How Do You Fill The Void Caused by Borderline Personality Disorder?

I’ve probably written on this topic before, but I think it is worth revisiting: how do you fill the void inside you created by Borderline Personality Disorder?

Anyone who has been diagnosed with BPD and debriefed about its characteristics knows what I’m talking about. When you look inside yourself for some core identity or defining values, there are none. Your self perception is like an eggshell without a yolk: there’s something very fragile on the outside, but NOTHING on the inside. You act, walk, and talk much like any other human being, and many times can fool people into thinking you’re normal. Deep down, however, you’re a bottomless well filled with doubt, anger, confusion, anxiety, and nothingness.

I say this a grown male at age 33. During adolescence, most teenagers feel pretty hollow until they grow into young adults. If you’re under the age of 18 and reading this, take solace in the fact that many people your age doubt themselves on a daily basis. Very few teenagers truly “have it together” unless they are unusually blessed with some rare talent that ushers them up the ladder from “kid” to “adult” at high speed. Otherwise, you begin to find yourself in your college years and early twenties, after you’ve had time away from home to establish your own boundaries, self identity, and personal relationships.

The problem for those with BPD is that the self doubt and emptiness almost NEVER disappears, not even once we hit 30. Most people in this age range have a firm grasp of reality, their abilities, strengths, weaknesses, and life aspirations. On the other hand, people with BPD are metaphorically rowing across a fog filled lake, not sure when they’ll hit shore (if ever). It’s a really sh*tty feeling. Good personalities and functional lives are built on core values, beliefs, and talents that one can tap into to get ahead. If you’ve got BPD, you likely have no clue what you really want, how to get it, or what you really believe in. Or, if you have a vague idea one day, it changes the next. You’re a personality chameleon, constantly morphing to satisfy what’s going on right now, but when left alone, void of any self identity whatsoever.

The other day I was pondering the lives of my classmates from college and where their own journeys have taken them. My thinking was that I might be inspired to follow in their footsteps since I haven’t yet decided what to do with myself. My tendency is to always look at the high achievers and attempt to mimic them. The idea of being “average” doesn’t really appeal to me, because ever since my youth, I’ve been throwing achievements into my BPD void for temporary relief, only to see the feelings they create dissipate and vanish into thin air. If I can’t make something of myself on the inside, why not take what positives I get thrown at me from the outside?

It’s been a full 10 years since college graduation and some of the people I knew have gone on to do some remarkable things.

One classmate attended Yale for graduate studies and took a job with Pepsi. Pictures on from his Facebook profile show him enjoying baseball games from box seats at Yankee Stadium (not exactly cheap seats if you’re familiar with baseball). He graduated from college summa cum laude and has really hit his stride. I was always impressed by his intelligence, but now more than ever marvel at what’s he been able to do with it.

Another continued her incredibly successful collegiate athletic career and qualified for the 2004 Olympic Marathon trials. If you look at our college’s track records, her name appears in nearly every top 10 performance category. She also owns school records across many distance running events. No one in the past decade has come close to touching her times. Since then, she’s been working as a successful teacher at a private school.

Another has earned both a graduate degree and law degree from a top school, and is currently working for the Federal Reserve. He married his college sweetheart and they’ve had their first child. He makes a solid living and has a breadth of opportunities before him should he ever decide to take a job in the private sector.

One classmate took a more altruistic route: he went to live in Navajo, New Mexico where he worked as a teacher and track coach. He lived in a traditional dwelling made from basic building materials. A few years later, he successfully coached his team to multiple state championships. He was also featured in two critically acclaimed documentaries about Native Americans living in New Mexico and their plight after leaving their reservation to pursue their dreams. The films chronicled top runners and scholars, and my former classmate was featured many times talking about the disadvantages the Navajo face compared to the average American. One documentary was shown multiple times on PBS and garnered several awards. For a guy that graduated summa cum laude and could have easily attended an Ivy League Graduate school, he instead chose a dramatically less glamorous path and yet has enjoyed immense success and personal gratification.

All of these people have a few things in common: they knew what they wanted, they did the work to make their achievements possible, and have since reaped the rewards of success. I, on the other hand, have floundered my twenties away initially working as a bartender, waiter, and supermarket employee; later moving to Costa Rica to join the offshore gambling industry. To say the least, it’s not exactly PBS worthy documentary material. Now I’m reemerging at 33 and returning to the USA with little direction other than I want to do something that helps people instead of preying on their addictions. My life over the past few years has been selfish and in many ways detrimental to the rest of the world. I’m not exactly proud of what I’ve done, other than the fact that I’ve managed to sack away some money for a really rainy day.

