Looking after yourself

BPD is the most common personality disorder in Australia. Between 1% and 4% of Australians (250,000 – 1 million) are affected by it at some stage in their lives.[i] It is more common in females than males and the symptoms usually first appear during the teenage years or early adulthood.[ii]

[i] Australian BPD Foundation, What is Borderline Personality Disorder (BPD) https://bpdfoundation.org.au/what-is-bpd.php

[ii] Health Direct, Borderline personality disorder (BPS) https://www.healthdirect.gov.au/borderline-personality-disorder-bpd

There’s no one cause of BPD. It’s not possible to predict who will develop BPD but it is believed a number of things can contribute to it, including:

• adverse childhood experiences, such as abuse or separation
• stressful life events including trauma, and grief and loss
• genetics where there is a family history.

While young carers are not at higher risk of developing BPD, they may experience more of the risk factors — especially around grief and loss. If the family member you care for has a mental illness, or BPD themselves, you may also have a higher risk. However, this does not mean that you will develop BPD.

The symptoms of BPD can sometimes be confused with ‘normal teenage’ behaviour because they are often experienced by young people. A diagnosis is made by a mental health professional, based on the number and severity of the symptoms that are being experienced.

• Extreme or unstable emotions — Your mood and feelings may change suddenly. One minute you feel fine and the next you’re extremely sad, angry or anxious. You might also have violent or angry outbursts.
• Problems with identity and self-image — You may feel like you don’t really know who you are, or you don’t have a consistent sense of personal identity. For example, sometimes you feel good about yourself and other times you hate yourself.
• Feeling empty inside — You might feel like you’re ‘nothing’ or ‘nobody’. Some people describe this as feeling ‘empty’ or ‘hollow’ inside.
• Relationship problems — You might have trouble developing and managing relationships, or they may be filled with ‘ups and downs’, fights, break-ups and reunions. Your relationships are either perfect or horrible, with no middle ground.
• Deep insecurity — You might have a deep fear of being abandoned or being left alone. You might also feel intense fear if someone is running late or wants to go somewhere without you.
• Impulsive or risky behaviour — You may do things on the spur of the moment, or engage in risky behaviour such as driving recklessly, shoplifting, or misusing alcohol or other drugs.
• Constantly changing your mind — You constantly change your mind about lots of things including your goals and feelings towards other people.
• Self-harm or suicidal behaviour — You deliberately harm yourself or think about, talk about, or attempt suicide.

There can be many different combinations of these symptoms. One person with BPD may experience different symptoms to another.

This example might help you understand these symptoms more clearly:

Darla is 17 years old and lives at home with her parents and her 12-year old sister, Cassie, who has cancer. Because Darla’s parents both work, Darla looks after her sister after school. Darla sometimes feels both sad and angry because she doesn’t think that someone so young as her sister should have to be sick.

 Darla often feels very empty inside. She doesn’t know what she wants in life or who she really is. She constantly changes her mind about things and has trouble making decisions. She feels like she doesn’t fit in anywhere. Because of her caring role, Darla’s not able to hang out with the other girls after school, so feels left out. At times, Darla has told the other girls that she doesn’t think it’s fair that they leave her out all the time, and that she hates them all. Then, the next day she will apologise and try to make up, until the next thing happens that makes her feel rejected. The girls at her school avoid being around her and say they don’t want to be her friend because she’s too intense.

 Darla’s temper often gets the better of her at home as well as at school and it’s quite common for her to yell at her parents and her sister. Darla is extremely stressed about her troubled friendships, as well as trying to fit in her schoolwork around caring for her sister. Some days, she also feels very panicked and anxious about leaving Cassie because she’s terrified that her sister will die or leave her while she’s at school. Sometimes, she’s so anxious that she cuts herself in the bathroom before going to school and this helps her feel calmer for a little while.

 In the example above, Darla has some very normal reactions to her life:

• feeling sad and angry that her sister has cancer
• feeling left out because she can’t hang out with her friends
• worrying that her sister might die
• feeling stressed about her school work, caring roles and relationships.

However, Darla also shows some symptoms of BPD:

• feeling that she doesn’t know who she really is and how she fits in
• becoming extremely agitated and angry with people
• telling the girls, she hates them, and then apologising and being friendly the next day
• having very difficult relationships
• becoming extremely anxious about leaving her sister to go to school
• cutting herself to help her cope with her anxiety

While people may experience symptoms of BPD in different ways, it’s common to feel scared and alone. If you can recognise the above symptoms, it’s important you speak to someone as there are a lot of people who can help you. You may like to speak to a teacher, support worker or a counsellor. You should also talk to your doctor to find out what’s going on.

The sooner you get help, the sooner you’ll feel better. Treatment to help you feel better usually involves speaking to a mental health professional. In some cases, prescribed medication may be required, although medication is not usually the first treatment for BPD. There are effective group-based treatment programs for BPD that can also support family members.

Other things you can do include:

• learning ways to better manage your emotions when they are getting too strong, especially ways to cope with feeling distress
• using mindfulness meditation when you feel stressed or upset (e.g. Calm; Headspace: Guided Meditation and Mindfulness; Smiling Mind)
• learning and practicing skills to have less up and downs and more effective relationships with family and friends
• setting yourself small, easy-to-achieve goals and rewarding yourself when you reach them, as this will help strengthen your sense of worth, stability and control over your life
• talking to someone about how you feel — the Check-in App allows you to do this online
• sharing and reading stories of other young carers to know you’re not alone
• learning as much as you can about BPD including symptoms, triggers, effective treatments and where to go for help.

BPD is a serious condition that can have a big impact on your life, so it’s important that you seek help by speaking to your doctor. Seeking help early is important so that you can learn skills to better manage your emotions and relationships.

You can also call:

Kids Help Line — 1800 55 1800

Headspace — 1800 650 890

Lifeline — 13 11 14. You can also ask for help via text message on 0477 13 11 14

You can find more information about BPD at:

Orygen Youth Health

ReachOut

SANE Australia

Your Health in Mind

Children of Parents with a Mental Illness