a woman standing in grass looking at a river

Someone said something hurtful today or something I perceived as hurtful. Now, I am afraid. They told me they forgot we had plans today and would need to reschedule. Something else came up. Something more important than me, I guess.

They really don’t want to see me, and they really don’t want to spend time with me. Now I’m crying. Look what they did! People who love you don’t do this! They don’t like me and that’s fine because now I hate them. Yes, I loved them yesterday, but I hate them today. They never liked me anyway.

This is why I don’t have friends. This is why I can’t have friends. Friends hurt. Relationships hurt. I’m too scared to try again. It is much easier being alone.

Something as simple as cancelled plans can send someone, like me, into isolation. Before my diagnosis, I was unaware that what I was doing was isolating. I just knew there were periods where I was terrified to be around people. If someone said something I perceived as hurtful, then my relationship with them could change in an instant. We could go from speaking every day, to hardly speaking at all.

The only thing I felt was everlasting was the fear of the intentions and words of others. That is still true today. Having borderline personality disorder (BPD) means perpetual misunderstandings. Misunderstandings on both your end and on the end of the person you are communicating with.

Communication is a never-ending problem for me, affecting my ability to develop and maintain interpersonal relationships. I have an aching, nagging desire to interact with people on a personal level, but that fearful, irrational voice in my head wins me over every time with “what ifs.”

“What if this person is just trying to get something from you?”

“What if he/she is just pretending to be your friend?”

“What did they really mean when they said (insert said dialogue)?”

I manage well in passing interactions like, “Hi, how are you?” I can respond, “Good, and yourself,” and continue on with my day with little to no interaction with that person again. However, creating personal relationships is unbelievably difficult. Wanting to create relationships while having BPD is like being pulled in two directions.

Imagine a weak person is pulling on your left arm, and a strong person is pulling on your right arm. You are swaying from left to right, and both your arms are becoming stressed. You may start to panic, wanting someone to let go. The stronger person will end up winning, but both of your arms will be exhausted. The weak person is my “rational” thoughts, and the strong person is my “irrational” thoughts. My irrational thoughts about forming relationships always win because my fear is stronger than my courage. As much as I want the “weak person” (my rational thoughts) to win, it hardly ever happens.

Isolation with BPD is not wanting to be alone, but not wanting to be around people either. This is extremely conflicting and creates a lot of anxiety. I cling to just one person, and when that one person is busy, I will stay at home by myself no matter how much I want to interact. I can also become hostile towards them because I will feel as if they have abandoned me if they have other obligations.

Because I cannot trust anyone else, I would rather be alone for days on end waiting for one person than take a chance and spend time with someone new. The lack of support around me causes me to develop a lot of feelings of emptiness, depression and boredom.

Here are some things to know about the isolation BPD causes:

1. Isolation causes an inevitable sense of paranoia.

Since I am too afraid to spend time with people, I can go days without too much social interaction. Because I am lost in my own mind and alone during these times, I become paranoid. I become even more paranoid people are saying things behind my back or are planning things that could hurt me. This becomes an unbreakable cycle of delusions that is problematic because it only causes me to isolate myself even more.

2. Isolation also causes panic attacks prior to arranged interactions.

Being in isolation also worsens the anxiety I feel before social gatherings or interactions, causing me to have panic attacks. The idea of having to communicate builds up so much uneasiness that I become exhausted even hours before interacting. If I can avoid it, then I will. If I cannot, then it causes panic to the point of crying and hyperventilation. If I do have a high level of anxiety/panic, then I will disassociate.

This feels as if I am watching myself in a movie or as if I am out of my body. Since I had been in my own head for so long, it almost feels like I have forgotten how to have normal communication. I develop poor eye contact and look at my feet a lot. I will then resort to a corner or isolated area of the gathering to avoid social interactions.

3. The isolation in BPD can cause you to lash out.

Part of having BPD is extreme emotional reactions, even aggressive ones, to simple situations. If I have isolated myself for quite some time, then I will become irritable as a result of all of the racing thoughts I have failed to manage on my own. I may scream, slam doors or throw objects. I have never (and will never) hurt anyone; however, I have turned my anger onto myself with self-mutilation.

