Saturday, February 12, 2011

High Functioning, low functioning - Part two: High function in Borderline Personality Disorder

Getting back on track.

High-functioning borderlines act perfectly normal most of the time. Successful, outgoing, and well-liked, they may show their other side only to people they know very well. Although these BP's may feel the same way inside as their less-functional counterparts, they have covered it up very well-so well, in fact, that they may be strangers unto themselves. Non-BP's involved with this type of BP need to have their perceptions and feelings confirmed. Friends and family members who don't know the BP as well may not believe stories of rage and verbal abuse. Many non-BP's told us that even their therapists refused to believe them when they described the BP's out-of-control behavior. 

This description of High Functioning BPD is spot on for me. Even down to the comment about the therapist refusing to believe me when I told her about the out of control behavior of my youth. The violence and uncontrollable wrath. (Which I discuss here).

One of the biggest differences between high functioning and low functioning BPDs is the ability to recognize how much of a problem this disorder is and not allow it to overrun their lives completely. To recognize how adversely it will affect their professional and social lives if they let anyone see it. To make a conscious decision to present a different image. I see clearly how easily it can consume my life and destroy my relationships. I can foresee the results of letting go of  my control. Foresee how other people will react to how I feel and impulsively want to react; alienation and abandonment from the people I need to have around me. In understanding how this impulsive behavior can affect me, I can avoid some of these behaviors.

I’ve always refused to be controlled. By anyone, or even by my Self; me darker urges. Always fighting against letting this overrun my life. I won’t tell you this is easy. It’s a constant struggle, one that I am not able to overcome some days. Often it feels like a losing battle. But this war isn’t over and I’m doing all that I can to gain an advantage over this enemy within. I analyze myself, my behavior, how I interact with others, how I present myself. I push myself to get out of bed and live my life out loud.

When I meet new people it sometimes feels like I’m living a split personality. The witty, sociable, successful woman that knows everyone and laughs a lot. It’s not until I reluctantly let someone closer to me, that my fa├žade begins to break down. Little by little letting them see who I really am. I guess part of me still is that sociable hostess that smiles and masquerades. It’s not a complete picture though. I hide the darker aspects of myself as long as I can. To the casual observer, I do this very well. To those rare few that are willing to break through my mask, they see how much I’m crumbling inside. Maybe not the full extent, because part of me still refuses to show such weakness to anyone, but when I am in closer contact with people that seem to care about me, it is impossible to continue to hide who I can be.

Low functioning BPDs tend to externalize their problems; unable to maintain a regard for those around them, consumed by their own emotional catastrophes, they lash out at each instance of instability; lost in the moment. While high functioning BPDs may feel the exact same emotional crisis, they tend to internalize more. Instead of lashing out in the moment, they control the impulse and wait until they are alone and take it out on themselves. Only affecting those absolutely closest to them. To the person suffering, and to those around and caring for the person suffering, one is not better than the other. Not emotionally, not mentally. For me, while I may not be able to stop the emotional melt down, I can usually recognize that, despite how it feels, my world is not actually ending. Having at least one solid relationship, one stable support makes an incredible difference as well. Knowing that there is someone I can turn to, that is willing to help me, see that there will be a tomorrow can make all the difference. Tomorrow I will pick myself up, and do what I need to do. The same as the day before, and the day before that. There is a small comfort in knowing the sun does continue to rise, and tomorrow is one more chance to keep going. Sometimes we just need a reminder.

High functioning BPs often consume their daily lives with a self imposed structure; scheduling away every hour, every minute. Proactively attempting to avoid emotional disaster. This provides an external stability that makes the internal instability a little easier to bear. While things are so frantic inside, there is a calm in knowing there is order in the world. I have done this ever since I was little. Every hour scheduled away with activities, sports, studying. At University when I was so often alone, at some of the loneliest points I’ve ever been in, I kept a ridiculous course load, maximizing the number of credits I could take, developing rigorous study schedules that consumed my day allowing little time to be left to my own thoughts. This didn’t always work. It didn’t actually fix the fact that the sadness and depression was still there, waiting to surface when I could no longer keep up my guard. But in pushing myself, providing myself with a goal, I had something to reach for. Something to motivate me to keep going.

Maybe that’s another attribute of the high functioning BP; the ability to look to the future. Having something to look forward to, to reach for and achieve… It’s hard not to feel a little proud, a little relieved in knowing that such things can still be accomplished, despite it all. 

