(Trigger warning: Mention of self harm, suicide)
Happy, irritated, agitated, screaming, crying, cutting, numb. It was just another day in my room. I went to my class, wrote my paper and came back. Numb again.
A year later, I was screaming, throwing things, and almost biting my loved one. ‘Don’t leave. Stay. I will not be able to survive if you leave. I know you will leave. I hate you. Please don’t go.’ It was a typical BPD episode, triggered and reacting to the past.
Borderline Personality Disorder is experienced by a vast majority of the population.
The DSM 5 says around 8 percent to 10 percent of the individuals experiencing BPD are likely to engage in self harm or self mutilative activities.
Suicide attempts are a common occurrence with the disorder.
People have the basic needs of authenticity and attachment, and often one has to compromise their authenticity for attachment because survival becomes a threat.
What humans need is the truth, and belonging.
The most severe of individuals when they feel they can be authentic, more than often want the pain to end, and not end their lives.
It is this living side that as a first responder I try to work with collaboratively while acknowledging the part that wants to die.
It is almost of no use to argue with someone who has thoughts of suicide. The more you ridicule, shame and protest, the harder they resist and push back.
Humans Seek the Truth
But often when the truth becomes so painful, we replace them with disabling coping mechanisms that keep us safe at some point in time.
First response cannot replace therapy or psychiatric treatment, but is like CPR for mental health.
The distressed individual is in charge of their wellbeing and as a first responder I create safety and trust.
I have realised, all of us, neurodivergent or not, need connection and safety. We want to be seen, heard and understood.
It is human nature. And, when we are deprived of the same, the world becomes a threatening, scary place to live in.
It is important to have an ecosystem.
Like we need a village to raise a child, we need the entire community to raise adults trapped in traumatic childhoods living through life.
Coping with Trauma
Trauma can be anything and is not limited to abuse, wars and genocide. Gabor Mate, creator of Compassionate Inquiry says that anything that is beyond one's capacity to manage and occurs when a person is not able to process their traumatic experience in a safe environment.
Trauma is not what happened to us, but what happened within us as a result of what happened to us.
We need our psychiatrists, our therapists, our parents, friends, colleagues, first responders, pets and more than anyone, our own selves to get through life.
While it is an extremely painful disorder, it does not diminish one to a box of psychiatric conditions. We are whole as we are.
We need people where we can be authentic and express ourselves and when shame meets with empathy, it cannot survive.
We learn, we grow and we also slip, but it does not mean we start from zero. We hold ourselves with love and we move forward.
Building Support
The disorder entails 9 symptoms out of which if one experiences 5 or more such that it affects their daily function and interpersonal relationships, they are likely to experience the disorder. It is diagnosed after one turns 18.
I, a 23 year old woman, experience all 9 BPD symptoms. I was diagnosed in 2019, and eventually hospitalised for a suicide attempt in Mumbai. But, there is so much more to a person than a disorder.
When I got diagnosed, I did not know of the disorder or anyone experiencing it.
It is said that the causal reasons are not completely known but genetic makeup and/or prolonged trauma are some causes. I am profoundly lucky, despite the disorder.
I am lucky to have been in Mumbai, and receive treatment from some of the best psychiatrists, and therapists and a suicide first responder.
I, along with a fellow senior from my college, Milana Prakash who also experiences the disorder, felt the loneliness and set out to create an Instagram page— BPD Humans documenting our experiences and our journey.
Soon, we started a support group facilitated by a mental health professional for those experiencing the disorder.
Little did we know we were building a community.
Since the inception of the page, I have interacted with hundreds of individuals from India and abroad who have a clinical BPD diagnosis.
The commonality is the pain, extreme intense pain that has led to maladaptive coping mechanisms for all of us.
These have been in terms of hurting ourselves, feeling abandonment at the slightest of the hints and extreme dysregulation in interpersonal relationships, impulsive behaviors.
While the disorder is painful, it has been a journey of understanding my own triggers, to be curious about them and move from a black and white thinking to healing, to being compassionate towards myself and giving back to the community.
I have successfully completed my graduation in Mass Media with the support of my wonderful professors at Sophia College for Women.
It is difficult, I will not paint a rosy tint for the world. Infact, I had to take a year gap due to hospitalisation and recovery.
I relapse still and struggle with relationships, but what I also am is a Suicide First Responder successfully working at Safe Space, freelancing as well as looking at projects in the world of consultancy firms.
We carry a lot of shame, shame that says I am a bad person and I do not deserve good. It is a hardwired belief. But, beliefs can be changed with compassion and consistent therapy.
I have lost the number of first response calls I have done since my training now.
The idea is to keep someone safe for now.
To listen to them and trust them with their story and see them as whole beings.
Suicide becomes an option when the body itself becomes a place of perceived or real threat. Most suicides are in fact, planned and people contemplating suicide let others know. Hence, it has to be the most preventable deaths.
This disorder can be alienating especially in a system where one is shamed not only by the lay person, but sometimes by the professionals alike. We need to change that, we need to bring compassion into care and see each other as humans capable of making mistakes and growing.
When in an episode, I can go from experiencing rage, hurting myself, being suspicious of others intentions looping into impulsive actions followed by a cycle of shame and guilt.
My mood can change in minutes, even hours which can be difficult for someone to understand.
It does not mean I don’t take accountability for my actions, but it also does not mean I am a bad person. We are taught to be a certain way, to play the game of pretense.
I ask the adults, why do we teach our children to be kind, and honest, to be punctual when the real world has its own ways of working with deceit and hatred?
Maybe we aspire for our children to hold up the morals we teach them, but what is teaching if not led by example?
Preventing Suicides and Finding Hope
We all want to be inclusive and mental health advocates, but all of us need to step into the role of mere advocacy to action.
Spaces like Safe Space are working relentlessly to train the lay person as well as professionals about Suicide First Response.
India is the suicide capital and it has only increased since the pandemic. We have a suicide attempt every 40 seconds in our own country.
And almost 76 percent of individuals with a history of experiencing a psychiatric illness. If you met me two years ago, I would have happily taken up a job working 24*7.
But, today I know better, I know my health comes first and so does that of everyone around me.
We need to move from brushing mental illnesses, especially personality disorders, under the carpet.
This does not mean you have a wrong personality, it simply means we experienced something so traumatic over the course of our lifetime that the body found coping mechanisms which helped us survive.
However, in the long run, as an adult the same mechanisms do not serve us. Whether it is fight, flight or freeze, whether it is dissociating, rage, impulsive behaviors do not serve us.
It takes time, effort and a whole lot of a village, an ecosystem to heal.
And, heal we will.
The process can be painful and different for different individuals, but there is always a living side that wants us to live.
It is human nature to protect, so when we go against that very instinct, we feel unsafe within ourselves and around the world.
It is my dream not only to heal but to extend the same support to anyone struggling right now.
Wherever you are in your journey, it can be different on different days, but you matter, just like I do, just like all those people I have interacted with who share the same diagnosis as I and those who want to end their lives.
So, please get the help that you need because today you can choose, reach out and know that no matter who you show up as, you are worthy of the truth and the truth will liberate you.
If you or someone you know difficult emotions for you and you need professional support, please reach out to a mental health professional or a helpline:
Kiran- 1800-599-0019 (24*7)
Samaritans- +91 84229 84528 / +91 84229 84529 / +91 84229 84530 (5pm-8pm).
(Maheema works at Safe Space India, is the co-founder of BPD Humans, a support ecosystem for people with borderline personality disorder, and is a certified Suicide First Responder.)
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