4. When I am being social, I can only pretend for so long.

I have BPD, but I am also a public speaker and Miss Maryland 2015 for the Miss World Organization, which puts me in social situations on a regular basis. I was able to manage social situations over short periods by making myself feel beautiful and glamourous. It was a lot like playing dress-up and make believe. I loved partaking in pageants because it allowed me to embody a confident, outgoing woman when I often felt unsure and nervous, with an unstable self-image. While I “pretended” to be much more confident and outgoing than I was in reality, it also gave me the courage to show parts of my personality while feeling safe in a physical image I felt was more acceptable to society. I still struggle with feeling “safe” in being myself.

Eventually, it became exhausting to keep my true feelings and changing identity a secret. Part of having BPD is having an unstable identity. One minute I want short hair and dark clothes. The next minute I would want to pretend to be Barbie. Being in pageantry required me to have self-confidence and knowledge about myself that I truly did not have and am still struggling to find. I could only pretend for so long. The same is true for having social interactions. It becomes exhausting and difficult for me to manage.

BPD is a serious, complex mental illness, with isolation as one of its primary symptoms. It is an illness that is often difficult for the public to understand as people with BPD struggle with “back and forth” thinking — we want relationships but also push people away. We want you to understand our intentions are not to hurt you, and we really do not want to hurt ourselves. All we want is understanding and love.

With patience and a commitment to helping loved ones struggling with BPD, they can get to a place where isolation from others can be an occurrence which happens less often. All we need is your support.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255. You can reach the Crisis Text Line by texting “START” to 741-741.

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When I was first diagnosed correctly with borderline personality disorder (BPD), I was 27 or 28 years old. I had spent years in and out of psychiatrist and psychologist offices. I had been diagnosed with bipolar disorder, severe depression,anxiety disorder, social anxiety disorder general anxiety disorder and a number of other disorders that didn’t quite fit the bill. This is not to say I don’t have some of those, because I do. Alongside the borderline personality disorder, I live with post-traumatic stress disorder (PTSD), which caused it, social and general anxiety, mild obsessive tendencies and severe depression.

My psychiatrist who diagnosed me did so after months of meetings with her and my therapist. They finally ran me through the list of symptom after they had discovered I exhibited all but one on a fairly frequent basis, as well as a history of them. When it was finally explained to me, my doctor couldn’t recommend anything other than helping me find an antidepressant and an anxiety medication to help manage the worst of it.

However, the worst thing about living with BPD is the assumptions people make about you and then proceed to voice to you. Here are three assumptions I have gotten regularly, often enough that I try to avoid bringing it up in front of people I don’t consider among my closest friends.

1. “You’re crazy. Like, you know, psychopathic and terrible. You must be a narcissist.”

No, not at all. First, no one gets to call me “crazy” but me. I’m not narcissistic or psychopathic, which are, by the way, legitimate mental illnesses. Just not mine. Do some research or talk to me about it. Not every borderline personality disorder diagnosis is the same and not every person with it has all the symptoms. Generalizations about a disorder that the speaker knows almost nothing about, and certainly doesn’t live with, is just insulting.

2. “You just want attention.”

This is one of the most painful assumptions. It’s right up there with “but you don’t look sick.” Invisible illnesses are awful and do include mental illness. I have good days and bad days. I just don’t let folks see the days where I spend 18 hours in tears debating if it is all worth it or the days I can’t bring myself to leave my house and deal with humanity.

My least favorite are the days I can’t even get myself out of bed because I feel so low that it’s affecting me physically. Yes, it affects you physically when you have a mental illness. Even more to the point, no, I don’t want your attention. I am not striving for it. I’m striving to get by another day, past another episode. In fact, I don’t actually want you to ever see me when I am having an episode. I’d rather the earth swallow me. So no, I don’t “just want attention.”

3. “You’re so melodramatic.”

