What happens when you have a breakdown?

Having a breakdown was quite possibly the worst thing I have ever experienced in my life. It was such a terrible thing, something I never want to experience again.

To give you a bit of background, I'll take you back to 1999 when I was just twenty. A promising music student with all the drive, focus and determination you could want.

I was in the department first thing raring to go, and the last to leave at the end of the day. I practised up to 6 hours a day and on top of that I had my lessons, coursework, lectures and then there were the numerous bands, choirs and orchestras that I belonged to. I didn't socialise that much and I didn't party. I was serious about this and determined to make a career performing with orchestras and chamber groups. I loved it. It was my life.

I was a model student - conscientious, ambitious, hard working and dedicated to my craft. On the flip side, my personality could be described as rigid, perfectionistic, highly strung, anxious, uptight and eager to prove myself. 

It's fair to say I was a workaholic..

Something happened at the beginning of the academic year in 1999 - My final year. I'm not really sure what triggered it but I began to get severe stage-fright. Sure, I'd gotten nervous in the past and managed to control it, but I'd never had anything like this. Suddenly it was uncontrollable and crippling. During one fateful concert in Birmingham (and one of my last) I was affected so badly I ended up throwing up all over my instrument.  

Rather embarrassed and mortified by the whole episode I decided enough was enough and went to my doctor who prescribed beta-blockers to control the physical side-effects of my stage-fright.  

It was wonderful! With the beta-blockers I could play a concert the way I practised in the practice room - no nausea, no freezing sweaty hands, no shaking and for the first time I felt I could be myself on stage. 

The year went on and my work intensified. 

Concerned family members began to take me aside and told me I was doing far too much and that it would all end badly. I refused to listen. I needed to do that work to maintain my high grades. They didn't know what they were talking about. I'd been doing this for years and everything was fine. And it was..for a while.

I continued to do well, with my trusty little pills accompanying me to concerts, but I noticed I was beginning to become a bit lethargic and flat at times..usually a couple of days after the last concert. I didn't take much notice and just attributed it to being tired after the concert.

Soon I began to be afraid of the feelings of nervousness and fear and as time went on I took the beta-blockers before every concert, every lesson and eventually even to get out of the house in the morning..I became addicted to them and relied on them to be be able to do the smallest of tasks. 

It took me a while to notice a link between the pills and an odd black feeling in my chest, but it was happening too frequently for it to be a coincidence. It also linked in with the lethargy I was feeling and the more pills I took, the worse it got. Everything went downhill very quickly. 

I was too scared to tell the doctor who prescribed them to me in case he took my little magic pills off me and I'd be unable to perform. I felt completely helpless, alone and very scared. I didn't know what was happening to me. I wanted to talk to somebody, anybody, but I couldn't own up to the shame of being reliant on beta-blockers to get through a concert.

Unable to talk to my teacher about the performance anxiety and the pills I decided to go herbal and tried tons of Bach flower remedies to see if they helped, but they didn't. I felt like a total failure and a fraud. There is a huge stigma about performers taking beta-blockers for their nerves, it happens more than you would think, but it's frowned upon.

By Easter 2000 I was a wreck. I didn't have enough energy to cook and I lost 45lbs in a matter of months. All my energy had been zapped. I could just about muster enough strength to get to the campus but my practice had fallen to one hour a day or even less. I started skipping lectures and not handing in coursework. When my instrument got too heavy for me to hold I lied to my lecturers I needed time off as I had a bout of glandular fever. I slept for 2 weeks. To be honest I didn't give a stuff if I failed my exams or not.

I didn't seem to have any emotions any more and felt shrouded in a thick grey fog which I couldn't see out of. I didn't know what was going on. It was terrifying. 

I started to act out of character. I couldn't sleep and I'd get up in the middle of the night and have a bath, or go out for long walks in my PJ's. I even went missing for a few days which I have little recollection of. 

We lived in a very old house built in the 1600's and I became convinced that the black, sick feeling in my chest was because the house was haunted and I was sensitive to it. (I always felt a bit better when I got out of the house).

I began to hallucinate. I thought yellow spiders had invaded my bedroom and absolutely certain that there was dog poo in my bed - I could smell it, but despite looking I never found it.

The black feeling in my chest grew in to a heavy stone and I felt dead inside. If I wasn't sleeping I was crying and when I walked, I shuffled with my head towards the ground. I didn't have the energy to hold my back up straight.

I didn't have enough motivation to be suicidal or concoct an elaborate plan, but I did cross roads without looking. If I got hit, I got hit. I didn't care.

