To the Emergency Room Staff, From a Person With a Mental Illness

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Dear madam or sir,

Welcome to your supporting role in my mental illness! Obviously, as I’m presenting myself to you (or if I’ve been presented to you), I’m not feeling well. This could be due to a number of reasons. Maybe I’m hearing voices that are persistent and incredibly distressing and scary. Maybe I’ve hurt myself (or want to) and feel unable to cope. I might feel like I’m being followed, have been bugged or watched. Possibly I feel like the world around me is unreal and find it difficult to drag myself back to reality.

No matter why I’m here, I assure you it’s real.

If I’ve brought myself here, don’t assume I’m “well enough to come to hospital, so I must be well enough to not be here.” Don’t dismiss what I’m going through because I have the insight to know I’m in distress. I’ve worked hard to be be able to do this; it has taken immense strength to get here today. This is true whether I arrived by ambulance, walked, drove or I’ve been brought by the police for my own safety.

From a young age, it’s hammered into everybody that hospitals are serious business. You only ever go there when things are dire. You only ever get to ride in an ambulance when you’re practically dying; any other visit or reason is simply wasting time and important resources. But when you have a serious mental illness (such as borderline personality disorder) you feel like people never take you seriously. You feel like you aren’t important enough to ask for help. You feel like people will call you attention-seeking for doing what you’re supposed to do.

I understand the emergency room can be the busiest place in any hospital, and that every nurse, doctor and consultant will be rushed off their feet trying to hold the place together and save the lives and limbs of the people they care for. When I come to you, I’m in just as much pain as the person with the broken arm, even if it’s invisible. I’m just as scared as the little girl crying for her mommy.

So if I’m left alone in a room with nurses rushing backwards and forwards outside, noises all around, with nobody but myself, I may start to feel like the loneliest person in the world. This makes me feel like nobody cares. My brain then picks up on these thoughts and amplifies them, turning them into malicious impulses to harm myself or to do stupid things just to show the people ignoring me I’m worth listening to. I feel the need to prove my illness is legitimate and that I need help.

And I understand I’m not easy to deal with. I understand you don’t always know what to say. But I’m also a human, in pain. It doesn’t matter that the pain comes from inside my own brain. It doesn’t matter you can’t see where it hurts. If we tell you it hurts, believe us. At least try to understand. 

Just now and again, take a minute to stick your head in and ask if I’m OK. Remember being this ill is very, very scary. Don’t leave me to ruminate by myself for too long. Don’t avoid my gaze. Don’t forget I can’t help being ill and don’t think, “It’s not my job, I’ll wait ’till psych gets here.” A small piece of kindness, even if I can’t respond, drags me back into the real world for a little while. 

I know your job is a thankless one a lot of the time. So let me say thank you for the people too ill to say so themselves.

I don’t blame you, and I’m thankful you exist. This letter will not even apply to a lot of you angels of the ER. But next time you do have a patient cross your path who has an acute mental illness, maybe you’ll remember this article. Maybe you’ll save someone’s life just by being kind.

Sincerely,

Your patient

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When I Realized I Was Thankful for My Borderline Personality Diagnosis

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I was recently diagnosed with borderline personality disorder (BPD), and upon hearing those words, my heart sunk. It couldn’t be me. When I thought of BPD, I thought of violent people who get angry at the drop of a hat and lash out at any little thing. That’s not like me at all — or is it? The more I researched BPD, the more it felt like someone was writing about me. Everything I read described me exactly.

One of the defining characteristics of BPD is unstable emotions, and boy are my emotions unstable. Something so small, like a causal statement or a particular song, can send me right off the edge. Sometimes I can snap back as quickly as I went into it, but most of the time not so much. I’m stuck picking up the pieces of an emotional nightmare which might not fade for hours. I feel like I’m floating in the ocean and being tossed by the waves. Some days are good and calm with no waves, but on other days the waves are gusting and throwing me so hard I feel I can’t take it.

I feel emotions more easily and deeply than others. I see this as a blessing and a curse. Depression feels overwhelmingly deep and dark, but feeling good feels amazing, like euphoria. I feel intense joy over small things and incredible gratitude for kindness of others. Because of this, I have empathy for others — but even that’s not always a good thing. Hearing about a friend’s divorce can send me into a whirlwind of emotions. While it’s good that I can share her pain and be there with her in it, it also means it may take me a long time to get my own emotions back in order.

Black and white thinking or thinking in extremes is another hallmark of BPD. Things are either all good or all bad. With BPD you don’t see gray, it’s only black or white. For me when life is good, it’s absolutely great. Sunshine, lollipops, the whole deal. But when one little thing doesn’t go the way I think it should, bam — darkness takes over. All of a sudden life is terrible, I’m terrible, it’s all hopeless, I don’t deserve to live, etc. I experience “splitting” in relationships, too. People are either all good or all bad. There is no middle ground. I can think of someone as absolutely perfect and wonderful, and then they do one little thing and they are the worst person in the world. I can’t sit with someone being mostly good, but somewhat flawed.