Sure, I’ll cop to that. I absolutely tend to be melodramatic in how I feel. However, saying that to someone who is overwhelmed by the barrage of emotions that batter them every single day is one of the worst things that a person can do. It invalidates how I feel, and it makes me less inclined to trust or speak to the person who does it about anything at all. It is damaging to me to such a degree that it can plunge me into a severe state of depression for weeks.

Every person diagnosed with this disorder is different. The disorder itself has such a broad list of comorbid disorders and illnesses that each case can be wildly and dramatically different. It’s hard to accept, but it’s harder to live with when I have to fight every step of the way for my health care, treatment and acceptance by my friends. So try and stay aware of what assumptions you make about people. You can’t always see what they are living with.

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Image via Thinkstock.

This article was originally published by Active Minds and was written by Stacy Pershall, a member of the Active Minds Speakers Bureau who speaks to schools and groups nationwide about mental health and eating disorders.

The place: Prairie Grove, Arkansas. The year: 1985. The setting: a bedroom closet with burnt-orange carpet and a brown slatted door. The protagonist, who’s also the antagonist: me, age 14.

The supporting (or not-so-supporting) characters: the boy who used to call me a dog, but now just stands in front of my locker every morning and barks at me while his friends laugh. The boyfriend who just broke up with me because, despite the fact that I don’t feel worthy of eating, I’m still not skinny enough. The cheerleaders in my all-white school, who think it’s an insult to say, “Gosh, Stacy, if your nose and lips were any bigger, you’d be black.” 

By the time I was in high school, I’d let them fill my brain. I no longer had any idea who I really was; they told me now. And so, in deference to them, I hid in my closet and sat on my shoes and wrote their insults on my skin with a Sharpie. DOG, I’d write across my face – I’d done it so many times I didn’t need a mirror anymore. Sometimes, when I was so hungry nausea took over, I’d allow myself to get down on my hands and knees and eat food out of a bowl on the floor. Then I’d pray for forgiveness for thinking my stomach deserved to be filled like other people’s.

The setting today: an EMDR therapist’s office in New York, where I’ve lived for 18 years. I tell her, “I’m mostly recovered since I did DBT a decade ago, but I have these things from childhood that won’t let go of me.” She places small, alternately vibrating buttons in my hands and says, “So, let’s make your brain reprocess them. Let’s make them let go.”

The acronyms: EMDR is eye movement desensitization and reprocessing, but you don’t have to use your eyes; other kinds of bilateral stimulation will do. I like the buttons because they give me something to clench my fists around while I talk about the people I still want to punch. 

DBT is dialectical behavior therapy, a treatment for borderline personality disorder, which – surprise! – can be based in trauma. One of the diagnostic criteria is out-of-control rage, which makes sense; when you live in a brain filled with long-gone people who are still making fun of you, you often lash out at right-there people who aren’t.

So I close my eyes and clench the buzzers and my therapist asks me what I’d like to believe about myself. “That I’m competent,” I say. “That I’m strong. That I don’t belong to those people anymore.” And then I cry, for the millionth time, because I’m still not sure I deserve to be free.

And I remind myself of what I’ve reminded myself so many times: dogs are good. Dogs are faithful. Dogs don’t deserve to be hurt.

The next night, I stand in front of an auditorium full of college students and speak about bullying for Active Minds, like I’ve been doing for the past five years. I tell myself that instead of fighting the Prairie Grove High School class of ’89, I’m fighting stigma. I’m standing in front of a room full of people who think maybe they don’t deserve not to hurt either, and I say in a strong, competent voice that they are allowed to let go of the pain. They’re allowed to eat. They’re allowed to have skin they don’t degrade. They’re allowed to have skin, period.

And after the presentation, I text my therapist. “I did it again,” I say. “I kept a few more alive.”

“That’s what guide dogs do,” she says. “Look at their beautiful, shiny fur.”

Don’t miss Stacy Pershall live on Mental Health on The Mighty, Friday, 10/21 at 5 p.m. EST. 

For me personally, one of the most challenging aspects of having borderline personality disorder (BPD) is having a “favorite person.” When I was first diagnosed, I searched all over the internet for information about my disorder because I had no idea what it was. One aspect of my disorder not many people spoke about, but I related to most, was the idea of having a “favorite person,” or FP for short. 

