Bipolar disorder and borderline personality disorder (BPD) are two separate conditions that frequently get confused with each other. Some people suffer from both together and for some people there is difficulty in deciding on a diagnosis. One thing that they unfortunately both share is stigma, which hopefully with education will be reduced.
Example of stigma on a comment on an article about BPD (people used to say the same about clinical depression 25 years ago):
I loathe politics. It's typically people with polarised views fighting online. Gun violence is a problem in America, but Trump and many of his supporters blame it on mental health issues. The comments below are a small selection from Trump supporters. Mental health is the scapegoat when it comes to crimes motivated by hate. It's a stereotype that all people with mental health conditions are high risk criminals and it reinforces stigma that all people suffering from mental health issues and taking medications are violent.
Several times in my life, I have been told that I am 'too honest'. Lying makes me feel extremely uncomfortable. Over the past few years, I have been working on an semi-autobiographical fiction book called Pet Purpose. I see it as semi-autobiographical because it is telling my story in disguise.
Originally, when I chose the title around five years ago, I intended to write memoir about my bond with pets. But more of life happened and the story has evolved into a story of courage as a young girl suffers trauma and loss, is later diagnosed with bipolar disorder and post-traumatic stress disorder (PTSD) and with her determination to survive, finally starts a healing journey many years later in adulthood.
The story loosely reflects my own journey, but I have changed the story-line to protect myself and others, even those who have hurt me. Changing names wasn't enough. I made the decision to write fiction, to 'lie to tell the truth', to help ease flashbacks of PTSD. So that I didn't have to remember it 'exactly' and keep re-traumatising myself. So that I minimise upsetting people. So people can't say 'that's not really what happened' (because they won't know what really happened) and minimise my message. So that I could have some distance while I still tell a personal story. So that I could express my truth in a creative way.
I grew up in a fundamentalist christian church that preached that illness was demon possession and oppression. They also preached that gays were going to hell and other things that I don't believe in anymore.
Many years later I was diagnosed with bipolar 1 disorder, which has episodes of full mania and severe depression. I have also been diagnosed with PTSD from trauma. When I was involved with the church, I was a very sincere Christian. When I had euphoric highs, I was told I was filled with the Holy Spirit. It certainly felt very spiritual. When a psychiatrist first asked me if I had 'highs' I told them that it was God. People in the pentecostal church I grew up in enjoyed getting 'high' on God. When I was suffering from internal torture and distress, I was told it was demons and that I needed 'deliverance' (exorcism).
I had a big bipolar mania episode two years ago. I'm still recovering. I told my psychiatrist that the medications were like putting a bucket under the Huka Falls. The Huka Falls is a powerful waterfall in Taupo, New Zealand that could fill an Olympic sized swimming pool in sections. You can hear the roar before you see it. The intensity and energy of emotions being released that had been shut down with PTSD was so powerful that it was a huge challenge to try to harness.
I have finally started trauma therapy at the age of 46 after suffering PTSD since I was a child and untreated bipolar disorder since my teens. I was misdiagnosed with 'treatment resistant depression' and in my twenties I was started on antidepressants which can (and did) trigger mania. Yet I still went incorrectly diagnosed until my forties. This journey for me has had a lot of suffering. I have had some extremely painful experiences physically, but the psychological pain has far outweighed extreme physical pain (that morphine hardly took the edge off).
Recently, news of teenager Noa Pothoven's death has been circulating on social media. Noa suffered from PTSD and anorexia after sexual trauma. The English-speaking media misrepresented the cause of her death, saying it was 'legal euthanasia,' which was not true. Pro-euthanasia campaigners jumped on this story. Noa died after refusing to eat or drink. She described her suffering from trauma as 'I breathe but I am no longer alive.'
I can understand that, as I felt like I have 'died' from sexual trauma as a child and again as an adult. The reason I legally changed my name was because my former name became a trauma trigger - I would have flashbacks re-experiencing trauma when anyone said my former name. Changing my name was part of trying to survive. Up until the effects of the adult sexual trauma, I had been surviving by 'shutting down' - the childhood form of PTSD. Plus avoiding. Then it morphed into something very complex with the co-morbid mania and depressive episodes of bipolar 1 disorder.
