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Having Borderline Personality Disorder sucks a lot. The struggle and pain of it all is so intense sometimes.

But I’m also discovering the gifts of highly sensitive emotional people.

  • We are naturally empathetic and compassionate
  • We are able to have deep and authentic relationships
  • Our joy is contagious and can be found in the simplest of things
  • We can’t ignore the pain and injustice we see around us
  • We make great artists and storytellers.

I’m glad I’m still myself with BPD and that having intense emotions isn’t inherently a bad thing. Emotions are signals that help us understand what is important to us, what we need in each moment, and how we relate to the world around us. I’m grateful for my emotions, even the sometimes really painful ones, because of who they make me.

Often I have moments when something will cause me to remember a choice or action I’ve made in the past that I feel embarrassed about or regret. Sometimes these things just pop into my head without any apparent reason. And I often start to feel really bad, embarrassed, worthless, stupid. I imagine that everyone who knows me only remembers this terrible stuff too.

Sometimes it’s just embarrassing stuff but sometimes it’s stuff where I’ve hurt someone, especially Kathryn, and I feel so much worse – rotten to my core. It might be from yesterday, it might be from a long time ago. When I was a kid there was a time I was mean to a good friend and made her cry, I remember that so clearly and still feel bad.

What I’ve been trying to consider in these moments is the difference between shame and regret. I definitely regret those moments that cause pain, but I think that’s different than defining my whole life by them. My whole relationship with that childhood friend was not defined by that one mean moment, and yet it’s the clearest memory I have of her. And when embarrassing or hurtful things happened in university – that’s not what people remember me for (or at least not the only thing they remember me for).

Today at work this came up. I felt so bad all of a sudden for a conflict that happened with my coworker a few months ago. I apologized afterward and things have been good since, but the memory of the conflict just sort of consumed me and in that moment became the definition of my relationship with this person.

As I walked to the bus stop, I reminded myself that this was a moment of regret, but not one that has continued to define my relationship with her and not one that defines who I am. This eased the shame quite a bit, which surprised me because I’m not used to finding a way to help shame settle down – usually it just overwhelms me until I sleep or do something impulsive/negative.

Obviously the more painful the memory, the harder this is, but I’m hopeful that this little learning moment will help me remember all the positive things when I feel consumed by only the negatives, especially in my relationship with Kathryn.

It’s okay to feel regret – it’s healthy. I don’t have to pretend like every decision I make is good or that my actions and words don’t have weight. But getting overwhelmed in a shame spiral has never once helped me make a decision that I’ve been proud of, I usually just act in ways to confirm the shame, which only makes things worse.

Remembering that those memories cause feelings of regret but don’t have to cause shame can actually help me focus on what I want to do differently, to think about how I can act more consistently with my values going forward. This is what I am working toward.

I need this today, and thought some of you might need it too.

If You Feel Too Much

Jamie Tworkowski, founder of TWLOH

If you feel too much, there’s still a place for you here.
If you feel too much, don’t go.
If this world is too painful, stop and rest.
It’s okay to stop and rest.
If you need a break, it’s okay to say you need a break.
This life – it’s not a contest, not a race, not a performance, not a thing that you win.
It’s okay to slow down.
You are here for more than grades, more than a job, more than a promotion, more than keeping up, more than getting by.
This life is not about status or opinion or appearance.
You don’t have to fake it.
You do not have to fake it.
Other people feel this way too.
If your heart is broken, it’s okay to say your heart is broken.
If you feel stuck, it’s okay to say you feel stuck.
If you can’t let go, it’s okay to say you can’t let go.
You are not alone in these places.
Other people feel how you feel.
You are more than just your pain. You are more than wounds, more than drugs, more than death and silence.
There is still some time to be surprised.
There is still some time to ask for help.
There is still some time to start again.
There is still some time for love to find you.
It’s not too late.
You’re not alone.
It’s okay – whatever you need and however long it takes – it’s okay.
It’s okay.
If you feel too much, there’s still a place for you here.
If you feel too much, don’t go.
There is still some time.

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How can I sleep when I can’t trust my own mind?

It takes me down dark paths, wandering into woods I know I’ve been lost in before.

