Borderline Personality Disorder – Active Minds Blog Changing the conversation about mental health Wed, 21 Dec 2016 21:09:12 +0000 en-US hourly 1 Learning to Let Go Wed, 12 Oct 2016 13:51:04 +0000 This post was written by Stacy Pershall, a member of the Active Minds Speakers Bureau who speaks to schools and groups nationwide about mental health and eating disorders.

The place: Prairie Grove, Arkansas.  The year: 1985.  The setting: a bedroom closet with burnt-orange carpet and a brown slatted door.  The protagonist, who’s also the antagonist: me, age 14.

The supporting (or not-so-supporting) characters: the boy who used to call me a dog, but now just stands in front of my locker every morning and barks at me while his friends laugh.  The boyfriend who just broke up with me because, despite the fact that I don’t feel worthy of eating, I’m still not skinny enough. The cheerleaders in my all-white school, who think it’s an insult to say, “Gosh, Stacy, if your nose and lips were any bigger, you’d be black.

By the time I was in high school, I’d let them fill my brain.  I no longer had any idea who I really was; they told me now. And so, in deference to them, I hid in my closet and sat on my shoes and wrote their insults on my skin with a Sharpie.  DOG, I’d write across my face – I’d done it so many times I didn’t need a mirror anymore.  Sometimes, when I was so hungry nausea took over, I’d allow myself to get down on my hands and knees and eat food out of a bowl on the floor.  Then I’d pray for forgiveness for thinking my stomach deserved to be filled like other people’s.

The setting today: an EMDR therapist’s office in New York, where I’ve lived for 18 years.  I tell her, “I’m mostly recovered since I did DBT a decade ago, but I have these things from childhood that won’t let go of me.”  She places small, alternately vibrating buttons in my hands and says, “So, let’s make your brain reprocess them.  Let’s make them let go.”

The acronyms: EMDR is Eye Movement Desensitization and Reprocessing, but you don’t have to use your eyes; other kinds of bilateral stimulation will do.  I like the buttons because they give me something to clench my fists around while I talk about the people I still want to punch.

DBT is Dialectical Behavior Therapy, a treatment for borderline personality disorder, which is – surprise! – usually based in trauma.  One of the diagnostic criteria is out-of-control rage, which makes sense; when you live in a brain filled with long-gone people who are still making fun of you, you often lash out at right-there people who aren’t.

So I close my eyes and clench the buzzers and my therapist asks me what I’d like to believe about myself.  “That I’m competent,” I say.  “That I’m strong.  That I don’t belong to those people anymore.”  And then I cry, for the millionth time, because I’m still not sure I deserve to be free.

And I remind myself of what I’ve reminded myself so many times: dogs are good.  Dogs are faithful.  Dogs don’t deserve to be hurt.

The next night, I stand in front of an auditorium full of college students and speak about bullying for Active Minds, like I’ve been doing for the past five years.  I tell myself that instead of fighting the Prairie Grove High School class of ’89, I’m fighting stigma.  I’m standing in front of a room full of people who think maybe they don’t deserve not to hurt either, and I say in a strong, competent voice that they are allowed to let go of the pain.  They’re allowed to eat.  They’re allowed to have skin they don’t degrade.  They’re allowed to have skin, period.

And after the presentation, I text my therapist.  “I did it again,” I say.  “I kept a few more alive.”

“That’s what guide dogs do,” she says.  “Look at their beautiful, shiny fur.”

My Cat, the Lifesaver Fri, 16 Sep 2016 13:00:31 +0000 IMG_1080 (1) I’m only a little embarrassed to say that I think my cat may have been partially responsible for saving my life.

I’ve struggled with depression, anxiety, and borderline personality disorder for a long time–almost ten years now that I look back on it–but I’ve always been able to find my way back with some time, effort, and a lot of therapy. But last summer I fell into a depressive episode that was deeper, longer, and more debilitating than anything I’d ever experienced

For the first time my mood wasn’t the only thing affected by my mental illness. My body hurt, all the time, constantly. I was either sleeping for 14 hours a day or less than four. I’d go two weeks eating almost nothing and another two weeks eating almost anything. I could barely move but worse than any of that, I could barely think.

