A True Story About Borderline Personality Disorder (BPD)

Borderline Personality Disorder or BPD is a mental illness that can have a devastating impact on lives of the patient and their families. It occurs in about 2% of the population (more often in women then men); but accounts for 20% of inpatient admissions to a psychiatric hospital. People with this disorder suffer severe mood swings. They are prone to self-injury, and suicide attempts. Although, the cause has yet to be determined, studies show a genetic link. They also reveal that the patients may have suffered from sexual abuse and brain injury. This article is a true story about one family's struggle with this disease and the impact it has had on their lives.

I was at work when I got the call. The nurse at my daughter's school needed me to come in right away; she told me that my daughter Amy had been cutting on herself. I was so shaken, so totally taken back that I barely could tell my boss that I had to leave on a personal emergency. I was scared out of my mind. I was totally unaware that she had been doing this to herself. She seemed normal to me. This was a nightmare but it was only the beginning.

When I got to school, Amy was sitting quietly in the office waiting for me. I was lost in a fog. The nurse start explaining to me what had happened and suggested I take my daughter to Community North. It is a hospital that has a psychiatric wing: a hospital that I was to become quite familiar with over the next 10 years. When we arrived, Amy spoke with the crisis counselor and she was admitted to their adolescent ward.

They took her back into the ward and we filled out a lot of paperwork. There was a questionnaire asking us about her health and about any symptoms that we had noticed. Honestly, we hadn't noticed any at all. When we got back home we told her sisters and brother what was going on. They were as upset as we were by the whole thing. Some of my other children held themselves responsible. I guess most of us believed it was our fault. We struggled to find answers. We even grilled Amy. She gave us stories, but I don't think that she had a clue either.

During her 2 week stay, they put her on medicine and began psychotherapy. We also had family counseling. The doctor's originally diagnosed her with depression. It wasn't until much later that they had properly diagnosed her with Borderline Personality Disorder. At the end of the 2 weeks, Amy seemed to be much better. She was discharged and life seemed to return to normal. She was on medicine and began to see a counselor.

After a period of time, we were lulled into the belief that she was turning the corner. She seemed to be making progress. But this was just the calm before another storm.

She entered high school and began talking with a counselor there. They seemed to have established a really close relationship. I was glad that Amy had found someone that she could confide in; it gave me hope: a hope that was soon to be dashed by what was yet to come. You see another symptom of Borderline Personality Disorder is that the patient forms strong attachments to people and then when they feel that the person they've become attached to has abandoned them they react. She reacted. I got another call at work. This one was worse than the first. The school called me to tell me that Amy had overdosed on some pills. They said that she had taken them before she had arrived at school and told her counselor some hours later. They were transporting her to the hospital and needed me to go there right away. I was panicking; I barely got the words out to my boss this time. I got behind the wheel of my car and drove like a bat out of hell on the interstate. This was the first time that I had been able to drive on an interstate since I had a serious car accident; years before. But, the only fear I felt as I was speeding down the highway, was that I would arrive at the hospital too late. I was shaking as I went to the registration desk in the emergency room. I asked about my daughter and the immediately took me back to her. She had had been given deactivated charcoal and she was stable. I tried to talk to her about what had happened but she had little to say. A woman that was next to us had overheard our conversation and she came to reassure Amy that things would be OK. This woman told us that she had suffered from severe depression for many years and then the doctor's finally had found the right medicine for her. She felt totally better now and was able to lead a normal life. This gave me some hope but I don't think it had much impact on Amy. It was back to Community North. Again there was turmoil in my house as we all tried to cope with the idea that we had almost lost her.

Amy did her 2 week stay, we had more family counseling and she was put on different medication. She swore to us that this was the last time we would have to make the trip here. This was only one of the many promises we were yet to hear.

It was back to normal; or so we thought. Amy was as desperate as we were to find some cure for her Borderline Personality Disorder. Other symptoms of BPD are distortions of the thought process and impulsive behavior. I'm sure it was these symptoms that had led Amy to believe that if she were to have a child; she would never again harm herself.

She seemed to be doing really well. (I'm sure that you can see a pattern now.) She had dropped out of school but completed her GED. She had a part time job. Everybody at work loved and respected her because she was a very hard working person. There she met the future father of her child. Everything was right in our world. Things couldn't be better. Then, things started happening all over again. She quit her job and broke up with her boyfriend. I began to worry.

From the first time she began cutting on herself up until this moment in time; there were times where she would disappear. She would be gone for hours and I didn't have a clue as to where she had gone. Sometimes, she was gone overnight and once she disappeared for more then one day. I can't tell you how many times I traveled the streets of my neighborhood to look for her. I even filled out missing person reports. She had also started writing her famous "letters". Letters always meant bad news.

