Helen White, Content Manager of Stigma Fighters Down Under, is a wonderful friend and colleague of mine who is living with Borderline Personality Disorder. When I had the opportunity to interview her about her illness, Helen gracefully answered my questions with honesty and openness. I am so happy to share that interview with all of you.
HW: I was diagnosed with borderline personality disorder about three years ago, although looking back I’ve lived with it most of my life undiagnosed. I think from memory there are four main “traits” and nine behaviours under those traits. I hit about seven of nine and work bloody hard with a psychiatrist to keep things balanced and make sure I’m properly medicated.
I’m returning to functional now by the way but there was a period when this got so damaging it cost me a lot in my life.
There’s very little knowledge of borderline out there and I’m always trying and keen to get the word out more.
AB: What prompted you to seek medical help leading to your diagnosis?
HW: Long story so bear with me.
I used to walk to work over a bridge crossing the Yarra River. I loved that walk in the sunshine, with the river, thee ole and views of the MCG. I can’t remember exactly when I realised I had stopped enjoying the walk, and instead regarded it as grey. It was all grey. After getting the grey seeping into other areas I went to the doctor, I think I might have depression was what I said.
This was about 2005. A lot of things had happened. One of my favourite nieces had been diagnosed with an inoperable brain tumour that was supposed to kill her. I’d recently lost two cats very suddenly. I’d had to make a change in career direction as it became obvious that I was very moody and difficult to work with in my last job (I was also bored stupid and hated going) and my anger flared up in the workplace. At that time I didn’t know my anger was a symptom; I put it down to being unable to fit in, hating what I did, and life circumstances.
So the doctor asked a lot of questions, and also talked about his own experience with depression. I was prescribed Lexapro. Both the medication and the openness of the doctor helped lift the fog a little. However it didn’t make things ‘normal’ whatever that may be, and I still felt grey. So the dosage was lifted.
The work I was doing at that time was managing a finance team responsible for putting together accounts for the major arm of an ASX 200 company. It was high pressure, long hours. I thrived on it. My team were close knit, but management viewed me with a great deal of reticence, it was partly personality clashes, partly that I was not seen as a wider team player. I hated the after work socialising; I wasn’t any good at it. I felt sick and nervous if I had to go to a function. I had trouble forming relationships with colleagues because of this. So I felt always under scrutiny, and was often taken down in meetings by my boss at the time. It used to upset me a lot. Now I see the response was irrational and out of proportion, but at that time it seemed normal for me. I would berate myself internally for being too sensitive. I was also a perfectionist which worked against me. If things went wrong I took it personally, and because of managements’ attitude I copped the blame anyway. To give an example of the intensity, at one point over year end I worked forty-two days straight, usually 12+ hour days. The first day off was because my cat was dying and I had to take her to be put to sleep. Toxic in retrospect.
One Monday things were so grey they were almost black and without even knowing what I was doing I booked an appointment with my doctor for that morning. I walked into his office and when he asked what was wrong I cried. And cried. And cried. He wrote me off work for a month and monitored me weekly. I don’t remember much of that month; it’s a blur of intense depression. My mind had broken down and shut up shop. I went back to work part time in the second month and full time in the third. And proceeded to go straight back into the bad habits.
At this time my physical health began to decline, I had developed hip pain that took a year to get correctly diagnosed (torn cartilage) and I had an arthroscope, again disrupting work. Then my back started to give me problems. I had disc degeneration and suspected intra-disc tears. More time and countless procedures attempting to put a stop to the uncontrollable spasms that resulted, pain score usually 8-9.
Looking back by now I must have been a liability at work, but I carried on because that’s what my upbringing had taught me to do. I was never allowed to fail. The best students got prizes and I was under pressure to be one of them. Indeed I did and do have a lot of intellectual capacity although these days my medication cocktail makes things harder for me.
I began to make mistakes at work and visibly wasn’t coping well with the stress (at one point I built a wall around my cubicle with empty Pepsi Max bottles – I was going through about 3 litres a day to keep going. So I was moved to another managerial position in a reshuffle (where there were some redundancies too, one of which was a direct report to me. Delivering that news was gutting to me).
However, my health got worse. I was on a cocktail of medications. Pain killers (Tramadol, Endone, OxyContin), Valium as an anti-spasmodic and anti-anxiety, Lexapro and Lyrica. Only problem was no-one told me how to take them properly, so I was just popping pills as needed. I was also self medicating by drinking to much and over exercising. I wasn’t sleeping properly.
I began to loose my temper a lot. I had spasms at work. In an attempt to manage my stress I worked from home two days a week, but this actually made things worse as people were always calling me, needing me to come in for meetings, and now I was considered by our French parent company to be available 24/7. My memory was suffering, and so were my reactions to people, I began to overreact to the slightest thing, and still I felt grey, not good enough, stupid and worthless.
All this spilled out at home. I must have been hell to live with as I was always angry when I got home from work, the Lexapro had pretty much made my sex drive non-existent, and there were too many times when I had to be helped to bed because of pain or alcohol (or both).