If I DID NOT have BPD, I could probably spell out in vivid detail what I want out of my life and the emotional obstacles I’d need to overcome in order to live out my dreams. I could tell you that I believe in social justice, higher education, and making an honest dollar. Further, I could say that I actually make a difference in the world.

Unfortunately, I DO have BPD, and despite my three decade plus existence on Earth, I still don’t know what I want – let alone how to achieve goals and feel good about myself – while contributing to society in a positive way. Perhaps I’m using BPD as a crutch for my personal procrastination, but I honestly STILL DO NOT know what I want out of life despite being 10 years past college graduation and having a lot of interesting living tucked under my belt (for better or worse).

People could probably better identify with my struggles if I was missing a limb: it’s a clear and discernible handicap that others can understand with sympathy and respect. Instead, BPD lurks beneath the surface of my existence as a constant reminder of what I’m not and it festers like a constant cancer on what little human relationships I actually do have. No one feels sorry or respectful for someone with BPD because we make it pretty damn hard to be lovable, let alone respectable. The little we can accomplish is overridden by a giant emotional toll on those around us and others have little empathy for our struggles. When you’re a personality chameleon, it’s just as easy to be invisible as it is one of the crowd; manipulative for self gratification or devoid of any sense of responsibility to the rest of the world.

Now do you see why I’m so empty inside?

What I Want to Be Versus What I Am

I was born in 1979, qualifying me for Generation X status. Growing up, we watched PBS shows like “Sesame Street”, “3-2-1 Contact”, “Mr. Roger’s Neighborhood”, and of course many cartoon shows like “Transformers”, “He-man”, and “ThunderCats”. One of the common themes in these shows was “You can be anything you want”. This was constantly reinforced in school, just when it was becoming en vogue that boys and girls could be brought up to have interest in the same sorts of careers. No longer were girls just nurses; they could be doctors. No longer were boys just lawyers or businessmen, they could be school teachers, counselors, or personal assistants; jobs usually set aside for women.

When you’re 10 and told the world can be yours, it’s a rather empowering feeling. In 1984, Geraldine Ferraro was nominated the first female Vice Presidential candidate (Democrat) of any major party. This opened up doors for a generation of young girls who wanted to take part in politics and government. Then, with Jesse Jackson’s 1984 presidential bid, youth of color saw a glimmer of hope for those among them aspiring to take high political office, just as the hopes of the Civil Rights Movement were inching towards fruition. Yes, it was a promising time to be alive, and we were reminded of that during every pep-talk handed out by our school teachers.

The problem is, when we hit adolescence, elements of the real world start to rear their ugly heads. Competition in academics, the arts, and athletics become more intense, with top achievers setting their sights on getting into a prestigious university. The C-average student who said in 4th grade that he wanted to be a doctor suddenly finds himself behind the curve unless he’s in advanced placement classes, scores highly on the SAT, and ranks at the top of his class. Similarly, kids who wanted to play football find out rather quickly that unless they are at least 5′ 10″ weighing 170 pounds, they’re going to get creamed on the field against their much larger and stronger peers. The first grader who wanted to be a star singer comes to the realization that because she didn’t take voice lessons from an early age, her chances of getting into a good music school or even making it as a starving artist are slim to none. At the relatively tender age of 17 or 18, you find out that there are indeed limitations on what you can do.

Does that mean your childhood dreams are forever out of reach? No. You can take “the long way” around to get to your preferred destination. A 9th grader hoping to be a banker but lacking the grades and social connections necessary to get into an Ivy League school could eventually find himself in that career, but only after a substantial “detour” to a more modest post-secondary school, years of networking, and several unpaid internships. Whereas a top Ivy League grad pretty much skates into the world’s top investment banks, anyone from State U with average grades is going to have to work substantially harder unless someone in their family is willing to pull strings to land them a job. The same holds true for those wanting to be doctors, lawyers, scientists, engineers, or any other advanced professional career.

