Content warning: this piece describes acts of self-harm, mentions suicide, and refers to multiple mental health issues.
2017: a turning point
My work shift was starting in half an hour, and I was only 10 minutes away — nice and early. Rush hour was over and the roads were nearly empty. I felt calm.
If I veer off now, no one else gets hurt.
2014: first attempts at finding help
“You seem anxious. Did you want to reschedule?”
It was my first time seeing a therapist and my hands were shaky. I was living in Toronto and most of my support system was back in Manitoba. I told a doctor at the walk-in clinic near my house I never had energy and would often get dizzy and claustrophobic on public transport. I figured I was either deficient in vitamin-something or having panic attacks. He referred me to this therapist.
After a bit of back and forth talking, the therapist said I was likely struggling with anxiety and depression. He cut the session short and wished me luck. There was no follow-up appointment. I guess he figured, “mystery solved,” and I was too anxious to ask for more of his time.
Months later I was still panicking on the subway. I often had to get off the car and up onto the street before heading back down and to the next station. The doctor at the walk-in referred me to a second therapist.
This one said it was more likely I had Post Traumatic Stress Disorder (PTSD) and something on the subway was triggering me. He recommended I figure out what my triggers are, but didn’t book a follow-up appointment because I mentioned my plans to move back to Manitoba in a few months.
“We can’t do anything in that amount of time,” he said.
2016: the echo chamber
“That’s great! I’m glad you found something that works for you.”
As excited as I was to finally be seeing a therapist in Winnipeg, I knew she wasn’t a good match. I needed someone to help me get off my ass and enjoy life, not someone to congratulate me for playing video games as a form of managing stress.
I had left messages at four different offices before someone at hers answered. This was such a low point for me I could hardly process what I had to do. I hadn’t been reading titles, or credentials, or specializations — only looking for variants of the word “therapy” and phone numbers.
I only went to two appointments. If I wanted someone to encourage me to game I could visit my brother for free.
2017: a call for help
It was how calm I felt that nearly pushed me over the edge that day driving to work. I wasn’t fighting tears anymore. None were coming. I was asking myself, ‘are you sure?’
I unlocked the back door at work and turned off the alarm on autopilot. I think I meant to reach my desk but I slumped to the floor half way there. I don’t know how long I sat there but I know the store didn’t open on time that day.
In the pitch black, I messaged a close friend asking for help. She’d been seeing her therapist for a while and said she was pleased with how the sessions were going.
She sent me her love, and a phone number.
The therapist (a registered psychiatric nurse) called back within the day. She was warm and receptive. She listened to my concerns and had me fill in some paperwork. We confirmed I had been struggling with anxiety and depression but had to dig further to see what else might be going on.
2018: treading water
My therapist helped me see how difficult it was, and still is, for me to recognize and regulate my emotions. I was terrified of being alone, despite my mom, my brothers, my boyfriend, and my friends showing me nothing but love and support. There were other struggles too —I was spending more money than I could spare and speeding down highways. I was scratching my skin so hard it was scabbing over. I was shutting people out. Isolating.
I’ve never considered myself suicidal. But sometimes when life felt especially hard, the option to stop it in its tracks felt tempting.
After some time, she started me on what’s called dialectical behaviour therapy (DBT) to help me navigate the fluctuating emotions. DBT is a type of cognitive-behavioural therapy created by Marsha M. Linehan — a psychologist and author. It teaches people to live in the moment and regulate their emotions by identifying those emotions and focusing on the facts.
The combination of skills and medication now keeps my head above water to this day.
2019: official diagnoses
I eventually asked my therapist about whether I had borderline personality disorder (BPD). Linehan created DBT for people with BPD, and I found myself relating to infographics and articles I’d found online. She referred me to a psychiatrist who asked me to retell certain traumatic stories and answer a series of questions about how I respond to certain emotions.
The psychiatrist diagnosed me with BPD and PTSD on the spot.
2003: a smart kid with bad grades
I’d struggled with schoolwork my whole life. I always asked questions in class. I pushed to understand as much as possible. In middle school, a teacher called my mom to commend me for helping other students after I had finished my work. It was fun for me. But once I walked out of the classroom the fun seemed to leave too.
I stared at handouts for hours without processing a single thing on the page. Reading a single sentence felt like trying to hit the centre of a dart board blindfolded. I cried and threw papers to the floor and slammed doors. Looking back on those meltdowns now is honestly embarrassing.
And no one understood why.
“I don’t get it. She’s so smart,” my teachers said to my mom.
“Smart” should have felt like a compliment. Instead it felt like I had screwed up some God-given gift.
I was diagnosed with… needing glasses. We all assumed the problem was solved.
2020: TikTok diagnosis
“Tell me something you do because of ADHD that you didn’t know was because of ADHD.”
Attention deficit hyperactivity disorder (ADHD) typically presents as trouble paying attention, controlling impulsive behaviours, or being overly active, according to Centers for Disease Control and Prevention. The girl in the video said she stores as much of her belongings as she can on walls: shelves, hooks, corkboards, whatever. Because once something is out of sight and blended into the environment, it’s virtually impossible to find again.
