the rest of the day and did not ease. I continued to feel low. This continued over the next week and I remained feeling extremely low. It was noted by colleagues that I was actively withdrawing, I struggled greatly with my concentration at work and this did affect my social life and work productivity. I also had periods of extreme irritability. During this period, I was also very paranoid about what people thought and overly apologetic (although this is common behaviour regardless of my mood, so I guess this wasn’t that unusual). I have also noticed that my memory is extremely patchy, unable to recall simple details / events – such as what I have done on certain days, who was present and associated details. I continued to struggle with my appetite, and have had little desire or motivation to eat or prepare food.

  • On one day, although I am unsure of the date, I did still feel low but I also felt like there was a strange bubble of warmth in my stomach and torso. Not like the butterflies I have experienced, more like a full balloon. This was after a night that I struggled to sleep. This feeling did appear on other days but to a lesser degree and did not last as long

*11/04/2018 –I saw the epilepsy nurse who confirmed that the seizure activity and other physical symptoms I experience are functional / dissociative episodes; cause be Non-Epileptic Attack Disorder (NEAD) (also known as Psychogenic Non-Epileptic Seizures, PNES).

12/04/2018 – I was still low when I woke up, and continued to feel lethargic and withdrawn throughout the day. In the evening I was not hungry at all – even less so than I had been previously – and, although I had been tired earlier in the day I no longer felt able to sleep. I was also extremely agitated over noises from next door which, although I could sort of justify it that they were louder than normal, led to me ringing mum to walk around the house and check cupboards / rooms – behaviour that I have not performed often since shortly after I began living on my own. I watched TV all evening, eventually deciding to go to bed at midnight as I knew I had work the next day. But once in bed I still didn’t feel like sleeping so played on my phone until 1am. I then made myself turn everything off as I knew I had work. I did sleep through until 6am.

13/04/2018 – woke up feeling brighter but slightly detached from the world. On the bus I noticed that I had cramp in my left arm, the butterfly feeling, although not overly strong, was detectable and I was feeling more turned on. Things were more interesting on the bus – I noticed a post box I had never really given much attention before purely because of the colour. On getting to work I felt chattier and more upbeat than I had done the previous weeks, my change in demeanour was enough for a colleague to comment on. But still had a residue of feeling sad sat behind it all and by lunchtime I felt very detached from the world and in a bubble.

14/04/2018 – Safe to say the dissociative symptoms are really coming to the forefront whenever I get more stressed and emotional. It’s been such an up and down week, add in my diagnosis from the epilepsy nurse and nerves about seeing the psychiatrist on Monday and you have a recipe for disaster. I went out for dinner with my best friend last night and thank goodness it was her, because she is one of the few people I actually believe will love me and stick with me regardless. We had a lovely meal, and then went on to a bar afterwards, but I don’t remember getting there. The next thing I know I’m waking up today, at my parents, feeling extremely peculiar. I managed to collapse and have some sort of dissociative seizure whilst out and end up in the back of an ambulance, again. I am now completely riddled with guilt and embarrassment and I really don’t understand why people are still willing to socialise with me.

 

Then, on 16/04/2018, the appointment with the psychiatrist resulted in my diagnosis of ‘Borderline Personality Disorder’. But we will go into more depth about that next time.

Bee x

Under the Spotlight: My Seizures

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Seizures have, without a doubt, been the most disruptive element of my life – more so than any of the Mental Health challenges I’ve had and certainly with a lot more effect on my future.

They started in November 2014 when I was on a night shift. If I hadn’t been working in a medical environment it is unlikely people would have picked up on them as it was the nurses that noticed I seemed to blank out for 30 seconds or so. Initially this wasn’t disruptive to work and purely meant I couldn’t work 1:1 with any child or young person but it did mean I had to give up my driving licence immediately. So many people have said that I should have just kept it a secret and kept driving but if I had had an accident and killed someone knowing that I shouldn’t be driving I would never have forgiven myself.