One day at work I totally lost my temper and lashed out (unreasonably) at a girl in the tax department. I also had a back spasm which meant my team had to help me to the medical room where I could lie down and wait it out.
The next day I was supposed to be working from home, but I got a phone call from my manager and her boss saying that I was considered a safety risk at work, that they didn’t want me to come in, and that I was being suspended on sick leave until I had undertaken an independent medical assessment. I fell apart. I drank a lot of vodka and in tears of anger, frustration and pain grabbed the kitchen knife which my ex wrestled away from me. He put me to bed, still crying, where I fell asleep.
It took a while for me to go the the doctor (I had a new one by this time as my old GP had retired. I still see her now), and let out a little (only a little mind you) of what was going on. To her credit I think she saw through me. She looked at my medications and said that in her capacity there wasn’t anything else she could ethically do. I had to see a psychiatrist.
Now for the last six months I had been seeing a psychologist who was teaching me CBT (to little avail. I now know that with BPD CBT is of little use, it addresses the symptoms not the cause, and not very effectively at that). My doctor knew this and, whilst being careful not to disparage the psychologist, suggested that I hadn’t had much improvement and so must see this psychiatrist.
So off I went, extremely reluctantly. It took a lot of sessions for me to even tell the full story about work, but the first thing she did was regularise my medication. Unknowingly I had been slipping down the slope into addiction with my “as needed” approach. I was given a strict regime and a mood stabiliser – Seroquel – was introduced. 150 mg of the stuff! As this began to take effect I began to stabilise a bit, but things still weren’t right. I would persistently catch myself thinking “I want to go home” even though I didn’t identify the UK as home. I’m effect my brain felt displaced, wrong, unsettled.
I was taken out of the workforce in May. I didn’t see the independent doctor until July/August. That was a waste of time and effort as she basically told me everything I knew about me help, asked me what I thought I could manage (I said three days a week work) and she just write her report based on what I’d told her. This started a very intense period with management and HR. They were obliged to try and reintegrate me into the work force, especially as they had acted illegally in the summary suspension and we all knew it. However they didn’t want me back, that was apparent. So the wrangling over redundancy and money began, with me not taking anything at face value. Invariably I would take notes (and made sure they knew it) and say I had to discuss whatever with my solicitor (I didn’t have one but it was a good negotiating tactic). Eventually they paid me a lot to go away.
I was still seeing the psychiatrist every week or fortnight and eventually she began to unlock me. I was a hostile patient having seen too many useless therapists during my time. Eventually she got a kind of emotional map I suppose, and said she thought I fitted well with BPD. I was given a fact sheet and I matched seven of the nine key points. And more to the point, this diagnosis made sense. I could see myself matching these symptoms easily, and that they had been a pattern all through my life.
Medication was further adjusted given this diagnosis. Lexapro went and Pristiq was added. Lyrica was removed and Valium was changed for Clonazepam. Tramadol usage was stabilised as was everything else. Of course over time medications and dosages have changed but these core medications still help today.
So that’s the long story about seeking medical help. In effect I didn’t seek it, it sought me out. It’s not been an easy ride at all.
AB: What would you like to tell people suffering from this illness?
HW: The main thing I’d say is persevere. Don’t believe all the “It’s the hardest personality disorder to treat” hype. Yes it is very hard to treat, and you may need to go through a number of therapists and many medication combinations but you can be stabilised.
Second educate yourself about the different types of BPD. There are many different aspects, and everyone is different (why it’s so hard to treat).
Third, talk to people with this illness. Find out if they have any associated disorders. I say this because talking to a bipolar friend on Saturday he was describing his societal anxiety (a specific anxiety disorder) and every single thing he said about it was like “oh – me too!” So I’m off to talk to my psychiatrist about this. I was never really told there could be associated conditions, but that is mostly because I didn’t know enough to think to mention this aspect of myself. Tell your psychiatrist EVERYTHING! Even the embarrassing stuff like I have no sex drive – it’s probably your meds. With me Lexapro killed it and Pristiq bought it back. My boyfriend had the complete reversed experience!
Fourth CBT can help a little, but generally it’s useless with BPD. You need medication.
And overall, if you don’t get results with one therapist try another. And another, until you find the right one.
I would like to thank Helen for taking the time to answer my questions and for being so brave and open about her experience. It is safe to say that I know very little of the disorder in comparison to my knowledge about schizophrenia and anxiety, and I feel blessed to be educated about the illness and about the beautiful people that are surviving it.
I am Helen White – Content Manager for Stigma Fighters Down Under. I live with Borderline Personality Disorder and Chronic Pain, which I manage with the help of a collection of amazing specialists. It’s taken about 10 years to get to this point but the fight was worth it. I share a house with 1 1/2 men, 5 fish and 2 very spoiled Siamese. I hope to go back to studying for a Masters in Information Management this year, and I am also learning how to garden – the roses were growing and flowering nicely until our weird climate meant they got black spot. Now I’m a pesticide warrior.