Understanding BPD and other Personality Disorders (Part One)

Understanding BPD and Other Personality Disorders

This is Part One of a series of blog posts which will explore borderline personality disorder (BPD) and other personality disorders.

I have explored borderline personality disorder in a previous blog post (posted in August 2010) titled, "What is BPD?"

Within this blog post (and throughout this blog-series) I wish to further explore the thought processes, and behaviours, related to BPD (and other personality disorders); and how these relate to our rapidly changing states of mind, feelings and emotions.

(The mental health diagnosis I have been given is that of borderline personality disorder. ~ Nicola Edwards)

The fluctuation of moods is one of the main characteristics shared by those with a  borderline personality disorder diagnosis.

The rapidity with which our thoughts and feeling change is often extremely overwhelming and often can make a person with BPD feel confused. Which can, therefore, make it harder for that person to communicate their true thoughts and feelings clearly to not only others, but sometimes to themselves also.

I cannot tell you how many times close friends and family become frustrated with me because they feel I am "not making any sense" - which, in turn, frustrates myself because I feel "misunderstood" by them.

Other characteristics of this mental illness include; distorting reality, depression, a tendency to see things in "black and white" terms, and impulsiveness (a trait which I covered extensively in "What is BPD?")

Probably the most common trait shared by those with a borderline personality disorder is an overwhelming feeling of "emptiness" along with a chronic fear of abandonment.

I often feel as if I am being forced to live within a world in which I do not fit into, nor belong to; as well as it being a world in which, I feel, I am not wanted.

As is the same with many others with BPD, I have a damaged view of myself; often believing there is "something wrong with me" (i.e. that I am "defective"), and I would sometimes even go as far as to regard myself as "evil". Despite whether or not there is actually any real truth to this sort of "faulty thinking".

More often than not, this type of faulty thinking and damaged view of oneself is due to abuse during childhood, frequently sexual abuse, but it can sometimes also result from more subtle forces, such as a mismatch between the extremes in temperament, common among people with borderline personality disorder, and a not-so-accommodating parenting style (particularly during the BPD-sufferers childhood).

This negative perception of myself, or (to phrase it better) lack of self-worth, can make it very difficult for a person with a personality disorder diagnosis, like myself, to form and maintain relationships (of any kind); as well as, participate in social interaction at an "acceptable" and/or "appropriate" level. Feelings of "emptiness" and "not belonging" are also more-than a huge hindrance on day-to-day life; as are also the constantly changing thoughts, feelings, and/or states of mind towards real, or imagined, current life circumstances.

The thought processes, associated with personality disorders, are thought to generally manifest in a person's behavioural patterns in two different ways; either a person will either externalise their thoughts and feelings, or they will internalise them.

A person whom internalises tends to turn their anger inwards; even if their anger is directed at another person, they will not confront this person or behave in an aggressive manner towards them. Instead they direct their anger at themselves; for example, by blaming oneself, or through self-harm, or self-deprecation.

On the other hand, a person whom externalises tends to turn their anger outwards; which can manifest itself in aggression, angry outbursts, law-breaking and hyperactivity.

It is quite possibly true to say that either sets of actions, whether that be internalisation or externalision, are consistent with BPD; and that both can possibly occur in the same person, on the same day!


It is believed (particularly within personality disorder support groups and communities) that there are those with borderline personality disorder whom are "high-functioning", and these are those whom are "low-functioning". (Although some experts would dispute the existence of either of theses modes in the context of BPD.)

A person whom is "high-functioning" is thought to be able to present a stable and calm image when within social and professional circumstances and situations. In other words, they are able to "normalise" their behaviour when they are "in public" - and hide their illness from the outside world. However, when that same person is with close friends or family (i.e. behind closed doors), that "need" to hide their mental health problems, or to "normalise" their behaviour, no longer feels necessary. Often in situations involving close family and friends the traits generally associated with that person's diagnosis can become much more apparent.

