Charlotte Casler, a senior in vocal performance, has been deeply impacted by her diagnosis with Borderline Personality Disorder (BPD), and she shared her experience in the hopes of destigmatizing this disorder and helping others impacted by mental disorders feel less alone. 

Borderline Personality Disorder is characterized in the Diagnostic and Statistical Manual-5 as pervasive instability in interpersonal relationships, self image and emotions, accompanied by feelings of emptiness, impulsive behavior, dissociation, self harm and suicidal tendencies. 

This combination of afflictions can be difficult to overcome and requires professional intervention. 

Licensed Family Counselor Martha Burns recommended that people diagnosed with BPD work to understand their own changes in mood and how they handle situations. She recommended people with BPD remove themselves from confrontation and give themselves space within their relationships. 

According to Casler, her personal experience involved frequent breakdowns that eventually led her to seek treatment. 

“I was having what I would call breakdowns really frequently,” Casler said. “They started off small, just crying, and eventually escalated into this nightmare where one moment you’re fine, and then you’re triggered by something, then you find yourself on the floor of the laundry room in your dorm, and someone else that lives in the dorm and the RA are scooping you up and pulling you off to have an emergency appointment … and that was the catalyst for seeking treatment.”

Casler said her diagnosis with Bipolar Disorder exacerbates the symptoms of her (BPD) in a challenging way.

“The comorbidity of those two things was tearing me apart limb from limb. It was taking away everything that I had ever known about myself, including my grasp on reality,” Casler said. “I ended up in the emergency room because I was having these episodes.”

Casler said that receiving a diagnosis had upsides and downsides because the stereotypical portrayal of individuals with Borderline in media is negative, with content often showing this condition as “evil, vicious and self-serving,” according to Casler. 

“It was really affirming to have a diagnosis and to feel validated and to feel like all of this nastiness that I’ve been feeling was real,” Casler said. “But on the other hand, it’s really difficult.”

These stereotypes and depictions can be harmful, and compassion is necessary because there are many successful ways to treat BPD that allow symptoms to be managed. 

Casler strongly recommended therapy for anyone diagnosed with BPD and said that Dialectical Behavioral Therapy (DBT), a behavioral intervention that teaches distress tolerance, made a major positive difference in her life.

“DBT was more beneficial to me than I could ever have imagined,” Casler said. “It put a spotlight on all of these things that I didn’t even know were there. I had lived my whole life thinking, everybody else gets to be normal, and I get to be Charlotte. I get to be over emotional and turbulent and so fragile all the time. I thought that was just how I had to be. It turns out, that’s not true.” 

Casler said she was always looking for a way to be in control of her life, and DBT provided this for her. 

“Because of DBT, I was able to have control in a positive way,” Casler said. “I didn’t have to have control by going out and making reckless and impulsive decisions. I could have it because I have the tools that I needed to process my emotions.”

Some exercises Casler learned in DBT include radical acceptance and the “opposite to emotion” skill. Radical acceptance involves facing reality and accepting what happens without judgment. 

“Opposite to emotion” involves acting in the exact opposite way to how you are feeling. Casler said there is a time and place for each method, and sometimes it works best to fully feel an emotion. Other times, she said acting happy and playing happy music when she feels upset can be an effective tool. 

Casler mentioned an acronym in DBT that has been particularly helpful to her: TIPP, which stands for Temperature change, Intense exercise, Paced breathing and Progressive relaxation.

“You have to match the intensity of the emotion that you’re feeling with something else equally as intense,” Casler said. “That for me has looked like stepping into an ice cold shower fully clothed, and it has also looked like going on a run and running as hard as I can.”

Casler stressed the severity of BPD and the importance of acknowledging this for those who deal with the disorder. She said she benefited from time in group therapy, though she initially had doubts about it.

“Group therapy has a huge stigma,” Casler said. “I was right there with everyone else thinking that it was going to be stupid, and it wasn’t.”

Casler emphasized the benefits of medication, and encouraged those with BPD to work closely with their prescriber to find what works right for them individually.

“I could not function without medication,” Casler said. “I would be a fraction of a human being, and that is okay.”

Casler said it is important for those who do not have BPD to know they may never understand exactly what their loved ones with BPD are going through or why they are behaving certain ways, but they can hold space for them by remembering their silent struggle.

“I am going to try to hold myself together as best as I can and make myself into a person that is functioning who looks normal, but the one thing I need from [others] is to always know in the back of your head that I am in pain and that I am suffering,” Casler said. “No matter how I make it look on the outside, I need just one other person to remember for me that every breath I take is harder than it should be, everything that I do in a day takes twice the effort, twice the energy. It is like pushing a boulder up a hill.” 

Casler warned those diagnosed with BPD that when they finally take accountability for their mental health, it can be uncomfortable and difficult to maintain.

“The unfortunate truth is that it’s easier to stay the same than it is to change,” Casler said. “Before you had the skills, before you knew better … you could blame anything. Your mom, your dad, a bully at school, a romantic partner, an unfortunate financial situation. All of a sudden you realize, you’re the captain of this ship, and that’s hard because everybody wants all of that control until they realize how much responsibility it comes with.”

Despite all the ups and downs, Casler said the work of mental health recovery is worth it.

“I would rather be held accountable for my actions a hundred times and face the consequences of my poor decisions a hundred times, no matter how hard it is, than to ever feel as out of control and hopeless as I did before,” Casler said. “I can promise that it is worth it.”