Beyond Borderline

Previously, I had found using the diagnosis of Borderline Personality Disorder offered a helpful framework for both thinking generally about my mental health issues and looking for promising interventions. Recently though I’ve changed my mind, not only because I think focusing on a specific diagnosis can mean missing important extra-diagnostic symptoms and therefore overlooking worthwhile interventions, but mostly because I don’t fit the symptoms as well as I once did. Until I pretty recently, I would’ve run the gamut of Wikipedia’s BPD symptoms;

• I would go to incredible, wildly irrational lengths to avoid my perceived fear of abandonment;
• My interpersonal relationships were highly volatile, often becoming intensely close in a short period of time before being torn apart just as quickly;
• I had no meaningful sense of identity;
• I would regularly binge eat and binge drink;
• I would regularly think about suicide, with varying levels of seriousness;
• I was wholly unable to regulate my emotions, and was prone to bouts of serious depression that would last weeks or months;
• I was persistently angry, but totally unable to show it.

Now, I’m not really sure any of these fit. I have a stable romantic relationship that at least seems proportional to reality - I don’t spend time worrying about my partner leaving me, and even if they were to do so, I think I would bounce back. My sense of identity is slowly coalescing around the ideas of running, software engineering, and effective altruism. I think that together, these things are all interesting and net-positive, and labelling myself as some combination of the three makes me feel good about myself. I barely drink, although I do still struggle with emotional dysregulation at times, and use (binge) eating as a coping mechanism. With that being said, I haven’t had a serious bout of depression since April 2020, when frankly if you didn’t experience a period of intense depression then you didn’t have a proportionate grip on reality. I haven’t seriously considered suicide in the last two years, which might be the only time I’ve been able to truthfully say that in the last 15. I still struggle to show any of my anger, but I am far less angry than I once was.

It’s reasonably common to grow out of BPD at around my age, and maybe all I had to do was sit tight and wait for my dues to be paid, but I feel like I worked hard for this. That’s not to say that “this” is the picture of perfect mental health, quite the opposite - I still can’t effectively regulate my emotions without some kind of self-destructive coping mechanism, but at least now I am far more alert as to when my emotional state is beginning to go south, giving a more productive intervention and an earlier juncture a greater chance of success.

I’m not interested in finding another label for whatever addlement remains in my psyche. At this point I think I am knowledgeable enough and resourceful enough to be able to think about myself holistically, and derive root causes to problems when they arise. There is still a lot of hard work to be done, and it requires a different approach than succeeded previously.

A related thing that’s been on my mind recently is the best way to talk about mental health in public, and I think there is a certain niche that I can, in some infinitesimal part, fill. It’s become a lot more common for people to share their mental health struggles with the world, and there are now people who I am going to only slightly perjoratively refer to as “sadfluencers” (a quick Google search reveals this term has not caught on yet, so if it does, I claim coining rights and expect this post to be cited).

This is good! Mental health stigma is bad, and it used to be even worse! It’s killed huge numbers of people, and been responsible for even greater suffering! For friends on the left, it’s a tool of the patriarchy! For friends on the right, it’s responsible for massive loss of productivity every year, and contributes to the UK’s continued economic stagnation! For friends in the centre, perhaps your own ailing mental health is responsible for your lack of conviction, and you’re blinded to it by the raw overwhelming power of the stigma! All of these issues could be alleviated by people being publicly open about their mental health!

Before we get too carried aware that posting videos of you chugging SSRIs on TikTok is the solution to the world’s problems, you’ve probably guessed that I have a minor objection to this. Well, not an objection per se - I think these people should keep doing what they are doing, and that they’re doing a public service, sarcasm and snark aside. But, to me, a lot of it doesn’t ring true - it is compartmentalized, detached, at times veering dangerously into being performative.

And, you know, maybe everything is performative, maybe this post is performative, whatever. Maybe all the writing I do about my mental health is equally compartmentalized and detached, and I am a hypocrite. Perhaps, but I think I can talk about mental health in a more authentic, more genuine way than most others; able to anchor my thoughts in reality when I need to, but equally capable of drawing back the curtain of the irrational when I need to. I have a particularly British sensibility for prudence, but it’s equally important to me to minimize the amount of filtering done between brain and tongue (from experience, said filtering bears a heavy psychic cost). You will not catch me posing with silvery foil packets of medication on Instagram (if you think this is a joke, someone I know did this this week), nor will you read me saying that while yes, I do have a Mephistophelian demon who constantly whispers to me that I’m unloveable and is constantly trying to goad me into trading my sanity for immeasurable knowledge, I’ve actually got him chained up under lock and key in a bunker 50 feet underground, so I’m doing totally fine and well, thank you for asking. This is pretty clearly not the case - devils are notoriously claustrophobic and adroit at escaping entrapment in confined spaces - so mine pesters me on a daily basis, so much so that I’m frequently not fine and well, although I appreciate you asking regardless. I so rarely see people discuss the ongoing process of attempting to get better, even though so many of us are stuck right there. So that is the gap I will try to fill; to continue trying to hone in on basal issues, researching, attempting and evaluating interventions, and iterating. My brain is a computer, and I am an engineer - I will solve problems like one.

One last thing - since I’ve stopped posting daily, I’ve felt my personal bar for posting has gone way up, hence the lack of posts. I think this is bad; posting is good for accountability and for clarifying my ideas. I’m going to make efforts to lower my bar again, but that does mean there will be more posts like this one - about only loosely related things, which may or may not shift tone midway through, and with criminally little editing.