The constant questing, nagging, demanding fear is this: what if I’m wrong?

What if what I think will help me only makes things worse?

What if this attempt for peace of mind is really just a desperate plea for attention, for a demonstration of being loved?

Am I worth the concern that others show for me when I struggle most with my illness?

Am I just escaping my responsibilities by curling back into illness or I am actually challenging this illness with the hope for better treatment?

Aspects of hospitalization feel addictive – the safety of being surrounded by people, checked on every 30 minutes to ensure I’m not doing something to harm myself.

Nearly every trigger and method of suicide removed, a near risk-free environment.

Pressure to be productive and responsible and healthy all eased.

An enforced and regular schedule of meals and sleep, all without the challenges of cooking and tidying.

And of course, the outpouring of concern from friends and family.

But what is the cost?

Loneliness and boredom and too much time to think.

All the negative judgments of myself find evidence to support themselves.

I could curl up in this darkness, and just… stay.

Will being here really help me create long-term stability or is this just the start of another cycle of regression?

Am I actually ill or is this all in my mind?

Well, I’m back in the hospital for a medication change.

Psychiatric medicine has come so far in being able to treat people who suffer from debilitating depression and anxiety. And yet the system is still so far from perfect. When your current meds begin to lose their effectiveness as tolerance builds up in your body, you basically start back at square one in trying to find a medication or combination that will create long-term stability.

And because I’ve had such negative reactions to some meds, and have such high impulsivity when I feel suicidal, the risks are too great to be a guinea pig outside of hospital anymore. So I’m here, and I’m committed to getting better, and I’m grateful that the staff admitting me last night was compassionate and understanding and more importantly, recognized the severity of my need.

Being here (on the same unit I was on in 2014) is both nostalgic in an odd way and frightening. The last time, a hospitalization we thought would be a few weeks stretched on and on for months until a whole year had slipped away from me.

Kathryn keeps reminding me to let this all unfold as it will, cultivate hopefulness that I will get back to my life soon – hockey starts this week, I miss my clients at work, my friend’s wedding is next weekend, the GS Halloween Party the week after that. I don’t want to miss any of this.

And so in the most difficult moments I will ask for help and use my coping skills and remember it doesn’t always feel like this. I am not here to escape my pain. I’m here to confront it and find a better way of managing it.

Even today, six years after beginning to understand how Borderline Personality Disorder effects the way I feel, think and behave, I still have moments of overwhelming shame. Some of this is internalized stigma. But no one is born believing being ill is equivalent to being bad. We learn it from our culture.

And so to cope, I find myself sometimes splitting – a term used often for people with BPD, but one that I have mixed feelings about. I honestly didn’t believe I did this when it was first introduced to me. Splitting happens when how you currently feel contradicts what you believe to be true. As much as it causes problems, it helps to cope with the dissonance that this type of contradiction brings. Instead of having to face the contradiction, you write it off as an impossibility and deny the existence of one aspect of the split. Referring to splitting as “black and white thinking” has helped me understand how this coping mechanism (however distorted and harmful it may be) plays out in my life. And I can see it happening in small and large ways almost every day.

Here’s an example: this past week I spent time with five other people at a cottage in Muskoka. The honest truth is that these five people happen to be among my favourite in the world – Kathryn (obviously high on my list of great people), her sisters and their husbands. One evening, in the heat of a very competitive board game (and after a long day in the sun which had worn everyone out) my sister-in-law accused me of cheating. I was initially surprised and confused – was she teasing or being serious? I could not tell. As she continued to question my honesty, I was hurt and then quickly very angry, and then even more quickly incredibly embarrassed at what I felt like was an overly intense emotional reaction. I had to leave the table – but thankfully, was able to do so with a commitment to return in five minutes and we were able to carry on with our game.

When I spoke to her about the accusation later, she admitted that she was just very disappointed that her team was losing. She confessed that the intensity of competition which the six of us constantly feed makes her feel tired and sometimes not as smart or skilled or quick as the rest of us. She exposed her own vulnerability in that moment of accusation. After learning this, I felt so much grace toward her, and she accepted my apology for having a very quick angry response.

