Triangles: the Holey Trinity of Possible BPD (Part 1)

Words by Kat Muscat

Published on August 7, 2014

Part One: Triangles

After I left the session that fucking envelope was too tempting. An address and phone number in black, barely legible scrawl, the way they all seem to write. Sealed stuff always does win out, especially when it’s about you.

‘Thank you for seeing Miss Kathryn Muscat (age 23 yrs) for opinion and management concerning a long standing mood disorder… I have sent her to a counsellor recently, and have tried her on Aropax and Efexor with little help. She currently takes Diazepam on a PRN basis, but has found this becoming less effective. She is aware of alcohol dependency, both physical and psychological… She regularly experiences panic attacks and episodes of marked confusion and despair. Her symptoms are incredibly intrusive, and I feel she needs long term medication but am at a loss as to the best option given her poor response to treatment.’

So, reading my doctor’s referral was a mistake. It’s a spare copy in case the fax didn’t work because apparently people still fax things. Luckily, the restaurant I’ve retreated to is mostly empty during my silent-movie-star cry, the one that only happens when no one’s around to give me kudos for such glamorous sadness. Though I’m still ready with an excuse about accidentally putting too much chilli in my pho. On the way home I fill the new script. The pharmacist’s lowdown contradicts that of the psychiatrist and I am given a different hand-out. This one I don’t read.

Later, in the kitchen with my girlfriend, I ask how much she knows about Borderline Personality Disorder (BPD). A follow up appointment is scheduled a month from now, but that was my psychiatrist’s best guess at the end of our 1.5 hours together. While well versed in many other non-neurologically typical conditions, the particulars of this one have evaded both of us. As she throws fennel into the risotto, Gen says she’s heard that while it is definitely a thing, woman are much more likely to be diagnosed with BPD than men. And then we start talking feminism. About how, speaking in broad strokes, women do have more to be afraid of, depressed or angry about, and how fucked up pathologising that is. Instead of, y’know, combatting the problems. Both of us struggle to answer where maladjusted coping mechanisms end and where mental illness begins.

‘Maladjusted’ is a word I heard repeatedly throughout the shrink sesh and it sticks to the top of my mouth like rotten citrus. Cuts through the rockstar illusions I still occasionally harbor about my ability to easily outdrink most of my friends. The three-day benders; the stories I’ve collected. All those bottle caps that clink deceptively like coins in the bottom of my bag. ‘Maladjusted’ pulls the pieces together so they clash uncomfortably, releasing zesty awfulness.

It is three days before I do any of the suggested research. SANE Australia summarises the symptoms of BPD as

  • deep feelings of insecurity
  • persistent impulsiveness
  • confused, contradictory feelings, and
  • self harm.

 

All of these fit. During this time I struggle with the idea of telling my parents. I could fudge the facts and frame it solely in terms of financial assistance (which I am lucky they’re able to afford — being mentally unwell is fucking expensive). In the end I decide against disclosing the new diagnosis for now, not wanting to worry them.

Compounding the fear of upsetting my family and friends, I am afraid of confirmation bias. That I’ll use BPD as a ‘get out of jail free’ card to be a total jerk. This fear doesn’t really make sense, since I’ve dealt with depression and anxiety for over a decade. But psychosis is a fairly new beast. One that I’m desperately unpracticed at lion-taming. Then there’s the ominous threat that the psychotic episodes will only get worse if not treated. This had been repeated often. The audio-visual flickers, the spirals of unreality that terrify may become par for the course if there’s no self-crafted handle to hold onto. Free tickets for time-travel to places of trauma are less fun than most other free things. At the same time, it all feels inseparable from who I am. Intrinsic. Or as my first philosophy teacher described it: ‘without which not’.