I’m having a baby! I’m in my second trimester now. I thought I would stay quiet about my pregnancy on my blog as it’s something so personal, but as the weeks go by I feel more value in talking about it with you. As expected with this under-represented and under-researched condition, I can't find much online or in print about BPD and pregnancy. It's not easy to find different voices discussing how pregnancy feels for those with BPD to be found. I have two motivations for sharing my experience of pregnancy. First of all, there are too many inaccurate and damaging stereotypes about people with BPD and, unfortunately, they extend into the realm of parenthood. As always, I want to share my reality which is a far cry from the fearful myths. People with BPD can have happy lives, there is hope and we can be wonderful parents. I'm hopeful that sharing my experiences of this pregnancy might help others who are pregnant, hoping to have a baby or are new parents. So far, my pregnancy is going well. I’ve been feeling my usual self, but with a hefty dose of nausea. I've made a YouTube video which shares: - how pregnancy is going so far - perinatal (maternal) mental health services - anxiety-inducing test results - midwife appointments - anxiety about telling others *Please note this video mentions early pregnancy loss in the early weeks of the first trimester. Also, if this video is hard for you to watch, please don't watch. I know it can be really hard to see people talking about their pregnancy if you are longing for a baby of your own or have experienced a loss.* Really hope this video helps you if you have BPD (or relate to this diagnosis) and are pregnant, hoping to have a baby, thinking about it or are a new parent. Helpful website for all things pregnancy related: - Tommy's, pregnancy charity with support and information https://www.tommys.org As ever, thank you for supporting me and all of you who have bought my book, Talking About BPD: A Stigma-Free Guide to a Calmer, Happier Life with Borderline Personality Disorder. I'm delighted with how many people are reading and relating to it, plus all the heartfelt reviews. Thank you so much from the bottom of my heart.

[*Note: This post mentions suicide and self-harm, but in no detail*]. It shouldn't even have to be on my Christmas wish list, but, as a person with one of the most stigmatised mental health diagnoses, it unfortunately is. In summer 2021, the article 'Improving Attitudes Towards Personality Disorder: Is Training for Health and Social Care Professionals Effective?' pointed out that: Health and social care professionals are more likely to hold negative attitudes towards people with a diagnosis of personality disorder than toward people with other mental health diagnoses. Negative attitudes have also been found to adversely impact care and service provision. (Attwood et al, 2021). Being judged harshly or treated unfairly by some mental health professionals and services is not something 'all in my head'. There is a growing body of research into stigma by healthcare professionals towards people with BPD which contextualises, and affirms, individual experiences of stigma. One study on so-called ‘difficult patients’ in mental healthcare, for example, found that patients with a diagnosis of BPD were judged more negatively by staff than patients with other diagnoses (such as schizophrenia), even when their behaviour was the same (Koekkoek, van Meijel and Hutschemaekers 2006). Such stigma leaves more than just a foul taste in the mouth though. It often leads to discrimination with real world impacts such as: Fewer services for people with BPD than those with other mental health diagnoses, or no services at all Lower quality of services for people with BPD than those with other mental health diagnoses People with BPD being too afraid or demoralised to ask for help due to past experiences of being belittled, mocked or instantly dismissed by professionals Being referred to (explicitly or implicitly) as an 'attention-seeker' or a 'drama queen' when trying to access crisis care, for example when suicidal or during times of self-harm Over half (57 %) of people with BPD in an Australian study reported that providers shunned them, compared with only 29 % of people with other mental diagnoses (Lawn, 2015). This is not just an Australian issue, I know it's happening in the UK and in other places around the world. I've got first hand experience of stigma and discrimination on the basis of my BPD diagnosis, as I write about extensively in my book. I don't have enough fingers on my hands to count all the times I've been kicked out into the cold to fend for myself when I was suicidal, offered absolutely nothing when I needed completely everything and viewed as 'too clever for help', 'uncompliant' or a 'sensationalist, over-emotional teenage girl with nothing to cry about'. Let me tell you how much the ensuing wounds hurt. Let me tell you the weight of this resultant trauma I carried. And then let me tell you how proud I am of my survival because I am alive. And how many years I spent trying to understand how all of this was allowed to happen to someone in so much pain. And finally— after years of eating self-loathing and self-blame for breakfast— knowing none of this was my fault. If you're in this situation, please attach the responsibility to where it belongs (clue: not yourself). To have respect for someone can be defined as having due regard for their feelings, wishes, or rights. Basic respect is this at its most uncomplicated, unadorned level. Was there basic respect, when as a young woman I was suicidal and left for several hours in an A&E corridor, then a small room, without food or drink, all the while watched by a male security guard who would not even let me go to the toilet without following me down the corridor (I was not sectioned)? When I asked if I could leave to get a snack and a drink, he said not to leave and I was scared of the police being called if I did, so I stayed put with my hunger and thirst. I know that a cold snack and a small drink would have meant the world to me in that moment. I have too many anecdotes like this when really I shouldn't have any. This is my no means my worst treatment too, but it's Christmas and I'm not digging deep into my most painful stories tonight. In case anyone is reading and is wondering what basic respect would look like for me in mental health care settings, let me give some examples. Please excuse me if my list looks a bit pie in the sky, but it's Christmas and if there's one time of year I'm allowed to dream this is it. Relevant and safe treatment for my condition by a suitably trained professional Timely access to treatment, not having to wait months or years when experiencing high levels of distress daily Being notified when I'm coming off waiting lists Having my treatment (medication or therapy), and any possible side effects or risks, explained to me Being spoken to like any person without a mental health condition would be spoken to Being seen as a person with skills, hopes, ambitions, potential and something to offer the world Being listened to and regarded as honest unless I give you a good reason to not to trust what I'm saying Having my suicidality and self-harm understood as expressions of emotional state and/or difficulties I am facing, rather than as character flaws or silly little whimsies I am glad to say that I have had all of the above and more in my last experience of mental health care. I experienced this through my DBT therapist and the wonderful team in which she worked. In my next post, I will explore why and how I have trusted mental health professionals after a multitude of poor or traumatic experiences. This Christmas, I ask that everyone—everyone!