A few months later however I had two tonic-clonic seizures in my sleep (what is considered a stereotypical ‘fit’) and, unlike the absence seizures that I had been having, this was deemed too much of a risk and I could no longer work on the care floor. I had been planning on applying to study nursing but this was also now out of the window and with it my career path. This is what ultimately led to me leaving the children’s hospice when travelling there was a struggle without a car and they couldn’t offer me fulltime hours in any other role – leaving was heart-breaking and, alongside driving, taking away the career I was planning is the biggest life change that the seizures caused.

Throughout this time I was having tests – EEG’s, MRI’s, I was having scan after scan but they didn’t show anything of use. They put me on anti-seizure medication just in case but it seemed pointless when they couldn’t prove a cause. After 9 months of seizures they stopped and that meant, after waiting a year seizure free in line with DVLA guidelines I could reapply for my licence. I bought a car and for three glorious months had my freedom back but this was short lived as a stressful period in my life triggered the seizures to come back in November 2016 and I was back to square one.

The symptoms have changed since – I was still having the absence seizures but with the addition of neck spasms and the left hand side of my face dropping like I’m having a stroke occurring when I’m stressed – and it is this addition of this which meant in March this year I finally had a diagnosis and an explanation – Non-Epileptic Attack Disorder (NEAD) also known as Psychogenic Non-Epileptic Seizures. Basically just another way my brain copes with stress and it goes hand in hand with the BPD diagnosis but fortunately I haven’t had anything in a few months (touch wood!) It also changes the driving rules and I am now just waiting for the go ahead to reapply for my licence. And once I have my licence I can review my work situation and, with the added freedom, hopefully go back to doing something that I am passionate about.

The seizures have been disruptive of not only my life but the people I love, with my mum having to drive me around everywhere and I am just fortunate that my mum and my friends are all understanding of the fact it isn’t through choice and that they are willing to help me out and put up with it. Even when I collapsed and have a seizure at a friends wedding and again a week later after a nice meal, they call the ambulance and look after me and are still willing to keep socialising. It has certainly shown me just how fortunate I am to have these people in my life. And I always  wanted to go in an ambulance when I was younger so at least I can say I’ve done that three times now; one even dropped me home.

Bee x

My Mental Health Story: The Next Chapter – Uni and Worklife

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Part two in my mental health story… we discussed part one, school and college here.

After a lot of hard work and commitment to hypnoanalysis I did it, I made it to University. I even hosted a cocktail party with my friends before I went to prove I could cope around people drinking, and a few nights out to confront my fears of people being out clubbing and being sick. I chose a University a five-hour drive away so that I couldn’t just run home when I got stressed and anxious, I had to stand on my own two feet, and I had an absolutely incredible year. I made some amazing friends, who really understood and supported my journey and I still miss, and I proved to everyone that I could live independently and cope in the face of the things that had previously induced crippling anxiety. Without that year and really embracing the University lifestyle I don’t think I would ever have made it to a place where I could cope with my anxieties on my own.

The problem came at the end of the first year. I studied Biology, which I adored, however the career prospects from biology weren’t what I wanted to do – predominantly it would mean going into research and I’ve always wanted a more person-centred career. I chose to leave because you get one years ‘grace’ for funding, so I can still get funded for another 3 year degree course when I eventually work out what path I want to take – so I chose to drop out as, although hard and rather stressful, it would open up more opportunities to find the career I wanted.

Once I returned home I lost direction as the path I had anticipated being on – finishing the degree and getting a career – had suddenly disappeared and I felt lost and confused as to what to do next. Especially as all my friends remained at university, I felt a bit out of sync and like it was something to be ashamed of because I have always been extremely academic, and a degree was what was expected of me. So, although I knew it was the right decision for me it was still an anxious decision. And, with the hindsight of the identity instability of BPD it explains why this affected me so badly.

As I was suddenly at home I needed to find a job and ended up in retail, purely through availability – which is when the depression started as I started to worry that I would be stuck in a minimum wage entry job and had made a bad decision in leaving. I didn’t have the experience or knowledge to work out where to go next or what career path to follow; and this led to my depression diagnosis. It was predominantly a mixture of the stressful few months, having to rethink my future and being unsure of the future, and fear of what others thought, and I made the decision to go on anti-depressants.