But when I read about self-harm and suicidal behaviors, the BPD diagnosis really hit me. Because I feel things more intensely, overwhelming emotions are just too much. I can’t even begin to describe the torment it feels like. Imagine you’re in a sickening bright room curled up in the corner. People are pointing at you and screaming horrible things, but you can’t do anything to make it stop.

That’s when I realized my diagnosis was beneficial for me. It helps me understand myself and why I do the things I do. It helps me get support from others struggling with the same issues. A great thing about BPD is that there is a great recovery rate with therapy. It won’t be easy, but now that I can define the problem, I can start gathering the tools to make it a little easier.

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20 Secrets of People Who Live With Borderline Personality Disorder

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There are many things you may not know about borderline personality disorder (BPD). Like how it affects 50 percent more people than Alzheimer’s disease. Or how research has shown people with BPD who engage in treatment have good outcomes. Or how just because you’ve seen one media portrayal of someone with BPD, doesn’t mean you know what someone with BPD is actually like.

To shine some light on this misunderstood mental illness, we asked people in our community who live with borderline personality disorder to tell us what they wish others understood.

Here’s what they want you to know:

1. “I feel everything, all the time. It’s exhausting. But it also makes me passionate, which is beautiful.” — Aliçia Sarah Raimundo

A quote by Aliçia Sarah Raimundo that says, "I feel everything, all the time. It's exhausting. But it also makes me passionate, which is beautiful."

2. “Please don’t point out when I overreact. It’s not easy to get over it myself. I beat myself up over my words and actions fine on my own.” — Tatauq Helena Muma

3. “We feel more intensely. It doesn’t necessarily mean we’re more sensitive. Depression just isn’t depression for us; it’s rockbottom. Happiness isn’t just happiness; it’s the greatest high ever.” — Heather Yonkers

4. “My mind and heart could be telling you I love you while my words are the direct opposite. Don’t take it personally. Allow me to take a nap or write down my thoughts for better communication.” — LeChondra Sapp

5. “Don’t believe the stereotype. Not everyone with BPD has anger outbursts and manipulative behaviors. That’s the type of BPD often portrayed to the extreme in the media, but not everyone with BPD is the same! Just because I don’t fit the stereotypical borderline doesn’t make my illness less valid. — Alyse Ruriani

A quote from Alyse Ruriani that says, "Just because I don't fit the stereotypical borderline doesn't make my illness less valid."

6. “BPD is the best curse. To be able to feel every emotion to the fullest can often be very rewarding. However, we feel the bad to the fullest, too. The smallest problem could feel like the end of the world. Personally, I have lost a lot of people because I’m ‘too much to handle.’ The struggle is real, but guess what? Without stuggle there is no progress.” — Tia Marie

7. “There’s no reason to be afraid of me.” — Jennifer Davis

 

8. “I’m not trying to start drama.” — Mary Hannah Cleve

9. “My moods change constantly. I have zero control of my own emotions. If you think it’s a roller coaster knowing me, imagine how hard it is being stuck in my own head. I promise you that I’m trying hard to keep myself in check, it’s really difficult though.” — Sam Thayer

A quote from Sam Thayer that says, "If you think it's a roller coaster knowing me, imagine how hard it is being stuck in my own head."

10. “I wish people understood the fear of abandonment. It’s so hard to trust.” — Aunt Sam

11. “I’m not ‘difficult’ — even psychiatrists assume this! I’ve had doctors make up excuses not to see me when I mention borderline. I’ve learned not to even talk about it.” — Jenna Bagnini

12. “We are not all manipulative, selfish people.” — Maureen Damico

13. “I’m just as confused by it as you are.” — Vikki Rose Donaghy

A quote from Vikki Rose Donaghy that says, "I'm just as confused by it as you are."

14. “Please don’t say, ‘It’s because of your BPD’ all the time. My opinion matters even if it doesn’t line up with your opinion. I am not my diagnosis.” — Victoria Torgerson

15. “Sometimes my constantly switching moods may seem conflicting and make you frustrated, but I’m the one experiencing it. Sometimes I can’t make sense of it either.” — Christina Chalgren

 

16. “When I say my moods switch within seconds, I mean literally seconds. That’s why I always say ‘I’m OK’ — because I’ve been called a liar when my mood changes from an extreme high to an extreme low in two seconds. It’s like being on a roller coaster I can’t get off of, no matter how badly I want to.” — Dylan Jonathen Kirchhoff

17. “We’re not all lying, attention-seekers. Sometimes we’re just doing our best to survive with the limited skills we have.” — Mirella Joy

A quote from Mirella Joy that says, "We're not all lying, attention-seekers. Sometimes we're just doing our best to survive with the limited skills we have."