— who interacts with mental health services is given basic respect as a minimum (and ideally with all the trimmings). It's a shame I am having to ask, but many things go ungiven until we ask for them (or shout from the rooftops). I do think perceptions of BPD are changing slowly amongst professionals. There are certainly a large number of professionals who are pulling their weight to call out the stigma and dismantle the discrimination and this gives me some hope that one day I will have a Christmas during which basic respect is not at the top of my wish list. Take care everyone and wishing you all a merry Christmas and a prosperous New Year. References: Attwood J., Wilkinson-Tough M., Lambe S. and Draper E. 'Improving Attitudes Towards Personality Disorder: Is Training for Health and Social Care Professionals Effective?' Journal of Personality Disorders, 2021; 35(3). Koekkoek, B., van Meijel, B. and Hutschemaekers, G. (2006) ‘“Difficult patients” in mental health care: A review.’ Psychiatric Services 57, 6, 795–802. Lawn S., McMahon J., 'Experiences of care by Australians with a diagnosis of borderline personality disorder' Journal of Psychiatric Mental Health Nursing. 2015;22(7):510–21. If you enjoyed this post and are able to, I would be most grateful if you would like to buy me a Ko-Fi to help me pay for my website and domain subscriptions. Thank you to everyone who has helped me far.

[*Reading about conversion therapy may be difficult, especially if it has affected you so please take care and see the bottom of this post for a link to support.*] Conversion therapy is a practice that seeks to suppress, 'cure' or change a person's sexual identity and/or gender identity. Conversion therapy calls itself a form of therapy, except that it's not...because it's harmful, dangerous and abusive. It's currently legal in the UK for LGBTQIA+ people to undergo conversion therapy, but there are increasing calls for this destructive practice to be made illegal in this country. Conversion therapy (or ‘cure’ therapy or reparative therapy) refers to any form of treatment or psychotherapy which aims to change a person’s sexual orientation or to suppress a person’s gender identity [Stonewall.org.uk]. Conversion therapy is abhorrent because it tells LGBTQIA+ people that there is something 'wrong' with their sexual identity and/or gender identity and that they need 'fixing'. It should go without saying that there is nothing wrong with being LGBTQIA+ and there is nothing that needs fixing. The real thing that is wrong and the true thing that needs fixing is the prejudice, stigma and barrage of negative feelings that sadly exist towards LGBTQIA+ people. It makes me furious that thousands of people continue to be told that there is something 'bad' about them when this is absolutely not the case. Hearing destructive messages like this— especially from people in positions of authority such as doctors, psychiatrists, psychotherapists, religious leaders etc— can put a huge strain on a person's mental health and well-being. Conversion therapy can—and frequently does— take in settings in which every person should feel safe, such as physical healthcare, mental healthcare and social care. It can also happen in religious, educational or community settings. It's not right that a professional may push a person to disown, change, suppress or fear their own sexual orientation or gender identity. Stonewall's LGBT in Britain - Health report states that five per cent of LGBT people have been pressured to access services to question or change their sexual orientation when accessing healthcare services. This percentage rises to 9 per cent for Black, Asian and minority ethnic LGBT people aged between 18 - 24 and nine per cent for LGBT disabled people. It's just not okay. Lasting consequences of conversion therapy include trauma, intense shame, mental health difficulties, dysphoria and difficulties with relationships. The website Ban Conversion Therapy shares stories of people who have experienced conversion therapy, how it made them feel and its agonising impact on all areas of a person's life— from relationships to health, identity and more. The UK Government has published a consultation to find out what people think about this dangerous practice. This means they are seeking seeking views from individuals and organisations on their proposals to ban conversion therapy. To share your views, take a look at the guidance published on the Ban Conversion Therapy website and have the government consultant page open in another window. Hopefully nobody is reading this post and wondering why it's here on Talking About BPD. As you know, I keep my posts here closely related to borderline personality disorder (despite having interests in poetry, disability more widely, education, literature, vintage clothing, art etc!). However, I have readers and social media followers who are LGBTQ+ and the thought that someone could be hurt by conversion therapy is horrible. Nobody should have to go through this and I am longing for a world in which every LGBTQ+ person can live without fear or judgment. Too many LGBTQ+ people have a rough deal and it's really not fair at all. I'm crossing my fingers that conversion therapy becomes illegal in the UK very soon and we will follow in the footsteps of countries including Brazil, Samoa, Fiji, Agrentina and Norway who have implemented bans of various kinds. If you are one of the thousands of people who have been affected by conversion therapy or something similar, please visit the Get Support section of the Ban Conversion Therapy website for some options. Sending so many kind wishes to anyone who has been hurt and please know I want you to feel safe and welcome whenever you visit Talking About BPD.