I then found a job as a Support Worker for adults with learning disabilities and epilepsy (definitely an irony in that once the seizures started) and this was where I realised my niche and that working with people really is, as I had always anticipated it being, the place where I flourish. Once I started working in care I began to come off the medication, however a colleague began to pick on my lack of experience and lack of confidence, at which point I chose to remain on the medication due to the damage this had on my confidence and general feeling of wellbeing. Again, I think this was related to the uncertainty of the future and whether or not I would be good at the job. I have always been so petrified of what other people thought and of not being good enough and it has played havoc on my confidence and direction. But I know that I was damn good at that job and, once a few individuals had left, our team really made a difference to those service users day-to-day lives.

Next, looking for some more progression and a higher salary, I took a position in a children’s hospice as a carer and again was in an environment I adored and was comfortable enough in to come off the anti-depressants completely. But by this point my personal relationship had become unhealthy, with a lot of emotionally abusive components; although I couldn’t see this at the time despite friends and family trying their best to make me realise that it wasn’t a good place to be. Between this, my mental health and just the general stress it all created, I started having seizures… initially they were absence seizures and I would just stare blankly into space for a few seconds; it could appear to some so much like daydreaming that I wonder if people would have realised what they were it wasn’t for working in a medical environment. Then when I had some full tonic clonic seizures it was too much of a risk in that environment and, as they couldn’t provide me with enough hours in other roles to continue full-time (we did try a while of being a housekeeper but made a joint decision that I was certainly not a natural and it was best I stopped that for everyone’s sanity) and I had to leave. It was devastating as I adored the job, the organisation and working with children and young people knowing that I was doing something that made a real difference; and that is how I ended up where I am now, but that’s the next bit of the story.

From the start of the seizures, to a diagnosis of Non-Epileptic Attack Disorder took two and a half years, but we can talk about that more in depth another time. All of my reactions to situations, and the desperation to have a career I can be proud of as a way to identify myself, all support the Borderline Personality Diagnosis – it’s amazing how much more sense things make sense in hindsight.

Bee x

Let’s Do This…

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My hands are literally shaking as I write this… this means it is out there… for all I am open about my various mental health struggles, I’ve never put them into such a public domain before and that is petrifying. Add in what my diagnosis entails and the fear of rejection is getting more overwhelming with each word written…

I guess I first started struggling to noticeably struggle with my mental health at the end of Secondary School and going into college, around 16 years old, but in hindsight the attitudes and coping mechanisms developed long before this. At college it became crippling, my anxiety levels peaked and with it came emetophobia – the fear of vomiting. Many parts of my life completely stopped and I was sure I’d never get any semblance of a normal life again, but with a lot of hard work, hypnoanalysis and incredible family and friends I made it through and even made it to Uni… but we can talk more about that journey another day.

With University came a whole host of other issues, triggered by my desperation to live a ‘normal’ life and therefore not taking the time I needed to really recover from my anxiety disorder and decide what I wanted to do with my life, so I took the decision to leave and return home with the aim of going back when I knew what I really wanted to do.

Fast forward six years and my mental health issues never went away, they just got different. On a bad day my anxiety disorder and emetophobia can be utterly debilitating. But we’ll get to that. I ended up in an extremely unhealthy relationship and on antidepressants which I decided weren’t working and took myself off and this, in turn, led to me having seizures… I lost my licence, the job I loved and my independence, and after years of doctors and tests it turns out that they, too, are just another manifestation of my mental health and a diagnosis of Non-Epileptic Attack Disorder (NEAD) on 21st March 2018.

And after having been put back on anti-depressants which triggered a hypomanic phase (actually, that’s a funny story… I’ll tell you sometime), I was diagnosed on 16th April 2018 with Borderline Personality Disorder (BPD). It’s been a whirlwind, it explains so much but creates so many more challenges, and there will only be more going forward with a caseworker and treatment still to come.

So that’s where we are, and why we’re here – I have been writing since before this started and I thought, why keep this to myself? BPD is such a stigmatised disorder, and so much more prevalent than people realise, but how will we change that stigma if no-one is willing to come forward and talk about it. So here I am – we can talk about how I got to where I am, and join me on my journey going forward as I start treatment and face whatever else life has to throw at me… Hopefully we can have some fun too!

Bee x