As I later reflected on this incident with my therapist, I realized that the shame that followed the anger was closely related to this concept of splitting. I love my sister-in-law very deeply, and to feel so much hurt and anger toward her contradicted how I usually feel. I felt I could not tolerate loving her and being angry. And so, I compartmentalized – either I had to deny my own emotion (which led to shame and self-criticism) or reject my love for her.  And of course, in any relationship, this is not healthy.

It’s not just with other people that I do this. I find myself splitting circumstances (I struggle to work every scheduled shift due to anxiety, and so I should just quit); splitting my current emotions from the past or future (I feel sad and even though I remember that I’ve felt happy before, I don’t believe I will ever feel happy again); even splitting aspects of my own identity (“I have hurt others because of my struggle with mental illness” gets split away from “I am a strong mental health advocate”).

The most damage comes when I split aspects of my own self into black and white. At times I feel like I am this creative, caring, intelligent and insightful human, ever searching to live well and love well. But in just a small moment later, I might feel completely useless, unworthy of being loved, a failure in every attempt to learn or grow as a person. Not only am I rotten to the core, I have no hope of being able to change anything about myself. I’m sure you understand where this kind of thinking leads.

I know others experience this too. It might not feel as intense, or be as conscious a process, but we all have these moments where we feel like rejecting the conflicting aspects of our own self. As is often the case, a friend recently shared a quote from author Elizabeth O’Connor on this very subject at just the perfect time.

I share it with you here, in the hope that reflecting on it will help me make peace with and even embrace my whole self while challenging you to do the same.

“If I respect the plurality in myself, and no longer see my jealous self as the whole of me, then I have gained the distance I need to observe it, listen to it, and let it acquaint me with a piece of my own lost history. In this way I come into possession of more of myself and extend my own inner kingdom. Suppose we come to know that every recognition of anger and jealousy and greed and sloth is an opportunity to lift out of the waters of unconsciousness a tiny piece of submerged land. Then, would we not pity the man who is so identified with the good that he denies any intimations from below that this good may not be the whole of him? Unaware that he is cut off from a large part of himself, he does not understand what it means to be on the journey of becoming whole.”

– Elizabeth O’Connor, Our Many Selves

A recent conversation with a friend led me to describe a technique Kathryn and I use regularly when I’m feeling overwhelmed. It is especially helpful when I experience the kind of panic that leads to racing thoughts and quick shallow breathing.

Often this feeling will race out of my body in frantic movements. I might rush from room to room with no purpose, fling pillows and blankets around on the bed, squeeze my eyes and fists and chest as tight as I can, hold my breath until I am desperate for air and start hyperventilating, or flail about in other unpredictable ways. Sometimes I’ve even acted in destructive or intimidating ways because of the rushing surge of panic that flows through me, and of course, this leads to greater problems in the long run.

This is, quite logically, distressing for Kathryn to witness. One time when feeling this way, I stood out on the balcony of our old apartment during a massive storm and let the wind and rain and thunder swirl and panic with me. The image of the wind blowing through the open door behind me and swirling around Kathryn too helped me understand just how this chaos spreads from me to her.

The chaos flows through us both.

She gets overwhelmed by a rushing desire to help me calm down, to ‘fix’ what I’m feeling.  And so she offers solutions – try ice, cold water, let’s go for a drive, just sit for a second, put lotion on your skin, play piano – on and on. She lists mindfulness skills that often help but seem useless to me in these moments. All she wants is to help us both settle, to prevent further escalation, and to begin the process of problem solving the source of the emotion. The real trouble, though, is that in these most frantic moments I seem to lack the ability to grab hold of a coping skill and stay focused. And her hurried attempts to help me calm only heighten my sense of anxiety. As I watch her begin to feel the chaos, guilt only increases my panic further.

And then about six months ago, she came up with a new idea seemingly out of nowhere. “Blow up a balloon.” That’s all she said and then she started doing it herself, imitating the kind of inhale and exhale one would use to inflate a large balloon. She has told me to take deep breaths many times before with little improvement to the sense of panic or my breathing, but somehow this clicked.

Just blow up balloons.

