The joy of living with borderline personality disorder

I hopped out of my grampa Joe’s car. My four-year-old legs weren’t yet long enough to reach the ground without being airborne for a fraction of a second. My little shoes slapped onto the cracked asphalt of the parking lot in front of a Scarborough, Ont., strip mall. Bright signs in sharp yellows and screaming reds hovered over a bakery, a moneylender, a rug shop and a fast-food place all crowded next to each other like too many teeth in a mouth. People milled between shops and hauled bags swollen with purchases back to their vehicles.

Overcome, I sighed and placed a pudgy hand over my chest. I cleared my throat and did the only thing I could think of to release the euphoria bubbling inside my chest. I began to sing the entirety of “A Whole New World” from Disney’s 1992 film, Aladdin.

Grampa Joe stopped fiddling with his keys. Grandma Kath, or G.K., quit rummaging through her purse. They watched me, this strange child their son had brought home along with his girlfriend. Their faces shifted from perplexed to charmed as I sang. My G.K.’s eyes were watery when I finished the song. Grampa Joe smiled down at me and ruffled my hair. “Come on, Doo Dah. Day’s not over yet.”

*

Let’s play a game. What would you rather?

1. Emotions that are stable and consistent. You’re able to feel pain, sadness, joy, anger—all the stuff that makes us human—but there’s a cap on the intensity of these emotions, as if someone’s limited the peaks and valleys of an audio wavelength so it won’t blow out the speakers.

Or 2. Emotions that exist almost exclusively in extremes with little ability to regulate them. You feel like your loved one is leaving forever when they huff out the door to take a few calming breaths, which summons a pain that radiates across your body in burning ripples. You want to rip your hair out from the roots and claw the flesh from your bones when you’re overwhelmed or stressed. But the pendulum swings both ways. You also live with the highest highs and pure moments of unfiltered delight—picture Drew Barrymore laughing in the rain. Sometimes you feel so happy it explodes from your throat in the form of a Disney song.

*

People with borderline personality disorder feel their emotions deeply. Marsha M. Linehan once likened the emotional sensitivity that people with the disorder experience to having “third-degree burns all over their body.” McLean Hospital in Massachusetts, a leader in treating the disorder, notes that “these episodes can also involve extreme feelings of positivity and euphoria.”

Perhaps this is why I so often heard my caregivers repeat that Henry Wadsworth Longfellow refrain growing up: “When she was good, / She was very good indeed, / But when she was bad, she was horrid.”

Relative to the well-documented detrimental and destructive behaviours of people with BPD, there’s a dearth of studies that highlight the positive aspects of the disorder—the spontaneity, the capacity for limitless joy and deep passion, the resiliency, the resourcefulness, the driving urge to find happiness no matter the cost. There are moments when life with BPD is daunting. When it seems that my emotions snap with the strength of an alligator’s bite until my solid form is torn into a shuddering mass of snot, tears, blood and spit. But my joy contains summits as stark as my depths fall.

*

Chasing happiness is what makes us human. Yet the feeling can be elusive, slippery and hard to hold onto.

It didn’t matter what town we were living in, what my cake looked like or what group of friends I’d managed to cobble together to celebrate my birthday, I always made the same wish. Each year, I inhaled deeply, filled my cheeks with air, closed my eyes and blew toward the dancing flames. “I wish I was happy,” I thought (because you can’t tell anyone your wish or it won’t come true). And not the fleeting happiness that came when I was with my grandparents or away at summer camp. I wanted happiness that persisted. Happiness that I could bask in. Happiness that wouldn’t extinguish so easily as a candle flame.

But people far more fulfilled than me have long struggled with the transient nature of happiness. Abd al-Rahman III was the Caliph of Córdoba during the 10th century; he was a man who knew all flavours of success: military success, political success (he reigned for 50 years), intellectual success and what was then considered sexual success (he was said to have kept two separate harems). At the end of his life, he decided to count all the days on which he had felt truly happy. “I have diligently numbered the days of pure and genuine happiness which have fallen to my lot,” he wrote. “They amount to 14: —O man! place not thy confidence in this present world!”