Friday, February 11, 2011

We interrupt our normally scheduled program for a brief Announcement

Remember a couple weeks back I applied for a job at one of the most innovative R & D labs? Well…

I got the job!

I’m incredibly excited. I get to be a real engineer again. I’ll be doing FEA modeling, structural analysis and hands on laboratory testing. This is exactly what I should be doing with my college degrees. Well, almost. If I was doing this for the space program than it would really be EXACTLY what I went to school for, but this is the next best thing. I negotiated up the pay scale. The job includes full benefits, 401k, decent sick and vacation time and full access to the campus facilities and recreational bonuses.

I’m still in a bit of shock. This is better than I dared to hope for. And I maintain my perfect track record for interviews =)

If I wasn’t so sick and exhausted right now I’d probably be bouncing off the walls hypomanic style.

Evil Genius brainwaves ACTIVATE!

EDIT: I am very optimistic about this new opportunity. In a previous post I discuss Identity Disturbance. For me this means my professional identity is radically different than my baseline identity. This is both good and bad. Bad because, it generally leaves me with something of a dissociated attachment to myself and a detachment from my emotions because I do not connect with the person I think I'm supposed to be. Good, because in my detachment, my rational mind is uninhibited and I can excel professionally (and academically when I was in school). In essence, it is possible to take advantage of my disorder and, at times, make it work for me.  The environment for this job is much more innovative than my previous jobs, so I can potentially maintain a more solid grip on my identity while maintaining my professionalism. It gives me a lot of hope that, if I can control my emotions in one setting, there is also hope that I will be able to gain control of them in all other aspects of my life. Further proof that it is possible to be functional and successful, even if I'm struggling with so many things elsewhere. 

Thursday, February 10, 2011

Questions from across the Borderline

A reader asked:

My psychiatrist won't even consider borderline as a possible diagnosis because I'm not 21. Is that normal? Do you have any advice?

Hm. I know most psychiatrists won’t consider diagnosis until at least 18. 21 seems a little high. This is mainly due to the fact that people’s personalities are still developing and they don’t want to influence how your personality might evolve on its own. I would advise working on the symptoms, those issues that lead you to believe you have a borderline personality. Even without the official label of BPD, the underlying symptoms are there and undeniable. Working with a psych or a therapist on all of those things will certainly still help. With my therapist we don’t sit there and dwell on BPD. We work on my depression, handling and coping with my dissociation, finding healthier ways to manage my emotions instead of cutting, etc. Even without an official diagnosis there is still a lot of help you can get for yourself.

Wednesday, February 9, 2011

Quotes from the Borderline

"Now in the dark world where I dwell, ugly things and surprising things, and sometimes little wondrous things, spill out at me constantly and I can count on nothing."

 ~A Scanner Darkly

High Functioning, Low Functioning: Part 1 - Low Function in Borderline Personality Disorder

High functioning vs. Low functioning. These dividers can be applied to most any mood or personality disorder. What this means is that people with BPD vary a great deal in how they function in their every day lives. From the ability to live a normal lifestyle, maintain a steady job, cope with mundane trials of the day to day, relate and interact with the people around them, etc.

“People who are close to low functioning BP's often find themselves living from crisis to crisis. They often feel manipulated by self-mutilation and suicide attempts. However, because the BP is obviously ill, non-BP's continue to offer their support. Some BP's are so incapacitated by their illness that they are unable to work. They may spend a great deal of time in the hospital because of self-mutilation, severe eating disorders, substance abuse, or suicide attempts. BPD makes it very hard for them to form relationships, so they may have a weak support system. They may be so incapable of dealing with money that they have no cash for food or a place to live.”

My best friends in college really made me see just how pervasive BPD was in my life. Our lives were so parallel, so exactly the same. When her mood would shift, my mood would have shifted in the same way (even before we had talked to each other and knew how the other felt). When I was up, she was up. It was actually pretty creepy how synced our lives were. She was the first person I ever met that truly understood how my brain worked. How we fuctioned was our one difference. Where she was low functioning, I was very clearly high functioning.