I don’t have to solve the current problem that is leading to the panic. I don’t have to convince myself to feel differently. I don’t have to focus on relaxing muscles or consciously slowing my breath. I just have to blow up balloons. I just have to imagine a balloon in my hand, and try to blow it up. My initial attempts are usually meagre at best, hurried little puffs that would do little to inflate a balloon. But then I take a deeper breath in, and blow again… and then again… and again.

And if I start to turn back to the panic, we just say it again. “Blow up a balloon.” I tell Kathryn the colour. I imagine the shape and how it would feel against my fingers, my lips. I get to the point that my inhaled breath is massive, deep into my belly, and my exhale is long, slow and forced through pursed lips. I feel my chest rising and falling with my breath, and as if by magic, my body and mind begin to calm too.

Calm.

As these balloons get bigger, I relax my breath – the sense of hurry leaves, and I find I am now casually blowing up balloons, no longer as if in a race. The tension in my muscles reduces, my movements slow down, the storm in my mind begins to clear and usually at this point I become much more able to focus on those coping skills and problem solving skills that will actually help whatever situation is causing the sense of panic.

As I told my friend Rob all of this, I realized why the skill works so well. Blowing up balloons is such a simple concept – it’s so easy to connect to it, regardless of a person’s emotional state of mind. And it’s a visual activity, our minds can picture it even when we are just pretending. It doesn’t take patience or a great deal of focus (which is lacking in these moments of panic), and anyone who is being triggered by someone else’s panic can model it, helping themselves stay calm in the process.

Anyone can use it as a skill.

About a week later, Rob, who is a nurse, told me that he pulled over at the scene of a car accident and one of the drivers was in a state of shock and panic. He took charge of the scene, pointed at her and said “Blow up balloons with me!” and demonstrated what he meant. They did this together for several minutes as he assessed her injuries and they waited for the ambulance to arrive on the scene. And somehow, incredibly, it helped.

There is magic in our breath. Grab ahold of yours in a moment of panic. Just blow up balloons.

I wrote this prayer for a friend’s family member who was feeling suicidal. Later that same day, I found myself in the ER after overdosing on my medication. Without realizing, it was pre-emptively for me too. And now it’s for you if you ever find yourself in a place of needing it.

To feel understood in their pain,

For compassionate people who can truly listen,

For a real safety plan that reduces the vulnerability they and family feel,

For peace during the long wait for mental health services,

For the root of this pain to be addressed and not masked,

And endurance for the road ahead,

These things I pray.

A few days ago, I spent 24 hours in the ER due to a medication overdose.  It was a combination of feeling extremely impulsive and moderately suicidal that led me to swallow the medication. Extreme impulsivity often goes hand-in-hand with Borderline Personality Disorder, and I know it very well.

I quickly regretted it but also didn’t know what else I could have done in my emotional state that would have been better.  This is a scary thought because when I am calm and feeling well I can see a great many options that would have been better, but in that moment I felt blinded to anything else but the pills as a solution.

For those who have no idea what this kind of impulse feels like, I present an examination of an impulse. This is a description of what went through my head and the choices I made that led to the behaviour. Keep in mind this occurred after a few weeks of stressors and triggers building, reduced coping skills and growing severity of impulsive acts.

Sometimes I do have these impulses and I very successfully cope with them. Myself, my wife, and my therapist were all actively working to reduce the vulnerability and intensity and very aware of the growing concern, but it just was moving faster than we were. We had identified many possible impulsive acts, but it had not occurred (at least not strongly) to them or me that overdosing on my medication was one of them. I just didn’t think things were that severe yet.

I was alone at the time and it all took about five minutes. This may be painful to read if you know me well, but I am still sharing it in the hopes that you may grow in your understanding of what I and many others experience.

If you would rather not read the following because of a potential trigger for yourself, please consider skipping it. Here is a picture of my adorable cats, Gus and Elliot, so you can take a moment to choose if you should walk away (please do if you think you should!!!).

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“I need some water,” I think as I open the cupboard. I was not even thinking of overdosing at this point but I knew I was very stressed and impulsive and moderately suicidal. Moments ago I called Kathryn to tell her this and she is now on her way home. I have told her and myself that I can promise to be safe for twenty minutes until she arrives and I believe that I can be. Water at this point will very much help.