[TW this post mentions suicidal thoughts and self-harm] If you're not already familiar with them, Samaritans is an organisation that listens to anyone by phone, email, letter or web chat (currently a pilot) who wants to talk about what's on their mind. Samaritans is run by trained volunteers and their phone lines are open 24 hours 365 days a year for anyone to call. They also have some branches which are open at times for in-person conversations. For full details about what Samaritans do (and don't do), as well as their confidentiality policy please visit their website. Samaritans have helped me countless times. Over the last decade I must have called hundreds of times. I've phoned them in the middle of the night, on street corners, on trains, on the way home from work and after appointments or therapist sessions that left me heartbroken and shaking. Sometimes when I've called them, I've been feeling suicidal and other times not. At times I've been breathless and panicky, talking so rapidly I was breathless. Other times, I have been sobbing from such a primal depths that I felt if I didn't connect with a human I would die from the feeling of disconnection. In my book acknowledgements I thanked the Samaritans who listened to me—without them in those moments I don't know how else I would have got through. I don't remember the exact first time I called Samaritans, but I think it was when I had my initial (and terrifying) mental breakdown. I was a young adult, just nineteen years old, and since that times I have called them at various frequencies. Some months I struggled to cope meaning that I needed to call on a daily basis, usually at night when I felt the lowest. There have been days when I've called several times just because I didn't know how else to survive my emotional pain and I didn't have mental health services to take care of me. I know that picking up the phone to talk to an organisation like Samaritans can be fraught with trepidation or anxious thoughts such as 'what if I'm wasting their time?', 'what if someone needs the call more than me?' or 'what if they think I'm being silly'. I wanted to share my six pieces of advice that I've learnt from being a long time Samaritans caller. I really hope they give you confidence to call if you think it might help you, but you're too nervous right now to take that leap. 1. You are worthy of a Samaritans' time Even though you may feel unworthy, and may have been treated as undeserving in the past, you are absolutely worthy of care and understanding. Who is to say one person's pain is more agonising than the next person's? An indvidual's difficulties cannot be measured against someone else's, like a sapphire's hardness can be compared to a diamond. At Samaritans, there is no hierarchy of whose call is more important; such judgments are impossible to make and even if they were possible they would not be helpful. The volunteer will respect your decision to get in touch regardless of the content of the call and you are equally welcome to call if you are suicidal as if you are not feeling suicidal. Volunteers will want to make you feel comfortable, in part so that you feel welcome to contact again in the future should you choose to. Rest assured also that callers are of all genders, ages, socio-economic backgrounds, ethnicities and so on. There is no one demographic or 'type' of caller and, in fact, you probably know people who have called Samaritans they just might have kept this private. 2. It’s your choice what you talk about When you call Samaritans, the volunteer makes it your space and time. You can talk specifically about what’s on your mind or you can talk more generally if that's easier. Feel free to paint a highly-detailed picture of your situation to the volunteer or use broad brush strokes and keep it more vague, whatever is most comfortable at this time. Some ideas of what you might possibly talk about are emotions, feelings, problems, events, relationships or conflicts. Perhaps you want to use the call to debrief after a difficult appointment or perhaps you have received difficult news and are feeling overwhelmed. 3. There are countless reasons why people contact For some people, calling Samaritans is a way to alleviate the pressure when everything feels too much; having the space and time to express can make stressful things feel more manageable. For others, a phone call is a chance to think out loud and problem solve. Whilst a Samaritan won’t give you advice as such, they will be able to listen to you and ask questions that may help you reflect and find your way towards the next step. Sometimes people call because they have a specific situation they need to handle. Once I called because I had been to an appointment and I had felt really distressed at the appointment. As soon as I left the building I was overwhelmed with huge emotions that frightened me so much I had a panic attack. I called Samaritans and the volunteer listened to me as I managed to regain composure and make myself okay enough to get to work. Other times people call because their life more generally feels like a huge, tangled knot or a dark, friendless cave. 4. It’s okay to take your time You don’t have to have a plan of what you want to say or have all the words formed. It is normal to struggle to articulate things, especially if they are emotionally difficult or you have never spoken about them before. It can be helpful to tell the volunteer something like: 'I'm not sure how to start' or 'I haven't talked about this before so it might take me a little while to find the words'. It's likely that the volunteer will be able to reassure you that it’s okay to take your time and offer gentle questions if it's helpful at any point. When you're on the call, there is no pressure to say everything at once. There is no limit to how many times you can call, so you are welcome to call again another day and have another conversation (even though it will most likely be a different volunteer next time). Everyone is different with how much they say and the speed at which they express themselves— the volunteers are aware of this. 5. You are in control Although all Samaritans volunteers undergo the same training and abide by the same organisational principles, every volunteer is also a human with their own communication style (after all, conversation is an art not a science). If you call and you don’t 'click' with that particular volunteer for whatever reason, you can end the call. It's as simple as clicking 'end' on your phone or saying 'I need to go'. As calls are allocated to numerous branches, it is very unlikely that you will reach the same volunteer twice. Talking about personal topics, especially if they are emotionally difficult, can be exhausting. If you become too tired, stop. Furthermore, if you simple change your mind and don't want to speak anymore, or feel the conversation has come to a natural end, you can end the call. It’s completely your choice when the conversation finishes. You are in control. 