18. “Living with borderline can be overwhelming, horrible and wonderful all at once. My emotions can be all over the place, but I’m doing the best I can. This is part of who I am, but it doesn’t make me any less of a person.” — Miranda Tymoschuk

19. “I have trouble regulating my emotions. Something someone else might be able to let roll off their shoulders might overwhelm me. Living with borderline personality disorder means I have to fight to survive every day.” — Meghan Winter

20. “My personality disorder doesn’t define who I am, it explains it. Yet in many ways I’ve learned from having it. It’s not all bad — it’s a humbling learning experience.” — Kerri Wolfton

A quote from Kerri Wolfton that says, "My personality disorder doesn't define who I am, it explains it."

*Answers have been edited and shortened. 

 

Editor’s note: Number seven has been reedited to delete a line pertaining to “multiple personalities.” 

20 Secrets of People Who Live With Borderline Personality Disorder

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7 Things You Learn About Yourself After a Borderline Personality Diagnosis

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As someone who’s been diagnosed with borderline personality disorder (BPD), I know it can be an intense daily roller coaster ride. But getting a diagnosis can lead to some important self-discoveries, too.

Here some things you might learn about yourself after getting diagnosed with BPD:

1. You might have to accept most people won’t get it. 

When you’re trying to explain your diagnosis, it might be hard for others to understand. If they think they get it, they’re probably being misled by pop culture references like “Girl Interrupted.” Do your best to educate your loved ones about what BPD means for you.

2. Sometimes you can’t trust your instincts.

If you have BPD, arguments with people you love might feel like the end of the world. I feel like if I argue or say the wrong things, my loved ones will abandon me. Part of living with BPD is learning to accept that sometimes what you’re feeling or thinking is brought on by your disorder.
 
3. Your diagnosis can be a relief and a curse.

Finally being told you have a legitimate disorder can be a massive relief. But at the same time, it can make you start questioning everything you thought you knew about yourself. This can be the beginning of self-exploration. The journey is a hard one, but it’s worthwhile.

4. It’s not your fault. 

While we do need to take responsibility for our own behaviors and actions, it’s not our fault we have this illness. BPD is caused by a combination of both environmental and genetic factors — but 60 percent of the risk of developing borderline disorder is caused by genetic abnormalities.

5. You can still have a great personality. 

I know that even with my BPD diagnosis, I can still be the life and soul of the party. Most of the people I know who are diagnosed with BPD are intelligent, artistic, creative and charming, despite their disorders. Also, because I have a loose sense of who I am, I’m very willing to try new things. This means I’m generally an open-minded person, and I experience a lot some people might miss.
 
6.  Your partner and best friends are the strongest.

I know from personal experience being with someone with BPD isn’t the easiest — I have a terrible habit of hating the people I love most. The people who stick with me can see through that.
 
7. You’re one strong cookie, too. 

If you’ve just been diagnosed with BPD, you’re one hell of a strong person. It’s difficult living with unstable relationships, impulsivity and inappropriate reactions to stress all while trying to figure out who you are.

One thing I’ll promise you is that the more self-aware you become, and the better you understand your cycles, behaviors and what you need to be healthy, the easier living with BPD will be. Once you’ve learned what parts of your personality are actually BPD and what parts are you, you can become the best person you can be. You’ll be able to respect and be respected, understand and be understood and above all, love and be loved.

The Mighty is asking the following: Give advice to someone who has just been diagnosed with your mental illness. What do you wish someone had told you? If you’d like to participate, please send a blog post to [email protected] Please include a photo for the piece, a photo of yourself and 1-2 sentence bio. Check out our Share Your Story page for more about our submission guidelines.

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10 Things I Wish My Loved Ones Knew About Borderline Personality Disorder

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To the people who love me with my borderline brain,

I’ve been in therapy for seven months now and have only just uttered the dreaded words borderline personality disorder (BPD). This is my attempt at helping you to understand where I’m coming from and why I do the things I do.

Here are some things I want my loved ones to know about my experience with BPD:

1. I’m not a bad person. 

My behavior is sometimes fuelled by my disordered thinking patterns. I do things some might think are heartless, manipulative, rude, dangerous and downright horrible. And I’m not using my disorder as an excuse! I’m just trying to tell you those things are not the sum total of me. They are a product of a legitimate disordered way of thinking that can be hard to understand. So try to see past the behavior and see the person you love under it, because I’m still here, just trying to control my brain.