There is currently a euthanasia debate in New Zealand and I have found it to be very triggering. I have been tearful and withdrawn and dissociating. I know the reasons why it is triggering for me. One of the reasons is connected to the death of a beloved pet cat, Tommy who was severely injured in an accident at the time I was sexually abused as a child. The vet said he would suffer in extreme pain for the rest of his life if we tried to keep him alive. I am still processing that loss, but now as an adult, I would have still chosen euthanasia for a pet with the extent of injuries that Tommy had. I have written a book (still editing it) called Pet Purpose and these are some of the central themes - suffering and loss and trying to survive with trauma and bipolar disorder.
I do not see the topic of euthanasia as black and white. I have been grateful for that option when pets have suffered terribly at the end of their lives. To me, it would have been cruelty to let my pets die a 'natural' death when they were suffering so much.
People have asked for it as a compassionate choice for humans, so I am not opposed to giving them that choice for certain situations. There are valid concerns for the vulnerable but I do not see it as being compulsory. Noa was refused euthanasia and told to complete her trauma therapy and wait until she was an adult. Noa felt she could not wait that long.
Every day, I make a choice to stay alive. Part of staying alive is finding meaning in life (and religion does not give me that meaning - it is another trigger - for example people telling me I needed demons cast out of me and that I would go to hell if I killed myself). It takes courage to live with bipolar disorder and PTSD. Bipolar disorder and PTSD both have a much higher suicide risk than the general population.
Recently I painted a self-portrait - my first since I was a teenager. I called it Painting Courage. I chose a selfie where I had a convincing smile as a reference photo. I can mask a lot of the time. I can smile and people think I'm fine. I can usually mask that I have invisible disabilities and that I am still processing a lot of pain.
For me, painting semi-realistically takes courage too. Lately, I have been doing that as I have been having trauma therapy. It was a very long process to be finally approved for therapy. I continue to hope that things will improve.
I intend to get back to completing my book, but I feel afraid and anxious at times about publishing it because the themes are very personal. Even though I have changed the story-line, the essence and emotions of my story are still in there. But for a while there, writing the book was one thing that gave me a sense of purpose. My wanting to help people understand some of what it is like to suffer from bipolar and PTSD. To try to survive.
I am a recovering perfectionist. A perfectionist is someone who puts unrealistically high standards on themselves with overly critical self-evaluations. Some may project that onto others as well.
I got triggered by my own perfectionism while painting a bird - my second attempt at painting a bird (below). I'd invited constructive feedback by other hobby artists during the process but then I felt my normally low blood pressure rise, I felt angry inside and I felt 'done'. My frustrations came out in scribbling paint over the background and overdoing the highlights as per suggestions. I knew I had to stop.
Over the past few years, I have been on a journey of processing trauma. Finally, I am seeing a trauma psychologist, and she agrees that I have been finding ways to process trauma on my own.
I am a very sensitive person and I can feel very intense emotions. So intense that I would 'shut down' all the emotion and the trauma would be locked inside, still there - frozen and stuck. It has been a process like in waves, to get unstuck. Sometimes there would be intense waves of intense emotion, like I expressed in the scribble below today. Scribbling messy words helped discharge intense emotions like anger.
Today I burned 15 journals I'd filled during a bipolar mania episode nearly two years ago. I flicked through them and condensed the essence of the journals into one page of some of what mania with trauma was like. I have been diagnosed with bipolar 1 disorder and post-traumatic stress disorder (PTSD) and they amplify each other. I was back on medications but it took MONTHS to try to get the mania under control. I've summarised some of what it was like below, based on skim-reading the journals before I burned them:
Today I burnt 15 journals. Journals I had written during months of a mania episode after going back on medications for bipolar 1 disorder two years ago. I was encouraged by my psychiatrist to journal rather than blurt out all my disjointed thoughts on Facebook. So I filled over 20 books, mostly school exercise books and scrapbooks with colourful scribblings, often in felt tip pen rather than biro.
I had felt an extreme need to express myself at the time. I understood what I wrote, but it would have been complete nonsense to anyone else. Trauma was a recurring theme in amongst all the mind-maps, associations and symbolism. I was trying to process my trauma and calm my racing brain. Often my brain was racing too fast and was too disorganised to write, so I painted brightly coloured abstracts instead.
Xanthe finds creative expression including writing and painting to be therapeutic and helps her to manage her diagnoses of bipolar disorder and post-traumatic stress disorder (PTSD).