She mostly managed to do the essential things. But more often than not, if she was down, she couldn’t get out of bed. She’d lie there for days trapped in her depression, lost to the world. Everything dragging and painful. Her relationships were traumatic and charged with furious fights and tears. She’d get drunk, drive to a secluded spot and cut her arms, waiting for her girlfriend to find her. Continuing the fight. Not wanting to be with her, but being afraid to lose her at the same time. Every relationship was marked by the last encounter. She would count the days until the next explosion and measure the value of her relationships by how long the ‘good periods’ lasted. Which, inevitably, weren’t very long. Her home life was a mess of turbulence, pushing away even her family who she believed couldn’t accept her and wouldn’t support her in seeking the help she needed. Her emotions were written all over her face. There was no hiding how she felt. No hiding from how she functioned. Her anxiety made it impossible for her to face the world. Every action that someone did, everything someone said could have a dozen different meanings, all of them bad and meant to injure her. Of course, this wasn’t generally true, but it’s what it felt like for her. This made her push people away, refuse to allow closer bonds to form, or if they did she’d pick them apart looking for weak links that could be used against her.

In time though, she realized she couldn’t keep living like this. She has since started therapy and is on anti-anxiety medication. She is engaged and is successfully completing University. It took dedication on her part, but she’s slowly pulling herself up.

Of course, there's a lot of room in between high-functioning and low functioning BP's.

Tuesday, February 8, 2011

Acting In, Acting Out with a Borderline Personality

“Most borderline behavior is about one thing: trying to cope with internal anguish. BP’s commonly manage their intense pain in two ways: they either act "in" or act "out". Some BP’s will mainly act "in". Some will mainly act "out". And some will act both in andout.

Acting “out” behaviors are attempts to alleviate pain by dumping it onto someone else - for example, by raging, blaming, criticizing, making accusations, and abusing others either verbally, emotionally or physically. They blame loved ones for all their problems, put others in no-win situations, and use emotional blackmail to get the love they need. Acting-out behaviors cause direct anguish for friends, family members, and partners.

BP's who act “in” may mutilate themselves, make suicide attempts, express self-hate, and engage in selfdestructive behavior. They may try to hold in their anger, and blame themselves for problems that are not their fault. Acting-in behaviors mostly hurt the BP themselves, although, those who love and care for them are affected.”

To pull on a BDSM term, I’m a switch. I like to think I’ve grown out of the more violent ‘acting out’ of my youth, but really I’ve just changed to almost solely internalizing and that’s not necessarily any healthier. It’s probably better for those around me, because I no longer take out my anger and frustration so overtly on those around me. However, all that anger and frustration is almost exclusively aimed at myself now. Though there are those certain occasions when something triggers me otherwise.

When I was younger (pre-diagnosis) I would rage at how little anyone seemed to understand me. Of course I also did my damnedest to keep people out of my life and my turmoil. Rarely did a day pass that I didn’t get into a screaming fight with my family. I would get in physical fights with my siblings. I would put my fists through windows, walls, kick down doors. I was wrath personified. I blamed all my problems on all things external. It was people not ‘getting’ me, people not taking the time to talk to me, people not being smart enough to understand, people not caring enough to understand, pushing my buttons to agitate me, make me uncomfortable to control me. All I saw were the things that set me off outside of me.  I didn’t understand what was going on inside me.

Through out this time however, I ‘acted in’ as well. I was suicidal. I kept what I was really feeling locked inside, not knowing how to deal with it, I’d take out my inner pain on my own flesh. I hated my life, the constant turmoil that my life was in, the pervasive feelings of hopelessness that this was all there was for me. Nothing else to look forward to. I hid these things. To me, the feelings of perpetual sadness, loneliness, these were ‘weaker’ feelings and I didn’t want anyone to know I had weak moments. The rage I felt, at least was strong.

Now, externally I’m calmer. I have developed a lot of self control over the outward manifestation of my emotions. I can still have a very sharp tongue and I do tend to criticize but I also try to temper this. Frankly I also justify my criticisms with the fact that I am incredibly intelligent and also generally honest to a fault, so when someone has an opinion or an idea that I know isn’t plausible I don’t stay quiet. I do try not to be mean, but I don’t let people run with silly ideas. Maybe I should just stay quiet and people will like me better, but that wouldn’t be me. I’d rather be disliked for who I am, than liked for who I am not. 

My self destructive behaviors have lessened significantly but they do still crop up. I’m working to end my expessions of self harm, though the thoughts can still be nagging. I have no idea how to stop these thoughts. I try to temper my drinking which can occasionally get out of control. I still have a lot of self-loathing, resentment for how my brain works and that I can’t lead a healthier life. I still struggle with hating my body image which I am also taking steps to work on. I am also prone to making impulsive decisions and letting myself get swept up in moments that would probably be better observed from the sidelines, but a girl’s got to live a little, right?

