Hereís what Iím willing to tell you.
Iíve had an interesting life. My work has revolved around two passions: my passion for art, and my passion for social justice. Iíve been an actor, a playwright, an activist for various causes, an educator for a union, and now, Iím working primarily as a visual artist.
Iíve struggled a great deal in the last few years, but Iím taking small, slow steps forward. Iím thinking positively at times about what the future might hold for me, and trying to figure out how to get there. Thatís pretty different, for me Ė vastly different from the choking hopelessness that has had such a tight grip on me, and that still rushes out to grab me at times, like a mugger in a dark alley.
Hereís what Iím not willing to tell you.
I donít want to tell you about the weeks I spent hospitalized at the Centre for Addiction and Mental Health, when I had been so smothered by despair that my only goal was to die.
I am particularly unwilling to tell you the degree to which my challenges (read, ďillnessĒ) have been shaped by a condition I was diagnosed with: Borderline Personality Disorder, or BPD. Itís not the only label Iíve had plastered on me, but it might be the most interesting. From my perspective, at least, itís more interesting than depression (no offence to all the depressives out there).
What is BPD exactly? Youíre not alone if you donít know the answer. While itís more common than bipolar disorder, itís not as well understood. BPD is a serious mental health condition characterized by incredibly unstable emotions. While people who suffer from bipolar disorder fluctuate between manic and depressive states, they are likely to maintain one mood for weeks at a time. Someone with BPD may struggle to maintain a stable mood even for an hour. As a result, those who have the condition experience trouble with impulse control, difficult or fractured relationships, poor self-image and often struggle with drug or alcohol abuse.
I had invented (or so I thought at the time) the idea of cutting myself when I was in my teens, and in my forties, found it to be a surprisingly helpful tool. You could say BPD has made me a fairly active case study Ė all those visits to hospital emergency rooms for stitches, staples, and glue for my self-inflicted wounds. Self-injury helped me to feel balanced, calm, in control. When I felt my anxiety and rage and self-hatred were too sharp, cutting myself helped to realign things inside, so I could move on.
(Self-injury sends more Canadians to hospital each year even than strokes.)
Itís very challenging to try to explain to others why non-suicidal self-injury is so soothing. All I can say is that the proof of its effectiveness is in the numbers. While not everyone with BPD engages in self-harming, it is a typical complication of a common illness: with a prevalence of around one to two per cent of the population, there are half a million or more people in Canada grappling with BPD.
Even scarier than all those people out there using self-harm to keep their grip is the suicide rate of people with BPD: at ten percent, this equals thousands of suicides every year; in fact, 60 times the suicide rate for the general population.
I have an idea of the mark a suicide leaves on a family. My own brother jumped off a bridge, fatally, when he was 29. I was 25. Even though it was years ago, as far as Iím concerned, it might have happened yesterday. There happen to be othersí suicides Iím still contending with: my best friendís, my ex-partnerís. Some coworkersí, too.
You could say I had lots of inspiration when I myself decided to end my own life. I damn near succeeded, too, but my therapist figured out where Iíd gone to overdose, and I was eventually found by emergency services. Four days on a ventilator, seven in the ICU and three weeks back at CAMH, and I was as good as new. Well, almost. The same could not be said for my loved ones, all of whom I had betrayed when I made my bid for freedom. BPD is devastating not only to the person struggling with it, but to their family and friends as well.
Remember, this is all the stuff Iím not willing to tell you. Youíre not reading this; Iím not spilling my guts.
What I must tell you is this.
There is no way to talk about BPD without talking about discrimination. Itís not uncommon for people diagnosed with BPD to be ďfiredĒ by their doctors, including mental health professionals, or refused service. Some psychiatrists, not wanting to burden their patients with the stigma of BPD, will not diagnose it in anyone. I donít know if thatís supposed to be honourable, but Iím pretty sure you canít get treatment for an illness you donít have.
Despite being about as common as schizophrenia, there are next to no healthcare resources for people with BPD. Waiting lists for the few existing programs in the GTA are closed due to demand: a wait for treatment at CAMH is usually two years. Thatís a pretty long wait compared to other potentially fatal diseases. I doubt Iíd wait two years to get chemotherapy. At CAMH, there are around 200 beds for schizophrenia patients and 15 outpatient clinics. CAMH has 1 clinic for people with BPD; they are able to treat around 32 clients a year.
So we Ė people with BPD, families of people with BPD, workers who provide treatment for people with BPD Ė are trying to tackle these problems. We are taking fledgling steps to create a national organization, the Canadian Association for Research and Education in BPD, to bring BPD into the light.
Please wish us luck. Or better yet, get involved.
To be informed when the Canadian Association for Research and Education in BPD has launched its new website, or to get involved, contact Lisa Walter at email@example.com.