I notice the pills in the cupboard where the water glasses are, and the quietest voice in my mind thinks, “I could take them all.” Instantly I react with an internal firm “No.” I close the cupboard but I do not let go of the knob. I think I should call Kathryn. I don’t pick up my phone which is directly beside me on the counter. Sometimes I think I ignore these warnings because this feeling of being on the edge of impulsiveness can be kind of addictive, like an adrenaline rush, and this thought briefly occurs to me but I quickly ignore it because I don’t want to give up the feeling of adrenaline or the possibility of a solution to the stress I feel, even if I rationally know this version of a solution is extremely flawed.

I re-open the cupboard. I am still telling myself “No, walk away now.” I pick up the bottle, just to see how many are in it – which again I recognize as a signal to walk away and immediately call for help but again, I ignore it. Next thing I know the pills are dumped out on the counter so I can count them. This is almost like a ritualized behaviour that I have done before when I’ve felt impulsive about overdosing – I have still walked away at this point in the past, but it’s getting exponentially more difficult as the impulse and adrenaline build. It is a slow and methodical count, not a frenzied rush. I want to be accurate so I even count again. 76. I know if I do take them, the hospital will ask how many and I want to be sure they know I am not exaggerating. I am clearly aware of the consequences of this action but I still am not walking away.

I don’t know if I really want to be dead, but I think I do. I know I’ve felt this way before and it has gone away, I also know I’ve been very ambivalent about wanting and not wanting to die at the very same moment. I don’t know if this is more about impulse and self-punishment, and maybe alerting others to the danger I am in through a very risky action, or if it is actually about the chance that this could kill me. I think it likely won’t because I’ve done it before and I know a lot about the risks associated with my medication in overdose, but I realize I am playing with fire. These thoughts are not so much conscious words in my head, but I am very aware that this is now a very serious situation.

“I could pick up a few,” I think. I feel the weight of five in my hand, then add five more, and two more and a few more after that until I have 25. I shift them around a bit, consider the size of the handful and wonder if I could swallow them. I am hoping my phone will ring or Kathryn will walk through the door but I still don’t make a move towards walking away or calling for help. With my other hand I pick up a glass and get some water. As I do my hand with the pills moves slowly toward my mouth. The pills are in my mouth and I think, “I could still spit them out. Do I really want to do this?” I avoid imagining what will happen next and I swallow them with water. I feel a decent amount of regret instantly but also some pleasure that comes from the adrenaline of taking a very big risk. I begin slowly counting out 25 more, even though I am incredibly aware that it would be better to stop now. The same thing happens with these 25 and I only now start to grow scared that Kathryn will “catch” me. I quickly pick up the rest with next to no regret or concern for the consequences, shove them in my mouth and swallow.

Panic sets in but I force it away and start thinking about how I will cover up what I did or if I should be honest immediately with Kathryn. I want time to decide, so I put the bottle back, behind her medication so that she is unlikely to notice that it is empty if she happens to open the cupboard, and I go into the bathroom to stare at myself in the mirror.

The look is a mixture of terror, shame, hatred and yes – even pride. I feel courageous at the very same moment I feel overwhelmingly stupid, ashamed, regretful and worried. I consider trying to throw up but that has never gone well for me in the past. I start to run a bath so I can “relax” and appear normal, and have some private space when Kathryn gets home, so I can decide what to do. Having a bath will appear to her like a very skillful thing to be doing so she will be less suspicious of whether I was impulsive. She arrives home within 5-10 minutes and we talk briefly. I know I sound depressed and suicidal, I know she can tell in my voice and demeanour that everything is not okay, but I hope she just thinks it is because I feel like crap and not because I did something.