*

“You did it,” I whispered to myself. I was waist-deep in the warm sparkling waters of the Mediterranean. My fingers danced along the sea’s surface. I squinted back toward the golden shore. It was dotted with brightly coloured umbrellas, children who played with plastic buckets and shovels in the sand and women tanning whose oiled arms sheltered their eyes. I smiled so wide in the sunshine I thought my mouth would tear at the corners. The beach, the ocean, the swimmers—the entire world exploded into colours so vibrant they stung my eyes. It was like some invisible force dialled up the saturation of reality. I gasped. I dunked my head beneath the lazy waves and screeched bubbles of delight into the salty ocean.

My aunt had pulled me aside by the elbow a few weeks earlier at a raucous family gathering ahead of my first solo vacation in my early 20s. “Make sure when you’re in Greece, you just take a moment to appreciate where you are. That you got there all by yourself. No one helped you. You wanted to experience something, and you worked to save up the money for it.”

And I had worked to get to the shores of Naxos in the Cyclades Islands. I had spent months meticulously poring over colourful travel guides, carefully budgeting ferry trips between the three islands I planned to visit, booking low-price hostels, and mapping the bus route from the Athens airport to its sweaty and bustling port, Piraeus, before I had left on my two-week trip. I was leaving nothing to chance. It had been three years since my last hospitalization and I still had a tendency to become easily flustered by the unexpected.

Which is exactly what had happened the day before. I was meant to let the pension I booked know when my ferry would arrive so they could pick me up. I dialed their number into the scratched and graffitied keypad of a pay phone at the port. The line rang and rang. I called again, but no one answered. I whimpered and paced along scorching sidewalks that stank of urine and pigeon droppings. I turned on my data to send the hosts an email. I constantly refreshed my inbox. Sweat ran down my back in a steady stream. No one replied. My first night in a foreign country and I had nowhere to stay.

At a loss of what else to do, I shuffled onto the ferry with the other passengers. We departed as the sun began its descent beneath the horizon. It illuminated the white buildings nestled into brown hills that the ship steered past. The sky and the sea turned dusky. Sun glitter flashed in the boat’s wake. I sipped a rich coffee and looked out the window. The bright-red sun, aglow in washes of golden and pink, slipped behind two dark land masses in the distance.

I told myself I would be fine. I would get off the ferry and wander the port town until I found lodging regardless of cost. I could find cheaper accommodations in the morning. Worst case, I’d sleep on the beach. July temperatures in Naxos average around 27 degrees Celsius. I would have known I had nothing to fret about had this not been my first visit to Greece in the high tourist season. The ferry’s ramp yawned open at my destination and revealed a town nestled in darkness. Illuminated windows danced in the inky hills like fireflies. A group of people waited on the dock. They waved signs for accommodations and yelled over each other about their amenities. Faced with these options, I smiled and hoisted my pack onto one shoulder. “Who can do 20 euros a night or less?” I shouted into the crowd. A small woman whose wild curls were pushed back with a bright-green bandana elbowed her way through the shouters and took my hand. “I’ll do 20 for you, but don’t tell the French boys in the next room. I charged them 40 each.”

Underwater, eyes screwed shut against the salt water, I was beyond appreciating where I was or how I got there. I was so happy, so pleased with myself, it felt as if my heart was going to leap through my chest. Before I’d left Canada, I hadn’t been sure if I was healthy enough to make it on my own in unfamiliar surroundings where I didn’t speak the language. But I had done it. Every cell in my body felt like it was vibrating. I crested the surface. The water droplets on my skin shimmered like diamonds catching the light. A rapturous booming laugh escaped my lips. I beamed in the gentle waters.

*

Happier people tend to be healthier. One study found that people who experienced more optimistic emotions had greater resistance to the common cold. A 2005 study that examined chronic pain in women determined that those who were more cheerful were less likely to experience physical pain. Wide-ranging research from the Harvard School of Public Health demonstrated that happiness and hopefulness can reduce the risk of heart disease by half. Happiness has a direct correlation to good physical health.

Unhappiness has antithetical results. People with depression have an increased risk of cardiovascular disease, diabetes, stroke, pain and Alzheimer’s disease. Those with BPD are also at risk for chronic diseases, arthritis and other serious health problems linked to obesity. Traumatic stress in early life can impair brain development and immune systems, and stress response systems.

