It’s Mental Health Week across Australia. Each state starts and ends the special week at different times, but today—Monday—there’s a lot of overlap. So I want to explain why this week should feel like an important call-to-arms, and tell you what it’s like to live with a common—and little understood—mental illnesses: borderline personality disorder, or BPD.

Between one and two percent of Australians suffer from BPD. Women are up to three times more likely to have it than men. It is often connected to (or misdiagnosed as) another mental illnesses, which means it can get lost in other, bigger discussions. It can blend in with depression, anxiety, and bipolar. It might be genetic, or it may result from trauma. It might also be both, or neither.

It is hard to offer a simple medical definition of BPD, but I’ve heard it brilliantly summed up as “chronic irrationality.” Think severe mood swings, impulsivity, instability, and a whole lot of explosive anger.

BPD feels like floating above a dinner party, above the chitchat and laughter, looking down at the smiling people who understand one another, and thinking: why not me?

It sends you into spirals of self-doubt and hatred. It makes you feel like a tangled slinky, forever bumping inelegantly down a flight of stairs. You know something within you is twisted, and even once you’re told what, you’re left wondering why.

There’s always this stifling sense of isolation. I say “sense” because I can be surrounded by the most supportive friends and still think they’re out to get me, or mocking me behind my back. The tragedy of BPD is that it runs on such solipsism that it inverts me as a person. I become toxically narcissistic—self hating to the point where I irrationally project my emotional insecurities onto those around me.

It almost goes without saying that it’s hard to maintain relationships. The combination of feeling absolutely nothing while flinching at everything doesn’t make for a whole lot of fun. BPD makes me lash out, allowing some of the cruelest things to tumble from my mouth. And believe me, there are only so many times loved ones will forgive a lack of control.

People often discuss BPD by describing an “emptiness.” For me it’s more an oscillation between the impossibly empty and the impossibly full. I keep seeing my neighbour’s pool in winter, just an empty bowl of dusty blue tiles. Imagine standing in the middle of that, when suddenly the pool fills up. In an instant you’re drowning. People describe BPD like that: a flip. A big switch going off in an invisible instant.

I think it’s this erratic oscillation that makes BPD so hard to communicate—particularly to those who are close. Because on the surface it looks like I’m just being an ornery prick. Like all mental illness, it’s best treated with patience and empathy. And unfortunately, like depression or hypomania, it places the onus on people who are not necessarily in a position to help or understand, no matter how much they may care for you. In a relationship, BPD can leave both parties feeling isolated.

It brings out my mean streak something shocking. I’ve always had a devilish way with words, particularly nasty ones, and BPD is like a Terminator vision that highlights the chinks in everyone’s armour. Unlike my mania, which tends to make me charismatic and eloquent, a BPD “turn” or “moment” sees me turn sour and crude.

I remember once wagging a butter knife at my friend’s mum and her baby boomer friends at their dinner table after they were bemoaning the Gillard government. I accused them of “dry butt fucking my generation into oblivion.” They stared at me in open-mouthed shock, so I added that that they should “go huff asbestos in a ditch.” It’s not the kind of thing a level-headed person whips out at a 6 PM dinner with freshly introduced adults.

Of course, the outburst didn’t give me any sense of relief. It turned into a looping internal monologue of personal recrimination and self-hatred. Every decision is retroactively punished.

It’s a mirage illness. You feel like someone without fingerprints. You have no identity. You move between things constantly, people and passions. Onlookers can be tricked into seeing you as boldly transformative. In reality, you are someone without a sense of self. Sometimes I feel like a snake shedding infinite skin.

BPD isn’t talked about, but it needs to be. Suicide is an epidemic in Australia and BPD helps to drive people towards it. The stigma around BPD is pernicious. People accusing sufferers of using it as a crutch or an excuse for erratic behaviour are only pushing us deeper into the pit of isolation that worsens the symptoms and the pain. Conversation can dispel a lot of the hurt, and while we have Mental Health Week we may as well take the opportunity to air it out, and punch it in the sunlight.

Luckily, BPD is treatable with consistent therapy, self-awareness, and support. It doesn’t have to be a lifelong chum like depression or anxiety. The ghost can definitely be outed. But like all mental illness, to do that requires some love, from friends, strangers, and yourself.

And the s*** thing about BPD is that it makes love hard to come by.

October 10, 2016,  Patrick Marlborough, vice.com
 

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