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The Subtle Signs of a 'High-Functioning' Mental Illness

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Let me explain.

I’m not that different than anyone else. In fact, most people I meet have no idea I have any struggle whatsoever. But underneath the layers of makeup and smiles, past the bubbly laugh and light step, it’s not so hard to see I’m hurting inside.

I have depression, anxiety and borderline personality disorder (BPD), but most of the time I seem perfectly normal. Since I am not crying in front of the world, the assumption is made I am perfectly fine or nothing is wrong. Well, this is not the case. There are many things people struggling with the same or similar illnesses do on a day-to-day basis that give insight into how they’re actually feeling. But these things are often overlooked or deemed annoying, but “normal” personality traits.

Depression:

1. Sleeping all day.

Back home, my mother would drag me out of bed each morning, preventing me from doing this, but immediately upon entering college, it became a practically unbreakable habit. When you have depression, you are faced with unending exhaustion, so the moment sleep becomes a possibility, you take it, often missing important events and appointments in your life. Although this is a frequently acknowledged symptom of depression, it is often brushed off by friends and family and thought of as just “laziness.”

2. “Zoning out.”

When I’m at my lowest, my thoughts retreat to the back of my mind and are replaced with a gray emptiness that separates me from the rest of the world. I seem a little less “there.” This particular symptom is often referred to as depersonalization and often feels as though you are watching your life as if it is a movie, rather than living it yourself. This, though it may look like fatigue or distraction, is actually a major symptom of depression. So when you have to wave your hand repeatedly in front of my eyes or knock on my head yelling “hello!” it’s probably a sign I’m struggling.

3. Avoiding new people.

The thing about depression is sometimes there are these little internal voices speaking to you, telling you people don’t like you, you’re pathetic, you look ugly or sound stupid. Meeting new people — or worse — trying to befriend new people, is absolutely terrifying and exhausting to someone struggling with depression. So to all of the people in my classes, it isn’t because I don’t like you! It’s because I’m tired and terrified.

4. Not talking about it.

I like to think this particular habit is one I’ve broken. Since leaving home, I’ve opened up a lot about my depression and (for the most part) it’s helped. See, it’s incredibly difficult to talk about depression because often people take it in two ways. Either they nod their head and say they’re sorry for you, but don’t actually care and obviously don’t really believe you (terrible) or they become totally rattled and believe at any second you will try to kill yourself in some grotesque and violent way (even worse). Because of these reactions (both of which I have seen on multiple occasions), people are very hesitant and scared to admit they are struggling with these problems.

Anxiety:

1. Asking repeated questions.

This one probably isn’t surprising, although I’ve only recently realized this was something I did because of my anxiety. All through high school, I’d ask my best guy friend “would you still be my friend if…” followed by something totally ridiculous like “I had the voice of the Allstate guy” or “I had a third arm.” I’d always ask as a joke, but would be constantly looking for some kind of confirmation he would still be my friend no matter what. I was so concerned he’d leave me or that our friendship was conditional and he’d just up and leave at any given moment (this is also a symptom of BPD).

2. Bailing at the last minute.

Sometimes the idea of going out, seeing people and again, making new friends, is too much. There have been so many instances where I’ve agreed to something and after a day of prepping, worrying, sweating and plucking my eyelashes out over it, I’ve cancelled at the last minute. Sometimes trying to explain your way out of it — though anxiety inducing as well — is much better than actually going to the event.

3. Not being able to fall asleep at night.

This is a symptom most of your friends probably won’t see, but will surely have heard you state time and time again. When you have anxiety, you’re constantly replaying things that happened or may happen in the future over and over in your head. Your heart rate rises and your palms begin to sweat and sleep becomes an impossibility. Fun, right?

4. Speaking rapidly or pacing.

Sometimes, when my anxiety gets going, all of the nervous energy resting in my chest wants to make its way out, so I will start speaking louder or faster and often start moving around restlessly, in an attempt to rid myself of some of the unwanted energy. When you see this, it’s not because I’ve had too much coffee. It’s because the anxiety that’s pressing on my lungs is about as strong as a bump of caffeine and there’s nothing I can do about it. And trust me, if I could “chill,” I would.

