Some people have said it’s a career death sentence but my lived experience of mental health problems makes me a more compassionate clinician.
I work for the NHS as a psychological wellbeing practitioner. I love it. I want to give something back and help others as, in my early twenties, I was diagnosed with borderline personality disorder (BPD), one of the most stigmatised mental health conditions. People suffering with BPD are often described as manipulative, violent, attention-seeking and impossible to treat. The label itself is a problem, appearing to suggest someone’s personality, who they are, is inherently disordered. Growing up in an invalidating environment or experiencing prolonged trauma in your early years doesn’t mean you are untreatable. Offered the right treatment, those who have been diagnosed with personality disorder can get better.
I grew up in a house blighted by domestic violence. At 15 I was in a sexually and emotionally abusive relationship. At 18 I left him and managed a year at university. Then my mental health deteriorated significantly. Intense emotions appeared, seemingly out of nowhere, and kept me in a state of intense fear and hopelessness. I felt like my body was about to explode and that my terror and shame would kill me. To cope I would self-harm or take overdoses; these were rarely life threatening, more an act of desperation in not knowing how to cope with my suffering and the empty void in my chest that was unbearably painful. The depths of the hopeless desperation are difficult to convey in words.
Trips to A&E occurred frequently. I was often treated as a nuisance. Some staff were very kind, but overall I experienced a shocking lack of compassion, an experience shared by many. For five years I was passed from one mental health professional to another. These appointments were months apart, often less than half an hour, and I wasn’t offered any treatment. I was asked to remove my clothing, and a nurse called me fat. I was told I was being “a silly little girl” and was untreatable, a hopeless case.
After my mum demanded help for me I was eventually offered dialectical behavioural therapy(DBT), designed to treat BPD. I still don’t know why the decision was made to refer me. BPD was never mentioned. I feel it could have easily been a lucky guess.
Everyone diagnosed with a personality disorder deserves to have access to appropriate treatment. Nice recommends that NHS trusts should have multidisciplinary specialist teams to provide joined-up services, psychological interventions and peer-support for personality disorders. However, accessing these is a postcode lottery. When they are not available the most likely result is falling into the gap between primary and secondary care and receiving nothing. Alternatively you can be offered short-term therapy or medication. Steps are being taken to bridge this gap, the recovery colleges being rolled out are a step in the right direction, but they don’t replace specialist services.
People with personality disorders are often the most vulnerable in society, but providing adequate treatment isn’t cheap or easy. However, helping people stay well would reduce the significant financial costs to social services, the healthcare system and wider society.
I’ll be forever grateful to the NHS as DBT saved me and utterly changed my life. I’ll always struggle with the consequences of being traumatised, but I’m able to manage my life and my emotions, my suffering is significantly reduced. Mental health problems still carry stigma and personality disorders are stigmatised even further, both within the general public and mental health services.
We need to keep breaking down the “us and them” barriers. We all suffer at times, there is no divide between ‘ill’ patients and the ‘normal’ professionals.
Courtesy: The Guardian