I felt cut off from the rest of the world, trapped in a strange bubble. People began to look grey and when I saw their mouths moving in slow motion, I heard no sound coming out. When I saw the sun in the sky giving off warmth I couldn't feel it. It meant nothing to me.

Personal hygiene went out the window when washing my long hair, brushing my teeth, drying myself and getting in and out of the bath became too much physically. (I resorted to using baby wipes - the best invention ever!)

I didn't have the energy to talk to people and I avoided them in case they asked questions. I was probably quite rude - I didn't care what people thought of me and I cut people off or just walked off when they were talking to me. It was hard to even crank my mouth in to a smile and I couldn't be bothered. All I could think about was getting home to my bed to cry or sleep.

It's hard to describe the exhaustion I had. My body felt like a lead weight and it was literally too heavy for me to move. I felt I could curl up in the middle of the street and just sleep.

I began to think I was losing my mind. I eventually managed to drag myself to my GP surgery. Things came to a dramatic head when I collapsed in the Doctor's office in floods of tears and hysterics saying I didn't know what was wrong with me and maybe I was depressed or something but I couldn't take it any more. 

He made a quick phone call, abandoned his morning surgery and drove me in his car to the nearest psychiatric hospital where I was admitted immediately.

Hospitalisation was a relief and I slept for weeks. Much later on I tried to come to terms with what had happened.

The university were very nice about it all. I was too ill to sit my final exams but because the rest of my work had been very good I was given my degree anyway for which I'm very grateful. 

On reflection...

At the time I never told the hospital about the beta-blockers, and they never really tried to get to the bottom of why I became so ill in the first place.

Out of curiosity I did a little experiment about 3 years ago where I wanted to see if the beta-blockers had had the effect on me that I suspected.

I knew it was a bit risky but I took only one, and sure enough a couple of days later I felt the old familiar 'black feeling' and lethargy returning which took me weeks to recover from.

I asked my consultant if these pills had a link with depression and it turns out that they have the adverse effect of severe depression in a very small percentage of people. Okay..so that particular mystery was solved, but to be honest I believe the breakdown probably would've happened anyway..

A few months ago I found a diary from 1999 with my Uni schedule which had all my practice, rehearsal and concert times as well as my courses. I flipped though it and though "My God...How could I have sustained this for so long? How could anyone sustain this?" It's no wonder those closest to me voiced their concerns. They were right. It did all end rather badly.

What I thought was putting me ahead came at a terrible, terrible cost and it ruined any chance of a professional career I might have had.

My perfectionistic and rigid personality didn't help either. 

I still have an uneasy relationship with classical music but this is a huge improvement from retching every time I looked at my instrument. I eventually swapped it for a different instrument, one that had no associations with the past. I don't play that much these days though. The enjoyment of playing and listening to classical music is no longer there.

Going to concerts still makes me very sad, especially if any of my former colleagues are playing. It emphasizes the huge sense of failure I felt during the aftermath of the breakdown. I felt I had let everyone down after such a promising start.

After all that I've just said, it might sound strange for me to say this, but having that breakdown was probably the best thing that could have happened to me! It wasn't apparent until many years afterwards, but it's true. 

Why? I hear you ask...

Well...It happened for a reason, and I learned some difficult but valuable lessons from it.

• I learned the importance of the Work/Life balance. If I'd eased up, had some fun and allowed myself the chance to relax, things would have been different. I'm not weak or selfish if I want to take time out for myself.

• I've learned to say "No", (Very liberating by the way!!). A lot of those things I did at university were because I believed people would think less of me if I didn't do them. 

• I learned to talk to people about what is going on. In hindsight I would have told my teacher about the problems I was having and he may have come up with things to help. I also would've told the doctor about the effects the pills were having on me. He probably would have just changed them and prescribed therapy to help with the stage fright. - There is always an alternative.

• I've got more perspective in my life now. I believe there's more to life than work, and I find it distressing to see the workaholic culture that's expected these days. I've seen so many nervous breakdowns and break-ups of marriages due to workaholism, and I'd rather have my health, happiness and family than a high-powered, stressful job.

• I've learned it's not a weakness to ask for help. Once I got over my initial embarrassment, I encountered many kind and generous people who were happy to give me the help I needed. I don't think I would have got by without them..

• I am very aware of my health and the triggers that cause me to go downhill. Some would say I'm too cautious about this, but they're not me and they've not been on my journey. Since the breakdown I don't deal with stress very well, and my resistance and energy levels are much lower. It's frustrating, but I just have to be a bit more careful with what I take on.

