Borderline personality disorder: affective instability and emotional dysregulation

This is my sixth post in a nine part blog series on the criteria for borderline personality disorder (BPD). In this post I am looking at the sixth point of criteria:

“Affective instability due to a marked reactivity of mood” which translates basically to issues with mood and emotional control.

There’s a common misconception that the mood swings that come with borderline personality disorder are somehow less dangerous or less serious than more prolonged depressive or hyper-manic episodes due to their transience. Not only is this wrong, but many people with BPD live with both a baseline of very low mood, and emotional instability on top of this. This criteria of emotional/mood dysregulation is perhaps one of the defining aspects of BPD as highlighted in the alternative diagnostic name ’emotionally unstable personality disorder’.

As a teenager, most of us had mood swings. And yes, a lot of teenagers are ‘moody’. But this is completely different to the catastrophic and often highly debilitating changes in mood that come with BPD. Often they are completely unpredictable. They aren’t normal. They aren’t something to be laughed at. Because living like this is literally like being on a swing except the swing is going too fast and it’s too high up and all you want to do is jump off and crash back down to the floor. I spent a lot of time feeling like I was a freak for feeling and thinking the way I did. For spending so much time with so much emotion I just didn’t know how to cope with it other than turn to self-harm. It’s not a ‘teenage thing’ for your mood to be so out of control that you feel like life isn’t worth living.

First of all, mood can be distinguished from emotion. My mood remains at a baseline of being persistently low (I have a diagnosis of clinical depression alongside BPD). However it does move up and down from this relatively quickly and in extraordinary extremes. I can wake up in the morning and for no reason at all be completely weighed down by the heaviest, most depressing thoughts. I feel like I can’t breathe I’m so sad. It’s like waking up and the grey filter has been turned up to max and I don’t know what to do because I’m stuck. And then it’s the afternoon and suddenly I have all this energy and I’m running around chatting shit at a million miles an hour feeling so ‘happy’ (if you could call it that) that it feels like my heart is going to burst out of my chest. And then back down. It’s more than just a feeling. These ‘moods’ aren’t just in my head. They’re physical too.

And then there’s emotional reactivity. The part that those of us with borderline personality disorder are continuously told that we have control over, that we can learn to live with, but that’s a lot easier said than done. Learning to live with this is basically having to rewire all your thought processes to be able to deal with every little situation that everyone else can just do automatically.

Having high emotional reactivity is basically having extreme and often inappropriate emotional reactions, thoughts, and actions, to events that others would interpret as neutral or not emotion-inducing.

Example. Your  friend leaves a message on read for days. They’re active and posting on other social media and you begin to think that there’s a problem and you’ve done something wrong. You rack your brain trying to think of something you’ve done. You quickly come to the conclusion that the reason why they haven’t replied is because they hate you and they think you’re a disgusting disgrace of a human being that is better off dead. This sounds manipulative, and in some unfortunate cases these feelings can lead to immediate relationship dissolution when these fears are then voiced back to the other person who cannot understand where on earth you’ve come to this conclusion.

Of course, the rational thing to do is just to accept that we’re all busy and that your friend will message you back when they have time. That you have loads of other friends. That social media isn’t real life. And if they are fed up with you and you haven’t done anything? That’s their problem. But in those moments where you’re so full of emotion you feel like you’re about to combust, you can’t see clearly. All you can feel is fear and anger and panic. It leaves you feeling like a monster.

This can also present as inappropriate empathy. You watch a sad movie and the person you’re with cries a little bit and is fine but you’re an absolute wreck and spend the next three nights crying yourself to sleep because you can’t deal with the emotion that the film provokes. You’re basically living your life in a strange world where everything is warped and nobody can understand why your reactions are so weird.

Sufferers of borderline personality disorder are tough as hell because not only are we fighting an illness that is difficult even for professionals with decades of training to get their heads around, but a lot of us are fighting a mental health care system that has little sympathy or support for personality disorder sufferers. But we are also sensitive. We don’t need your criticism. We’ve heard it all before. ‘She’s too emotional’ ‘I never know how she’s going to be!’ ‘She can’t be mentally unwell if she was happy earlier’. We’re all carrying around a burning hell inside our own heads in which we are only ever a crumbling footstep away from falling off the cliff. It’s hard living with an illness that is so unpredictable.

These days, unless I am exceptionally angry or I’m drunk, you probably won’t tell that I’m particularly distressed or unnerved by something that you were fine with. I’ve become skilled at masking the pain. It’s just inside, waiting for somewhere else to go. I’ve taught myself not to cry in public. Not to shout people or to lash back. Not to get attached to anyone, because the emotions that brings is going to send me hurtling back into a fully fledged relapse. In some ways I’m living a lonelier existence trying to fight all these feelings and all this pain. In some ways I’ve had to become cold. But until I can receive proper therapy and learn to deal with this in a way that is healthier and more substantial long-term, it’s all I can do just to keep myself alive.

unstable mood post

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