"Living alone, I think of all the friends I've known, but when I dial the telephone, nobodies home"

The title are a few lyrics from "All By Myself" but at this current point in time they seem to suit my life quite well.  I've always been a "popular person", and never struggled to make friends.  As I've said in previous blogs, I never stuck to one person like glue, I would float around different friendship groups.

When I started University as an undergraduate at the University of Birmingham (about an hours train ride from home) I moved into halls of residence and instantly had another 11 friends, the other 5 girls I shared my flat with and the 6 boys next door who we all became close to.  For 3 years I'd got a great social life, with people always up, no matter what time of day or night, and they were always ready for a laugh.  It was a great distraction.  A few of them knew about my problems but I never really talked much about myself.

Following Birmingham University I moved to Edinburgh to start a post-graduate course at Edinburgh University.  There were another six people on the course I had chosen.  This time though I had moved in with a friend who was also moving to Edinburgh.  I thought I knew him quite well but it turned out I didn't know him very well at all. The other people on my course were living in halls apart from one or two.  The first two weeks started off fine.  I got on well with the others from my course.  We went out a few times and I had them all round to my flat for drinks.  Then my flatmate met them all.  That's where it all went wrong.  He knew about my psychiatric problems, and after a few drinks too many he told them everything.  After that night they didn't want to know me.  I became an outcast.  That's the first time it's ever happened to me.  I was never bullied at school, and although these people were never nasty to my face, I knew they spoke about me behind my back, and I felt very isolated.  Edinburgh was over 4 hours on a train home, and the train fare was over £100.  I was skint, having used all my savings and loan to pay for the MSc course. I developed an expensive drinking habit, and any money I had went towards that.  I often would go without food, or eat a 30p vegetable curry from a tin can.  I think that is the most miserable I've been for a prolonged period.

I moved home to my parents house after there were no more taught elements to the degree and wrote my dissertation from there.  That was in June 2009 and I have lived in this area ever since.

For a year I worked as a medical secretary whilst I finished my dissertation and so I would see people at work.  I would class them as my "friends".  We went out a few times a month.  They were all older and most were married with kids but we all seemed to get on just fine.

I left that job and became a carer, hoping to train the following year as a social worker.  Sadly, during that time I was signed off work sick, that was fourteen months ago, and since then I've been socially isolated for the most part, except for the time I've spent as an inpatient in the local psychiatric hospital.  I also moved into my own house in February.

I speak to a couple of people from my time at Birmingham.  The rest just seem to have drifted away.  Even the two I still talk to have their own lives.  It feels like everyone has gone to the next step of their lives and I've been left behind.

I always vowed I'd never make any lasting friendships with someone from a psychiatric ward.  My problems were enough without having friends who also have problems.   However, when you're living in such close company with other people it becomes difficult to avoid becoming friends.  I've spent a total of six months living on the same ward as one girl in the last year and I think she might be my first "best friend".  There was another girl who I was also friends with but due to her manipulative behavior I finally dropped her a few weeks ago.

Sadly though I feel the time has come to also say goodbye to this friend too.  She spends most of her time either depressed, or in hospital.  Although it's great when we can spend time together, one of us is usually down and I just think the friendship we can have is very limited.  I also think when I'm down I bring her down too.  She's often arranging to meet with me but then she stands me up.  Her reasons are always valid, but it's a source of stress I could do without,

So there goes my last friend.  Come the New Year it will be just me.  I feel sad about that.  But least if it's just me there's no one else to hurt me or let me down.

Filling the void

One of the symptoms of BPD is a chronic feeling of emptiness.  It doesn't happen all the time.  Sometimes I feel jam-packed full of life and excitement.  But when the emptiness strikes it's really difficult to deal with.

I find myself flitting through different coping strategies.  I self-harm to distract from the emptiness.  Sometimes I over-eat and buy myself loads of food to try and fill the emptiness.  Sometimes I do the opposite and go on a diet to give me something else to focus on, something which makes me feel like my life is worthwhile.  I often spend money on clothes, or other things to try and make myself feel better.  I used to go out and sleep with men to keep myself from feeling the void inside.  The biggest thing I've done is buy a puppy.  I'd been intended to buy a puppy sooner or later, but one afternoon when the emptiness struck I went out and brought one home.  She helped fill my emptiness for a month.

