#2 - The Diagnosis
I kept running into the same problem over and over again until one day I started to wonder if the problem was me. The Diagnosis helped me to answer the problem of me.
Hello,
I’m so sorry this newsletter is a bit late. I was so engrossed in Casey McQuiston’s romance comedy yesterday, so I’ve only got to finish the letter today. I hope it’s delivered in time for your afternoon tea.
Among several letter ideas, I’ve decided I should talk about my diagnosis before I talk about everything else. My diagnosis has played a huge part in my life. Even today I’m still revisiting and reexamining my past through the lens of said diagnosis. It’s one of the reasons I started this newsletter as well. I’m grateful that you’re taking this journey with me.
So, enjoy your tea, enjoy your snack, enjoy your reading.
I’ll see you soon. 💛
Trigger warning: suicidal ideation.
It's hard not to divide my life by The Diagnosis; before and after. Ever since I was a little kid, I'd always suspected that I was more sensitive than the average person. It had gotten me into all kinds of trouble, until The Diagnosis helped me to make sense of it. Almost like a person who's just found god, ever since I finished psychotherapy, I've been (over?) correcting myself. After all, I got The Diagnosis at 31. I have a lot of catching up to do with myself.
But why at 31? It wasn't for a lack of trying, but more of ignorance and the anxiety that people wouldn't believe me. I didn't know where to find answers. I didn't know people who went to therapy. I didn't know any therapists. I didn't have any money to consult my issues either. Besides, who was I to find a therapist? I had a job, I didn't have any physically open wounds, I had a roof over my head. Sure, I had my heart broken by boys over and over again and it hurt like hell, but it's not like I hadn't been there. This had happened before and I survived it. Maybe my problems were average problems; and I was just exaggerating them. I doubted myself; what if I was just looking for attention?
It took me knowing just one diagnosed person who went to therapy to finally get the help I desperately needed. So I'm making it a point to pay it forward by sharing stories about my Diagnosis, so you know that you have options.
In April 2017, I met a man. It was a mutual love at first sight. We got it on right from the get go and we felt so right for each other. But it also felt too good to be true. And on the third date I found that it was, indeed, too good to be true. But we kept seeing each other, despite the tears and drama. Until one day in January 2018, I had enough. We had a mutual breakup. The second he and I finished saying our goodbyes, I broke down crying in my bed. And I couldn't stop crying for four days.
I don't know what kind of image appears in your head when I said "I couldn't stop crying for four days", but I was quite literally couldn't stop crying for four days. I put down my phone and cried until morning, at which point I fell asleep. Then I woke up a couple of hours later to get ready for work. I cried again. I stopped crying long enough to wash my face, brush my teeth, and put on some eyeliner. I told myself I shouldn't cry because it would ruin my makeup. But I cried again as I was riding ojek on my way to work. I reached my desk, sat down, turned on my laptop, then ran to the restroom, crying, hiding myself in one of the stalls. I held myself together by the bursting seams for the sake of delivering bare minimum work. I cried and cried and cried, I didn't even know I had so many tears in me. I kept imagining myself as a dry corpse, dying from dehydration.
This happened for a couple of days until my boss even took notice (bless him). I decided I have to do something about it. I took a sick day, left the office, and went straight to Sanatorium Dharmawangsa. The doctor prescribed me antidepressant (Depram) and mood stabilizer (Lamictal). Then I went to my friend's to cry again for the rest of the day while hugging their fat cat. I was on antidepressant for half a year.
If I have to describe what I went through at the time, I was very lonely. I felt so alone and isolated even though I had a lot of kind friends who kept me company. I was even living with a roommate. I used to illustrate my loneliness with driving a car. I told them I was driving a car by myself. No matter how tired I was, I couldn't stop driving this car. It had to keep moving. And it terrified me. I longed to have someone I trusted to take the wheel when I was too exhausted to drive. He would drive this car for me while I rested. He would take care of me. My friends tried to understand but eventually they all followed up with the same question. Why don't I just park the car by the side of the road and go to sleep? And the question annoyed me. They didn't understand and I didn't have the eloquence to elaborate.
Once I stopped crying I finally had the space to think and find further help. Thus began my journey to find a professional who could tell me what was wrong with me. I met a few, each better than the last, but I never felt like they answered my problem. At most they only gave me drain stoppers to keep me functioning, but I was still clueless on why I seemed to keep running into the same problems over and over again. Then my friend, Abigail*, recommended me to see her therapist, E.
