I’m the kind of person who can speak at great length about something in casual conversation, but when asked specifically about it… I draw a blank. This happened to me the other day when I finally got a call that I’d been approved to see a psychiatrist (I was on a waitlist for almost six years!). I had to give the admin assistant some basic information about myself while booking the appointment and I struggled to come up with anything valuable (“I have anxiety, and that makes me feel, like, anxious?”). Awful.
Luckily I have some time before my appointment so I can make a list of my relevant symptoms and experiences. I think it’s important for anyone to have a list when they go to a doctor’s appointment, but especially for those of us with anxiety or processing disorders; it makes the process a lot more streamlined and then we don’t have to worry as much about remembering every single detail we need to talk about.
I thought I’d start by posting about some of my most common symptoms and why my family doctor and I expect that I’ll be diagnosed with Borderline Personality Disorder after a proper evaluation by my new psychiatrist.
1. Fear/avoidance of (perceived) abandonment, rejection, or criticism. This is probably the most significant symptom for most people with BPD – many of the other symptoms are extremely interconnected and based in a fear of rejection. And I’m not talking about the reasonable “fear” that most people have – this is an obsessive thing and it causes a lot of anxiety and depression. It also results in incredibly unstable, dramatic relationships and friendships. I can’t stand the idea of being rejected or disliked, so the sense that it may happen can send me into an emotional meltdown. It can lead to obsessive or intrusive thoughts, panic, anger, and depression.
2. Splitting, or the constant switch between idealization and devaluation of others and self. It took me a long time to recognize this behaviour in myself because I do consider myself to be an open-minded and empathetic person and I don’t generally think in black-and-white terms. However, I tend to quickly develop fascination or admiration of other people who are nice to me (this is referred to as ‘FP’ or ‘favourite person’ in the BPD community) and it can quickly switch when I get a sense that the other person doesn’t care about me in the same way or think about me as often. Instead of putting them on a pedestal for giving me positive attention, I then withdraw and hyper-focus on their negative qualities (often qualities that I’ve entirely made up as a defense mechanism, like saying that they’re mean and spiteful for pretending to like me in the first place). Most of the time I internalize this splitting and the affected party will only notice if they see me withdrawing, but it’s a very aggressive behaviour that I absolutely hate.
3. Impulsive behaviour. This is a coping mechanism usually intended to relieve anxiety, depression, or some other kind of pain, trauma, or intense emotions. For me, it presents as binge eating, passive self harm and irresponsible spending, but I used to do things like substance (alcohol) abuse and other risky behaviours. This is especially problematic because, while the impulsive behaviour can help relieve the emotional issues, it doesn’t usually AND is also followed by guilt, shame, anger, or more depression. It can really lead to a spiral of negative behaviours and reactions.
4. Disturbances in identity. I constantly feel as if I’m in the midst of an identity crisis, not knowing who I am as a person, who I want to be, and what I want to do with my life. I’ve been in university on-and-off since 2008 and my goals with my post secondary education have been absolutely all over the place (social work, teaching, psychology, journalism, art therapy, interpreter, back to teaching, back to social work, etc.). I have a lot of trouble nailing down how I see myself and how I see myself navigating the world. Furthermore, I lose a large sense of myself when I’m on my own – it’s difficult for me to understand who I am without it being in relation to someone else. I know I’m going through one of these crises when I find myself obsessively reading about my Myers-Briggs type or Pottermore house or zodiac birth chart… rationally I know that they don’t define me as a person whatsoever, but it can help me grasp onto something when I’m feeling lost (or it can do the opposite if I decide that these things don’t fit me).
5. Dissociation. Like splitting, it took me a long time to realize that I had experienced dissociation – I never fully understood what it was until I perused Tumblr and read descriptions of it from people with BPD. There are often times where I feel like what I’m experiencing isn’t real, like it’s a dream or a game (I’m technically there, but the stakes are very low since it seems “fake”). Sometimes I have to remind myself that I’m actually present by doing something like touching my hands together or making very purposeful movements to prove to myself that it’s real. One of the best ways I can think of to describe the sensation is to compare it to the movie ‘Being John Malkovich’; I’ve climbed through a door that enters into the mind of another person and I’m seeing everything from their eyes but it isn’t really me per se.
There are so many more symptoms of BPD and I do experience quite a lot of them, but these are the most troubling for me at this point because I’m not totally sure how to manage or treat them. Some of my other symptoms, the ones that overlap with my depression and anxiety, are managed with the medication I’m taking and that’s an amazing help. These ones, however, likely require some medical intervention to properly wrap my head around. I’m so happy to know that I’ll finally be able to see a psychiatrist and be able to work on these issues.
What are some things that you do to prepare for appointments (mental health or otherwise)?