A person whom thought to be "low-functioning" in relation to their personality disorder diagnosis is believed to lack control, or have no control, over the way in which their mental illness affects their outward behaviour when either in public or at home behind closed doors.

Again, both of these behavioural patterns are consistent in a person with a BPD diagnosis. In other words, it is possible for those with borderline personality disorder to fall into both the "high-functioning" and "low-functioning" modes.

When I am confronted with social situations where I feel uncomfortable or anxious, and where I feel I may not have made a good impression (regardless of whether this is true or not), I find myself "switching" from blaming myself for having what I feel are poor social skills, to blaming other people for people for not being wholly accommodating towards my lack of social skills and interaction.

I have a tendency to internalise when in social, and professional, circumstances or situations - i.e., blame myself for lacking in social and/or problem-solving skills - I tend to keep any bad thoughts of feelings to myself. I tend not to externalise my distress in those situations - I don't show aggression or lash out.

However, with close friends and family my tendency is to externalise my anger and/or distress by becoming aggressive or defensive. Behaviours which are often due to myself misinterpreting an off-hand comment from a loved one, as a thought-out personal attack on myself.

The constant fluctuation of moods (commonly known as Affective Lability), as  characterised by the borderline personality diagnosis, often causes distress in those with the mental illness, and can be very confusing, making it hard for that person to communicate their feelings clearly to the people around them.

In Part Two of this series I shall be further exploring personality disorders - focusing, as I have in this post, on borderline personality disorders - and the way in which people with these mental health diagnoses interact directly with other people, as well as the world around them.

Thank-you for reading; and I look forward to, hopefully, seeing you again in Part Two!

Previous blog post - August 2010: "What is borderline personality disorder (BPD)?"

"Understanding BPD and other Personality Disorders (Part-Two)" has been added. ~ 27/04/2012


"Understanding BPD and Other Personality Disorders (Part-Three)" has been added. ~01/05/2012

New Poetry!

Eleven new poems have been added to the Free Your Mind 'Creative Bank'

The first new entry is a submission from a writer known as 'Spizzie 69'.

Past the Expiry 
The Darkness deepens as the pointless Plot thickens And the Black Clouds Weep at the memories of the past.
They have now just become shadows that fade into the nothingness of time
The once effective have became the rejected and now put aside to become The forgotten
Like the autumn leaf that now falls to the ground with its use expired
to be absorbed back into the soil and become the muddy foot print of something that once was!
Or as easily disposed of as the discarded waste from the night before!
So as the sunsets for the long night ahead, often wondering if there will be a dawn?
No new Day? No new Hopes? No new Dreams? No Life? No existence?
Best Before!....... Sell by! ..........Use by! .........Warranty invalid!........ Sold as seen....Dispose of carefully.....and Please DO NOT RECYCLE!!!

The following (10) poems, which have also been added to the 'Creative Bank', were originally posted to my Myspace blog in May 2010 and April 2009.

~Nicola Edwards

Sonnet

Falling in love is a common affair; 
a task arranged to be an ultimate end
to the loneliness that I bear.
I want more than just a one-night stand; 
I’m looking for someone I can depend
on, and someone who is willing to care.
I want someone who will always be there.
To never know love just doesn’t seem fair.
They talk about love in songs and losing
your heart to the one they promised would come.
But, no knight in shining armour ever comes
to rescue me from life’s knocks and bruising.
So, I remain alone, my heart intact, 
not knowing if love is fiction or fact.

Science Fiction

What wouldn’t I give to travel with Kirk and Spock
and boldly go
where no man has gone before.
Or run with the Doctor where nothings ever slow. 
To enter the TARDIS and claim
“It’s bigger inside” before we go.
I’d leave this life and runaway.

Perhaps, 
if it were all real,
I wouldn’t plan this to be my final day.

Lies

Deep in the darkest part of her soul
is where her lover lies.

On the other side of the river, 
as far away from home as allowed, 
she lives a double life
which will bring her trouble and strife.
But her heart tells her it’s alright.

