Thank you, Millie Jane, for this guest post. Millie shows compassion for her boyfriend who lives with a personality disorder. Too often those with personality disorders are vilified by family, friends, and even mental health professionals.
Millie is UK-based. I’m curious as to how the UK and the US differ in treating personality disorders.
- National Health Service (UK): Personality Disorder
- National Institute of Mental Health (US): Personality Disorders
- A comparison of UK and US guidelines for drug treatment in borderline personality disorder. Int Rev Psychiatry. 2011 Aug.
Under US law, insurers don’t have to offer those with personality disorders parity (equal coverage) for their mental health care. California’s parity law covers these serious mental illnesses (SMI) and severe emotional disturbances (SED) of a child: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorders, panic disorder, obsessive-compulsive disorder, pervasive developmental disorder or autism, anorexia nervosa, and bulimia nervosa. People living with personality disorders do not get parity treatment, which is an unjust travesty leading to unnecessary harm.
Living with Someone with a Personality Disorder
Author: Millie Jane
Does having a personality disorder ruin your chances of having a long, happy relationship? The answer is no, you just have to be in a relationship with the right person. I’m writing from the position of that other person. My boyfriend has both Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD), but that doesn’t mean I’m not the happiest I’ve ever been in a relationship. Sure, it has more challenges than perhaps the “ordinary” (note the quotation marks – there’s no such thing as an ordinary relationship), but I’ve always been the sort of person who can tough out a challenge, which means I get to reap the rewards. His personality disorders are a part of my boyfriend, but not all of him. And the good times definitely outweigh the difficult ones.
Disclosure: I am not a qualified mental health specialist by any means; I simply wish to share my own experiences and advice in the hope that I may be able to help someone in a similar position.
Manifestations of Personality Disorders
A fantastic thing to do when you’re in contact with somebody who has a personality disorder is to do your research. I’m sure if you’re reading this, you’re most likely already doing exactly that. There are many aspects to personality disorders and of course each case is unique, so for the purpose of this post I’ve chosen a select few features of BPD and ASPD that I feel are the big players when it comes to relationships, and some of my experiences with these.
Borderline Personality Disorder (BPD)
When someone is afraid that you’re going to leave them, it makes it difficult to have confidence in a relationship. I think it’s easy for people to get ‘put-off’ by this kind of insecure behaviour (especially early on), and the requirement of almost-constant reassurance can be tiring. This fear of abandonment can also surface in the form of the person suffering with the personality disorder threatening to leave you over what you perceive to be small things. How can you feel secure in a relationship if this keeps arising? The answer is just persistence and understanding. These ’threats’ are just a form of fear expression, to prevent you from leaving first – which is what BPD sufferers see as inevitable at some point down the line.
This is a touchy subject and the hardest to navigate. It’s incredibly difficult to see someone you love hurt themselves, and a lot of people can’t handle this. If you search online for what to do in this kind of situation, it’s most likely going to tell you to call an ambulance or the police so that the person can be detained in some way to prevent them causing further harm. People suffering from personality disorders find the intervention of strangers exceedingly stressful and, through experience, I’ve found that this isn’t always the best course of action. Don’t get me wrong, if you do not feel equipped to deal with these situations by yourself, you must seek outside help, especially if you feel in danger. There have been times when I’ve resorted to calling an ambulance, as I was unable to calm my boyfriend down and the cuts to his wrists were too severe for me to patch up and required medical attention.
The ability to foresee self-harm is key. If you see an episode arising, being able to hide dangerous objects and helping them take their emotions out another way can prevent self-harm. The most important thing is to remain calm. People with BPD take out emotions on themselves, and they will likely worsen if they have to deal with your emotions as well. Assess the situation. Is the item they are using to do damage going to hurt you if you intervene? If it’s an object such as a knife, do not put yourself in danger by attempting to take this off them. Try to resist from threatening to leave, as the abandonment issues will enhance an episode. Talking in a firm but caring voice, such as that of a parent, can help. Be understanding, don’t tell them what they’re feeling is wrong, highlight positive things and comfort them. I’ve had times when my boyfriend has broken down and ended up laying on the bathroom floor, and I’ve taken a pillow and blanket to him and laid down holding him until he was ready to get up and have me bandage his wounds. Every situation is different, but just knowing to remain calm and supportive is the most important thing. Every day I rub his scars with bio oil, and this kind of acknowledgement and acceptance really helps build trust so that he’s more likely to listen to me during an episode. After an episode, the person usually regrets it and feels ashamed, and so it’s important not to emphasise how it affected you and make them feel worse.
Antisocial Personality Disorder (ASPD)
You may have heard the saying that all anger stems from fear. I feel as though this is a good phrase to remember in heated situations with someone who has a personality disorder. Often, they may get angry over things you wouldn’t expect them to. Try to ask yourself what the anger could stem from, what are they afraid of? For example, fear of abandonment often surfaces in anger. If you remain calm, speak in a soothing voice, and do not mirror the anger, you can often dissect the issue together and overcome it.
Disregard toward Others
This is probably the biggest issue when it comes to being in a relationship with somebody who has a personality disorder. The important thing to remember is that disregard toward your feelings does not mean they don’t care about you, it’s just an intrinsic part of their disorder. When you’ve been awake all night because of an episode, and then have to work all day and get home to a filthy kitchen, it can be tough. When you try to talk about how you’re feeling, they may emphasise their own issues and value them above yours. This can often seem selfish and be frustrating, but it doesn’t mean they don’t want the best for you, their disorder is just causing them to overlook how you might be feeling. I’ve found the key to this is to step away and take a moment for yourself. Do yoga, have a bubble bath, read a book in a different room. When you feel the moment is right, you have to calmly and maturely talk through what is going on and help the other person see what you’re feeling. Communication is key, and letting the other person know that you understand and don’t blame them can help improve things between you.
Being aware of the manifestations of personality disorders can greatly improve your relationship, but the person suffering still needs to get the right medical help. Unfortunately, too many of us know the struggle of dealing with mental health services. The funding simply isn’t there, and people with mental health problems are largely overlooked as these issues aren’t visible. As if it weren’t difficult enough to seek help in the first place, not receiving the care you need can be incredibly discouraging and cause feelings of hopelessness. If you’re trying to help someone facing this, you need to encourage them to be persistent and not give up. Help is out there, it’s just not always easy to find.
Getting the right diagnosis is the first step, but the aftercare is also key. My boyfriend spent years of being passed back and forth between various mental health services, to no avail. None of the NHS services would prescribe him the medication he’s on now (anti-psychotics) as they felt they were too severe. After many different cycles of the wrong medication, he finally forked out to see a very expensive and distinguished psychiatrist, who after just one hour changed his medication, which has in turn changed his life. Not everyone can afford this, I understand, but there are many specialists out there with fair rates, and it’s worth the spending in exchange for a full life. Many psychiatrists will allow a free session if you’re looking around to find the ‘right fit’, as it’s important the person with the disorder has a doctor they feel comfortable with. Also, if you spend more for a psychiatrist to get that initial correct diagnosis and prescription, you can then change to a less expensive psychologist or counsellor for regular sessions.
Personality disorders are often misunderstood, and people (even some doctors) avoid them because they don’t want to take on the ‘hassle’ of it. The disorder does not define the person and with the right help, compassion and understanding, these people can live a full life with love and success.
Author: Millie Jane