About ten minutes later I look at her with an honest and scared expression and I can see that she instantly knows I did something bad – we’ve been through this before. I quietly say, “I took all of my pills.” I see the split second moment when she wonders if she heard me correctly and then the fear, panic and even a bit of anger. At first she asks if I am lying, but very quickly she can tell by my behaviour and expression that we are about to be on our way to the hospital…

Obviously this is riddled with examples of distorted thinking and opportunities to intervene. One thing I’ve learned from writing this examination is that I should very strongly consider saying “No, walk away now” out loud, very firmly, even if I am alone.  If it feels too hard to give up the plan altogether, delay as much as possible to give more opportunity to call for help or take very small steps away from the plan in the hopes that it will get easier to move away further.

Delaying for me would look like listing all the states I can think of, naming every city I have ever been to, recapping the plot of a funny episode I’ve seen recently out loud to myself. Any emotional delaying (crying or really imagining the consequences or even noisy but kind of anxious yelling) could make things worse, so it has to be calm, based on memory, and something that can involve a lot of unemotional detail (i.e. cognitive distraction). I may not move away from the pills or put them down doing these things, but it’s more likely Kathryn would have arrived or I would have slowly reached for my phone.

For the next several months and maybe ongoing for as long as I’m on medication, I will be given a very small supply of my medication by the pharmacy, as my doctor is very aware of the risks and is incredibly supportive without being punitive. And Kathryn and I have agreed that at least for the next few weeks, maybe longer, the pills will stay in her purse. If she isn’t home, they aren’t home. I only need them at bedtime and it would be extremely rare that she is not home then, and she could always leave one or two if necessary.

The reality is that I will never be able to eliminate all potential triggers and risks for impulsive acts – but absolutely the more safety measures we can put in place, the more we recognize a growing impulsivity, and the quicker I choose to help myself or ask for help, the less likely it will be that I make a decision I will deeply regret. And I absolutely, deeply regret what unfolded on that day.

I went to work five days in a row this week. I know this is something a large percentage of the population does without much difficulty or thought. For me it was a struggle.

It’s easy for me to forget the toll that being in the hospital for most of 2014 has taken on me. I often feel so disconnected from the vague memories I have from that period. ECT effectively erased many of the experiences from my memory, and the ones I do recall are clouded with uncertainty. But I have my written reflections that I occasionally read through, and Kathryn tells me what those dark days were like for both her and me.

The most difficult aspect of rebuilding my regular life after my mental health stabilized was learning how to cope with the up and down days that still occur, without such strict control enforced on my environment. In the hospital I had next to no responsibilities – I did not have to cook for myself or clean anything, my activities and doctor’s appointments were scheduled by someone else, I could not leave at will or have access to any number of ‘risk’ items that are present in my normal everyday environment. No one expected me to show up anywhere on time or follow through on any commitments. If I got anxious and didn’t want to do something, or just felt like staying in bed all day, there wasn’t anyone trying to pressure me to do otherwise.

But the hospital is not like real life. In real life, I still need to follow through with my commitments on difficult days, especially when others are relying on me. Things are not magically all better now that I’ve been home and stable for a decent period of time. My mental health is something I still have to manage on a daily basis. The difficult days are fewer and don’t wipe me out quite the way they did in 2014, but they still come.

The transition back to work was perhaps the greatest challenge of all, and took far longer than I expected. It was only last fall that I began taking shifts again, and even then sometimes a week or two would go by where I didn’t work at all. I love my job and that made it so complicated when I felt like I couldn’t go because of how anxious I felt. It was discouraging to have week after week pass by without making the gains I was expecting myself to make.

It’s been about six months since I began a contract at work that involves working five days a week. With the contract, a routine was established that makes consistency a whole lot more achievable, but that doesn’t mean it has been easy. The temptation to call in sick when I feel like I can’t cope with another day sometimes feels too strong to resist. Once I get to work, things always go well, it’s just getting there that seems to be the hardest part. And I admit I give into this temptation far more than I wish I did.

It’s hard to admit weakness. Especially in the workplace, where confidence and showing your strong side seem so valued, to say I struggle with working all my scheduled shifts feels vulnerable. I greatly value being a reliable staff for my clients and my employer, and I know I’m letting them and my coworkers down when I don’t make it to a scheduled shift.

Consistency is the one area that I need to work on most in relation to work. And I know that each step in that direction will make the next one that much easier. Working five days this week may have been a small triumph, but it is one that I am deeply proud of accomplishing.

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