The easiest way for me to describe how having an FP works is this: I’m like a dog who destroys the house when she’s left at home, but then acts really happy when the owner comes home and pretends nothing happened.

To put this into a real life situation, I will text my FP every morning when I wake up saying “good morning xx,” and if they haven’t replied within five minutes I automatically assume they either hate me or I have annoyed them. That thought sends me into utter panic and causes a lot of distress. If I were to think about it logically, I would probably tell myself they’re probably still asleep — but when it comes to having an FP all rational thinking goes out of the window. 

For example: 

FP: (talks to me all night)

Me: They love me.

FP: (doesn’t text me back in the morning)

Me: They hate me, this was all a game. I am a fool to think they ever loved me.

It is well known that people with BPD struggle with abandonment, and having an FP makes that struggle even worse. An FP is someone you absolutely adore, whether it be a friend or a partner, but the problem is you give that person the responsibility of your happiness. My first ever FP was my now ex-boyfriend. Our relationship was a struggle because without him by my side I couldn’t be happy. When he would leave, I’d be incredibly upset, which even sometimes turned into anger. I only understood he had become my FP after we broke up, and when I look back, I think if I had the knowledge and understanding I do now we would have worked better. When your partner is your FP, it can make your relationship incredibly difficult. You constantly need reassurance and validation from your FP, but sometimes asking for too much assurance comes across like you doubt them or don’t trust them, and that can lead to so many problems. 

It’s not impossible to have a relationship with your FP. It’s no walk in the park, but with a lot of dedication and hard work it can be so very rewarding. Because at the end of the day, your partner is your favorite person and being with them is awesome! The one thing you need to learn when your partner is your FP is self-validation. Now believe me, I know self-validation doesn’t come easy to people with BPD, but with practice it does become easier. You have to constantly tell yourself that your FP loves you and that you deserve to be loved by them. 

All I can say is that be proud to have an FP! It means you can show that person so much love and passion.

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My patient is sitting in front of me with a concerned look of his face.

“What’s going on in your mind?” I ask.

“Look at you. You’ve got it all together. You’re married, have kids, have a job… I want those things, but I’m not focused enough. One day I work for something, then the next day my goal will be completely different.”

He is older than me and we met each other at a job training a long time ago before I was a psychologist. Now he’s in front of me and while he’s lamenting the “wasted years,” he’s also viewing me as a person who — to put it quite bluntly – has her shit together.

You don’t even know, I think to myself. I studied two years of computer science, one of graphic design, finally finished psychology and then worked three years in neuropsychology, four in human resources and now clinical psychology. The reason: borderline personality disorder (BPD), same as him.

“I’m tired of this,” he continues. “I feel like a failure. I haven’t accomplished anything. I don’t like how my life turned out.”

While it’s true he isn’t happy with his life right now, he’s working to accomplish the things he wants to accomplish. He’s still not there, but at least he’s on track. However, this state is more than that. It’s the characteristic period of hopelessness that we BPD warriors go through.

If we look at the cycle of BPD, there’s usually an intense motivation (“World, get ready for me”) that lasts a couple of days, then the sudden and sharp decrease of motivation (“What the hell was I thinking? I can’t accomplish this”) and finally the depressive phase (“I hate my life, I’m not good enough for anything.”) He is in this last phase right now. He’s living in the darkness, the rage, the disappointment and the suicidal thoughts. I know them well.

So I try to show him the bigger picture, explaining the stage of the cycle his illness is taking him through. I tell him the goal of therapy is to have these cycles be more manageable and less significant in his life. I tell him this period will be over soon, this part of the cycle repeats sometimes and that we’ve only been in therapy for two months.

He acknowledges what I’ve said but then replies, “It’s easy for you to say because you don’t know what it’s like.”

Oh, but I do.

“You don’t know what it’s like to be so desperate to stop the voices in your brain that you will try anything.”

The small scars on my arms prove you wrong.