6. Samaritans take a non-judgmental approach One thing you might worry about before calling is eliciting shock, repulsion, distress, pity or panic a volunteer. Anxieties like this can be especially strong if you have been met with negative reactions or unwelcome emotional reactions when expressing yourself to friends or family. After such experiences it's understandable to be afraid of speaking openly, even to strangers. However, I want to reassure you that Samaritans volunteers are trained in non-judgemental responses. Their stance is curious and open, rather than one that rushes to push their emotions and beliefs onto you. If you think it might help, you are free to tell the volunteer how others’ reactions have made you feel in the past. I also find it helpful to remember that a Samaritans volunteer is lending their time and skills to this role because they want to. A volunteer must believe (or personally know) that listening non-judgmentally is a valuable resource or they wouldn't be spending their time doing this. The volunteers feel good when they offer you the time and space that you were struggling to find in other places and so keenly needed. Have you ever contacted Samaritans? I hope you found this post reassuring and helpful, if you're needing some confidence with making a call. Let me know what you think if you would like to. I would also like to highlight the organisation Shout here too. Shout is the UK's first free 24/7 text support service. It's described as 'a place to go if you're struggling to cope and need mental health support'. My book, Talking About BPD: A Stigma-Free Guide to Living a Calmer, Happier Life with Borderline Personality Disorder, which offers coping techniques for managing emotional distress is out now.

It's been over a fortnight now since my book, Talking About BPD: A Stigma-Free Guide to a Calmer, Happier Life with Borderline Personality Disorder, was released. The response has been utterly heartwarming and uplifting. It makes me so happy to read the reviews, comments and messages about the book that readers have been sending me. First of all, I'm really glad the book makes so many people feel seen, validated and understood. I know how invisible and silenced people with BPD often feel across many different settings. Secondly, I'm delighted it can go some way to helping individuals feel worthy of care and more confident about themselves and life in general. I know how difficult life can be with this often stigmatised and misunderstood diagnosis for a multitude of reasons. Anything I can do to make life feel that little bit easier is something I want to do. I have spent thousands of hours over the last two years planning, writing, editing and communicating with my publisher Jessica Kingsley (JKP). Every last ounce of hard work was worth it because I have made a book that encapsulates how I feel about BPD and my life with it. I am proud of bringing this book to fruition and the icing on this cake is how many people it's comforting. Thank you so much to everyone who has supported me to make this happen. I think I need a break soon because I am really tired from all the excitement of launching the book! - Rosie Watch the book launch live here: Purchase the book here.

Join me on Thursday 21st October at 7.30pm BST for my online book launch. I will read a few short sections from my book, before moving onto a Q&A session. Feel free to ask as many questions as you like about BPD &/or the book in the chat. The book launch will be via You Tube Live on my YouTube channel ('Talking About BPD'). Follow this link from 7.30pm BST to take part: https://youtu.be/z3GOd5-B0zc Hope to see you there! This book has been two years in the making and I can't wait to finally share it with you. A special thank you to my publisher, Jessica Kingsley, for making this happen and Kimberley Wilson for writing the beautiful foreword. To get your hands on a copy of my book click here: https://www.amazon.co.uk/Talking-About-BPD-Stigma-Free-Personality/dp/1787758257

After two years of hard work, my book is almost out! Thank you to everyone who has tweeted me telling me they have pre-ordered...I am so happy! I hope you love it. I am Rosie. I have BPD. I am not an attention-seeker, manipulative, dangerous, hopeless, unlovable, 'broken', 'difficult to reach' or 'unwilling to engage'. I am caring, creative, courageous, determined, full of life and love.' Talking About BPD is a positive, stigma-free guide to life with borderline personality disorder (BPD) from award-winning blogger Rosie Cappuccino. Addressing what BPD is, the journey to diagnosis and available treatments, Rosie offers advice on life with BPD and shares practical tips and DBT-based techniques for coping day to day. Topics such as how to talk about BPD to those around you, managing relationships and self-harm are also explored. Throughout, Rosie shares her own experiences and works to dispel stigma and challenge the stereotypes often associated with the disorder. This much-needed, hopeful guide will offer support, understanding, validation and empowerment for all living with BPD, as well as those who support them. Here's what the reviews says in case you are wondering whether this book is for you... 'I am grateful for Rosie Cappuccino's 'Talking about BPD,' as I finally have an authentic, stigma-free book to recommend to my DBT clients. A mix of personal experience, research-based information, and skill-building material makes this a must-read for those with BPD plus their loved ones and providers.' ― Alicia Paz, M.A Owner of Online DBT Skills 'Rosie is a strong and compassionate advocate for individuals diagnosed with borderline personality disorder. I'm forever thankful for her encouraging message of hope and recovery. As a DBT therapist, this is a book I can strongly recommend to my clients and their families.' ― Amanda L. Smith, LCSW, Treatment Consultant for Borderline Personality Disorder and Self Injury and author of The Borderline Personality Disorder Wellness Planner for Families 'This book brings to life, and provides an invaluable insight into, the experiences of the stigma that is encountered when living with Borderline Personality Disorder, as well as approaches for managing BPD.' ― Professor John Baker, University of Leeds, Chair of Mental Health Nursing Click here to pre-order. I hope you find this book comforting and helpful. Writing is was an act of self-affirmation to be honest and I hope reading it gives you as much confidence as writing it gave me. - Rosie x