I was working in SCBD at the time. Turns out E's office was only a few floors above mine. He just returned from his PhD abroad and opened his clinic. It was all very new. But even when I was going through the registration and first intake, I knew this one was different. E gave me a preliminary questionnaire to gauge my condition, asked for my emergency contact, and interviewed me for two hours to collect more data. It was very clinical, much like going to a doctor to consult ailments. None of the psychologists and psychiatrists I met before did this. I was beginning to have hope. But the issue was I was on antidepressant.
When I met him, it had been months since my crying days and my life was so-so, as in drama-less. I told him I couldn't tell how I was really feeling. I felt okay, but maybe it was the antidepressant. In the end he suggested I tried tapering off the medication. If my problems returned off-medications, I should look for him again. And so I tapered off the meds for a few months and honestly, I thought I was fine. E emailed me a few months after we met, asking if I wanted to see him again. I said no. I think I was fine. So I didn't see him again, until the pandemic happened.
I'm not going to waste your time describing the pandemic. We're all still in it. In March 2020, I was lucky in so many ways. And yet I was so unhappy and anxious, I wanted to resign and do my own thing. I hated everything about my job because of reasons that made and didn't make sense at the same time. I didn't like my colleagues, I wanted to manage my own time, this wasn't exactly what I wanted to do, etc. It was, uh, crazy. I had a really good job. I was paid well, I was remote working, they didn't micromanage my time, and I was working in the heart of the entertainment industry. Still, I wanted to leave. There must be something awfully wrong with me.
So yes, I went looking for E again. He remembered me and asked why I didn't return two years ago, because he had a strong suspicion on what was wrong with me at the time. I told him he didn't give me any reason to return, so I didn't. It was all very funny and my answer ended up as a feedback for him. And now that I’m back here, let's figure out what the fuck is wrong with me. After a month of weekly sessions, evidence collection, and patient observation, E gave me The Diagnosis. I had Borderline Personality Disorder.
I was floored. I thought I was depressed, but a personality disorder is an entirely different animal. How? So we officially started psychotherapy. The very first thing we did was understanding my symptoms.
Having BPD means I have difficulties regulating my emotions. Have you ever seen someone who got disproportionately angry over something petty? That is what emotional dysregulation looks like. There are nine symptoms in BPD:
Fear of abandonment
Unstable relationship(s)
Unclear self image
Impulsive
Suicidal behavior
Extreme emotional swings
Emptiness
Explosive anger
Out of touch with reality
In order to get a BPD diagnosis, you need to have at least five symptoms. In my case, I identified with seven. To help me understand BPD further, I read Kreisman & Straus's "I Hate You, Don't Leave Me". And suddenly; finally; everything in my life made sense.
To put it simply, I was mindblown. I never skipped my weekly therapy sessions. It was the oasis I've been looking for in the desert. It was a lifeline. It felt like going to an after-school lesson where each week I got to learn about myself and why I did the things I did. I had a personality disorder, yes. And I would have it for the rest of my life, also yes. But I had answers. And it was everything. I was breathing again.
The psychotherapy for BPD is the Dialectical Behavior Therapy. It consists of four modules: mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation. In mindfulness, I had to learn how to separate myself from my symptoms. I had to learn how to recognize when my BPD is acting up and influences my decision-making. And I was horrified to learn how many bad decisions I'd made because I was scared. People told me I was smart; I thought it made me a rational decision-maker; but I was not. I was a bundle of nerves. I dated the wrong man after the wrong man, hopping from job to job, constantly thinking that I was losing everything I had, because I was not being rational. I was a fucking mess.
I got even more mindblown (and horrified) when I learned that negative emotions made me feel really uncomfortable. I feel an emotion ten-fold. A small happy thing can make me feel super happy, but the reverse is also true. A small scary thing can drive me off the cliff. I couldn't tolerate them, and so I kept looking to distract myself from them without actually processing those emotions. And the behavior led me into making even more bad decisions. This could lead to substance abuse and suicidal behavior. Feeling so hurt, you want to numb yourself from everything. I thought I was a strong bitch, but apparently I was not. I was traumatized and I didn't have the tools to heal.
It all reached a point where the rug was swept from under me when we discussed my meaning of life. Through my whole life, all I'd really known were sadness and anxiety, and everything that came with it. But after I put my symptoms aside, and regulate my explosive emotions to a baseline level, who am I? What do I like? What do I want to do? Why do I live? I could not answer those questions. It felt like I was struck by lightning in the middle of a vast and empty field. I didn't have anything to live for. I was a waste of space.
I should just die.
