Coping with BPD during a Global Pandemic

As we go back into a national lockdown, I found myself contemplating how much of my flat mood is related to wading through a global pandemic for such a long time and how much is simply due to living with Borderline Personality Disorder (BPD).

Many of the BPD symptoms exacerbate the challenges that a global pandemic poses for us all. My reflections also brought up some of the positives that have come out of the last 10 months for me, though I have mostly focussed on the challenges in this article. Also, it is worth noting that I am only sharing issues I can talk about from first-hand experience and that there will be others with BPD who are experiencing these times in totally different ways.

Extreme fear of being alone, abandoned or rejected

One of the symptoms used to diagnose BPD is extreme fear of being alone, abandoned or rejected, sometimes resulting in drastic measures to this.

One issue that has exacerbated this symptom is that support from the Community Mental Health Team (CMHT) has been very hard to come by – even more so than in pre-pandemic times. They are under massive strain and many, many people (myself included) are being discharged or left for very long periods of time (18 months in my case) without appointments at a time when we are most in need consistent support. This seems to be particularly the case for those of us who are managing to avoid self-harming, but are still struggling a lot with mood and with being able to get out of bed and manage basic self-care etc. This can feed into the fear that we will be left without support, despite needing it, unless we self-destruct in some way.

If we challenge the decision to discharge us, we are often told that we are reluctant to be discharged because of our fear of being rejected/abandoned/alone due to BPD, and perhaps this is the case in some situations. However, it is my view that usually this fear intensifies, rather than causes, the difficulty of being able to cope with being left without support at such an incredibly unsettling time.

None of this is being said to belittle the CMHT – it’s simply a reflection of the strain they are under due to the pandemic and resulting staff shortages and due to increasing numbers of people struggling with their mental health. However, it is important to note that it does have a knock-on effect on those being discharged or left without support at such a hard and uncertain time.

Having good professional mental health support in place is incredibly containing, especially when life is so unpredictable and challenging – without support in place, everything feels more chaotic and harder to cope with. I’m concerned about how we will continue to manage long-term with no support in place, without our mental health further deteriorating.

As a single person, living alone, the first lockdown meant having no close contact with anyone for months. Thankfully, this time the UK government are allowing the support bubbles to continue, meaning I can spend time with my parents, which has been an absolute life saver! Being able to play a game of canasta with them, hop in their car and go for a walk along the canal or simply sit in front of their fire and watch TV with them makes a huge difference! I feel so blessed to have them literally just around the corner and to know I can drop in to see them at any time.

I want to acknowledge that there are many people where this is not possible for whatever reason, and that there are many other ways that this symptom of BPD is making life incredibly difficult right now, whether due to relationship difficulties, living in abusive situations and many other situations, and my heart goes out to those people.

You find it hard to think in shades of grey

One of the symptoms used to diagnose BPD is the struggle to think in shades of grey.

This has been both a blessing and a curse for me! In terms of following the rules, it’s made it easy when the rules are very black and white in some ways. However, I also found that if I was out for a walk which lasted 5 minutes more than the allowed hour, I’d feel sick with guilt. It’s also caused me great frustration when I see other people blatantly not following the rules!

Additionally, as soon as the first main lockdown was over and the rules became much less clear, I found it difficult to adapt to the flexibility and having to make decisions for myself, with there being no straight ‘right’ or ‘wrong’.

The flitting from one set of rules to another and the confusion of it all has also been incredibly unsettling and felt very chaotic, for example due to the uncertainty of whether planned meet-ups or a course can go ahead. In the past, my way of managing chaos has been via disordered eating, but I’ve been trying very hard to not go down that path. Finding a sense of order and calm in healthy ways has often felt too exhausting or overwhelming to manage, causing me to struggle to get out of bed and tackle basic day to day tasks, and to shut myself away and avoid contact with other people to try to shut it all out.

Severely unstable sense of identity

One of the symptoms used to diagnose BPD is having a severely unstable sense of identity.

In some ways, being in lockdown has actually increased my sense of identity as I’ve tried new things and done more things for myself, like singing, gardening, learning to crochet and running.

In terms of my values, the pandemic has made me come to my own judgments and stick to them at times when the rules were more flexible, even when they didn’t match those of other people. This has been positive, but also difficult and exhausting as I don’t easily know what I think or trust my own judgement, so it feels like a mental workout to do so!