Borderline Personality Disorder (BPD):

1. Extreme emotional volatility.

When I was in the seventh grade, my friends had this joke about me being so “emotional.” The boys would just say it over and over until it became a point of major embarrassment for me, though I doubt they knew this. My dad recently told me I’d been the same way since I was a baby, with sudden and unexplainable outbursts and fits that were nearly impossible to resolve. It’s been something incredibly humiliating throughout my life. Meltdowns in public places, drastic reactions to little events that make people look at me like I’m absolutely “insane” and even physical violence on a few occasions. The thing is I don’t mean to overreact and in the moment, I truly don’t believe I am. Every emotion someone with BPD feels is so severe and in tense situations, they will act according to them, which usually means a major reaction. If this is you, don’t feel ashamed. There are a lot of us struggling with the same thing.

2. “Are you mad at me?”

Oh. My. God. If I had a dime for every time I’ve asked this question, I swear I’d be Warren Buffett. With BPD comes a huge fear of abandonment. For me, it manifests in my friendships. If I’m not getting enough time or attention from my friends, I will often lash out in small ways, which I know makes them mad (even if they tell me it doesn’t). I feel incredibly guilty afterwards, and ask “are you mad?” repeatedly until I’m satisfied they’re not going to peace out at any moment.

3. Depending too much on your loved ones.

Do you have a friend who always kind of seems to be causing problems? That friend who is always jealous of your other friends, is way too protective over you or who is always angry or upset and you don’t really know why, but for some reason you still love them? Yup. That’s me. I hesitate to write this one, because I worry people will see me as being some awful creature. The truth is I’m not, but I think it’s important to mention because it seems to be one of the biggest missed signs of BPD. I wish it were different. And thanks to my friends for loving me despite it.

If you are struggling, know you are not alone and there are so many people out there going through the same thing. You just have to look for them.

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

If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741.

We want to hear your story. Become a Mighty contributor here.

Thinkstock photo via Archv.

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When You Have an 'Unpopular' Mental Illness

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At age 23, after several years of experience with high anxiety, major depression, trichotillomania, disordered eating and a long list of issues I didn’t yet understand, I was diagnosed with borderline personality disorder (BPD). This may seem like the cherry on top of an already difficult situation – especially considering the stigma associated with personality disorders. In reality, I was overwhelmed with much needed validation and relief. I finally had an explanation and I wasn’t alone. Once I stepped out into the real world, however, I felt silenced.

When I was able to share my diagnosis out loud, I noticed an entirely different response than when I previously shared my experiences with depression and anxiety. The term “personality disorder” itself often seems to be enough to scare people away from the entire conversation. It became clear early on a lot of people don’t want to hear about it, much less learn about BPD in order to advocate and support those who are affected. I assume this comes from a place of fear and intimidation, largely due to the lack of public knowledge and the destructive images and ideas we’ve learned to associate with personality disorders.

People with BPD or other personality disorders are assumed to be violent, abusive or helpless. However, many people with BPD actually tend to be notably empathetic, passionate, loyal and perceptive. We also just happen to experience extreme and often overwhelming emotions, mood swings, impulses, fear of abandonment and identity instability. Additionally, these symptoms tend to arise without a moment’s notice, hitting us like a tidal wave. Sometimes BPD looks like panic attacks, emotional meltdowns, self-harm, dissociation, impulsive decision-making and euphoric highs – all in one day. Other days, we live and exist just like anybody else. The unpredictability of BPD means we never really know what each day will bring.

While mental health awareness and advocacy do seem to be on the rise, the stigma surrounding mental illness is still strong. I’ve noticed an increase in people willing to seek help and disclose information about their mental health, particularly with anxiety – the most common mental illness in the United States – and depression. While this is to be celebrated and anxiety and depression are serious mental health concerns, mental health care and awareness cannot end there.