*This post mentions suicidal thoughts and self-harm urges* This summer has been marked by both soaring happiness and deep, despairing lows. As a whole, I've been full of happiness and enjoying all the good things in life, feeling content and at peace in so many ways. Things have been happening in my personal life to make me feel so joyful and grateful. At the same time though, amongst these happy feelings, I've had to face huge sadness as a result of something that happened. I won't go into details about this upsetting thing that happened as I like to keep some privacy especially when other people are involved. In summary though, I had communication with, and decision-making from, someone I care about that really, really hurt. Like really, really hurt. Pain deep inside me that I thought was gone re-spawned and it made me feverishly distressed. I was once again under the spell of distress that not much can reason with. I was pulled into the depths of agony that mean I think of suicide and about hurting myself. I was tormented with the thoughts of my own worthlessness and pointlessness. For a few days I struggled to cope with most things and needed support from my family and partner. I was hurting so deeply that I felt suicidal on and off for a couple of weeks and I was having urges to punish and hurt myself. I'm not religious, but at some points I even wanted to pray and beg to a deity to take my pain away. I cried so much my face swelled up and I had reduced vision. I had headaches and couldn't eat or sleep properly. I waited for it to pass and it did. It always does. I managed to use some DBT skills to get me through and I think I'm okay now. I have all those good things that make me feel content and peaceful. I am still upset about the incident that happened, but my sadness is bearable now. Perhaps I will write more about it later.

This is the second guest post by Katja P. (she/her), a secondary MFL (modern foreign languages) teacher and mental health activist. In her previous post, Katja describes how education needs to become more inclusive and accepting of education staff with BPD (borderline personality disorder). In this second powerful piece, Katja shares how the label 'high functioning' has been used by professionals to invalidate her very real and very painful difficulties, as well as deny her the support she needs and deserves. *Just to let readers know, this post mentions suicidal ideation, self-harm, bullying, binge eating and alcohol.* 'The label ‘high functioning’ has followed me my whole life. Back in the early 2000s, mental health provision was a million miles away from how it is now. Precisely why the bullying started is a mystery, yet it continued from year 7 right through until the end of year 11. My lunch breaks were spent in the toilets, and I spent an hour hiding there after school until I could be sure that the group of girls in the year above wouldn’t follow me home, shouting abuse, spitting at me and throwing rocks. I was also having additional major problems outside of school, so schoolwork became my escapism. I was a high academic performer, so how could someone like me possibly have mental health problems? Teacher expectations of me became ever-increasing, and their approval gave me validation. Even as a teenager, my lack of identity was evident and by becoming outstanding academically, I finally felt I had a sense of who I was- an overachiever. After excelling at my GCSEs, the school made it clear I was tipped for Oxbridge. Three months into my A level studies, I was involved in a serious accident and off school for four months. For a sizeable proportion of that time, I was unable to walk and in constant pain, which prevented me from being able to focus. When I returned to school amid constant hospital appointments, it was clear the school had lost interest in me. I stopped eating and was also secretly drinking heavily and self harming as a way to cope with feelings of failure. I dropped out and went to college. I opted to resit my AS levels alongside taking my A2 papers, doubling my workload- I didn’t want to repeat a year and lose another of mine. That autumn I went to university. I’d relocated to allow myself a fresh start, but straight away problems emerged. I found university culture to be very enabling for someone prone to extremes. This was where most of my impulsive behaviours really started to take hold. At the same time, problems with relationships began. Although I made friends, I lost them quickly, usually as a result of them telling me something I didn’t want to hear. Romantic relationships started out as intense but became unpredictable and fiery as I repeatedly tested partners’ commitment to me. I would also act very irrationally and put myself in dangerous and damaging situations on a regular basis. This behaviour continued into my year abroad, where my issues were compounded further by the language and cultural barrier. I had no friends and became withdrawn, isolated and lonely, which pushed me further into destructive habits. I returned to the UK three months early as I was suffering from suicidal ideation. Despite this, I consistently came out with firsts and 2:1s in my exams and assignments, which masked the chaos of my private life. For several years, I was caught in a cycle of seeing my GP and being referred to wellbeing services who would carry out an assessment. None of the criteria ever applied to me, so they would look at my responses and say exactly the same thing each time- there is nothing we can do for you. Once, I ticked the boxes I thought they wanted me to tick and actually got to meet one of the psychological wellbeing practitioners. She encouraged me to talk about my most traumatic experiences. At the end of the session, she looked up from her notes and informed me that actually, having five or six very traumatic experiences in life is totally normal and I appeared to have worked through my trauma all by myself and was fine now, so there’s nothing she could do. After six years of this back and forth, I was finally referred to psychiatric services in January of this year for a BPD diagnosis. However the psychiatrist admitted they didn’t like issuing a BPD diagnosis and preferred to treat with medication where possible before diagnosing, due to the stigma and lack of treatment options. They questioned how useful a diagnosis would be for me personally. I felt like I needed it on paper. Although I now have my diagnosis and am on antipsychotics and mood stabilisers, DBT is unavailable to me. I’ve done the best I can to help myself- working through DBT workbooks by myself, becoming vegan to stop binge eating and quitting