“Borderline Personality Disorder has become almost romanticised on TikTok.”

I was 18 when I was diagnosed with Borderline Personality Disorder. I had just spent eight months in a children’s Psychiatric Intensive Care Unit (PICU). It would be another five years before I would be admitted to an adult personality disorder unit. 

Having a personality disorder is a profoundly unsettling experience – for me, all of my senses and emotions are heightened, the tiniest thing can set me off. I am hypervigilant to the way that other people respond to me and the tiniest sign of hostility can cause a huge meltdown.

In recent years Borderline Personality Disorder has become almost romanticised on TikTok and whilst I’m glad that there is an online community for people with my disorder, I hate that some people think it’s a cool or quirky thing to have. It’s debilitating and it’s ruined my life. 

The transition between child and adult inpatient services was quite a smooth one for me. I had been warned by the manager of my adolescent PICU that I would be ‘eaten alive’ in adult services, but it wasn’t like that at all. I actually found the adult patients easier to get along with. 

For a while, I coped well in the community with support from my community mental health team (CMHT). I did a course on distress tolerance, started mentalisation-based treatment (MBT) and eventually was accepted onto a highly competitive (in terms of places) dialectical behavioural therapy (DBT) course. I also completed my university course in English Studies, with only one admission in three years. 

Unfortunately I was admitted again at the age of 21 and I would bounce between the local ‘acute’ wards (the ‘general’ kind of psychiatric unit) and psychiatric intensive care units, which were more likely to be far from home as there are less of them.

In January 2021, after being in hospital for three months in a psychiatric intensive care unit in Durham, my team decided that I needed more specialist treatment. 

Unfortunately it was not a smooth road to accessing specialist personality disorder treatment. They first mentioned it in January and I didn’t move to the specialist unit until the following June. I spent the months mostly in psychiatric intensive care, although the final month was spent in acute care as this was a requisite to move to a PD unit. 

Although I had been on 1:1 observations on the acute ward, when I arrived at the PD unit I was immediately placed on ‘four checks’ which means that someone checked on me every 15 minutes. I spent the first few days locked in my room whilst they waited for my COVID results to come back. I had a few minor incidents, but within days of coming out of isolation my observations were reduced to ‘two checks’ as in every 30 minutes. Pretty soon I was on ‘one check’ which means I was only checked hourly. 

The timetable at the PD unit was great. We each had weekly 1:1 sessions both with an appointed psychologist and with the occupational therapist, as well as a weekly DBT and sensory self soothing groups. Ward round was once a month but you could make requests to the team every weekday morning.

Every morning those who had the leave or were informal (voluntary patients there of their own free will) would go to the shop. You either had to go 1:1 or 1:3 depending on your leave status. Most people were in the second category so we would go with one member of staff, three at a time. Many of the staff were ‘drivers’ so they could take us out in the hospital vehicles. 

Some of the activities we did on the PD unit were amazing. For example, we would go out for meals every week. We went on trips to the neighbouring towns and cities, to local farms, to shopping centres, food outlets, museums, and even on a special trip to a theme park. In the evenings we would watch movies, play bingo or board games, or sing karaoke. 

Unfortunately the PD unit could not facilitate patients being on high observations, so when my mental health deteriorated they had to move me back to psychiatric intensive care. But the plan moving forward is for me to move back to a specialist unit so that I can continue the therapy programme and make a slow and steady transition back into the community. 

Psychiatric intensive care (PICU) is a lot different to a PD unit. Usually patients come from an acute ward, but sometimes they come from rehab like me. I’ve been to several PIUCs both adolescent and adult, and they all vary, but have some fundamental things in common. They are all very restrictive.

When you arrive you aren’t allowed many (if any!) personal belongings. Lots of patients are on 1:1 or even 2:1. On my current PICU we have had many patients also spend time in seclusion (locked in a bare room on their own whilst a staff member watches through the window, they’re usually in there for violence towards others) for short periods of time, but there’s also been one patient in ‘long term segregation’ for at least four months.

Some patients aren’t allowed their own clothes and have to wear ‘strongwear’ which can’t be ripped. On the other hand, some patients do really well here and are almost ready to be discharged – they have their belongings, they access the group timetable and facilities such as the salon and the gym, they have grounds leave etc. 

What I’d finally like to say is that being inpatient or ‘grippy socks jail’, as it’s been popularised on the internet, is not cool or quirky. It really, really sucks. You have your freedom taken away, your belongings taken away, you’re thrown in with potentially very unwell and sometimes aggressive patients.

There are good times, but they are few and far between. I can’t wait to live my life in the community and be able to see my friends and family on my own terms.