I’ve seen many a psychiatrist over my time spent battling mental health problems. Some have been okay, and some have felt like a complete waste of time. Since my relapse late last year, I have taken the private route in seeking mental health help due to the poor service and agonisingly long wait the NHS offers. The cost of something as vital and precious as your mental health is extortionate. I am fortunate enough to be able to go down this route, but it saddens and angers me that this isn’t even an option for some. I could rant about this issue for hours but let’s not diverge.
In my latest psychiatric assessment, I was given a new diagnosis of an Emotionally Unstable Personality.
This first question that may pop into your mind is possibly, “What is that…?” So in this post I will be trying to unpick and delve into the world of a personality disorder that many may have preconceptions about.
The more well-known name for this illness is probably Borderline Personality Disorder but it is defined as Emotionally Unstable Personality Disorder by the International Classification of Diseases (ICD-10) classification system produced by the World Health Organisation (WHO), which is used in the UK. *side note* my psychiatrist emphasised that she didn’t feel that it was appropriate to class me as having a ‘disorder’ as such, due to having had coped well in aspects of my life such as maintaining a job and a long-term relationship.
When I first got my diagnosis, I wasn’t at all shocked or surprised. The question of having a personality disorder has been debated throughout my whole adolescent life. As a teenager though, it was hard to pinpoint whether my highly changeable moods from elevated highs to depressed lows were as a result of a change in hormones as I was growing up, or a personality problem. Now that I am 20 and I have struggled with my moods and various other mental health issues to this day, the diagnosis made complete sense.
For me, having a borderline/emotionally unstable personality means that I am immensely sensitive and find it extremely difficult to manage the way that I feel. I have exceptionally thin skin which leads to not being able to handle harsh criticism or confrontational situations. I feel strong, overwhelming and intense emotions that can vary throughout the day. Despite being referred to as a ‘personality disorder’, EUPD is not a personality defect, but is best understood as a limitation in a person’s capacity to regulate emotions.
These are just some of the symptoms that people with EUPD can have:
- A fear of being abandoned: Most people with EUPD have a fear of being left alone by friends or family, and will do anything to avoid this real or imagined abandonment. My fear of being abandoned had an extremely large role to play in my first relationship. Looking back at it, I realise that I was with my ex for so long because I was just so scared of being without him. I thought that I would be nothing without him. I was terrified of him leaving me or finding someone else that I would do anything he wanted and made it my priority to make sure he was happy. I never felt worthy enough for him and so I would tell myself that I couldn’t let him go. How wrong I was. This obviously then manifested into an extremely unhealthy relationship, but one that I could not see at the time.
- Distorted and unstable self-image: People with EUPD can have a persistently unstable self-image, to the point of attempting to control it, that affects their mood, values, opinions and relationships with others. This obviously links to the anorexia that I suffer with and it is very common for those with eating disorders to suffer with a personality disorder or vice versa. When having a bad body image day, it can put me in a terrible mood and make me feel as though I am a the worst person known to man. I can become triggered by the smallest of body related conversations or photos and this can fast become a downwards spiral, sometimes leading to harming myself as a quick fix to handle the emotions I don’t feel like I can cope with internally.
- Impulsive behaviours: This can include reckless driving, drinking alcohol, dangerous sex, substance abuse, self-harming or suicidal tendencies. I experience the latter two and have been battling self-harm since the age of 13. It is something that I still struggle with, however, it is under a lot more control than in previous years.
- Chronic feeling of emptiness: There are some moments when I feel completely empty and hollow inside. I often feel as though I do not have a purpose and am constantly questioning my being and existence. I question who I am, what I like, what I enjoy in life and if I even know myself. I am easily swayed by others and go into a panic when I don’t feel like I have a strong sense of who I am, or what I stand for. For example, if someone went travelling, I would feel the need to go travelling. If someone did a charity run, I would feel the need to do a charity run. This can be especially difficult when it comes to careers and money; feeling the need to earn more or change jobs for a higher salary, purely based on what others around me have said.
- Uncontrollable anger: People with this illness can suffer with uncalled for, intense and uncontrollable anger that leads to immense guilt. I can sometimes have an outburst that feels like lava is erupting out of my mouth, and once I have cooled down, the guilt starts to sink into my mind and body.
- Paranoia: This can include ‘out of body’ type of feelings as well as paranoid thoughts when stressed. Thoughts such as thinking that everyone is saying bad things about me behind my back, or that someone is following me around is highly distressing and can lead to an episode of extreme paranoia and anxiety. I experience very black and white thinking and find it hard to find a neutral ‘grey’ area. If a friend were to cancel on me, I would automatically assume it’s because they don’t like me, because I’m a bad person, because they think I’m annoying etc. rather than rationalising the different reasons that could have led to this. I tend to view the world in an ‘all good or all bad’ fashion which can be very frustrating for those surrounding me.
- Intense and highly changeable moods: People with EUPD have periods of intense depressed mood, irritability or anxiety that can last for a few hours or a few days. I find this particularly difficult to deal with as I never know what mood I’m going to wake up in, how often it will change that day, how long my mood will last for etc. It can be scary and very draining. A lot of people would describe me as a drama queen and so I find it difficult to recognise whether my reaction is justified for the given situation, or if others would see it as an over-reaction or a cry for attention. I find it hard to take negative criticism and words can hurt me like I have been physically hurt, sometimes causing a long-lasting traumatic effect.
These symptoms and the effects that they have are all personal to me and cannot be assumed are the same for all sufferers of an emotionally unstable personality. For instance, when it comes to a fear of being abandoned, for some people it means not being able to be alone and therefore becoming extremely clingy, and for others it means completely isolating themselves in order to avoid getting hurt.
The good news is that BPD is treatable despite what the old myths say. I am currently having psychodynamic psychotherapy which focuses on my unconscious. My therapist and I explore past experiences and try to link these to my current problems to try and help explain why I feel the way I do. Other forms of therapy to help treat EUPD that I know of are Dialectical Behaviour Therapy (DBT), Cognitive Analytical Therapy (CAT) and Mentalisation-Based-Therapy (MBT). I am due to start MBT therapy via the NHS however they are yet to get back to me after my initial assessment, which funnily enough came out with the same diagnosis as the private assessment. I have also started a new anti-psychotic to help with my moods swings as well as carrying on my anti-depressants.
I’d like to say thank you for reading this post if you made it this far. I feel like I have hit a significant milestone in my journey of recovery having this new diagnosis and I will continue to better myself each day.