alcohol to keep my mood more stable. But I strongly suspect that clinicians have placed me near the bottom of the list of priorities because I’m considered high functioning. Mental health professionals seem to only look at my life through a superficial lens. I do not present as someone with a serious mental health condition. I have a strong marriage, a happy and healthy child, am educated, articulate and well presented, have a respectable career with a stable income and have made some impressive accomplishments. What they don’t see is that, in order to maintain this facade, I am constantly trying to keep my head above water. My quirky fashion sense and eccentric outfits? Courtesy of a previous spending addiction. My outstanding work ethic and achievements? Thanks to an innate fear that if I stop being occupied, my descent into paranoia and intrusive thoughts will be inevitable. My reputation as being sensible? Down to my abstinence from alcohol because I am unable to have one drink unless it is followed by twenty more. My socially-acceptable sized body? A product of obsessive over-exercising to try and rid myself of [x number] of calories I’ve just consumed in a binge eating session. My ability to be calm and rational under almost all circumstances? Well, that’s a skill I’ve developed thanks to dissociation. This is usually the point at which a psychiatrist rubs their hands with glee and congratulates me on my “excellent coping strategies” and prepares my discharge paperwork. It’s time that we lost the high functioning and low functioning labels- everyone deserves a right to help for BPD.' - Katja P. Thank you again Katja for this piece exposing the harm caused by 'high/low functioning' labels. Reading your experiences of being denied help makes me emotional, firstly because it makes me angry that so many people are not given the care they need and secondly because I relate so much. I too have been called 'high functioning' due to certain aspects of my life. I have been ridiculed, shamed, invalidated and denied help on this basis causing me further trauma and pain. It's high time professionals stopped using a person's work or academic performance, their family, friends, clothes, make up, personal hygiene etc as 'reasons' why someone doesn't need support. Mental health problems are so much more complex than what someone is wearing or what grades they got- surely that should be obvious by now. A huge attitude shift is needed from some professionals and services, as well as much easier access to specialist, high-quality and empathetic mental health services. Anyone who needs help for am mental health difficulty should be given help. Thank you so much again Katja P. I am sure this post will be validating for many readers who will relate. You can read more by Katja P. and find out more about her work by following the links on her previous guest post.

This guest post is by Katja P (she/her), a secondary MFL (modern foreign languages) teacher and mental health activist. In this post, Katja talks about how education needs to become more inclusive and accepting of teaching staff with BPD (borderline personality disorder) and other mental illnesses if young people are to have diverse role models. 'Since my BPD diagnosis, I’ve looked to ways of addressing the insidious ways discrimination and prejudice can permeate through the education sector. It would be easy to assume that schools and colleges are at the forefront of equality, but this sadly isn’t always the case. Earlier this year I set up a campaign encouraging schools to become Disability Confident, a government initiative that aims to increase access to employment for disabled individuals. Some schools already guarantee interviews to disabled candidates but, following on from my media work, I was inundated with messages from teachers and teaching assistants with BPD who had been treated unfairly. From exceeding job description requirements yet being denied an interview due to declaring their diagnosis in their application, to being demoted or managed out after diagnosis, to having reasonable adjustments refused because BPD ‘isn’t a disability’, through to trainee teachers having job offers rescinded after time off for BPD related issues. It made for disturbing reading. Shortly after my campaign launched, I received an anonymous email advising me to remove the campaign for ‘bringing the profession into disrepute’. I found it odd that anyone wouldn’t support a measure to widen participation and inclusion. At the time, the petition had fewer than ten signatures. Although part of me found it laughable that anyone would feel threatened by a petition with such a low number of signatures, it did indicate part of a wider problem. Fellow teachers confided they were reluctant to sign, despite supporting the campaign, “in case my school finds out.” Repeated efforts to contact my MP to discuss the matter were met with stony silence, and my union were initially reluctant to support me. The fact is, the campaign held a mirror up to societal attitudes towards the most stigmatised mental health conditions, and the reflection is still pretty damn ugly. Mental health campaigns scream from billboards and magazine pages, encouraging us to be open about our mental health. Something I have learned since my diagnosis is that openness is generally only encouraged for certain mental illnesses. Openness is actively discouraged if you have a personality disorder, psychosis or a dissociative condition. Those labels invalidate everything else you may be. I may be a graduate studying for a masters who speaks six languages and is a committed and passionate teacher, but the moment ‘Borderline Personality Disorder’ appears on my CV, this cancels out who I am, and I become what I have. So, why don’t I leave all mention of BPD off my CV if it’s so reductionist? My response is simple- why should I? If people with serious mental health conditions are to have a voice, actually telling people I have a personality disorder is a good starting point. It allows me to request reasonable adjustments in order to ensure I can carry out my work commitments effectively. Many schools dissuade staff from discussing their mental health under the guise of ‘unprofessionalism’. But children need diverse role models, and people with BPD are often excellent teachers due to high levels of empathy and creativity. I don’t tell students about my BPD, but they have an uncanny ability to seek out teachers who understand what it’s like to struggle. School leaders may shrug- well, it doesn’t apply to our school. It does. The incidence rate is estimated to be around one in 100 people. In reality, this is likely to be far higher. Factor in the following; borderlines are