For Mental Health Awareness Week, Imogen explores many aspects of her journey with borderline personality disorder (BPD). She sheds light on how it felt to receive a diagnosis, access treatment and manage unique symptoms of ‘splitting’ and dissociation, as well as stigma associated with the condition.

I was formally diagnosed with borderline personality disorder (BPD) at 22 years old. The symptoms I’d been experiencing since my teens had significantly increased over a two year period, leading to me reaching out for help. I was struggling with my mood, swinging from one extreme to the other. I felt unrecognizable in myself and in the way I was behaving and reacting to some of the most inconspicuous things.

As I was explained the criteria of diagnosis and the symptoms associated with it, I felt relieved. It was momentarily comforting that what I was going through had a name and it wasn’t just some fault in who I was as a person. I had been diagnosed with depression, anxiety and developed an eating disorder in my teens, which prompted me to see a series of therapists and psychologists. After a couple of sessions, they all said that they could do nothing for me; that I was “difficult”. So, being told many years later that I didn’t have control over some aspects of what was happening to me was the start of a long shift in perspective. 

In sum, BPD is a disorder of instability: in emotions, behaviours, thoughts, relationships. It impacts every aspect of my life. My episodes happen once or twice a week, but they are the tip of the iceberg. Below the surface is a list of more subtle symptoms that can make me feel isolated and estranged from others. The sudden unpredictability and speed at which my emotions plummet or skyrocket, can often cause me to neither trust my moods nor feel safe in my own body.

The guilt after an episode can be the hardest to deal with; the lost time and mess of it all. My self-awareness, which is caged during the episode, comes flooding in like a weight on my chest. I’ve struggled mostly with dissociation, paranoia and ‘splitting’ which has affected my interpersonal relationships, and at its worst, my education and early career.

‘Splitting’ tends to be where an episode takes form, like a switch that suddenly flips my thought patterns upside down, affecting how I perceive and experience my immediate reality. People can become either all good or all bad; the polarised thoughts that follow don’t feel like my own and can cause distress and confusion. On the other hand, dissociation usually follows an episode, feeling like a complete disconnect from the world around me, as if I’m experiencing reality from underwater. Sounds are muffled, my movements are slowed, my sense of self dissipates and I can struggle to remember what happens during these times.

After reaching out to my GP many times, I was referred to several different professionals before finally being referred to the Personality Disorders Unit, where I received my BPD diagnosis and treatment. After ups and downs, I am still learning how therapy works for me; how to open up and be vulnerable during sessions. I am grateful to have received treatment relatively quickly, but there have been many obstacles throughout the process including almost being turned away because of difficulties faced in therapy. I feel there’s little room for tailoring treatment to the infinitely different needs of an individual, especially when it comes to accommodating the complexities found in personality disorders. I hope that one day there will be more recognition of this.

My life now is very different to last year. Although I still have a long way to go, I’ve gained so much more clarity and self-confidence. I’m proud of my progress and feel optimistic about the future. I’ve received unconditional support from those closest to me and I cannot thank them enough. I have learnt a lot from reading about BPD and I’ve also learnt a lot from my own experiences, progressively learning from each episode to identify triggers but also to find out what works for me. This has helped me to move through new episodes with more ease. A lot of the progress I have made has been through trial and error, and hasn’t always been linear.

BPD is still shrouded in stigma and misunderstanding. I have experienced this first-hand, from people saying they no longer felt they could be my friend to my own unwillingness to talk about my experiences from fear of being seen differently. But I always remind myself that the inability to regulate my emotions is at the heart of my BPD. My emotions can feel earthshattering and I can act impulsively, but more often than not, it comes from a place of fear. The fear of losing something dear to me, of not being heard, of having done something wrong.

But I am not alone, and I can and will eventually learn to control these emotions. In the meantime, I’m still me. I still love writing, running and the ocean. Despite all the setbacks that can make me feel hopeless, like I’m in front of an Everest that I’ve already tried to climb so many times before.

The only advice I can give to others is to reach out and speak up. Keep learning about your diagnosis and your experience. Don’t settle for anything less than respect and support from those around you. What you’re feeling is valid. Although it may make you feel like the world is ending at times, I promise you it’ll start again in the morning.