2. It’s OK if you can’t understand me.

This is not me “just being negative again.” This isn’t a teenage temper tantrum where “nobody gets what it’s like to be me.” This is a tried and tested theory. Unless you have a personality disorder you will not understand one. Not in any logical sense. And the main reason? Because my disorder makes no logical sense.

3. My impulses are hard to fight. 

When I get a random impulse to do something, it feels like an immediate requirement. It isn’t a want, it’s a need, and if I can’t do what I’m being told to do I become despondent, depressed and probably seem sulky from the outside. But inside I’m fighting a terrible battle of wills. My impulses let me filter out negative emotions when I’m unable to deal with them in a healthy way.

4. I’m not emotionally shallow. 

In fact, I’m the complete opposite.

One of the symptoms of borderline personality disorder is “splitting.” For me, an example of this is when I connect with someone and then almost immediately (sometimes) disconnect from them. I go from idolizing them to never speaking about them again. Understand this doesn’t mean I don’t care about people when we’re connected. In fact, sometimes I need to force myself to disconnect from someone because the emotion I feel towards them is too much to cope with.

5. When I’m down I’m not just down.

My pain is sometimes like a combination of black hole and a Dementor from Harry Potter. It can feel darker than black and deeper than the ocean. It feeds itself and grows bigger and bigger. It feels like all I can do is lie there in a bundle of tears until it goes away. So when I’m feeling down, know I’m not just sad.

6. I’m not “just being dramatic” either.

I can practically hear your eyes rolling at that last point. But I’m being 100 percent serious. Being told to “woman up,” “stop being ridiculous” or other tips to “just stop being depressed” doesn’t work.

7. I play favorites.

When I connect with somebody they are elevated beyond everyone else. If you ever feel slighted, ignored or like you’re second best, it’s probably because I only have eyes for my current favorite. But it isn’t a conscious decision to choose them over you. It won’t even occur to me connecting to someone else is an option. My “choice” is never with malicious intent.

8. I have fear of abandonment.

This means if I’m “connected” to you and go for periods of time without hearing from you, I might become panicked, depressed, irrational and bitter towards you.

9. I’m scared of losing you. 

I’m irrationally terrified of upsetting you, making you hate me, annoying you and making you leave me.

10. I need reassurance daily. 

I need to feel loved (especially by my favorite). I need to feel like I haven’t destroyed our relationship by being such a “horrible person” (or even by saying something I irrationally interpret as stupid). I need to know you’re here for me and you haven’t disappeared since we last spoke.

Living with BPD thinking isn’t an easy task. It can be painful, frustrating and dangerous for my health. I hope now you can understand me and my BPD brain a little better.

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An Instruction Manual to Me and My Mental Illness

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Often friends and family will tell me they don’t know how to help me when I’m in a mental health crisis, or how to act around me when I’m feeling low. So to make things easier for everyone involved, I present to you: Me, An Instruction Manual.

Thank you for purchasing your very own me, with an included mental illness! Each one of us is made differently and no two are alike! Here are a few things to remember:

1. I am unique. I have bad days, good days and even days I can’t quite understand. But I’m not crazy. I simply want to be me, living life the best way I know how. Although I make mistakes, so do people without mental illness. Don’t treat me any differently.

2. You can’t fix me — please don’t try. Mental illness is treatable, but not always curable. But for the most part, those who seek treatment can lead “normal” lives.

3. Whatever coping skills work for you might not work for me. I’ve done a lot of work formulating my own coping skills, techniques and routines designed to help me cope with everyday life. You can’t make things better for me. Only I can do that.

4. Don’t ignore me. I find it difficult sometimes to find the words to ask for help. When I do, please don’t ignore or dismiss me. If I come to you seeking help, I need help.

5. I am not seeking attention. On the contrary, being the center of attention gives me anxiety. I’d rather blend in the background than have people worry about me.

6. You cannot get sick from me. Funny thought, I know, but I’ve actually encountered someone who thought this.

7. I have borderline personality disorder, but that doesn’t mean I will automatically make life harder for you. I’m loyal as a dog, caring and defensive of the people I care about.

8. My anxiety makes me a safe person to be around. I try my hardest to control my surroundings to make things less stressful for everyone.

9. Don’t be afraid if you don’t know what to say. The worst thing you can say to me in a crisis is nothing. I just like to know someone’s there for me.

10. Know that for me, stigma is still very real. Although I publicly discuss my illness online, it’s still difficult for me to discuss it in real life, especially with people I’ve just met. If you’re one of the lucky few I’ve opened up to, it means you’re important to me. I trust no matter what I told you about my mental illness, you still think of me as the same person. Thank you.

Follow this journey on Manic Medic

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Real People. Real Stories.

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