To the Doctor Who Told Me BPD Meant Giving Up My Dream
A lot of moments in life can be defining, even if they seem small. My first one was when my beautiful, wonderful dog (who was just a puppy at the time) took her first steps into my home. It was her unconditional love throughout the majority of my life that birthed my love for animals. I have always wanted to be a veterinary surgeon. Fast forward 17 years and I’m not only a vet student, but I’m studying at Cambridge. My dream truly is set to be a reality.
Yet, I found myself sitting through another defining moment in a small room in A+E (the U.K.’s Accident & Emergency mental health crisis services). This was not my first trip, but it was the first time I sat in the hospital in my hometown. It was midnight. My parents had dragged me there at their wit’s end with worry. They had no idea what to do with a son who was blind to everything but the desire to take his own life.
Mental health teams in Cambridge had discharged and dismissed me up to this point with comments such as, “I think you are actually in control of your emotions.” It is for this reason I had lost faith and, running out of options, I had come back home with my parents.
In this hospital, it was different. The lady opposite me listened for four solid hours. She wrote notes on everything: being picked on in school for my weight and sexuality, disordered eating, turbulent and dysfunctional relationships (which other mental health professionals, in their own ignorant discrimination, have called “typical of a gay man my age”), bouts of psychosis and paranoia, self-harm and emotional instability. This instability fluctuated from suicidal depression to extreme elation, anxiety or anger in a matter of hours. The persistent suicidal ideation is why I sat before her.
The situation I had come in for and the information I had given were exactly the same as that I gave other mental health teams. The response was profoundly different. To me and my parents, she gave me her measured response, “Let me be clear: You are not in control of your emotions. You are very ill. I think you need to take sick leave from university.” These words cut through me, but she offered hope.
At the time, it was assumed I could have bipolar disorder, but nothing was certain. With this in mind, she reassured me even doctors lived with mental illness and it would not be an obstacle. All I needed was time away to recover, a dream halted, not ruined.
I had an appointment with a psychiatrist back in Cambridge that had been arranged last time I visited A+E there. The mental health worker said she would send her four-hour assessment to the team there. They would assess me with all the necessary information.
So, a few days later, I was in Cambridge again at my appointment. The doctor sat down and told me he had no notes on me, apart from some very scant words from a visit to hospital the year before. He had none of the notes from the nurses’ hours of work in the past month in either Cambridge or in my hometown. I, of course, asked him to retrieve them, to which he refused. I told him my plans for treatment back home, and he angrily retorted he could do very little for me, except give me a diagnosis. He dismissed any ideas I had about the possibility of bipolar disorder and told me I had borderline personality disorder (BPD). He offered no explanation as to what this was. Stressed from the situation, my nose started bleeding. He continued to tell me there was no drug treatment.
I ended the appointment abruptly, very uncomfortable. As I left, he said the words that will remain with me the rest of my life, “I think you should give up Cambridge. Not for one year, completely. You clearly can’t handle the pressure.”
That sentence still stings now. I sat in the car with my dad, sobbing, on the phone to the mental health team back in my hometown. They arranged an appointment with another psychiatrist and confirmed I would be able to access services there on sick leave. The same week, I packed up my room and left. I remember driving away, thinking about the doctor, and saying to my dad, “It feels like all my dreams are dying.”
I am infinitely lucky. I was and still am incredibly grateful to have had access to services that, no matter what my opinion, saved my life on numerous occasions. They were focused on making me healthy again. I have friends and family who go above and beyond to support me, understand me and love me (and I hope I can return the same sentiments). While I have worked hard, I have a lot of privilege that has allowed me to get a good education and follow my dream of becoming a vet. I know a lot of people do not and will never get this amount of opportunity.
My mental health was at rockbottom regardless of that. Mental health issues are indiscriminate and attack people in all walks of life, trying to get in the way of whatever personal progress people want to make. Thus, I did not let this doctor’s (probably well-meaning) words define me or shape my future. My diagnosis surprised me, but reading more into it, I realized my symptoms fit. I knew, like bipolar or depression that I had been misdiagnosed with previously, it was treatable.
With this in mind, what followed was long and hard on me, my family and my friends. I spent every day of the two weeks surrounding Christmas as an outpatient at my local acute, mental health hospital in intensive therapy. There, clinical psychologists explained the ins and outs of my illness. Crucially, they recognized academic pressure was not the underlying cause and I could return to study veterinary medicine when I recovered. A new doctor changed and increased my drug treatment. These appointments, though only small things, bolstered my confidence. I would get better.
I was referred onto therapy specific for BPD, which taught emotional regulation, interpersonal skills and distress tolerance. These eliminated old coping mechanisms like disordered eating, alcohol dependency, self-harm and suicidal ideation and replaced them with more healthy ones. They filled the empty hopelessness and the uncertainty of where my life was going. They taught me to create long-term goals. One goal was to use my time off university to take an exam in flute performance, a hobby in disuse due to the stresses of my illness. I learned how to change my own perceptions of abandonment and criticism, my emotional reactions and to incorporate a sense of rationality through mindfulness. I met a group of fantastic, brilliant people to learn from and share experiences with.
I took the flute exam. It’s very likely I didn’t pass, but it was good to show myself I could put my mind to something again. I completed and continue to use the psychological and drug therapy. All the symptoms of my BPD became manageable. I took time out to recover. It took diligent work. The support of my therapy group, my family and friends were instrumental in recovering. I owe so much to all of them.
A few weeks ago my doctor signed off a letter approving my return to university in October. Through the many hard years and the terrible experiences I had, I was blessed to end up having a positive outcome and good treatment. I know this is a story so many people in a similar situation have not been entitled to.
Mental health services in the U.K. are in disarray, underfunded and too inconsistent in different areas. Something must be done to change this crisis. If you are living with BPD or live with any other mental illness, then you should know you are not alone. There is hope, and the fight, even for the little things (like getting out of bed in the morning), is worth it. I spent years thinking recovery was impossible or a dream. Now I’m here, admittedly still with my bad days, but looking forward to the future.
So, the only thing I want to say to that doctor is: thank you. You are a good doctor. Our short meeting and my interpretation of events were not representative of that. For this, I’m sorry. However, you should know your throw-away comment inspired and still does inspire me to get better, to love my life, to keep going and, most importantly, to prove you wrong.
Image via Thinkstock.