“It’s exhausting, I can’t live like this. Who can ever be happy this way?”

It’s hard, but it’s not impossible. You can have a life worth living.

He’s going through one of the most difficult emotions a human being can experience: Hopelessness. Hopelessness is a thick fog that permeates everything it touches. It suffocates, poisons and steals the worth of everything. He needs hope.

So I do it.

I take my armor off and become completely vulnerable and exposed.

“I know you feel lonely and feel like no one understands you. Not even me. How would I know, right? I know that you feel like a failure because you have dreams you haven’t accomplished while everyone else seems to be on track with their own dreams. I know you feel like you are a burden to those who surround you and you constantly feel guilty for that. I know that you get to the point where you hate yourself for not being stronger, smarter, braver and more focused. I know because that person is me. I don’t know it out of a text book, I know it because I’ve lived it.

And you know what else I know? I know there is hope and help. Never in a million years would I have thought I’d be able to sit here in front of you or my other patients. I didn’t believe I’d be able to have a family and yet I have a wonderful husband and two sons. I’m going to be completely honest with you. You can feel better and have a good life. I’m not necessarily saying you will be ‘cured,’ but I am saying you can manage your symptoms if you know yourself and learn how to deal with unwanted situations. But in order to do that, we need to work on it. Trust me, I’ll do everything I can to help you get better, but we need to establish that I do know what I’m talking about and it does apply to you. I can help you help yourself. Please let me.”

His eyes filled with tears as he nodded. Several months later, he confided in me that this was a turning point for him, not only regarding my knowledge as a therapist, but in giving him hope that those of us with BPD really do have hope.

I always thought I had to show strength in order to help others, but this experience taught me that in some cases you simply need empathy and humanity. There is strength in vulnerability.

Goodbye superwoman, hello flawed me.

If you or someone you know needs help, visit our suicide prevention resources page.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255.

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I wrote an article for an Irish national daily a couple of months back, in which I stated the following:

My concern is that the current media representation of [mental health] issues is in danger of doing the subject more harm than good by having a really restricted focus in terms of how mental health problems manifest, who they affect, and how they are managed.

I have borderline personality disorder (BPD), which occasionally joins forces with severe depression, and as a service user/patient/client it frustrates me when I see the same stories being told over and over again, the same limited number of issues being discussed, the same “solutions” being presented.

One could be forgiven for believing that the only issues that affect people are depression and anxiety, that it’s only our younger population who are impacted, or that exercise will fix everything. While these are all valid points, they are merely the tip of the iceberg…

We’re making huge inroads in talking about [mental health issues], but we’re still dancing around the edges. I don’t want to hear anyone else “opening up” about their successful “battle” with depression. I don’t want to hear soundbites about how mindfulness, a good diet and regular exercise will help keep me well. I want to hear reality. I want to hear open, honest, and above all real conversation about this. About depression. About bipolar. About borderline. About schizophrenia. About all the other countless illnesses that affect us.

About people.

Immediately after the article was published, I was contacted to do both TV and radio interviews to discuss it further, which I had to decline. I knew while I would get great energy from them and it would possibly help take the national conversation about mental health a little further, it would also knock the stuffing out of me, and the fallout wouldn’t be worth whatever slim gain may have been made.

I realize there’s a massive irony in this — I gave out that media representations of mental health issues are very one-sided, yet when given the opportunity to do something about it, I had to say no or my mental health would suffer.

So I decided vlogging would be the next best thing. I’ve been writing about trying to manage BPD and depression for years, and now I want to show you what it can look like. None of these vlogs are scripted, rehearsed or edited in any way. They’re mostly recorded in my car because it feels like a really safe place to do them, if a little dull visually. And they are short — generally between one and three minutes. I tend to think a lot when I’m driving, and it helps to record my thoughts this way on a day when I may not get time to write. What you see is how I am — I don’t usually wear makeup, and I often look extremely tired and/or spotty. This is my reality. I’ve never sugarcoated my writing, so I’m not going to sugar coat these.

Image via Thinkstock.

Watch Fiona’s vlogs at Sunny Spells & Scattered Showers.

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