She has hidden her fear
that her lover will find out
she is another man’s wife.

  

Love Hurts

With all the will in the world I push him aside
until he is nothing
but a distant memory; 
until the pain he caused is fleeting.
No more will I be needing him. 
From here on out, 
it’s me, myself and I.
No more heartache, 
no more crying
with him I made a mistake.
From here on out 
I’m alone.

How I missed this painless bliss!

Lonely Woman

Whisky in hand,
in a dark, dingy bar.
It’s late and the bar is almost empty,
but the woman is unaware of the time
and even her
surroundings.
Only the no-smoking sign is apparent.
She downs her drink and rises from her stool.
Outside in the cold
she lifts a cigarette stick to her lips;
she inhales
and wonders what happier women do.
She exhales.
Time to call a cab; these streets aren’t safe for a lonely woman.

The Lonely Pupil

Troubled teenager, crouched in the corner
Shrouded in darkness, hair all a mess
Tear-stained face, lip split open
Covered in purple bruises.

The bell rings, and the student gathers her books,
Composes herself
Thinking how to explain away the damage
As the lonely pupil heads to her next class.

Do You See Me?

Do you notice I’m here?
Do you realize how I feel?

You’re oblivious
and it’s killing me.

Do you see me?
Do you even notice I’m standing right here?

My feelings run deep
and it hurts like tiny cuts.

Do you know I exist?
Do you even know I’m there?

My feelings for you
are like a cyst on my broken heart.

Will you ever notice me?
And how I can’t resist your tempting looks?

The End

The point-of-no-return
is getting closer.
Turning back
all I see is darkness
and the people I’ve left behind

Walking forward
I pick up my pace
making my heart race.
Unsure of what I’m heading toward
but I’m resilient and know I must carry on.

As I get closer
the light becomes brighter.
I’m scared of what lies ahead,
this path is unknown to me
and anyone who walks it.

I’m almost there now.
My breathing slows,
it becomes hard to think,
and my heart beats its final beat.
This is my stop. The end of the line.

Public Transport 

A curse on public transport

which bears the stench

of greasy takeaways;

and a curse on their sticky floor,

which invokes a sound like Velcro as you cross it to your seat.

A curse on public transport

for being unreliable, 

leaving me the commuter, 

to stand out in the drizzle.

A curse on public transport

for being a stifling oven 

in the summer,

and then below freezing in the winter.

But a final blessing on public transport

for without you I could not travel.....

On a bus

Looking out of a window
scenes rush by
- a woman drops her shopping –

on the bus a baby cries. 

The Problem with Armchair Psychology

An "armchair psychiatrist" is a person whom is not trained in, or has no background knowledge of psychiatry, but will still continue to give advice concerning, and often attempt to diagnose, the mental health of others.

Although people do perform these same type of armchair diagnoses of physical conditions, it is more commonly done with mental illnesses.

I believe that armchair psychology is a problem because the armchair psychiatrist is often under the impression that diagnosis of a person's mental state can be simplified down to a list of symptoms. It seems to me, armchair psychiatrists often see mental health diagnoses as capable of being easily sorted into neat categories by using a set of simplistic lists of symptoms.

But, I feel, this particular attitude towards mental illnesses, in many ways, trivialises mental health conditions as those whom are often the givers of this sort of "advice" seem to fail to understand the true complicated nature of mental illnesses.

I think people feel more confident to give uninformed diagnosis' of mental health conditions, as opposed to physical illnesses, due to the non-visibility of mental illnesses, which to a layman can make mental illnesses seem possible of diagnosis by observation simply by use of lists of symptoms.

I believe another large contributing factor towards the simplistic views of  armchair psychology is the regularity of so-called "experts" giving their opinions on the mental health of those in the public eye, or "celebrities", despite the fact that the discussing "expert" would never actually have had any contact with the person under discussion; certainly not in a context where they would be able to provide an informed opinion of that person's mental health!