But sooner or later the feelings of emptiness return.  Sometimes it hurts so much I just sit on the floor and cry like a baby.  I'm lonely.  I don't keep many friends.  And sometimes the few friends or family I do have are all busy.  Sometimes I just can't bring myself to talk to them because I know they'll only end up worrying.  So I just sit and cry and cry.  I wish I knew a way of permanently filling the space inside.

But for now I guess I just keep cycling through various different coping strategies which all result in the same thing; I feel emptier and emptier each time the feeling returns.

Magical Thinking

After being referred to see an outpatient psychiatrist I had a few weeks to wait before my appointment.  I arrived slightly late, as was usual for me during those days, and waited to be seen.  A small woman came to fetch me, Dr Singhal she was called.  I sat in the chair of this old fashioned doctors room, which was cold and smelled slightly damp.  She asked me endless questions about my childhood, growing up and my current situation.  I remember being irritated by her referral to my self-harm as 'self-laceration'.  She diagnosed me with depression and anxiety, which came as no surprise.  I saw her a around once a week over the following months.  She had changed my medication to Citalopram and I was also taking Diazepam (Valium) for anxiety, and Temazepam (Restoril) to help with sleep.


I'd been seeing her for around six weeks when I took my very first overdose.  I won't go into detail of that at this point, but it was shortly after this she diagnosed me with obsessive-compulsive disorder.  I remember being confused.  I didn't see any of the behaviours I did as obsessive-compulsive.  My impression of OCD was that of checking.  I'd always been a little bit obsessive with hygiene, but I would never have gone as far as to say it was severe enough to warrant a diagnosis of OCD.


She explained to me that a less common symptom of OCD is "magical thinking" and an "inflated responsibility". An excellent run down of OCD symptoms can be found here but I'll just highlight the relevant bits to my diagnosis.

Inflated responsibility and magical thinking

If you have OCD you have an inflated sense of responsibility. This means that you believe you have the power to either cause or prevent bad events that are personally important to you. 'Magical' thinking - performing special actions to prevent something happening (an extreme form of superstitious thinking) - is closely related to this. It makes you feel more comfortable, as if you had more influence and control over what happens.

The over-importance of thoughts

This means the degree of importance that you attach to intrusive thoughts or images. It's crucial to understand here that everyone experiences intrusive thoughts and doubts - that are usually absurd and are the opposite of what they want to do or think. In the 1970s researchers carried out experiments where they asked some people with OCD and some people without OCD to list their intrusive thoughts. They could find no difference in the types of thought reported by those with and those without OCD. The difference is that people with OCD have more frequent and distressing thoughts than others because of the meaning they attach to the thoughts and the way they respond to them. OCD is maintained when you interpret intrusive thoughts as a sign that is there a serious risk of harm to yourself or others (over-importance of thoughts), and also believe that you can prevent the harm by what you do or don't do (overinflated responsibility).
The actual content of intrusive thoughts comes from your values - the things that are most important to you. The thoughts represent your deepest fears. So, for example, a mother might have intrusive thoughts about stabbing her baby, because he is the most precious thing in the world to her and she would be devastated if anything happened to him.


(Full information about symptoms of OCD can be found at www.overcoming.co.uk)

After several weeks of denial I completely understood where she was coming from.  I didn't suffer from the stereotypical forms of OCD such as checking etc, although many of the "traditional" traits were present, but the magical thinking side of things certainly rang true.  


For the last eight months I'd been performing certain behaviours, from something as small as moving an object to a different place, or something slightly more serious like overdosing, to prevent harm from happening to those around me.  At it's worst I felt I HAD to cut myself fifty times a day to protect my friends and family.  Although I'm slightly more in control of things now I do still carry out random protective acts.


I also suffer with very intrusive thoughts about those around me dying.  It feels like by having the thought in my head, the likelihood of the event happening is increased.  That leads to a great deal of anxiety, which in turns leads me back to magical thinking.


My symptoms have been exacerbated further as my mother spent several years in and out of hospital with various illnesses.  At certain points she nearly died.  All of this has fed into the process and sadly made things a lot worse.  Fortunately she's been healthy for a few years now and I think things are settling down.  


When my cleanliness and hygiene symptom gets bad I end up scrubbing at my skin with bleach, or bathing in it to keep clean.  Fortunately I've been able to downgrade from bleach to medicated Dettol of TCP liquid.  


I went on to attend ten sessions of OCD group therapy.  Although I found it slightly helpful, the majority of the group suffered from checking behaviours and my struggle with magical thinking was for the most part misunderstood by the others in the group.  It took me seven weeks to realise how the programme could possibly help me.  Still, I did learn a few valuable coping skills.