I’ve always felt smart, and I’ve liked using my brain. My job demands that as my primary function, but suddenly I found myself floundering. I was forgetting common words; losing them halfway through a sentence I’d already started. I developed a stutter and couldn’t think through tasks or projects, immediately overwhelmed by everything. I would write emails with the same care and attention that I normally would but people would write back saying I wasn’t making sense, that the sentences didn’t mean anything when put together.

I’d fallen into old habits of self-harm, and I was struggling with constant thoughts of suicide. And if I managed to drag myself into work on any given day, I’d be faced with coming home utterly exhausted to a lonely apartment in a new city, far from my friends and family.

I did a decent job keeping up the façade of being depressed but functioning…or at least that’s the only explanation that I can think of for why my friends decided it was time to redouble their push for me to adopt a cat.

I’d wanted a pet for as long as I could remember but it was not in the cards for me as a child. So, when I moved out on my own it was a top priority after getting settled. A dog probably couldn’t deal with my life as an individual who worked full time and sometimes took weekend trips to friend’s houses, so I settled on wanting a playful cat.

My plans got derailed when it felt like I could barely take care of myself but my friends were persistently sending me the posting of the local shelter and, against my better judgement at the time, I fell in love with one based just on the description and picture. She was a small, four-year-old black cat who had been at the shelter for almost seven months after being found on the streets, abused by her last family.

She had a broken tail that healed so the tip pointed in the wrong direction. She was apparently overwhelmed in the cat room of the shelter, so she spent her days in the office of one of the dog trainers but never got too close.

She loved to play and hunt but it took her a while to warm up to people. Her personality actually sounded exactly like me and after a half hour of meeting her and playing she was purring and rubbing against my legs and arms. The shelter staff said they’d never seen her warm up to someone so fast.

So I took Luna home. I gave her a warm bed (even though she prefers mine), and her own food with too many treats sprinkled in (she also prefers mine), and lots and lots of toys (she prefers my shoelaces).

On nights when I felt depressed and suicidal and like the minutes were dragging until the sun would rise so I could start my zombie-like day yet again, she would snuggle close and purr.  I would tell her that I knew she’d had a hard life, but she was safe now; that I wasn’t going to leave her alone again.

I got worse before I got better, but Luna and her big, yellow eyes kept me company when I couldn’t sleep. She forced me to get out of bed to feed her and, while I was up, she convinced me to run around my apartment and play. And when I needed to go out to get more cat food for her it also made sense to pick up some fresh fruit and some human food from the grocery store. Cat litter and hair gets everywhere so I actually needed to start cleaning my apartment again and needed to do the dishes to avoid suspicious lick marks on my plates the next morning.

My cat certainly isn’t the reason that my depression finally abated (I have lots and lots of therapy and medication tweaking and family and friends to thank for that), but I do give her some credit. I actually don’t think I’m embarrassed to say that my cat may have played a part in saving my life because, even when I couldn’t convince myself of my worth and that my life was worth living, she was able to just by being excited for me to be home and coming running when I opened her food.

I just wish she could even remotely understand what her companionship has meant to me, but maybe I’ll just buy her some more toys in the meantime.

image1 (1)

Borderline Personality Disorder Month: Practicing Compassion Mon, 02 May 2016 12:41:53 +0000 Stacy is a member of the Active Minds Speakers Bureau. Bring her to your campus to speak about mental health.

PrinceMemeOf all the quotes I’ve seen in the wake of Prince’s death — and I’m a Prince fan to the core — this is the most beautiful and resonant to me: “Compassion is an action word with no boundaries.”

I spent a lot of years having very little compassion for other people, because I had none for myself. This is the aspect of Borderline Personality Disorder that causes the greatest stigma; it’s what causes others to view us as willfully manipulative and cruel.

But what was really happening is that I was severely mentally ill and without proper help for a long, long time. When I was finally diagnosed with BPD and found Dialectical Behavior Therapy — which is basically CBT meets Zen Buddhism — I started to learn what it means to be connected to other people. That connection is the basis of compassion.

And I believe now — I KNOW now, because by practicing it, I help save lives — that compassion is radical activism. There is nothing more terrifying, raw, and profound than looking into the eyes of another being and realizing that their pain, their suffering, their fear, their joy, and their dreams are yours too.

That realization, and the compassion of the people who saw the good in me when I couldn’t, is the one and only reason I’m not dead.

