“I am barely functioning, you just can’t tell.”

It was Spring Break of my senior year of college. I chose to stay at school for the break. I was supposed to spend the week studying; instead I found myself doing a self-taught course in psychology. I bought too many books and borrowed even more from the library. I scoured the internet for information and research articles. I didn’t eat or sleep much; I just focused on reading.

Lack of sleep and food, plus my obsessive research, created a really bad combination. I ended up in the emergency room. After diagnosing me with psychosis and ensuring the episode had ended, they released me with a therapy appointment for the next day. I left that appointment with a Bipolar 2 diagnosis. I didn’t think Bipolar Disorder answered all my questions, but I was just happy to have any explanation.

After a difficult summer, I returned to campus for graduate school. I felt even more lost than before. I was in a not-quite-relationship and had a job that wasn’t well defined. I was beginning to realize that I didn’t do well with ambiguity, and both situations created a lot of anxiety.

One afternoon I was in a meeting when I suddenly felt trapped. By then I had discovered cutting as a way to cope with distress, so I ran to the bathroom to dig out my razor. The panic subsided a bit and I was able to sit through the rest of the meeting.

When the meeting ended, my negative thoughts began to take over. I was convinced that I wasn’t cut out for grad school, I couldn’t do my job, and I was never going to be good enough for an actual relationship. I opened a bottle of ibuprofen and swallowed its contents

I don’t think I actually wanted to die that day. I just felt trapped and hopeless. I felt misunderstood and left out by my friends. It felt like I was all alone, battling the world.

After I took the pills, I had a moment of regret and went to a friend. She rushed me to the ER. I was held on a mandated 72-hour hold at a psychiatric hospital. By the time I was released I was convinced that I was fine. I felt great. My friends were paying attention to me and we had scheduled movie nights. My psychologist was taking me seriously. I even managed to end my non-relationship.

I finally had the courage to tell my therapist that I didn’t think I was properly diagnosed. I listed all my symptoms that I knew matched Borderline Personality Disorder. By this time I had read so many books and articles that I considered myself a bit of an expert. It seemed to explain how I felt. After sharing my concerns my therapist told me it sounded like BPD and officially diagnosed me.

By this point I had established a pretty complicated relationship with my therapist. I would come into therapy feeling fine with no issues to discuss. He would decide I was well enough to decrease the frequency of our sessions and I would agree.

Inevitably I would have a crisis shortly after and we’d go back to weekly sessions. This cycle repeated until he eventually decided that my food restriction was severe enough to transfer me to a therapist who specialized in eating disorders.

After graduation, I moved and had to find a new therapist. My BPD diagnosis had been redacted for insurance purposes. For the next ten years I would be in and out of therapy, and every therapist would tell me the same thing: I had some Borderline Personality traits, but they weren’t severe enough to be diagnosed.

Instead they treated me for Bipolar 2 Disorder, even though I told them that my mood swings were intense and short-lived. I was told that I was rapid-cycling and tried a multitude of mood stabilizing medications, never really finding one that worked.

These therapists had a highly stigmatized view of BPD, which is unfortunately pretty common. People imagine extremely intense, angry outbursts, complete with yelling and throwing things. They expect someone who can’t hold a steady job or relationship. They assume multiple suicide attempts and self-injury scars. People with BPD “ruin lives”. I didn’t present that way. I had a job, a family, and I didn’t ‘act out’. It didn’t matter how badly I was acting in.

I never gave up my own search for answers, and eventually came across “Quiet BPD”. Discovering Quiet BPD was like finding a lamp in a very dark tunnel. Quiet (or Discouraged) BPD is not an actual diagnosis, but it is becoming more accepted as a subtype. Some will describe it as high-functioning BPD, but I really hate that term. I am barely functioning, you just can’t tell.

Quiet BPD finally explained why I felt all the things that BPD described, but it remained invisible to others. My symptoms come across as personality quirks. “Oh that’s just how she is.” Moody and dramatic. Unpredictable. Over-sensitive.

In 2021, I was referred to a specialist after my therapist admitted that some of my symptoms were beyond her expertise. This decision changed my life. Along with some other issues I didn’t know I was dealing with, my therapist took my concerns about BPD seriously. He brought out the DSM and went through the symptoms with me one by one. By the end of the session I had a diagnosis again.

I know that there are certain parts of my BPD that are never going away, but I do think time and effective therapy will make them more bearable. I often wonder what my life would look like if I had gotten the help I needed earlier. Instead the stigma and stereotypes surrounding BPD kept me from getting the diagnosis necessary for proper treatment.

I recently read that focusing on the behavioural aspects of BPD does a disservice to patients, because it ignores the internal distress someone with BPD lives with. After my experiences, I have to agree.