It reared it's ugly head for the second time

After having a two to three year period of having really good mental health, I was totally shocked when I found myself back in a similar situation to the one I'd been in 6 years earlier.  After a couple of agonising months enduring a messy break-up with my boyfriend of over three-years I lasted only four months before I found myself with a razor in my hand.

The very next day I bit the bullet and went immediately to see my GP.  The surgery I attended was a massive surgery with around 12 GPs working there.  It was a bit of a lottery who you'd end up seeing but to my absolute luck I ended up seeing a wonderful doctor, Dr Basra.  I didn't know at the time but he went on to be one of my closest allies at university, supporting me on a weekly basis, writing countless letters to my head of department and personal tutor explaining why my work was so behind.  I remember waiting very very nervously in the large waiting room for my name to be called.  When I went in to see him he asked me a series of questions to determine the range of symptoms I was experiencing.  I walked away from the surgery for the first time in my life feeling that someone had taken things seriously without over-dramatizing the situation.

Over the next week I read the literature I'd been giving regarding anti-depressants.  It was something I wasn't overly keen on, but feeling like I did I'd have probably shaved my head if I thought it would make a blind bit of difference.  I kept things well and truly hidden from all six of my housemates at that stage apart from one, Ali.  The following week, Valentine's day 2007, I returned to see Dr Basra and he prescribed Paroxetine.  That evening, as I had done the previous Valentine's day I cooked a big pasta feast for me and my other friends who were without plans.  Nobody had a clue that my arms were sliced up and I'd just been prescribed anti-depressants.

After a few weeks it became harder and harder to hide it.  I'd stopped sleeping and would often be red-eyed from crying.  One morning, after a particularly bad nights sleep, I talked to each of my housemates individually as they came down at their various times and ate breakfast.  They were all very supportive, and a little shocked, as I'd always been the life and soul of the party.  I felt utterly embarassed admitting how much I was struggling.  I remember hiding my face under a fleecy blanket I'd got wrapped around me to keep warm.  I didn't go into much detail, just that I'd had problems when I was younger and that I was feeling a bit down.  It was all they needed to know.  Over the following months I did end up talking more to another housemate, Joe, who was training to be a doctor.  I didn't mention a thing to my parents, although our relationship was very positive.

Sadly I didn't get on with Paroxetine (Paxil).  It made me feel sick and dizzy.  If I'd have known that most of the anti-depressants would have various side effects I'd have probably stuck with it a bit longer but after around ten days I was switched to Venlafaxine (Effexor).  This made my insomnia worse and so I was finally prescribed Temazepam (Restoril), after several weeks of hardly sleeping.  I got some relief from Venlafaxine, but on a routine visit to see Dr Basra I had to see an alternative doctor, who took my blood pressure and stopped my prescription there and then as my blood pressure was too high.

I then endured around five months of fluoxetine (Prozac).  That made me feel like I was being jolted with a few volts of electricity roughly every fifteen seconds.  It had absolutely no effect on my mood.

Alongside the medical treatment I'd been referred for university counseling.  I found this somewhat helpful, and after switching counsellors a few times I was able to build up a good relationship with a nice man called David.

After returning from the summer break in a worse state than I'd been in six months earlier and having not seen Dr Basra for around six weeks, he decided the time had come for me to be referred to a psychiatrist.  I was a little distressed by this.  It's not a nice feeling knowing you've reached a point where you need to see a psychiatrist.

Managing Hatred

As a BPD sufferer I find myself shifting through a plethora of different emotions throughout the day.  I find the easiest of all emotions to identify is the feeling of hate.  Hate can come in many different strains for me, and the period for which  my hate for someone remains is flexible.  What I am starting to realise though is that a lot of the hate I feel towards people is usually very irrational.

A few examples here.  I genuinely hate a number of British TV personalities.  I absolutely loath them.  There are a number of celebrity figures who irk me, and I can distinguish between annoyance and absolute detest.  I have no real reason to hate these people, although they often are a similar breed of celebrity.  To name a few;  Carol Vordeman, Lesley Garrett, Alex Jones.  There are plenty more but those three have stuck in my mind today.  If I were to dig a little deeper there are a few commonalities between the three, but I'll avoid going in to analysis of that now.