Because, in reality, if this person really was under the care of the "expert" giving their "informed" diagnosis - or, to term it more accurately, their opinion - of another's mental health, then said expert would be bound to the rules of confidentiality and, therefore, would be unable to provide any public comment of the condition of that person's mental health.

Armchair psychology can be a problem due to the simplistic nature of an armchair diagnosis, particularly as the arrogance (for lack of a better word), often displayed by an armchair psychiatrist in the accuracy of their highly uninformed opinion of complex mental health conditions, not only trivialises mental illnesses; but, also, to a layman, a seemingly simple and easily reached diagnosis can make treatment of a condition also seem simple and easily accessible when, of course, this is often not the case.

I understand that engaging in armchair diagnoses of complicated mental health conditions can be a fun past-time or activity, but armchair psychology can have a damaging effect especially when an armchair psychiatrist begins to condemn another for disregarding their advice concerning their mental health - regardless of the fact that the armchair psychiatrist is, ultimately, wrong in giving their uniformed and/or simplistic "diagnosis" or opinion, of a complex condition.

Armchair psychology simplifies mental illness - and, in many ways, trivialises it - as it instills confidence (or arrogance) in what is generally an opinion born out of ignorance, or out of a lack of understanding and knowledge, of either mental health conditions and/or the person under discussion proceeding an armchair diagnosis.

This, I feel, is the problem with armchair psychology.

My apologies for no blog posts.

Hello.

My apologies for no blog post last month.

Unfortunately, due to personal circumstances (which I am not at liberty to disclose or discuss, at this moment in time), February will also be a post free month (other than this post, of course).

I promise I will be back blogging for FYM next month.

Until then,

Take care.
~Nicola Edwards

End-of-Year post: Free Your Mind in 2011

First-things-first: Thank you for continuing to support FYM!!! :-D

It has been a long year for the Free Your Mind campaign, and myself (N.E.); but we (FYM) are very excited about continuing to move forward in 2012!

During March and April FYM took part in an online "book-club" discussion, on Twitter and Facebook, with All-Walks - "an initiative founded by Caryn Franklin, Debra Bourne and Erin O'Connor working... to celebrate more diversity within the fashion industry" - in which we discussed Bodies by Susie Orbach.
Previous blog post: 'All-Walks Book Club.'

At the beginning of April 2011 FYM collaborated with Imagine-mental health charity's Croydon branch to hold an art exhibition, called 'Broken Paths', at Fairfield Halls (Croydon).
Previous blog posts:
pre-BrokenPaths promo: 'Upcoming art exhibition...'

I also posted a follow-up entry to this blog after the exhibition about some of my thoughts and ideas on how Free Your Mind can progress forward: 'FYM took part in first public event in April this year...'

Nicola E. (me, :-D) was sectioned twice this year; first in April, and then again in November - but despite the lack of quantity of posts on this blog, I am always trying to improve the quality of the content delivered by both FYM and myself.

I decided to start-up Free Your Mind after feeling I was being abused by nurses on a psychiatric ward who were prejudiced towards people with mental illnesses(!); and, during that particular stay in hospital I was arrested and charged with criminal damage (to hospital property) and alleged assault charges (pressed by nurses on the ward).

In October 2011 I appeared in court facing the above charges - after I returned from court I posted an entry to my Tumblr blog about what happened and my thoughts on the experience.

So, we end 2011 and move forward into 2012 - and at FYM we are grateful for all your support, and we look forward to you continuing to join us on this campaign's journey. :-D - Thank you!

Free Your Mind wishes you 

happy holiday cheer 

and all the best for the next coming year.

Drug Addiction and Stigma (+ my experiences with both)

Drug addiction is an illness, which can – often, but certainly not always – accompany other mental illnesses; particularly those mental health conditions associated with impulsivity, such as my own diagnosis of BPD (Borderline Personality Disorder).

Drug addiction comes attached with its own batch of stigma; and, often, when a person is struggling with addiction, this can be perceived by others – particularly those who know of their addiction - as their one and only defining feature, for which they can be demonised for.