There have been countless times that friends and peers – even people who consider themselves advocates and allies to people living with mental health issues – have dismissed or invalidated my mental illness the moment I show symptoms. The same people who take to social media to preach respect and compassion for those battling depression are – in my own experience – often the same people who choose to remain ignorant to other, more stigmatized mental illnesses. Not only is this problematic for obvious reasons, but it can be incredibly isolating for people who don’t fall in those more widely understood categories of mental illness.

In reality, borderline personality disorder is not all that uncommon. BPD affects between two and six percent of the population (mostly young women) and is believed to be more common than both schizophrenia and bipolar disorder. Although a lot of information about BPD is still unknown, there are many popular misconceptions about and even therapists known to turn away patients affected by BPD. The fact is people living with BPD, schizophrenia, dissociative identity disorder (DID) and other highly stigmatized mental illnesses should have access to the treatment and health care they need to live stable, happy lives. We can each either choose to remain ignorant to the prevalence and reality of the broad spectrum of health or we can recognize people all around us are battling these monsters – even if we can’t see it – and acknowledge they deserve to be heard, validated and loved.

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Thinkstock photo via Archv.

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Being 'High-Functioning' Makes Me Question the Validity of My BPD

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While I was seeing my former psychiatrist, she once referred to my situation as “high-functioning” borderline. I identify with this label in a sense because while I do have the diagnosis and experience the symptoms and the consequences of them, at the same time I do get up and get my shit done nonetheless. I went to school. I graduated. Now I get up at 6:30 a.m. and go to work. I am, as people say, a functioning member of society. Which is great I guess.

But then I feel like it makes others question the validity of my disorder. I mean, it even makes me question my own situation. It’s like, come on, you’re not bedridden so stop saying you have a mental illness. Come on, you’re up during the day, stop saying you’re a mess.

Struggle does not necessarily have to be outward. To so many around me, I am the picture of emotional stability. But inside, deep down, I am hurting. I am hurting so damn much.

I guess my point is, no matter how “high-functioning” you consider yourself to be, never think you have to defend your diagnosis. Never think your illness is invalid.

Because it is valid.

And so are you.

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When You Don't Fit the 'Classic' Definition of Borderline Personality Disorder

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Editor’s note: If you struggle with self-harm, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

The “quiet” borderline. It’s not something most people are familiar with, the perception of borderline personality disorder (BPD) is one who acts out. That’s the “classical” definition, but like every disorder, the condition manifests itself in different ways. BPD is one of the most misunderstood and I believe one of the most stigmatized disorders. Well most personality disorders seem to be. The perception of a typical borderline is someone who is violent, manipulative, aggressive, hostile and in essence… a bad person. While these things can be present in the disorder, most people with BPD are not violent people and are some of the most loving and caring people you will ever meet. We just have great trouble in regulating our emotions. It escapes me now but it was once said people with BPD are like people covered in third degree burns all over their body.

So we all know the “classic” borderline as someone who acts out. So what does being the “quiet” borderline mean? “Quiet” BPD is acting in, rather than acting out, but internalizing all the emotions they feel. The fears of abandonment, mood swings, anxiety, self-injurious behaviors, impulsiveness and even suicidal tendencies and black and white thinking (splitting) are all part of being a quiet borderline. But those emotions are typically acted against ourselves. We feel disconnected from the world, isolated, spending time rationalizing and internalizing emotions, which leads to self-destructive behaviors and suicidal gestures, including self-harm. One moment we have all the confidence in the world and then without warning or explanation, we come crashing down hard. We love you at one moment and then hate you in the next. Rather than telling you about it we act “in” on it, separating ourselves from you and then making up some bullshit excuse as to why we went AWOL without telling you the truth. I hate you — don’t leave me.

Oftentimes I myself find I feel disconnected to the world, like I am not part of it, many times questioning if I exist at all. Abandonment, whether perceived or actual, is often present in my life. I don’t know how many times I’ve asked friends and my girlfriend if they are leaving me and if they still love me. It seems no matter how many times I ask, the constant fear of being left is present. The quiet borderline can be summed up in Fyodor Dostoyevsky’s quotation:

“I swear to you gentlemen, that to be overly conscious is a sickness, a real, thorough sickness.”