• I am not superhuman! I know my own limitations and what my body and mind are capable of. 

I'm not ambitious any more. Most people around me find this hard to understand, but again, as long as I'm healthy, happy and working at something I enjoy, I don't really care about getting up the career ladder.

I can still be a nervous, anxious individual sometimes and yes I still get worked up about the crappy little things, but having been about as low as you can get, I'm not afraid of the bigger picture any more. Somehow, things will work out..maybe not in the way I expected, but often something much better comes along instead.

Hopefully I will never go through anything like that again, but I am thankful for all those valuable lessons I learned. 

I don't think I would be the same person today without all those painful years. 

The Only Way is Up.

Sometimes I hit rock bottom and not noticed how I've gotten there..it happens so slowly and Bam! one day you realise that you've got yourself into a terrible mess that you don't know how to get out of.

When I wake up in the morning and feel I have nothing to live for or nothing to lose, I want to go back to sleep forever. The ruins of what was my life lay mangled at my feet. "How did it come to this?" I ask myself.."Where did I go wrong?". Things were going so well..

I don't want to eat, or bathe, or do anything, or see anyone. I see no future..only a haze of grey emptiness stretching out before me. It feels like I'm walking through a huge vat of mud and completely numb except for the constant burning in my chest and throat about to trigger off yet more tears. My eyes are still swollen and head still pounding from the last lot. My life feels as if it's over.

Rock bottom is a terrible, lonely and painful place...but it can also a good place to be. You can't get any lower than this. It gives you a funny sort of freedom..the things that matter to the average person in the world don't mean a thing to you now.. The only way you can go from here is up. This is a chance to completely reassess my life and learn from my mistakes..Where did things go wrong? What changed that I fell off the path? And what can I do to put it right again?

It's not easy..it never is. And I get tired of that.

When it comes to this, normal everyday life has to take a back seat.

Sometimes it's a matter of forcing yourself to get up and brush your teeth in the morning even if it's the only thing you do that day...or forcing yourself to go outside when you haven't been out for a week. It doesn't matter that you've still got your PJ's on under your maxi skirt, but hey, I got out of the house! I've achieved something today!

Sometimes it's even a case of putting all my effort in to eating and drinking at regular intervals to build up a little strength and to give me a reason to get up...taking things in minute baby steps and slowly building up over time... .

But it's the small things like this that help you through rock bottom.

Soon it'll be time to identify what went wrong, and how I can do things in future to prevent this happening again. It takes energy though, and making some uncomfortable changes and decisions..which is daunting.

I'll get there in the end I guess..I always do..

An Episode from the Borderline - Life with BPD.

I thought it was high time I wrote something about that grossly misunderstood illness: Borderline Personality Disorder. (Actually the 'Borderline' bit of my blog name isn't to do with the disorder - it's that feeling of standing on the edge of life and looking in..of being on the Border Line and not quite belonging).

  

I was diagnosed with BPD in 2006, quite late on in my time in the psychiatric system. They've always said it was rather an iffy decision. Often the diagnosis is given when the doctors haven't the foggiest idea of what's wrong with you. If you are young, female and have a tendency to self-harm, your chances of getting the diagnosis will be higher. (BPD is the only mental health disorder in DSM IV-TR that lists self-harm in the diagnostic criteria).

It's not nice to be told you have a Personality Disorder. When I was told, it made me examine every single little thing about myself that might have led to this diagnosis. Was I some sort of psycho? Was I even a real person? I didn't seem to know anymore.. 

What did my personality even consist of? Was it my intellect? Was it because I possessed an earthy sense of humour and cracked up at the mere whiff of a fart joke?

Was it my personal habits? (Okay - I drink out of my cereal bowl when I'm feeling too lazy to spoon it all up), or that I laugh too loud or frown when I smile??

Was I too shy or too sensitive or too tomboyish? Was I considered not Normal? And what was normal anyway? I thought I was just like everybody else..

I've always believed your personality is what makes you, YOU, and when I was told on that fateful day back in 2006 that I had a Personality Disorder, it crushed me. In the space of a few seconds, the Kerry I had known and thought I was...was a completely different girl.

At the time, I was pretty much told "You have this disorder", (gee..thanks), but I wasn't told what it was or what the symptoms were, or even how to manage it.

For inspiration I looked on Amazon to see what books I could find on what it was all about and how to cope with the condition. 