Maybe it’s maturity, or maybe it’s just being so sick and tired of living in so much turbulence. I don’t believe I can live this way any longer. The path I’ve tread most of my life will end quickly if I let myself go to the darkness. I can’t do this anymore. I want to live a happy, healthy life. One that is not wracked with such emotional upheaval. I’ve chosen to become a stronger version of myself and I’ve been doing everything in my power to not give up the only chance I have at this life.

Monday, February 7, 2011

Quotes from the Borderline

'There's something about sitting alone in the dark that reminds you how big the world really is, and how far apart we all are. The stars look like they're so close, you could reach out and touch them. But you can't. Sometimes things just look a lot closer than they are.' 

~Beautiful Darkness~

Birthday Weekend Update

I don’t do a lot of day to day personal entries but I think this might give a little insight into how it feels to live my life.

Friday was my birthday gathering. The only person I didn’t want there was the one person that declined my invitation. Unfortunately she wasn’t the only one that didn’t show up. My best friend didn’t show up. Of all the people that showed, he was the one person I really needed to be there. He didn’t even think to tell me he wasn’t coming until well after the party started and I had to ask him. I’m heartbroken. It felt like my heart dropped into my stomach. I’m devastated. He said he had food poisoning. I don’t believe him. Not even a little. I think he lied to me because he was too much of a coward to tell me he didn’t want to come. All the caring he said he had, gone, meaningless. A lie. I'm always disappointed. In the end I'm always disappointed. I put so much of myself into other people. I only end up getting hurt. Fuck. Maybe I do expect too much and just set myself up for all this. I just want people to care about me like I care about them. I guess that's too much to ask for. So now I'm right back where I was so many fucking times before. Hurt. Disillusioned. Empty. That's what I get for putting myself out there and wanting to be close. It always ends. And it's my own damn fault for making the stupid fucking choices I made. In that moment I hated him, second guess everything he ever told me. How do you believe someone anymore when they can’t do one thing that they know is so important to you. I almost never ask anything of anyone. I don’t believe I have the right to impose one people. This was supposed to be the one day the people I care about should show they care about me. Just show up. He couldn’t even do that. I was anxious all day with the fear that he wouldn't show and he didn't. I rushed around trying to fill my time. Woke up early to make a Peanut butter cake with chocolate peanutbutter ganache filling and whipped cream cheese frosting. Made fresh bruschetta and homemade chicken tenders. Anxiety pulling at me the whole time. You'd think that would help me prepare for the disappointment. Nope. The stupid thing is. I laughed so much that night. After about an hour of silently dying inside, I just kept drinking. All my friends that did show up had a great time. They were wonderful and it was a night of non stop stupid movies, MST3K (yeah I’m a nerd), and what should have been a truly good evening for me. And in all honesty it really was a great evening, even with the underlying disappointment. My sis was there and that is what really mattered. 

The next day my sister, her bf and one of  my other friends went out East for wine tasting. It was an insanely good time. I haven’t laughed so much in a very long time. So much I had tears streaming down my face. Moments at a time. When the laughter died down, even for a moment, all I felt was a pervasive sadness. A depression leaving me hollow and tired. Then the next minute I’d be laughing again. Always tempered by how quickly I would slip back into my blacker thoughts.  Went to dinner at a really great BBQ place. More laughter, more sadness. From here we went to the Floating Kabarette in Brooklyn. I was exhausted. My body giving up on me. This is one of my favorite venues. Beautiful and entertaining. I could lose myself in each act, each performance, my mind distracted, but at each intermission I would have time to think again. I could feel myself slipping away, just listening to the others talk and laugh and have a good time. I pretended. Bouncing to the music, dancing in my seat, putting on a happy face so no one would know that anything was wrong.

My sister and her bf left early Sunday morning. I was done. I knew they’d have to leave soon, but it never feels like enough time. Everyone always leaves in the end and I’m left alone once again. I couldn’t pull myself out of bed. Slept most of the day. When I was awake I couldn’t stop crying, everything ached and hurt. Hours spent rocking in my bed, just trying to hold on. Fortunately I have a wonderful roommate that sat with my, held onto me while I lost it. I can’t keep going on like this. It’s too much for one person to take. I’m doing everything I can to get better, but nothing seems to help for long. I need something to work. Anything. I feel like I’m spiraling down into a black hole that’s impossible to return from. Hopeless despair.

There are days when understanding that these feelings are a part of my personality disorder helps. Not quite a comfort but at least provides some insight that I can work through. That understanding is often in retrospect though. In the moment, nothing else matters but the pain.

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