That said, there are many other paths one can take: learn a trade, join the military, start a business, invent something new, work for non-profit groups. These careers may not be as “sexy” as what you wanted to do while you were still coloring outside the lines in 1st grade, but they definitely pay the bills and can be quite rewarding. The point is that you can still live a good, happy, productive life even if your “dreams” go unfulfilled. A self employed carpenter worth his salt can clear $80,000 a year, even though he wanted to be a corporate lawyer at big law where he could have made triple that amount.

The scope of dreams is infinite, but the scope of reality is, sadly, quite finite.

I’m at a crossroads in my adult life career wise. I’ve been self employed for the past 7 years, making a decent living as an internet marketer. I learned all the tricks of the trade myself and never took a single computer science class course in college. This career path was much to the chagrin of my father, who was adamant about only paying for college if I graduated with what he termed a “worthwhile” degree. Music Appreciation or Political Theory wasn’t on his list, so I settled for Economics. Ten years later, I’ve forgotten much of my Economics knowledge but can write a PERL script to install an unlimited amount of WordPress blogs on a Linux server. I tried communicating that to my Dad, and he thought I was speaking in Chinese.

Now that I’m leaving Costa Rica and returning the USA, I’m reexamining everything. Do I want to continue in my current career “path”? Do I want to go back to school? Do I want to do some volunteer work? How can I pay the bills while I transition into something new? Am I limited by my educational “pedigree” or could I devote a year to studying for admission at a top graduate school? Should I run for city alderman or participate in politics, with the eventual goal of taking high office?

I have the luxury of all these options because of my limited social commitments. I’m not married. I have no children. My immediate family is somewhat close, although we tend to only get together for major holidays and the occasional wedding or funeral. I don’t have to worry about providing for anyone other than myself and a cat I adopted in Costa Rica. She’s a handful but pretty low maintenance otherwise. 🙂

I just find it inspiring when you see someone like President Obama appear on stage at the Democratic National Convention – a man blessed with exceptional oratorical abilities – bringing a crowd to their feet and making people cry. Sure, under all that rhetoric is a healthy ego: President Obama definitely believes in himself and is extremely confident. He’s also a fierce competitor. My question for him would not be one regarding politics (because those are debated on a daily basis) but more personal: “Mr. President, when did you decide that you wanted to be ‘Mr. President’, and how did you go about working towards this goal?”.

Mr. Obama didn’t necessarily state in first grade that he wanted to be President, he just pursued a life driven by achievement, competition, and winning. Eventually, this led him into politics and his ultimate calling as the 44th President of the United States.

Did he always know that he could be President, or was this something that dawned upon in during the course of becoming a mature adult?

For me, the problem isn’t thinking big. I have lots of ideas, plans, and goals. The problem is aligning those desires with who I truly am. It’s easy to think about being CEO of Apple Computer, but is that really who I am? It’s easy to picture yourself as the inventor of the next “big thing” in technology, but is that potential really within me? It’s easy to yearn for the power of high political office, but do I have what it takes to get there?

For once, I wish adults would stop telling kids “they can be anything they want”. Yes, this true to a degree, blah, blah, blah. The reality is that there are limitations to the extent of our success of Earth governed by our innate intelligence, talent, strength of character, decision making prowess, and ability to plan and organize our lives. For every Barack Obama, there are probably thousands of unhappy middle-aged men who wanted to run for office but just didn’t have financial resources, social skills, or charisma to do so.

That said, we shouldn’t exist in a caste society, with our position determined early on based on schoolwork, athletic talent, leadership capabilities, artistic abilities or musicianship. I still believe people should be free to pursue whatever dream gets them out of bed in the morning and excites them about the next day when they lie down for the night. It’s also important to be real and cognizant of our own abilities and limitations. Don’t settle for less than what you can achieve, not what you think you deserve. I suppose somewhere along this crucial process of self discovery, we figure out what we truly want based on what we truly are.

Anxiety Causing Nausea and Vomiting

Here’s a problem I’ve had ALL my life: anxiety that leads to acute nausea and sometimes vomiting. Although it isn’t debilitating in the sense that I can’t go about the normal duties of my life, it severely affects my ability to relax, organize my emotions, perform (academically, athletically or musically), and socialize. I know it sounds absolutely crazy, but once my anxiety boils over I get sick to my stomach and sometimes barf.