The quiet had ended and a new storm began. She had disappeared once more. This time she had left a letter behind. The letter informed us that she was 9 months pregnant. To say we were shocked doesn't even begin to describe how we felt. How could she be living with us and hiding her pregnancy all along? She hadn't received any prenatal care. She returned later that day. We made an appointment with her doctor for her first prenatal checkup. One week later her daughter was born. She was a beautiful child. Amy loved her daughter and took very good care of her. It was during this time that Amy had begun college. She wanted to be a Respiratory Therapist. She became very close to one of her instructors. They had spent a lot of time together just talking. Just like before, when she had gotten close to someone, an episode was triggered. She again spent time in the hospital. By this time, she had become really good at knowing what to say to be admitted and what she needed to say to get discharged. This became a pattern that would repeat itself often. Again, we heard her promises and again, the family had been in turmoil. The difference this time was that now she had a child. When she was discharged she completed her course of study. She graduated with honors from college and passed the licensing test for Respiratory Therapist on the first attempt.

She got a job as a Respiratory Therapist. Again, she worked very hard and was well admired by her peers. Again, she had an episode, and again she quit her job. Her episodes came more often. Her child was growing up and was starting to realize something bad was happening with Mommy. Every time her Mom would go anywhere she would cry. She always thought it meant Mommy was leaving her again. After awhile, she recognized the hospital where Mommy went; and, she would scream when she saw it. The separations were harder and harder on her.

The hospital too, became quite concerned. They weren't sure that they could help her anymore. They wanted to have her admitted to a long term care facility. But, there was a waiting list. They had changed her medicine several times and as a last resort started her on Electroconvulsive therapy. This was done on an outpatient basis. It is the therapy of last resort. They would put her to sleep and then induce convulsions. She would come home disoriented and very sleepy. Instead of helping the therapy seemed to worsen her condition.

More hospitalizations, more tears, more promises; it seemed to go on forever. Holidays or special family occasions seemed to trigger the BPD the most. But, by this time the family stopped believing that we were at fault; we even believed by this time that it wasn't Amy's fault either. She continued to make promises; act like everything was normal; lull us into complacency and then boom pull the rug out from under everyone.

Once, when she was alone with her daughter, she had overdosed. She called the ambulance and they came but there was no one to watch Racheal. They tried to contact me and my husband but we couldn't be reached. They had no choice but to take Racheal to police headquarters. When I got home, the door was locked and I couldn't get in. I banged and banged on the door but no one answered. I was really scared. My husband came home and told me about the situation and he had gotten Racheal from the police station. It was after this episode that I got Amy's power of attorney so that when she was hospitalized I could act as Racheal's guardian.

There are just two more episodes that I am going to tell you about. The first is the worst one ever. She had been admitted into the Psychiatric Intensive Care Unit and continued to harm herself while she was in there. I only visited her once and she sounded as if she had no hope at all. I was really scared. Amy had learned how to play the system. She knew what to say to get her out of that place. I really believed that she could fool them and that this time she would succeed in killing herself. What worried me more than anything else that she had to say; is when she told me that she wanted to give Racheal up for adoption. I knew from this that she had lost all hope. It was at this time that they changed her medicine again.

When she got out of the hospital; she was truly committed to the idea of never returning. Her daughter was 3 by now and Amy can see the devastating impact that her illness had been having on her daughter. She went almost a whole year, the longest she had ever gone between episodes; before she had her last episode. It was Christmas time and it was too much for her. She was hospitalized once again. Her daughter hurt more than ever before.

The doctor changed her medicine once again. She is now taking 3 different medicines (one anti-psychotic; one anti-depressive and one that is used to treat seizures). This combination seems to be the most effective. Amy is even more determined to stay out of the hospital. It has been 5 months since her last hospitalization

There has been a long lasting impact on our family. I can't trust Amy at all. I am always asking her if she's OK and I never can quite believe her. Sometimes, I see her become real stressed and irritable and I can not help but worry that it is going to happen again. I know my constant interrogations about her well being aren't helping matters. In fact, they may be pushing her in the opposite direction of where I want her to be. But, I keep making an effort to keep my cool and have faith in her and she keeps doing her best to keep her commitment to me and her child. Right now I wait and hope and pray that this time her recovery is for real.

There is more research being done on BPD. One of the more effective ones so far is a behavior modification therapy that attempts to give victims of Borderline Personality Disorder skills that they can use to overcome the compulsion to harm themselves and lead productive lives. There are also new medicines on the horizon so there is a lot of hope for patients diagnosed with this disease.

Amy and I hope that by my writing this article another family may be helped by our experience. The most important thing to remember is that Borderline Personality Disorder is a real illness. No one is to blame.

Source for some of the information in this article:

National Institute of Mental Health, "Borderline Personality Disorder, NIMH URL

http:// www.nimh.nih.gov