In my day-to-day life I often find myself going through periods of hating those that are truly close to me.  I find it difficult to accept that at times I feel hatred towards them, and quite often for only a very minor offense.  I suppose the best example of this irrationality is the relationship I have with my dogs.  I've just returned from a short-walk with them (I have a 4 and a half month old border terrier puppy, and an eighteen month old fox terrier-jack russell cross) and during the walk they both did a few things which irritated me to the point that I felt hatred towards them.  The older dog barks at anything that moves.  The younger dog has a habit of getting under my feet and tripping me up.  Sitting here now, I can see clearly that those things are just their little quirks.  They're not intentionally setting out to upset me.  They're two adorable dogs who are being just that.  At the time of the walk though I really hated them.  It felt like they were mocking me and purposely trying to annoy me.

The point I'm trying to make is that it's very easy to hate those around you when you're blinded by the strong emotions BPD can dredge up, but if you take a step back and look at the bigger picture it's not the person, or in the example above, the animal, you're hating.  It's the behaviour.  In an ideal world the feeling of hate would never emerge,  but even reaching a point where the two can be separated as an immediate reaction would make the world that bit brighter.

Betrayed by the school nurse

I'd been suffering with mental health issues for as long as I could remember.  As a child if I reached a certain level of stress I would repeatedly bang my head against a wall.  This was always done in private.  At the age of 13 I began self-harming and considered myself to be somewhat "depressed".  A school friend who had seen my cuts had told a teacher after I'd been self-harming for around a year, who had then told the school nurse.  I also saw a school counsellor about three times but found her unbelievably patronising.  The school nurse insisted I told my parents, but as a lot of the stress in my life came from my parents, who misunderstood my depression as being a sulky, moody, ungrateful teenager, I was determined they wouldn't find out.  I recall a couple of months where the nurse repeatedly told me to tell my parents, but I didn't want them involved.  I knew it wouldn't help at that point.

It was a dreary monday morning, and I was sat in a boring science lesson.  The school nurse would often turn up during lessons to take me for "a little chat", so I was almost relieved to be leaving the science lesson with her.  However, on the stairs up to the main office she dropped the bomb on me.  "I telephoned your parents this morning.  They're sat in there waiting for you".  I was nearly sick.  I felt totally betrayed by the nurse.  It ended up with a meeting between my parents, my year head, a trusted maths teacher, the school nurse and myself.  It was protocol.  Self-harm was very misunderstood ten years ago, and was definitely associated even more than today with attention-seeking or "being emo".  I was neither.  I also went to see my GP with my mum, but being an "old school" GP, and with it being a relatively new reason for visiting a GP a decade ago, she just checked the cuts for infection and sent us on our way.

My parents initially followed the typical reaction that most parents have when they discover their child is self-harming.  They took everything sharp and hid it away.  Of course they were unaware I had a special "kit" hidden under my bed.  I found the following months even more difficult.  They were more vigilant, although after about a week we never ever mentioned it again.  My mum, if she HAD to mention it would refer to it as "the time when you were silly".  I continued to self-harm for roughly another year.  I remember the last cut I made as a mid-teen.  It was shortly after the death of my paternal Grandad.  I was 16.  I'd just met the person who would go on to become my boyfriend and best friend for three and a half years.  Things were picking up and my days of feeling down and self-harming seemed forgotten.  I was sure I was "cured" and very relieved the "worst years of my life" were over.

Sadly, after the break-up with my boyfriend my problems returned, but I'll save that chapter of my life for a different post.


(To read my views on how turning to a new relationship to "cure" your mental health problems is essentially pointless please see an earlier post: Say no to Prince Charming )

The simplest of things are sometimes the hardest to do

With BPD some days run smoothly.  I get a couple of days per week where things run as if I wasn't ill.  However, for the remaining days of the week I often find even the simplest of tasks near impossible.

Getting dressed, cleaning teeth, brushing hair, showering, eating.  All these things become very difficult to complete.  I find myself just sitting and "being".  Not doing anything, the TV's off, I'm not at my computer and the radio isn't on.  I'm just sat trapped in my own little bubble.  It's not a horrible bubble to be in, but it certainly isn't a nice one.

I find the easiest way to combat this situation is to draw up an activity schedule the night before.  Sometimes I'm caught off guard and don't think a schedule is necessary.  These days result in the above situation.  But if I've pre-planned the day, hour to hour, sometimes minute to minute, with normal daily activities of living I'm more likely to live a normal day.

I know it sounds silly.  For your average person looking after yourself is just natural.  People don't think about it.  But with BPD the smallest molehill becomes a mountain.  It's not laziness.  It's just finding yourself trapped in  the bubble, a bubble which can often be very difficult to pop.