To cope with these emotions we turns against ourselves with self-hatred. Personally, I always cut myself to atone for how bad of a person I was. You drove them off. You deserve pain. It’s only fair you atone for this. Once I had self-harmed, I felt like I had atoned for how evil I am. Eventually it got so bad there was barely a spot on my body which hadn’t been inflicted with some form of pain. Once again, acting against ourselves. Sometimes done out of self-hate, sometimes done as a punishment to someone we saw as bad, even though just moments earlier we had been talking about how great they are, what a saint they have been.

Many times the quiet borderline refuses to face these symptoms or even acknowledge them. We don’t act out so therefore how could we meet the symptoms for BPD? This results many times in the quiet borderline going years without any diagnosis or being misdiagnosed. It was my refusal that landed me into a psychiatric ward for a stint. The cuts, the scars, the suicidal ideation finally caught up with me. In a way, it was like being arrested when my friend Whitney told me, “You are going to the hospital.” I was given an ultimatum, either I go willingly and check myself in or go in by force against my will. So I went “willingly.”

A few months back I was discharged. My arms are free from cuts and though many scars are prevalent, my destructive behavior isn’t quite there anymore. In the midst of episodes, I still want to cut myself. That’s something I don’t think I will ever be free of. I accept this. My doctor therapist and my friends and girlfriend hold me quite accountable in this respect.

Recovery from BPD is possible, but it is a long and hard journey. We have so many wounds that need to be healed, a lot of which we have repressed so deep it takes months of searching and meditation. Had my priest not told me to get help, I don’t where I’d be.

If you know someone with behavior like this, talk to them. Research what a quiet borderline is. Help us to help ourselves, because sometimes we just can’t. If you are a quiet borderline, you aren’t alone. I am with you in this fight. Medication and therapy can help you so much. There is no shame in seeking help. There is no shame in having a mental illness. We have a real sickness, just because you can’t see it doesn’t mean it doesn’t exist. Step into our mind, then you’ll know damn well it exists.

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

If you struggle with self-harm and you need support right now, call the crisis hotline at 1-800-273-8255 or text “START” to 741-741. For a list of ways to cope with self-harm urges, click here.

We want to hear your story. Become a Mighty contributor here.

Image via Thinkstock.

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What the Mirror Doesn't Show About My Borderline Personality Disorder

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Perspective. Looking at myself in the mirror is like trying to imagine other people’s perspective of me. Therefore, the mirror lies. It only reflects what is in front of it. Feelings and emotions can’t be seen.

My face is just a mask I wear every day to please others and sometimes, to lie to myself. But what is the reality behind the reflection?

Impulsivity

Only a few things can show emptiness, guilt and impulsivity. They are a ripple effect that begins with thoughtless and sometimes careless actions that end with remorse and despair. For me, impulsivity is the worst of borderline personality disorder (BPD) and if I could choose only one symptom to go away, this would be it. I have done terrible things impulsively and even though others can be aware of my actions, they can’t understand the reasons behind them and sometimes, neither can I. How can I reflect something I can’t even describe? When I look at my past, I can’t help but feel guilty about how I’ve treated significant people who I was so afraid to lose, but pushed away anyway, leaving a big hole inside me.

Pain

Another feeling that can be hidden is pain. When I grew up, I was taught to “always show my best side” and apparently, happiness and smiles are people’s best side. However, my deepest scars are worn inside. The struggles I have gone through because of my illness wouldn’t surface until later on in life, after a few misdiagnoses, a hospitalization and the accurate diagnosis of BPD.

I am aware I have a family that cares, my children who love me, a few friends who are just a phone call away and a husband who has demonstrated he is here for me through thick and thin. But then again, there are times when I feel empty, lonely and in a lot of pain. A pain I learned to hide, even from myself.

