The Face of BPD - Part 6 of 9

Part 6 of my nine part series of what the diagnostic criteria (symptoms) of BPD look like in my own life.

Criteria 6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

This one is pretty self-explanatory, but to put it in simpler terms, I would basically call it intense bad emotional states that come on suddenly (often with little or no outside provocation) and go away just as quickly.

My periods of depression were just as described in this definition: I'd be doing great and all of a sudden slip deeply into terribly intense sadness. Sometimes there was a clearly obvious trigger: one time, when learning of the wedding of a guy I used to date, I went very suddenly into a spell of depression that lasted an entire summer. In that episode, I became despondent, detached, lost interest in things I loved, and had such as hard time functioning that I ignored several important life decisions that made a serious impact on my future. Often times, however, there were no obvious causes. Perhaps a series of tiny setbacks sparked my fall, but I will never know for sure.

The really bad depression came in episodes that lasted for several months, but an equally detrimental and just as common, symptom of my BPD was the intense rushes of depression on anxiety that came on suddenly, lasted a few hours, then went away. I could wake up feeling on top of the world and in love with life, then one small – even unimportant – setback could spark me into feeling so depressed I felt suicidal.

“Reactivity of mood” is one of the aspects I am learning to deal with, and having some small successes. In working with my therapist as well as my DBT workbook, I am learning how to be more mindful and aware of what I am thinking. I’ve found that, as a daydreamer, my mind often wanders onto thoughts that make me feel bad – such something a person said or did that hurt me, or frustrating situations in my career life. When I think about those things, I have an emotional reaction. An my emotions, like that of most borderlines, can race out of control in a matter of seconds.

I shared an example of this with my therapist today, recounting a situation in which I was thinking about having to cancel plans with a friend and ended up feeling angry and frustrated with her because I felt that she didn’t understand or care about me. But one of the beauties of DBT is learning two key skills: distress tolerance and emotional regulation. I’m not there yet, but knowing some of these skills helped keep me from lashing out at my friend or feeling much worse than I did.

So, like many with BPD, I have found hope. I know that recovery is possible. I am the proof.

full list of BPD criteria here

The Illusion of Fine

Right now, in this little moment, I am fine. I am stable. No anxiety, no panics, no distress. I'm confident in my future - my ability to find a good job, to find some purpose in my life, to move on and become who I want to be. And its nice being fine - it gives me a heady feeling of comfort. But I know all to well that fineness can be an illusion.

For someone with BPD, emotions change quickly, often for no reason. The smallest occurrence, remark, or setback and send one quite literally into the depths of dis pair. I know, and recognize, this part of my condition. So although I'm enjoying the fineness, I know of its transience and am planning how to react when it is gone.

Just six months ago, I was fine. In fact, I was more than fine, I was on top of the world. I was beyond happy, confident, working hard and planning. I was confident in the future, looking forward to what life had for me, and had no idea what hell laid ahead. I was happy, yet it took only a few weeks, a few small situations and a few inconsequential people, to topple me. And once I fell, it took me months to get back up.

So now, today, I'm fine. But I know it will not last. So I continue to learn about the skills I will need when I fall again, when I am not fine. I'm practicing distress tolerance now, in little situations that ignite my emotions, like having a mistaken credit card charge. That way, when the big things come, when someone betrays me or breaks my heart again, or I lose something I worked so hard for, I will be ready. Ready to take those three steps to dealing with stress: Distract, Relax and Cope.

I'm glad to be fine, and I don't always think its an illusion in and of itself. But we set ourselves up for failure if we become so lulled by our fineness that we think out problems are over, that we've completely and forever healed, and that we'll never have another episode again. That's when we buy into the illusion that fineness sets up for us, and we let down our guard and fall.

Right now I'm fine, but next time I fall, I think I'll be ready.

Working Girl

Working is hard when you are in the middle of a depressive episode. Luckily, I had vacation time scheduled right as my latest one started, so the days when I couldn't get out of bed didn't interfere with my life. And I am blessed now to be at a very flexible on-call job where I don't have to work everyday and can turn down a day's work if I need to. But that flexibility makes it harder...its hard enough to get up out of bed on these cold fall mornings and get myself going under normal circumstances, but when I wake up feeling tired or depressed or angry it takes everything in me to get up and get to work.

We are not safe from our emotions anywhere - and work is no exception. For me, anger strikes in the most unusual of places and kicks me when I'm down (I, who's default emotion is anger in most every situation, and who rarely expresses it but buries it inside, making for more hurt and even bigger blow-ups when the explosions come). So today, my anger crept up on me at work, in a short 10-minutes of downtime. Its like a sports car - 0 to 60 in a matter of seconds. One moment I am find, the next filled with anger and hurt...and today I felt hurt knowing that the person who hurt me most recently is out there, going on with their life as if they didn't break me into a million pieces...and on the way to breaking someone else again, perhaps at that very moment I was sitting at work, in my chair, just trying to get through the day.

So today I was thankful for the notebook I've been keeping - the one I've filled with coping thoughts and self-affirming statements, and quotes from my favorite TV shows and music. I just read them over and over and over until the short break I had passed, and even wrote down a new quote I had heard a few days ago in a song. And I was swept back into the world of busy-ness again...