drawn to caring professions and are likely over-represented in education, clinicians are often reluctant to issue a formal diagnosis of BPD and prefer to treat it with medication, and most people with BPD have at some point been misdiagnosed. There is a very real likelihood at least one member of staff in a school has BPD. If an institution prides itself on its progressive stance on LGBTQ+ issues, racism and wellbeing, yet refuses to acknowledge serious mental illnesses, then it cannot stand for equality. Equality is not about cherry-picking which issues matter. If an institution is shouting loudly about having LGBTQ+ role models within its staff, or taking measures to widen opportunities for minority groups, yet is quietly binning CVs from suitable applicants who have disclosed a serious mental health condition, then it does not stand for equality. It stands for hypocrisy.' - Katja P A huge thank you Katja for this powerful and important guest post. As a fellow teacher, this post hits me right to the core—and I couldn't agree with you more fervently. As you express, there is still a long way to go until teachers with mental health conditions—particularly a stigmatised diagnosis like BPD—have equality. I appreciate the work you are doing to get this inequality noticed and push for a positive change in attitude and accommodations. Thank you so much for sharing this piece on Talking About BPD and thank you even more for pushing for the full inclusion of teachers with BPD. Please keep going if you can and I wish you all the best. Links to Katja P's work: Campaign/Petition: Encourage Schools To Become Disability Confident Teacher Toolkit Podcast: Supporting Teachers with Borderline Personality Disorder Times Education Supplement: ‘I’m a teacher with borderline personality disorder’ If there are any teachers or teaching staff reading this who want to write something for Talking About BPD, please drop me a line at rosie@talkingaboutbpd.co.uk and we can talk.

Today's guest post is written by Charlotte (she/her), a recent university graduate who lives with a diagnosis of borderline personality disorder (BPD) among other diagnoses and conditions. Charlotte is hugely passionate about Disney, swimming and a good book, and can be found on Twitter @charlotte_em_d. Future in Flux by Charlotte 'Recently, with the help of some wonderful people, I completed a three-year degree at university. However, I’ve now arrived at that point in my life where I’ve spent a lot of time asking myself the question ‘what comes next?’. Perhaps this is a feeling you can relate to? It’s a future I never planned for; a future I didn’t expect to be alive for – something that for so long, I never expected to become reality. The DSM-5 provides nine diagnostic criteria for BPD (of which, five or more are required for a diagnosis) (American Psychiatric Association, 2013, p.663). In this post, I will briefly explore the second and third criteria, and how I feel these characteristics may make it difficult for both myself and others to have hope for a future: 2. Up and down, very intense relationships associated with switching between idealising someone and then devaluing them. 3. Identity disturbance, including noticeable and ongoing unstable self-image or sense of self. Beneath the question of ‘what next?’, the real question ‘who am I supposed to be?’ is revealed. Like so many people who have, or relate to, the BPD diagnosis, my childhood was always overshadowed by a sense of constant instability [1]. I learnt how to regulate the actions and emotions of others, at the expense of my own. Now as an adult trying to make plans for a future, I find myself looking to people to tell me who to be, only to be reminded it’s time I need to just figure it out for myself. While I don’t mean to completely disregard this response – there is a lot of truth in it – nonetheless, it can be incredibly frustrating. Experiencing identity disturbance for me means I find it hard to know who I really am. My identity is very much fragmented and increasingly bound up with my relationships with people and the projects I am involved with. In some ways, it can be likened to (or is) what BPD communities’ term ‘favourite person’. It’s that person who you idolise in almost every way, although it can change – and change quickly too. When the person that I see myself to be is dependent on others and fluctuates so much, planning for a future seems near impossible. I think at some point for a lot of us we have had to try and figure out who we are in a world which tell us who to be. It’s exhausting work. Sometimes I have a plan – only to tear it to pieces myself three days later. Not knowing what will avoid all points of potential conflict; make the most people happy; lead to the least expectancy, negates being true to the person at the core of my being. I’m trying to follow her wishes as best as possible which means for now continuing doing what I’ve enjoyed so much over the last three-years. Despite all of this, my self-worth and value continues to rocket up and plunge back down; I have fear as much as excitement for the life in front of me. Sometimes I wish I had a better idea of who I am beneath the BPD, while at other times I can simply smile and look at how far that girl who once had no hope has already come. Notes 1. I personally avoid the phrases ‘childhood trauma’, ‘trauma’, and ‘abuse’ more broadly when describing my past. A lot of my experiences would be fall into these categories, but presently I feel it places blame on people still in my life and I still fear what this would mean. It is something I am still on a personal journey with.' - Charlotte @charlotte_em_d Thank you so much Charlotte for sharing your thoughts and experiences here. I think that many people will relate to you, especially after completing something as long and intense as a university degree. This sentence is so powerful: 'I learnt how to regulate the actions and emotions of others, at the expense of my own'. Your words have captured something that many readers will identify with, but may not have been able to summarise so precisely. It sounds very confusing to be in this state of not knowing, but I feel very happy that you are here expressing yourself and staying with these difficult feelings. Sometimes time brings a little more clarity, bit by bit, moment by moment. I'm hoping that this clarity comes to you soon and until then you can spend time doing things that bring you enjoyment like Disney, swimming and reading. Thank you so much again for sharing this here and I wish you all the very best Charlotte. References American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders. 5th edition. Washington, DC: American Psychiatric Publishing.