Happiness

Finally, even though there are many things that hide behind my mirror, one keeps me alive: happiness. I can’t “see” happiness every day, but I know there is a part of me deep inside that knows I am happy. Because happiness is not permanent. For me it is the amount of good moments that weigh more than bad ones — even when bad ones are harder to overcome.

Knowing I have BPD is happiness, because I finally know what my illness is and I’m learning to handle it. Going to bed early enough to wake up refreshed is happiness. Knowing I love my job even on the hard days is happiness. Realizing I raised my children — even if I was not the best of moms — is happiness. At the end of the day, it is not about how I look, but how I feel — and my mirror doesn’t show that.

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The Truth About My Need to Achieve

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Thinking back to the early years of my childhood, I can recall being a rather precocious child, always vying for attention in some small way and always trying to be brilliant. For
me, this meant shining above all others in school. I had to be the girl who could spell the most words, had read the most books, had to neatest handwriting. All I wanted was to be brilliant; not a great ask, at all! I had an idea of myself and if I could not fulfill this image in my head, I believed I would be wholly useless, a failure. My goals were extraordinary, even for a small child – I had hopes of Oxford or Cambridge aged 5, aimed at eventually studying a PHD when I was 7. I had constructed a vision of myself that I had to become and this has always stuck with me.

Looking back now, I realize two things. Firstly, this was an early manifestation of my borderline personality disorder (BPD) traits. Though it is only diagnosable post-adolescence, I believe I demonstrated some characteristics to a problematic degree in my youth, and that it was something I was always predisposed to. Secondly, since embarking on the road to recovery through therapy, I understand this idea of brilliance that I held so close was a need for validation. I wanted concrete manifestations of my goodness so that others around me could tell me I was great, as proven through my accomplishments. I held onto dreams of becoming this ideal person because it was a mask, a mask I wore to hide the cripplingly anxious and self-loathing person I was growing up to be. Under the ambition, ambition I still have to this day to an extent, I was a fragile, nervous person and I needed to somehow “trick” others into seeing a version of myself that I would have rather been.

As my BPD manifested itself clearly at the exit stage of my teenage years, I sought validation just as desperately as I had in my childhood, but the means of doing so varied greatly. I entered into serious romantic relationships; they were, as characteristic of BPD, unstable and I would constantly seek reassurance from partners that I was loved, liked and wanted. This extended to friendships, even to some relationships with family members, as I doubted the need others had for me in their lives.

By the time I was in my 20s, this kind of insecurity had ballooned and become a great obstruction to my relationships, my studies and my ability to form new friendships. I needed constant reminders that I was wanted; if I didn’t get them, I would “punish” the perpetrator by cooling contact, almost ghosting the people I cared for over some perceived slight that indicated to me I was not as wanted as I had to feel. I started drifting away from people, and they from me. I was lonely, and this only reaffirmed the little voice in my head, my BPD telling me that if I wasn’t being validated, if people were not constantly telling me so, then they did not want me.

Since I have begun therapy, I have started to separate that insidious little voice from my rational brain, the one that tells me that no one can respond exactly as I want them to. People are not mine to control and I cannot hand out punishments to those who do not telepathically understand what it is I want from them all the time. I am more able to contradict the gnawing voice that tells me I need to seek validation all the time, the one that said I had to brilliant or I would not be good, worthy or cared for. Sometimes I still fall prey to it and find myself wondering if my friends really do like me, or if I am just a needy, wanting burden upon them. But, I fight this voice because mine is louder and I will not succumb to what I now know is my disorder, something that I can learn to control. Through dialectical behavior therapy (DBT) techniques and a greater self-awareness, I can fight even this most vitriolic of my BPD symptoms.

To my loved ones; I am trying my hardest every day to win the battle with the little voice that wants to make me feel inferior and unworthy. Sometimes, I seem cold and unresponsive because I was not victorious and I feel like you don’t want me anymore. Most of the time, however, I am beating it and I am telling it that I don’t need it – I can validate myself now and know that I am loved. But there are times when I still need your understanding because this fight with my disorder will not be won overnight, and I will need you by my side.

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