Intense emotions that are extremely up and down

One of the symptoms used to diagnose BPD is experiencing very intense emotions that are extremely up and down.

I imagine that many people will have found that their emotions have been much more intense and more up and down than normal since going into the first lockdown back in March 2020. The brain in individuals with BPD works differently, causing us to experience emotions MUCH more intensely than those without BPD. This is the case, even on a good day! So, the base level of emotional turmoil that has come as a result of the pandemic is significantly more intense for those of us with BPD than it is for those without BPD.

About 2 weeks or so into the first lockdown, my emotions were all over the place! I found myself hysterically laughing one minute, then crying the next – far more intensely and changeably than my usual intense and changeable feelings!

Anxiety is an emotion that I’ve felt much more intensely in the last 10 months. At times, I’ve felt very intense anxiety about losing someone close to me to Covid-19 and I’ve found myself feeling sick with dread at the unbearable thought of this. I assume this feeling is normal, but having BPD, this is of course intensified.

Another anxiety I’ve struggled with at times has been simply leaving the house! When I’ve gone a few days without going for a short walk or run, I soon develop intense anxiety about going out the front door. So, I try to go for a short walk or jog at least 3-4 times a week, to avoid being stuck in the house for more than 3 days at a time. Other things like the thought of going into the office, or catching a bus fill me with severe anxiety these days, and as much as I long for the day things go back to normal, I’m aware that I’m going to have a lot of anxiety to contend with along the way!

To be absolutely honest, I’ve recently gone back to mostly supressing my feelings - something I’m somewhat of an expert at! However, this leaves me in a constant state of flatness, with no motivation, which often causes me to struggle with simple things such as getting out of bed or tackling basic day-to-day tasks. For example, I can go for weeks at a time without washing my hair, because doing it feels impossible. This suppression and flatness creates a real sense of emptiness, which I’ll explain more about below...

Intense chronic feelings of emptiness

One of the symptoms used to diagnose BPD is experiencing very strong, ongoing feelings of emptiness

And that emptiness is intense! This is a chronic symptom of BPD anyway, but it has certainly been intensified even further for me during the pandemic. I guess many of the things I’d usually do to fill that emptiness have not been possible to do – simple things like going to the theatre with a friend, visiting a new city, going on holiday, hugging my nephews and nieces, having exciting things to look forward to... The emptiness zaps your energy and desire to do anything, and even the motivation to do the things that you know will energise you is often in very short supply.

I know that when I allow myself to feel my feelings, validate them and comfort myself, and to do those energising things, then I do feel much less empty/flat. However, it is easier said than done, and doing these things without support from the mental health team, is much more of a challenge!

Stress related paranoia/delusions/hallucinations and disconnection from reality

One of the symptoms used to diagnose BPD is experiencing stress-related paranoia, delusions or hallucinations as well as dissociation or a sense of being disconnected from reality.

I’ve definitely found myself disconnecting from reality, a lot. My world has got a lot smaller and mostly consists of being home alone, living in my own little world away from the madness going on out there! While I’m not causing myself any direct harm by doing this and my ‘own world’ is often a pleasant place to be, it does mean that I lose connection with other people and the outside world. Over a long period of time, this develops the strong feeling of isolation, emptiness (chronic feelings of emptiness) as well as a real anxiety (intense feelings) of doing those things, even when it is safe to do so.

Reflections

Going back to the original question: ‘How much of my flat mood is related to wading through a global pandemic for such a long time and how much is simply due to living with BPD?’… My conclusion is thatthey can’t really be separated, but the BPD symptoms undoubtedly intensify the challenges that we face as a result of a global pandemic!

I’ve not discussed all of the symptoms/criteria used to diagnose BPD in this article, just the ones that have mainly flared up for me specifically in relation to the pandemic. I imagine that many of you will relate to much of what I’ve shared, whether or not you have BPD - it is so important that we look out for each other during these strange and challenging times, especially with there being such a small amount of professional help available at the moment. It is also worth remembering that for those with BPD, every emotion/scenario mentioned is experienced even more intensely than for those without, so please be extra gentle with us!

To finish, I want to say a HUGE thank you to all the NHS staff and key workers, who have continued to work so hard throughout the whole pandemic in order to keep the country safe, well, educated, and provided for – all of us at Borderline Arts are hugely grateful for all you do – thank you!