BIG mistake. 

To my devastation I came across books such as "Splitting - Protecting yourself while Divorcing someone with Borderline or Narcissistic Personality Disorder", "My toxic BPD Mother - 'A shattered Childhood'", or "Surviving a Borderline Parent", and probably the worst of all, "Borderline personality disorder, How to spot it - a checklist" written by an FBI special agent. The product description ends "Practical, fast, easy to read...this guide sheds light on a disorder that afflicts many, with serious consequences for the rest of us"..

Well excuse me while I go and find my axe for my morning spree.

I cried when I saw those books. What sort of person was I? Did people really think I was like this? I hid in my flat for weeks while I tried to process what I had read. It totally destroyed my confidence, and paranoia set in big time. I somehow felt I was a defective person, and that is still carried with me today.

The name "Borderline Personality Disorder" is misleading - Go to Wikipedia, punch it in and you'll get a rather hefty explanation of the whole BPD thing. It gives you the facts as they are, but written in a sensitive manner whilst addressing the stigma, myths and background surrounding the name of the diagnosis.

(Manipulation and Attention Seeking Behaviours will be covered in a later post).

BPD has a huge criteria and believe it or not, there are 256 combinations that would land you with a diagnosis. I have the DSM IV-TR sitting in my bookcase in the hall, and once for a laugh, I flipped through all of the personality disorders. I spent the entire time going "That's me..that's me...OMG, that's me...definitely me..WTF?..I have ALL the personality disorders in the book!..."

I think most of us would recognise aspects of ourselves in the pages of the DSM. It doesn't necessarily mean you have any of those things...it just means you're human. All of us have traits in our makeup that we're less than happy with..

I hate the term "Borderline Personality Disorder". Personally I prefer "Emotion Dysregulation Disorder" because that's what I have. When you get past all the stigma and pare it down to the bare bones, it just means I have a problem with controlling my emotions sometimes. That's it...No questionable personality..no morning rampages with my axe..no stalking sprees..

Once I had got over the initial shock and found out what it was all about, a light went on in my head. It described me very well and explained so many things that were a bit 'off' in my life which I didn't have any answers for. It was a huge relief and I was able to lump all these things together and store them away in my mind. 

As time went on though, anything that went wrong in my life or relationships I blamed on the disorder and I was very passive about doing anything to sort the situation. 

For a while, I even shunned the diagnosis altogether because the stigma of it got me very paranoid. I felt much better after that, and more like a 'real' person. But underneath I knew it was still there, lurking in the undergrowth waiting to be dealt with. 

There is a debate amongst doctors whether the patient should even be told at all. There is concern the sufferer may react badly to the stigma of such a diagnosis and having a Personality Disorder foisted upon them. I can relate to this. But despite all the anguish it caused, I'm glad I was told. It explained a lot that was going on, and now I know what the problem is, I can do my very best to put things right.

So what does an iffy BPD diagnosis mean for me?

Impulsivity: In the early years my diagnosis, impulsivity was a much bigger problem than it is now. 

In the past this included suicide attempts, self-harm episodes, overspending or bulimic binges, and buggering off somewhere when things got too much. 

Now it tends to mean ordering in a pizza when I can't be bothered cooking and not telling my boyfriend, or buying a dress or two in the sale when I hadn't planned to spend any money. Yes, I still feel the need to bugger off sometimes, but now I talk it through with folk before I go.

Of course, being with someone makes the impulsive side of things more difficult, and I think some of my impulsiveness was due to my single life, (I had lived on my own for 10 years before I met my boyfriend and very used to my own ways).. I have to think twice now before I do anything..which is maybe a good thing!

Almost all of the impulsive behaviours were because I felt myself to be in an emotional situation that I didn't know how to deal with, and these brought some temporary relief.

Intense and rapidly changing Emotions: This is something that challenges me day to day, but is improving as time goes on. People in my circle do find it baffling - I can be in the depths of despair thinking This is the End, yet once the conflict has been resolved, I can be back to my usual self very quickly.

Sometimes I overreact to things and feel things for longer and more deeply, whereas in the same situation, the average person would just feel a mild twang.

Fear of Abandonment: This is in the criteria but not entirely accurate for me - I don't fear abandonment, I expect it.

Fear of Rejection: This is getting better as time goes on, but it used to bother me a lot... Everyone wants to be liked..don't they? 

Now I can see that I don't always take to everyone I meet, so why should I expect others to? Everyone is different and has different tastes. I try not to give a stuff about whether someone likes me or not..but sometimes it's difficult if I'm feeling a bit low for whatever reason.