Common perception of a drug addict is that of that of a person whom is ‘immoral’ and 'a danger to society’; and, although, some may turn to crime to feed a habit, the image of the “immoral addict” is – in most cases – untrue, with its basis in prejudice.

Drug addiction is generally highly stigmatised due to the (mistaken) perception that, not only is an addict dangerous, but that they are the ones responsible for their problems - i.e. their addiction is self-inflicted.

But this stigmatisation is damaging; and, it is a large factor in contributing towards a person hiding their addiction, as well as keeping them in denial.

I’d like to take you back for a moment to FYM’s previous blog post in which I wrote about my most recent stay on a psychiatric ward, where I felt I’d been “over-medicated” and felt angry at the drug therapy I received whilst in hospital.

I didn’t, however, make it clear in my last blog post that this anger stemmed from my own ongoing struggles with drug addiction (and my addictions in general; self-harm included), and from my feelings that compliance with some of the (compulsory) medication is detrimental  to the likelihood of me making a successful recovery.

My appearance has become dishevelled of late, my skin is pale, and my eyes appear heavy; ongoing life-problems and mental health problems have taken their toll and it shows in my appearance.

Most of the prescribed medication makes my pupils dilate – so, although, it is apparent I am “on” a drug, it would be impossible to know which one - which sends out the image associated with the perception of the “immoral addict”, particularly to those who do not know me.  (The dilation of my pupils are due to compliance with medication; although, I have now requested to not be prescribed any addictive or dependency inducing drugs.)

However, this perceived image of me could not be further from the truth. And, the stigma displayed by strangers on the street – passers-by who pre-judge and making discriminatory comments – seems to be more persistent and is affecting me more than usual at this period when I am most sensitive.

Despite my ongoing struggles with addiction it is by no means a defining characteristic – everyday is a continuing battle with addiction, one in which I will persevere in fighting – but,  as I have written about previously on this blog, my illness does not define me.

Drug addiction is highly stigmatised due to a number of reasons, including, the taboos surrounding drugs and drug use, the perception that a drug addict is immoral, and the perception that a drug addict is responsible for their own plight.

But, like all stigma, the stigmatisation of drug addiction is damaging. Demonising a person purely on the basis of their illness seems thoughtless, and can cause hurt and pain to a person whom is already suffering.

A Long Weekend on a Psychiatric Ward: which left me feeling over-medicated.

Hello - I am back and blogging!

Nicola Edwards

As you may have seen on FYM's previous post I (Nicola E.) was sectioned, again, for the 6th time.

I have been sectioned once previously since launching this blog; but, I have not spoken about my experiences of that time.

My reason for this is that although I do have something to say based on my experiences during that time, I am still working on how it would be best to express my opinions.

This most recent sectioning, however, was the shortest amount of time I have stayed under a section whilst on a psychiatric ward.

It was a long weekend, but one which left me feeling over-medicated.

I wrote notes in a diary during that weekend about the treatment I was receiving on the ward.

The following is an account of the weekend; edited and compiled using notes from that diary.

I remained on the ward and, on a Section 2, from the 3rd-November-2011, to the 7th-November-2011

Quote from diary:

This (long) weekend has felt like a (cliched) POV rave scene from a drug movie... [sic]
[one in which] the protagonist is [stumbling] around being offered all kinds of illicit substances; but, instead of dealers around every corner, [instead] there were nurses with pills and injections. [sic]





Thursday; 3-Nov.-2011.
I was given two (2) Lorazepam almost immediately after my arrival to the psychiatric ward - which the staff on the ward felt I needed.

I asked for a "sleeping aid" that same evening, and I received two (2) Promethazine and one (1) Zopiclone.

I feel asleep that night, but did not wake up until late the following evening.

Friday; 4-Nov-2011.
Shortly after waking - and once having eaten a couple of slices of toast - I requested the same medication they had administered the night before in order to help with my sleep.

