It is May 2021, which means it it both Mental Health Awareness Month and BPD Awareness Month! In honor of that, and because I already stated on social media that I may get more in depth about the topic of dissociation, I have decided now is the time to sit down and do it.
In 2009 I was unofficially diagnosed with BPD. Unfortunately, being 17 years old, the therapist I was seeing refused to put it down on paper. He hoped with treatment for depression and anxiety, I would "lose the symptoms" or "grow out of it". I understand why he chose this both legally and for my own benefit. Being diagnosed with a mental illness at any age can be stigmatizing and hard to handle. Being 17 years old, it seemed fair at the time to "hope" it was something I'd grow out of; something that would be fixed while handling separate issues (like an oil change that leads to "you need washer fluid").
Unfortunately, at 29 years old, the symptoms are still there. And now in therapy again, I have my official diagnoses. Borderline Personality Disorder, with comorbid major depression and anxietal/OCD tendencies. Often times, when labeled "BPD" this mental health disorder is confused with Bipolar Depression. I would like to highlight now that they are not the same. The acronym is not interchangeable. I do not have episodes of mania (anymore); a key to Bipolar Depression.
For years, most of my symptoms were cut and dry; easy to understand. They included the BPD "norm": mood swings (lasting a few hours to a couple days, maximum); inappropriate anger or having to suppress anger to a point that it harms self (including self-denial of anger/feeling hurt); feelings of numbness or emptiness, fear of real or imagined abandonment (and acting out accordingly to try to prevent being alone and/or pushing people away to fulfill self-prophecy); behaviors of risk-taking, impulsion, and addiction; self-harm/suicidal ideations and tendencies (including attempts); reactive, uncontrollable emotions or emotional instability (good and bad); unstable personal and interpersonal relationships (markedly with periods of idolization and devaluation); "black and white" thinking; impaired self-identity/feeling a lack of a "sense of self" (including poor self-esteem)...
But then there was also, "dissociation". You can google the word:
Dissociation: a disconnection and lack of continuity between thoughts, memories, actions, and identity.
But unless you live with it, it almost seems impossible to understand-- impossible to believe it happens. In fact, even living with it is hard to understand because you're not connecting with the feeling. How can someone not recognize their own thoughts? How can they not account for their actions?
Roughly 75% of patients with BPD experience stress-related dissociative states, including:
Depersonalization: feeling of observing oneself from outside one’s body or feeling like oneself is not real
Derealization: feeling that one's surroundings are not real
Analgesia: an inability to feel pain
Emotional Numbing: an inability or unwillingness to connect with other people on an emotional level ; an inability to feel emotional responses to stimuli
For years I lived with this symptom. In fact, it may be the first symptom I ever experienced and I was completely unaware. I always felt weird about it, but never attributed it to being "ill" of any sort. Even while in high school and beginning research on this mental illness it never occurred to me what was happening was dissociation until I sat with my current therapist and discussed it. It is a feeling I have become very, very familiar with and at times one of the scariest symptoms I’ve experienced.
The first time I realized it was a problem was during my sophomore year of high school. I was sitting in my history class (US 1-- first period-- House 6-- Basement) and was about to take an exam. I looked down at the paper and looked at the spot at the top of the page that read, "Name". I felt an immediate sense of sheer panic mixed with overwhelming confusion.
‘Oh shit! What’s my name?’
I pulled out my student ID and looked at it. I nodded in approval. I put it back in my pocket and began to fill in my name.
I froze.
Had I really just done that?
This wasn't the first time I'd been in a dissociated state, but it was the start of “losing myself”. It has become a chronic battle where I just don’t know who I am without a "title" (such as a job or describing what I do) and at some points in my life I can't decipher what I wanted to do mid-process or how I got somewhere. I lose direction (metaphorically and literally) and I start to feel myself fade. It’s hard to describe such feelings, but I’m trying. So... Let me give you another example.