Today's guest post is by Angela (she/her). In this post, Angela describes her experience of having BPD and being part of the LGBTQ community. 'Hi I’m Angela, I was diagnosed with BPD in my early thirties, but have struggled with symptoms since childhood. I am passionate about mental health awareness and challenging the stigma associated with BPD. I love yoga, meditation and spending time with my loved ones. For as long as I can remember I’ve had emotional problems-- I have a diagnosis of EUPD [emotionally unstable personality disorder, another name for BPD]. I’m aware lots of people dislike having a diagnosis, but for me it gives me a sense of understanding of who I am. I also remember always finding women beautiful and interesting and not having much interest in men. For this reason I identify as lesbian and I’ve come to terms with that. I have struggled with all the big symptoms of EUPD at different stages of my life-- one example is the identity disturbance. To this day I still struggle to describe myself as a person. At the moment, I’d say I’m a bit of a “hippy chick” I’m into yoga, mediation and I love my crystals. I’ve had this identity before and it suits me best. I have had many different identities in my life: goth, artsy, hippy, scientist, girly swot, Barbie (whether I looked this way or not it’s how I saw myself) as my hair has been literally every colour under the sun! I find it stressful when I bump into people from previous phases of my life. I feel like I’m not authentic because I think of how I was at a certain time. I think this is why I spend so long questioning my sexuality. The LGBTQ community in 2021 is rich and diverse, but in the nineties it differed. Lesbians looked a certain way and because I was girly etc I never fit in which led me to question my sexuality so much. I went though a terrible time in my late teens where I wasn’t sure who I was. I would analyse every thought and emotion that I felt. I was always questioning “does this mean this?” and I didn’t know who I was. If someone said I seemed straight I would literally obsess over it for hours. I was the only person I knew who struggled with this. I was also obsessed with how I looked, what I wore and how I came across. I can see now it was my BPD causing me stress, but I was undiagnosed back then and nobody ever spoke about mental health. I read somewhere that confusion over sexuality can be a symptom of BPD. I am aware this angers people. On paper it can seem “if you’re gay then you have an illness”. I don’t interpret it like that. It’s not about being attracted to and loving people of the same sex, it’s the clinging to the identity part and the distress it can cause. I wish I could tell all this to the me of 20 years ago! I want to say that this is just my experience. I can’t speak for any other members of the LGBTQ community and I can’t speak for anyone else with BPD.' --- Angela Thank you so much Angela for sharing some of your experiences here. I am so glad you now have an understanding of yourself and it is interested that diagnosis has been a part of that. Like you say, you can't speak for anyone else who is LGBTQ+, however I imagine that parts of your experience will resonate with aspects of others' experiences. I also feel that what you have expressed demonstrates the importance of never judging a person based on their appearance. Something else that came to mind whilst listening to your experiences is the horrifying fact that 'homosexuality' was only removed from the DSM (Diagnostic and Statistical Manual, book of mental illnesses) in 1973. I am sad and angry that today, in 2021, many LGBTQ+ people continue to face widespread discrimination across a number of settings and situations. I just want to say to any blog readers who are LGBTQ+, you are welcome here and I want you to feel safe here. Hate or disrespect of any kind is never okay and if I see it on my social media I will call it out as soon as I can. Thank you again Angela and take care! Support: Switchboard provides a one-stop listening service for LGBT+ people on the phone, by email and through Instant Messaging. UK. 0300 330 0630 https://switchboard.lgbt References and further reading: Drescher, J., North, C. and Suris, A. (2015) ‘Out of DSM: Depathologizing homosexuality.’ Behavioral Sciences 5, 4, 565–575. Latest edition of the DSM: APA (American Psychiatric Association) (2013) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (5th edn). Washington, DC: APA. Bachmann, C. and Gooch, B. (2018) LGBT in Britain – Health. Stonewall. Available at www.stonewall.org.uk/lgbt-britain-health