Then I couldn't stop crying for four days, thinking I should just die.
As I was crying and trying so hard to practice the distress tolerance methods I'd learned, a part of me thought this was familiar. I had been here before. This was like the last time. I got through the crisis in 2018, I should be able to survive this one. But I didn't believe it. No, this time was different.
I realized I went about it wrong. It was not about driving the car by myself. It was about my not knowing where I was taking this car. As I continued driving, I kept spending resources for gas and oil while taking up space on the crowded road, standing in the way of others who actually knew where they were going. So I thought I wasn't allowed to stop driving, because if I stopped I was going to realize that I had no destination. If I stopped, I was going to rot by the side of the road alone, with people just passing me by.
Out of my seven BPD symptoms, suicidal behavior was not one of them. But that day in 2020, the absence of reason to live made me think I should go die. I got into an existential crisis so bad, nothing E told me was making me feel better. E was worried. So I called the one person who introduced me to E. I asked Abigail to come. Please come. Please help. I didn't know what to do.
Abigail dropped everything she was doing and went straight to my place. She sat with me until I stopped crying. And then we talked.
I told her my fears and how I felt useless for taking space. She replied with nothing I haven't heard before. That no one really knows what they're doing. That we're all winging it. That every person has something to give in this world, even if it's as small as watering a seed. She personally doesn't think there is any meaning in life, which means you get to make and choose your own meaning, whatever it is. They're all cliches, but that night I realized that I had never really thought about them before.
My line of work requires me to literally help people. So I know for a fact that there are people I have helped. Even if I only got to help one person in my entire life, that is still one person I got to help; which means my life is not useless. Nobody is.
After all the crying was done, it was time to revisit and reexamine my wanting to unexist. Do I really want to die? I don't know. But I know I want to see my nephews grow up. I still want to see my favorite bands and read my favorite books. I want to write my stories and share them with the world. I want to travel with my friends and family. I want to find my person. I want to live.
And so there and then, I accepted that life is meaningless; but god damn is living fun.
That night I experienced a tectonic paradigm shift in my life. I was literally a new person. I took it easier and stopped to smell the roses. I even enjoyed smelling the roses; something I used to pass by without looking back because I thought I had more important stuff to do. But my god, where have I been? These roses are so colorful and wonderful! How come I didn't appreciate them before?
For the very first time since I received The Diagnosis, I've finally got to see the whole extent of my personality disorder. BPD has trapped me in my own head so fully, I didn't get to live. I didn't get to feel the sun on my skin, the touch of my loved ones, the honey on my tongue. I have missed so much. I want to hug myself and tell her I'm sorry for missing so much. She could have had a lot more.
You see, I don't regret having BPD. I don't hate my BPD at all. But I am sorry I didn't get or receive help sooner. I could have saved myself from a lot of heartbreaks.
I passed another crisis and I should give myself more credit for it. I started living more slowly after that fateful event. E apologized to me. He felt like he introduced the topic 'meaning of life' too fast. Maybe he should have been slower about it, but I also understood that it needed to happen. For me, it was the key.
I finished therapy in May 2021. E had taught me everything he knew, given me all the tools I need to continue on my own. I look at my reflection in the mirror. A blank canvas, I thought. It's time to rediscover myself. What I like and don't like. Do I like blue? Do I like skirts? Am I an early riser? Do I have what it takes to gain abs? Am I a novel writer? Oh, how excited I am to get to know myself. She's been left by the side of the road too long. I'm picking her up. It's time to take her driving with me.
We don't know where we're going, but we're going to enjoy the scenery, letting this trip surprise us in its mysterious ways. We're going to meet people on the road. Some of them will be driving with us, some of them will wave at us as they pass us by. Sometimes the road may even lead us to treasures; big and small, but precious nonetheless. And before I know it, I have found my meaning of life.
Life is a treasure hunt. I can find them in a place, a person, a thing, everywhere. All it takes is living with my eyes and heart wide open. The good and the bad, living is so fun.
Do I still have BPD? Yes. Do I still find difficulties regulating my emotions? Yes, I’m working on it. Am I scared of the future? A little bit, but I know I can deal with it. And I thought to myself, this must be what growing and healing feel like. My friends, I really hope you'd get to feel it too.
*Not their real name.
Before you ask, this is where I went to therapy. If you can relate to the symptoms I discussed, please contact a professional. Do not self-diagnose nor self-therapize. Psychotherapy may take you to dark places, but a good therapist will put safeguards and ask for your emergency contact. You don’t have to go through it alone.