Another scenario was around the fall of 2013. I remember looking at Cookie one day (the little, furry love of my life) and feeling nothing. And it genuinely frightened me! How could I feel nothing for her?! My almost boyfriend at the time (we wouldn't start dating until December) would tell me how much he missed me while I was at school or tell me a "funny story" about his day and I couldn’t even find a spark of joy in it. It was like he had just told me what he had made for dinner. I didn't care-- No-- I couldn't care. I wanted to care so badly!
I remember trying to pick fights with him to see if I could even feel a negative emotion (since I couldn’t feel any positive ones). It was useless. And feeling “defeated” didn’t feel like anything either. Neither did any hurtful text messages I would get from my ex (the "Serial A&C" from my break-up post). I could feel nothing.
These were much clearer to understand as having disassociated from myself. But it wasn't until this year that I learned that the fact that I could not associate myself with an image of myself was also a form of dissociation.
It must sound crazy to hear that someone cannot recognize themselves in a photo, but it’s the truth. For years (and I don’t know when it started, it's been that long) I have been unable to look at a picture of myself and recognize or “feel” it is me. I look at it and it feels like I’m looking at a stranger. And while I have some of the world's worst self-esteem, sometimes, I can even admit the girl in the photo is pretty and I’ll say, “I wish I looked like her…” Yes, you may think/say, "But you are her!" No. To me, that is a stranger. I don't know her. I don't recognize her. I don't know her name. Where she lives. What she likes/dislikes.
There have been a few times that the disconnect isn’t as poor and if I stare at something like the necklace I'm wearing in the photo (a constant staple of my attire) I can eventually say, “Okay, yes, I see it now…” But it's still never a feeling of acknowledgement, of genuinely knowing it is me. I can never look at the face or the eyes, and see me.
To feel so detached from everything and everyone around you is scary. It gets even scarier when you become detached from yourself-- when you feel you aren't real or don't exist. When you question if you are just a figment of your own or someone else's imagination. But, this is what I have lived with for as far back as I can remember in some form or another.
I learned in my studies as a psychology student, that often times this is typically the phase of depression in which suicides happen—the body will not react to fear or “snap you out of it”. Maybe that's why individuals with BPD have the highest rate of suicide-- because this is a "hallmark symptom" to the disease. I'd be lying if I told you this doesn't often times scare me.
To feel like you've lost yourself or to feel like you've stopped caring about everything and everyone is an awful thing to have to acknowledge. It makes you feel crazy, unreal, guilty, shameful... The only good news to this, is that often times the feelings don't last very long. Much like the other feelings/emotions of BPD, this also only lasts a few hours to a couple of days at a time.
But if you ever start to feel this way, you need to face it. You need to acknowledge it; especially if you have a prior history of mental illness. You need to let someone know. This is not a healthy brain’s symptom. This is a serious part of a brain illness. And I know you may be uncomfortable talking about it or admitting there may be a problem, but know that discussing this does not make you weak. It takes strength to stand up against a mind that is trying to suffocate you; crush you out like a cigarette butt.
I don’t want you to ever feel alone if this is something you unfortunately live with. I want to remind you that it's okay to talk about things like this; it's okay to not be okay. What's not okay is to ignore it when it begins to effect your every day life.
Don’t make your health a topic of “personal business” or something "taboo". The stigma is bullshit! And no one, not even a doctor (whose job it is to help you get better), can help you if you keep this information to yourself.
Don’t be ashamed. You’re not the only one.
So, maybe you don’t dissociate. Maybe you are feeling depressed or anxious. Maybe you find your drinking is becoming an issue. And maybe you're not ready today, but this month, in honor of Mental Health Awareness Month and in honor of your life, take the first step to acknowledge that maybe you need some help and then start looking for the help you need.
You can do this! I believe in you. And I'm always available for those who want to talk about their fears or frustrations or uncertainty first.
Stay safe and well, everybody.
Always,
Me♥