Sensitivity: I am very sensitive to the way others treat me.*  I'm always being told I'm far too sensitive, which drives me mad. This is a lot better than it used to be, and back then, God help you if you had done something to cross me! Now I know that other people have their own battles and journeys and my being hurt was not always intentional...Just me being over-sensitive again!

*This is a tricky one though.. People with BPD have very high standards in how they treat people. They are often very kind and caring and go to great lengths to make sure others are comfortable and happy. The downside is that we expect the same in return, and when it doesn't happen, it's a bit of a blow and can cause a lot of anguish.

Poor Sense of Self: I think this, and not knowing my path and place in the world are the biggest problems I face in my life. It's not necessarily solely related to BPD - I believe there are other things in my life that contribute to this. 

I also get bored very easily and find it hard to stick to things once I lose interest. I'm unable to see the long term, and sometimes feel a bit trapped if anything like that comes up. This is something I am currently working on.

Several people I know of my generation would tell you they have no idea of what they want to do, or where they are heading or who they are, and that commitment scares them. None of them have mental health issues.

Black and White thinking: Guilty! This happens when I feel stressed or backed in to a corner and I can only think Black or White and forget to look for the Grey. People close to me have told me that my voice tone changes when I'm in this state of mind. I've never noticed it myself!

Chronic feelings of emptiness and loneliness: Even when I'm with people, I can sometimes feel desperately lonely. It's a hard one to describe..most people (myself included) find it very difficult to understand.

The feelings are usually more noticeable in the evenings.

Sensory Overload: Apart from my dodgy hearing, my senses are very acute. I've read that many BPD sufferers have faster visual perception and sensory reactions than the average person.

It's exhausting at times, and simple things like shopping in a busy mall, too much information to absorb, or too loud a film with subtitles at the cinema can be overwhelming. I used to feel really silly because a day at the shops totally knackered me for some unknown reason. Since then, I've met others who experience the same and I don't feel as bad about it.

This overload can lead to:

Dissociation: When things get too much, I just zone out and shut down completely. I've been told my facial expression goes flat and I totally withdraw. 

It's not pleasant, but since taking precautions to reduce some of the stressors, thankfully it doesn't happen very often.

In the past, I've lost days to dissociative attacks.

When an attack is about to happen I start to lose concentration and focus, and can feel my eyes glazing and head clouding up. It helps if I stop and take a wee break with a cuppa, go for a walk or have a short nap.

Treatment 

Sadly, there is not much out there by ways of treatment for BPD leaving sufferers feeling let down. Talking therapies seem to have a much better outcome than medication and it's just finding the right one to suit the individual.

I tried Cognitive Behavioural Therapy (CBT) for a while - it aims to challenge thoughts and change negative thoughts in to positive ones. I agree with the concept behind it, but I didn't have that much success with it to be honest - if ALL of your thoughts are negative, it can be bloody exhausting and depressing to change every single one of them into a positive thought. 

I struggled by for years, despairing that I would ever be at peace with my mind. At the end of my tether, feeling desperate and totally disillusioned by the National Health Service, I decided to go to a private therapist. I wish I had gone to him years ago. 

He gave me the tools to find the inner peace I was looking for. He made me realise that I'm just an ordinary person with troubles, not some dangerous person waiting to strike at her next unsuspecting victim without any warning, destined for the state hospital forevermore, Amen. 

It costs..but it is worth it. An investment for the future..

For me, Mindfulness Meditation has produced the most dramatic results in dealing with this condition. It has calmed my inner chatter and I feel more balanced within myself. I am able to cope with people and situations without overreacting in the way I might once have.

I hope this, along with grounding myself will lead me to discover my Sense of Self and Purpose that I lack.   

Out of all the BPD sufferers I have met over the years, no two have been alike. What I did find fascinating was that they were probably the nicest and most interesting people I have ever met. Vivacious, quirky, magnetic, and very kind and compassionate. Not the monsters made out by those books from Amazon..

Having a BPD diagnosis isn't a death sentence. There's hope for me yet, and the prognosis is good. There's a very good chance that I will not meet the criteria several years down the line.

It isn't all bad y'know!  It can be wonderful at times. Those intense emotions? It's not just the bad ones I'm stuck with. All the good emotions..happiness, joy, pleasure, compassion, love and excitement and so on.. I feel them much more than the average person. And all those amazing feelings make up for the crappy things a personality disorder can bring..