So hell yeah, compassion is an action word. Because to keep from shutting yourself off and approaching the world from a place of anger and fear — and one of the things I learned in DBT is that anger is just a secondary emotion to fear — is the hardest, scariest thing you will ever do.

You have to work really, really hard at love to overcome fear. It’s the one and only way. And just as there’s no anger without fear, there’s no love without compassion.

All is connected. All are one. Compassion for yourself is compassion for others. Lokah samastah sukhino bhavantu. I love you.

]]> 1
Mental Health News Round-Up: July 31 Fri, 31 Jul 2015 19:55:26 +0000 Suicide Prevention, Stress, and the Ideals of Perfection

Although I typically try to remain objective in the Mental Health New Round-Up, I break this form to share the following NYT article that includes my personal story.


Active Minds has been instrumental in my journey of recovery and advocacy and I am now involved with Active Minds Penn on campus (Check out our Chapter President’s video on her mental health story and another alum’s TedTalk video).

I am so grateful to Active Minds National for taking a chance on me as an intern when I was on leave and truly believing that sharing your story can change the world. Find out how you can share your story for Suicide Prevention Month.

(The typical mental health news round-up continues below)

Does Smoking Increase Schizophrenia Risk?

A new study in the Lancet finds a link between smoking and developing schizophrenia; further research is required to understand if one event is causing the other.

When Cancer Triggers (or Hides) an Eating Disorder

During cancer, patients often feel as the only thing they can control in their lives is food restriction. Thus, during and after cancer treatments some patients struggle with eating disorders.

What It’s Like To Live With Borderline Personality Disorder

One young woman shares a raw account of her experiences with Borderline Personality Disorder (BPD).  For Active Minds Speaker Stacy Pershall, writing and dialectical behavioral therapy help her to recover from BPD.

5 Things You Might Not Know About Borderline Personality Disorder Mon, 11 May 2015 08:59:53 +0000 May is Borderline Personality Disorder Awareness Month! Stacy Pershall, a member of the Active Minds Speakers Bureau who has a diagnosis of BPD, shares 5 things you should know about this oft-misunderstood disorder. Bring Stacy to your campus to speak today!
url 1. The disorder got its name from psychoanalyst Otto Kernberg, when Freudian therapists observed that people with BPD “came apart on the couch” and theorized that they were on the borderline between neurosis and psychosis. Now that we know more about psychology than we did in the 1960s (thank goodness), therapists have suggested renaming BPD something more accurate and with less stigma attached. Suggested names include “Emotion Dysregulation Disorder” and “Complex PTSD”, as people with the disorder have often experienced early trauma.

2. People with BPD are not intentionally manipulative, even when they do things like threaten suicide if you leave. They might know that such behavior is perceived as manipulative, but that doesn’t help a person with untreated BPD control the impulse to avoid abandonment in the moment. What you perceive as manipulation comes from fear, with anger as a secondary emotion.

3. BPD is often misdiagnosed as bipolar disorder due to the intense mood swings present in both. Bipolar disorder is more common, affecting 2.6 percent of the diagnosed U.S. population, while BPD affects 1.6 percent. However, due to frequent misdiagnosis, these numbers may be misleading. Accurate diagnosis depends on recognizing a trend of situation-dependent mood swings (often in response to relationship issues) vs. those not precipitated by circumstance.

4. There’s concrete brain science validating the existence and refining our understanding of BPD.  Evidence points to malfunctions in the limbic system, which controls emotional intensity, and the subgenual anterior cingulate, which controls emotion regulation. Learning skills to improve the latter helps moderate the former.

5. We can recover, because there’s effective treatment now. The gold standard is dialectical behavior therapy, created by Marsha Linehan, but there’s also mentalization-based therapy, schema therapy and transference-focused psychotherapy.
A  brief rundown of the differences: DBT focuses on mindfulness and has been described as “Thich Nhat Hanh meets tough love”. Mentalization-based therapy focuses on helping people with BPD recognize boundaries between their emotions and the emotions of others.

Transference-focused psychotherapy uses the relationship between client and clinician to create a safe environment for boundary testing. Schema therapy draws from all three to help clients identify and change the erroneous thoughts that lead to extreme behaviors.

If you or someone you love has been diagnosed with BPD and cannot yet access treatment, you should know about these
online resources:

]]> 1