It was a small correlation, but it was strong enough to pique my curiosity. I decided to do more research.
I’d been finding school especially hard since classes moved online last year due to COVID-19. The fact I’d tried to put my phone away about 100 times already and just couldn’t was a good sign I had to figure out why. Quick.
I Googled the symptoms of ADHD and found an article called, “Red Flags for Adult ADHD” by Heidi Bernhardt, RN. It felt like reading the teachers’ notes in every report card I’d ever received. I made a list of every trait I related to. It took two pages, and I suddenly had all the focus in the world while I tried to crack this case. I booked another appointment with my therapist. She read scenarios from what she called a script and asked if I related to them. I nodded back with my jaw on the floor.
I have ADHD.
Putting names to these things I’d been struggling with took away a lot of my anxieties, but getting there took a lot of persistence and relatively easy access to therapy. For some, this climb is much steeper.
Thea Danae’s story
Thea let the water fall from the showerhead onto her bare skin. It washed out the red from her arms and turned the tub pink around her. She’d cut herself again. Her legs covered the drain and the water was rising, but her boyfriend, Adam, sat there with her regardless.
Thea has BPD. Among its nine symptoms are extreme mood swings and chronic feelings of emptiness — both of which drove her to cut herself in the shower that day. Even with a good support system, BPD can be debilitating.
In addition to the low depressive episodes, Thea also has panic attacks. When they start to come on, especially in public, she finds a washroom and runs her hands under ice-cold water. She said it calms her and helps take her mind off the panic. This is the only self-soothing tactic she uses, and said she relies heavily on her mom and Adam to cope now.
Thea lives in Thompson, where waitlists are long and therapists are few and far between. She said seeing a therapist in person on a regular basis didn’t seem possible. But she was still struggling, and needed help. Unable to do so herself, her mom made the first call and had Thea put on a waitlist to be analyzed.
“I didn’t like thinking I was crazy,” she said.
According to the DSM-5, a manual used to diagnose mental disorders, you need to meet at least five of the nine symptoms to be diagnosed with BPD:
- Fear of abandonment
- Unstable relationships
- Unclear or shifting self-image
- Impulsive, self-destructive behaviours
- Extreme and fluctuating emotions
- Chronic feelings of emptiness
- Explosive anger
- Suspicion or feeling out of touch with reality
Thea met all nine.
She said she still has a hard time stabilizing her mood. Small things like not being able to easily reset a password can send her over the edge. She’d bruised her hand from punching a wall, and her neighbour texted to make sure everything was OK.
“Adam calmly put everything down, came in behind me, and rubbed my back.”
Accessing a therapist is difficult in her situation but with a diagnosis she at least has the words to find information on her own. For instance, it’s easy to find out the most common type of therapy for BPD is DBT. While Linehan’s workbook isn’t available online for free, most of the skills are easily accessible.
A skill used in DBT for bringing down intense emotions recommends changing your body temperature by holding your face in ice water, or holding an ice pack under your eyes. The cold slows your heart rate and allows you to calm down. It’s called TIPP, and includes additional steps to bring your body back to a calmer state, biologically. It’s an acronym:
Temperature (this is the ice water step)
Paired muscle relaxation.
Thea was already practicing a modified version of this by running her hands under the cold water, but can now follow through with the next steps.
My therapist taught me most people diagnosed with BPD also experienced trauma in their childhood, and it’s often believed to be the cause. Thea, however, has no idea what caused it for her.
Regular access to therapy could help uncover some of the causes for her fluctuating emotions as well as current triggers that may set her off. Otherwise she may continue to put herself in triggering situations without realizing the potential harm.
I’ve been lucky enough to spend the last few years with my therapist uncovering how certain childhood events continue to affect me.
Finding the root
When I first discussed BPD with my therapist, we both assumed it had to do with the fact my dad was never around growing up despite his promises. He once promised me a trip to Disneyland that turned into a drive to Fargo that turned into nothing. It seemed like the obvious connection. It took a lot of hours in therapy and a lot of self-reflection to realize there was bigger traumas that I had hidden from myself for years. Traumas I’m still processing and trying to understand. And they were affecting my relationships.
I noticed that over the years, I’d chosen relationships again and again with people who seemed to prefer control over balance — I worked for people who berated me daily and rarely felt heard by my partners. For years, I was letting people beat me down into an anxious puddle until I didn’t know how to fight back anymore.
Now I know, thanks to therapy, that traumatised people tend to retraumatize themselves. Great. I don’t know what exactly draws me to these people, but now I know it’s something I have to watch for.
And instead of panicking in stressful situations, I now follow a set of guidelines to make sure my reaction is appropriate. I check the facts of the situation and make sure my feelings fit the facts. If I still feel the urge to react in a negative way, I choose an opposite action instead.
For example, if I’m feeling left out, I may feel the urge to isolate. Instead, I try to reach out to friends and force myself to connect.