Saturday; 5-Nov.-2011.
For reasons, which I honestly cannot remember (although it is possible that I could have been ranting and raving; in other words, shouting and making a lot of noise ), I was forcibly medicated that same Saturday evening.

Quote From Diary:

My head was held back, and both pills [2 Lorazepam] and water were forced down my throat...
...which I did swallow - although I did feel reluctant in doing so.
After swallowing ALL of the tablets I had been given. The restraining nurses falsely accused me of not taking [the] medication; they, therefore, held me down for an injection (its is unknown to me what medication they had administered with the syringe). [sic]


I was asleep/unconscious/knocked out after receiving the injection.

I will be frank with you; my recollections/memories of the events during this period are "fuzzy" and disjointed.


Sunday; 6-Nov.-2011
I woke up shortly before midday on Sunday.

Not long after midday, however, I fell into an argument with a fellow patient, whom I believed, judging from from her behaviour, was prepared to say anything to try and push my buttons,


I took myself away from this patient, in order to avoid a fight; so I moved myself into the hospital ward's "courtyard" to smoke a cigarette.

Unfortunately, I was still full of anger; which was probably due to myself becoming oversensitive with her words, and then found myself dwelling too much on the (offensive) things that had been said to myself.

So, I inevitably got wound up and was no longer able to keep my cool; and, I ended up releasing my anger onto a couple of wall flower baskets, by kicking them both and then watching each basket fall to the floor.

Following the above incident, I was administered two Lorazepam.

Later on that day, in the mid-afternoon, I was admittedly rather bored; so, as a way of cheering myself up and to alleviate my boredom

Quote from Diary

...with Magic FM loudly playing on the psychiatric ward's radio - I jumped up onto the table to sing,
"I want to break free!"
It was spontaneous of me, but it [worked] as a release; and soon after I'd sung along to those five words to the song being played, I leaped down off of that coffee table. [sic]

Upon leaping from the table, I was approached by a nurse, who told me she felt that I needed PRN - I was given two more Lorazepam.

Monday; 7-Nov.-2011.
I'd not long been dressed and out of bed on that Monday morning; but, as I was walking from one part of the ward to another, I was stopped by a nurse who was stood inside the clinical room with its hatch open. The nurse offered me two Promethazine - which I initially (kindly) declined, as .I felt that I did not need the medication at that moment in time.

But the Clinical Nurse insisted I needed the medication to calm me down. However, I was calm (wasn't shouting or being aggressive) and, it was for this reason that I decided to comply with the medication which was currently on offer.

Later on, that same day; I attended a "ward round" meeting, with the ward Psychiatrist. It was at this meeting I was taken  off a Section and informally discharged.

It took a couple of days after returning home to overcome my fuzzy-medication-head and stop feeling so spaced-out.

I find it hard to believe that all of the medication I received over the "long weekend" were in-fact necessary. I genuinely felt like I was over-medicated.


"Part Two" of this post can be found here - Part 2 is an explanation of why I feel angry at the way I felt I was 'over-medicated'. ~ 03/12/2011.

Free Your Mind is away (again) as Nicola E. has been sectioned.

Once again, I have been sectioned as punishment for not pursuing help (in the form of therapy or counselling) following a serious sexual assault in 2009.

My father [name omitted] believes having me sectioned is the way to having control over my actions. He uses it as a form of punishment... -Nicola Edwards

Thank you for continuing to support FYM. We will be back soon (I hope!).

Being arrested on a psych.ward + my thoughts on these events. (link to Tumblr post)

I founded Free Your Mind in 2010 after feeling I was being abused during my time on psychiatric wards.

In early 2010 I was arrested whilst on a psychiatric ward, and on the 3rd October 2011 I faced the charges in court.

That same evening, with the charges out of the way, I posted a blog to Tumblr about my experience and my thoughts on the events:
My experience of being arrested whilst on a psychiatric ward + my thoughts on the events which followed.