Warning: This post contains some distressing content around psychosis, self-harm and physical restraint. Please be aware of this if you decide to read on.
What’s the first thing that comes up when someone asks you about symptoms of borderline personality disorder? Emotional instability, intense/rocky relationships and a lack of sense of self. There is a symptom I rarely ever hear talked about however.
Psychosis
There’s a reason you will almost never hear us talk about this to our friends and family. The stigma associated with people who experience psychosis is really scary, especially for people who feel like they’ve never fitted into society. It’s taken me a long time to come to terms with the fact that psychosis and delusions are a part of the BPD experience. Within the diagnostic criteria for BPD one of the symptoms is transient, stress related, paranoid ideations and extreme dissociation - which can both look very much like psychosis. The reason why Borderline Personality Disorder is named as such, is because it was believed it was on the line between neurosis and psychosis. Personally I don’t think that this goes far enough to explain the sorts of things we go through.
Firstly, what exactly is psychosis?
Psychosis describes a group of experiences where you interpret or perceive reality in a drastically different way from people around you. This often causes you to lose touch with reality. You might hear or see things that others can’t, or perhaps you might have strange/bizarre thoughts or beliefs called delusions.
Although I have experienced hallucinations before, what I suffer with most are transient delusions. At times of extreme stress or shortly after very intense emotions, I often have thoughts which to others make no sense. My partner and I call them ‘episodes’ and I’ve only ever referred to them as ‘funny turns’ in front of my family.
Here’s an account of what happens during my episodes:
It starts off as a small thought in my subconscious. Sort of like I’ve forgotten to do something, but I don’t know what it is. It comes with a sensation of anxiety. I’ve gotten pretty good at spotting this and take this as the first sign of what’s to come. If I am careful I can distract myself from the thoughts that come next, but it is all too easy to be drawn into them.
“Something isn’t right.”
“You’re being watched.”
Not voices, but thoughts inside my head. They don’t feel like my own and they feel like a warning. After this it all happens quite quickly if I can’t distract myself. Ideas pop into my head about having forgotten someone important. How? Your memories have been erased. Why? It’s all a big secret you’re not in on. Or maybe it’s more like I’m being watched. By who? Beings I cannot describe. Why? I’m in some sort of experiment.
The more I think about it the more distressed I become. I start looking for ways to escape or begin panicking about the world I live in not being real. This often leads to strange or self-injurious behaviour. I recall biting my wrists, because I thought it would get me back to the real world somehow. At this point my partner will usually notice and intervene in an attempt to stop me from hurting myself or running out of our flat. In my paranoid state I often think that he’s working against me, or is just a puppet for those trying to cause me harm. This can lead to me becoming verbally aggressive and on a few occasions in the past I have lashed out at him. I refuse to take my medication, as I think if I take it I will no longer ‘see the truth’. Which is just a part of the delusion. At this point suicide and self harm are a serious risk, because of a mixture of dissociation and time passing really slowly; which makes me feel as if my suffering will go on endlessly. I have to be watched really carefully to make sure I don’t hurt myself. My partner will often sit me on the sofa or the bed, and just watch me until I start to come out the otherside; making sure there is nothing in my reach. On occasion he has had to physically restrain me, which isn’t pleasant for either of us. I honestly don’t blame him for that, as it’s a last resort and the only way to keep me safe.
As quickly as it began, the thoughts start to subside. My medication kicks in (if i managed to take it) or I come back around of my own accord. I return to my usual self and start to see that everything I believed doesn’t make sense in the context of the real world. At this point it's better not to question things and to try to relax and distract from the thoughts. These episodes leave me feeling depressed and exhausted. Not to mention guilty about whatever embarrassing or hurtful things I’ve done and said. I’m really lucky to have a partner who understands what’s happening to me, and is able to make sure I stay safe.
As you can see these episodes of psychosis can be really distressing. They don’t last very long and that means that it’s very difficult to get any sort of help with them. The most advice I have ever got is to simply ride it out. Which when your primary carer is having to hold you down whilst you’re kicking and screaming, is not really helpful at all. The worst part for me is coming back to reality and realising the upsetting things I’ve done. I can become so low in mood afterwards that I can’t do anything for days, including my job or my blog. It has a significant impact on my life, yet most of my friends don’t even know this happens to me, because honestly I fear it might scare them away. It’ll probably come as a bit of a surprise to those that read my blog.
It’s important to know that everyone experiences psychosis in BPD differently. Some people see shadows, whilst others hear voices telling them they’re worthless. Once I was having a panic attack in a shopping centre and suddenly I couldn’t see anyones faces; which was terrifying.
Finally, I want all you out there to realise you are not alone. I encourage people within the BPD community to talk more about psychosis amongst ourselves. Maybe one day it’ll give us the courage to fight the silence around this symptom.
Out of Darkness. Xx