I only know to do this because I understand why my feelings are how they are. I’m able to understand because of my diagnoses. That being said, sometimes bad comes with good.
BPD carries a scary stigma
When you Google “BPD support,” the pages mostly cater to those who know someone with BPD. Not someone who has it.
And people demonize us. A page on Reddit credits itself as a support page for those who love someone with BPD, but the posters often refer to their loved ones as monsters. The most positive post I could find suggested people think of them as fire instead, because, “you know fire isn’t evil, but it WILL hurt you if you get too close.”
I won’t be sharing the page name. I don’t want anyone falling down the same rabbit hole I did.
Even with regular therapy, being labeled an abuser because of your mental health is hard to read. Especially with a disorder that often makes you question the strength and validity of your relationships. Without regular therapy sessions, having a BPD diagnosis can be incredibly isolating.
Jenna Patterson’s story
Jenna hadn’t read a book in 10 years when she decided to go back to school. She enjoyed reading as a child, but it took her an hour to get through a single chapter when she started again.
“I thought, ‘what is wrong with me? There has to be something wrong with me,’” she said in an a January interview.
She’d been diagnosed with anxiety and depression in high school and took antidepressants for about a year afterward. But she still had trouble completing even basic tasks like reading or doing the dishes.
Jenna said her ADHD diagnosis was life-changing. She made an appointment with her doctor, filled out some paperwork, and tried her first medication. When those didn’t feel right, she was easily able to switch meds. She said everything is still hard, but less so.
Jenna now finds it easier to start tasks, regulate her emotions, and calm herself when anxiety is high. She said she’s found comfort in understanding how her brain works.
Once the pieces fell into place, Jenna said her friends and family could see how much sense the diagnosis made. Her view of herself changed, too. Instead of beating herself up for not immediately starting a task, she’s learned to be more patient with herself.
There are some downsides, of course. Her meds diminish her appetite, and eating has become a chore. But she said this is all worth it.
“If it keeps you functioning and keeps you alive, that’s all you can ask for,” Jenna said.
She said she wishes people knew how beneficial medications and diagnoses can be and how much it turned her life around.
“It changed everything for me,” she said
I remember when I asked my mom if she thought I could have ADHD.
She was skeptical
Up until that conversation, her perception of ADHD was of the loud, hyperactive kid in class. Which is often how it presents — in boys. In girls it typically presents as forgetfulness, irritability, and being easily distracted.
Plus, one of my closest friends growing up had ADHD. If anything, I probably seemed like a Buddhist monk next to him — I don’t blame my mom for not noticing.
Once my therapist confirmed my suspicions, I called my family doctor and asked about medication. He agreed to try me on a low dose of Ritalin while I attended biweekly therapy appointments.
The first day felt like I was an entirely new person. Not only was I able to focus on assignments, but I also found myself cleaning throughout the day. Picking up little things here and there on my way to do something else. Surfaces in my house were starting to poke through the empty cups and dirty laundry.
Like Jenna, I still struggle. The hard stuff is still hard. But it gets done now. I used to stare at blank screens, pulling my eyes back to the computer every couple of minutes for hours, and still get virtually nothing done. I still have to pull my eyes back, but when I do it’s usually to a couple of paragraphs at least. And then I can get a couple more in before I drift again.
And when I do drift, I’m kind to myself. I know why my mind wanders now, and I don’t feel like I’m being ‘smart’ in the wrong way. My brain just works a little bit differently.
Accurate mental health diagnoses are important. Knowing I have BPD means wading through a lot of garbage stereotypes online, but it also means I can practice my DBT skills with a simple search. And even if I’d been diagnosed with ADHD as a child, there’s a chance nothing would have been done unless I was acting out.
With so many good reasons for seeking a diagnosis, you might wonder why anyone wouldn’t.
But many people don’t have friends and family to support them like Thea, Jenna, and myself. And even with those supports, asking for help isn’t easy.
Many people don’t have doctors they’ve been seeing for years who know and understand their medical history. Jenna and I were able to get the medications we needed because we’d built up relationships with our doctors for years.
Many people can’t afford the emotional labour of jumping from therapist to therapist until they find someone they trust and who will give them the time of day. It took me half a decade.
And many people simply can’t afford it. I could take my immediate family out for dinner and drinks for the cost of a one-hour session. I could leave a decent tip on top of that.
There’s been a shift, especially in this last year while we’ve all been urged to stay inside, in how we think about mental health. We’re spending a lot more time with ourselves now, and a lot less time with others. It’s having an effect on our brains and our bodies. The Centre for Addiction and Mental Health (CAMH) says isolation can cause feelings of fear, anger, sadness, irritability, guilt, or confusion.
Getting a diagnosis is such an important part of understanding ourselves. And it will only become more and more beneficial as time goes on and we learn more about mental health. If you feel like you’re struggling, reach out to a doctor or loved one. There is hope.
If you or someone you know is in crisis, please call 911 or the Klinic Crisis Line at (204) 786-8686.