Of course, happiness doesn’t exist in a vacuum. Happiness is impacted by determinants of health like financial stability, social support, access to health services, educational opportunities, experiences of racism and gender. Aligning with Abraham Maslow’s hierarchy of needs theory, a person must have physiological needs met like shelter, food and warmth before they can satisfy higher needs that bring about peak experiences, or a state of consciousness characterized by euphoria. People with mental illness are less likely to have those basic needs met.

But there’s more to happiness than meeting physiological needs. In the Harvard Study of Adult Development, a 75-year study conducted on human happiness, researchers learned that quality interpersonal relationships keep us happier and healthier (also in keeping with Maslow’s hierarchy). The people who were most satisfied in their relationships at 50 years old were the healthiest at age 80. Good relationships act as a protective factor for physical and emotional health.

People who are more isolated are less happy, live shorter lives and are generally less healthy. Loneliness can kill. Unfortunately, this is an area where people with BPD often struggle. Chaotic and unfulfilling interpersonal relationships are a characteristic that defines the disorder.

Additionally, not everyone with BPD is comfortable basking in their rare sunny moods. I frequent a subreddit about the disorder, and I often come across posts about how happiness can provoke fear or unease. Happiness is regarded as fragile. There’s a pervasive feeling that misery is just around the bend. Anxiety that the happiness will soon end or will be replaced by negative events or moods dulls the shine.

This aversion to happiness is known as cherophobia. The feeling can surface as a protective strategy in people with a history of trauma. For example, a child who was punished for being too joyous is more likely to feel uncomfortable when they express positive emotions. Cherophobia is correlated with depression and poor well-being.

People with BPD have poor long-term health odds. Happiness in people with the disorder could be fostered by strengthening social, physical and emotional supports. People with BPD could add years to their life if they’re encouraged to embrace happiness.

*

An interesting study landed in my inbox right around the time that I noticed fine lines were appearing on my forehead ahead of my 32nd birthday. Drawing upon earlier research conducted on people with depression, psychiatrists from Germany discovered that people with BPD who were administered Botox injections had diminished mood swings.

Their findings align with a theory first suggested by Charles Darwin. His facial feedback hypothesis proposed that emotions could be altered by the activity of facial muscles. The German researchers injected Botox into the glabellar region of the face, the lower middle forehead area where negative moods are expressed. This interrupted the communication between the muscles in the forehead and the brain, which changed emotional feedback. Four weeks later, people with BPD in the study had significantly reduced symptoms of the disorder. MRI images showed that Botox had stopped the part of the brain where fears are expressed from activating.

My curiosity was piqued. A quick fix that would curb my negative moods and help me maintain my fading youth? A promise of more positive feelings? An opportunity to choose between stable emotions or unregulated extremes? Sign me up.

But the more I thought about it, the more doubt crept in. Hadn’t I already tried to cap the highs and lows of my moods with daily antidepressants? I had rolled the dice on Lexapro at a more daunting time in my life when I’d been willing to forgo the positive if the negative would leave too. But my highs and lows only diminished slightly. What were the odds that I’d get lucky again? Would I be able to keep my unpredictable moments of bliss if I froze the muscles in my forehead?

“The Crab and the Fox” is one of the many fables credited to Aesop, said to be an enslaved storyteller who lived in ancient Greece. A crab chooses to leave the familiar seashore to travel to a lush meadow nearby hoping to feed. Unfortunately, a fox wandering the meadow has the same aim. The fox eats the crab, but before the death bite, the crab laments its choices: “I well deserve my fate, for what business had I on the land, when by my nature and habits I am only adapted for the sea?” The moral of this fable is that contentment with our lot in life is an element of happiness. 

Between life as an emotional storm or one in which my emotions were largely predictable, I used to always want the latter. Who wouldn’t? But I’ve grown accustomed to moods as jolting as whiplash. Can life with BPD be painful? Absolutely. But it can also be jubilant, ecstatic, and intoxicating. I’ll accept the lows if it means I get to keep the highs.

At the end of my life, I won’t be able to measure my happiness in days. It’s simply impossible for a person who can experience the whole range of human emotions in the span of ten minutes. Instead, I’ll count it in hours and minutes. And even if, when all those moments are totalled up, they amount to less than 14 days, the intensity with which I feel emotions will make it seem like a lot longer.