This started when I was in the third grade. My Mom wanted me to perform in the town talent show, and I reluctantly agreed. About 5 minutes before stepping on stage the night of the event, I was so overtaken by anxiety and nausea that I vomited all over the backstage. As they say, “The show must go on” and I was shoved out in front of the audience and played my medley of songs on the piano adequately, but definitely not like a virtuoso. It was a scary experience for me, and my parents completely ignored my anxiety thinking I had the stomach flu. In retrospect, had I been sent to a child psychiatrist, I could have probably learned to control my anxiety much earlier in life. Unfortunately, my parents didn’t believe in that sort of thing. My Mom was more concerned with trying to outdo the other parents. 😉

During my youth I also had a fear of vomiting in public, and that manifested itself into a circular form of anxiety: when my anxiety was triggered, I would begin to feel nauseous. Then, I’d get more anxious because I was nauseous and might vomit in public. Around and around it would go. This problem occurred most often in restaurants. One time I was so afraid to go out to dinner, I vomited in the parking lot just as my family was leaving the car to go inside. This “restaurant anxiety/nausea” went away once I hit my teen years, mostly because I washed dishes in a restaurant kitchen for money and this somehow got me over the hurdle of feeling nervous in a dining establishment.

When I was in high school and college, my anxiety and nausea arose during performance events, particularly track meets (with a more moderate form of anxiety developing prior to music recitals). Sometimes I would vomit before, during, and after a race. Again, like the restaurant anxiety, the anxiety beast fed itself and every track meet I attended I was a nervous wreck inside, despite the outward appearance of seeming ready to compete. This still bothers me to this day: When I plan to go out for a run, I get nervous about it because running is inherently a test of pain tolerance. As recently as last week, I went for a run and during a rest between climbing up steep hills, I vomited. It makes absolutely no sense to me, but it just happens.

Obviously the easy answer is: don’t compete, don’t run, avoid these types of situations and focus your life on other activities. The problem is, I’m 50% anxiety, 50% ambitious. I realize you have to perform to get ahead and it’s a part of daily life. Some people are not as competitive and don’t put themselves in performance situations. The strange part of my personality is that I enjoy competing, winning, and performing, but at the same time I’m equally horrified about the prospects of failure and putting myself in a situation that might be emotionally or physically stressful. What performance event (that matters) isn’t emotionally or physically stressful?

I did some reading on this situation and it is more common than you might think. There are several forms of anxiety, in addition to several different side effects. In my case, I believe I mostly have Generalized Anxiety, with a dash of Social Anxiety and Phobias mixed in. As for side effects, nausea and vomiting are the most pronounced, although I sometimes feel light headed, have dry mouth (especially upsetting when playing a wind instrument), uneasiness, sleeping problems, and muscle tension.

So what’s the science behind this? Remarkably, it’s fairly straightforward:

  1. Psychologically, you feel anxious for whatever reason.
  2. The brain has a chemical reaction to this perceived stress.
  3. The adrenal system either over produces or under produces cortisol and aldosterone.
  4. These two hormones are known to cause abdominal discomfort.
  5. The hormone imbalance causes the body’s systems to go out-of-whack.
  6. This builds until the stomach is disturbed, producing nausea.
  7. The sensation of nausea eventually becomes unbearable, and one vomits.
  8. In my own case, I’ve also noted that I will occasionally get a full-on abdominal attack that also produces diarrhea. Yuck! 😉

Another important hormonal system to consider: the adrenal glands. If you’re always anxious, your body will go into a constant form of “fight or flight” mode and release excess adrenaline into your system at the wrong times. The overabundance of adrenaline and its associated hormones is toxic to the body, eventually tiring you mentally and physically because you constantly feel ill-at-ease. This sops up important energy reserves and taxes one’s mental capacity.

With most people, these essential hormones are SAVED for performance events, not WASTED by anxiety leading up to the event itself. That’s why sports stars seem to have Superman strength on game day: they spent the week practicing intensely but in tight control of their emotions. Then, when the whistle blows or the gun fires, the adrenaline pumps into their system, and they’re literally unstoppable. Contrast this to people who are constantly anxious, and it’s easy to see how they might appear unsettled, overly nervous, or sneaking off to the corner to vomit like me.

What can be done?
(The following is my own medication regimen. Please consult your doctor before using any sort of anti-anxiety medication)

As I write this blog entry, my life is a cluster-f*ck of anxiety: I’m moving internationally in less than one month, I have a ton of things that need to get settled in Costa Rica before I leave, my business is in tatters, I’ve lost my motivation to work hard on my websites because I want to change careers, and I’m dealing with difficult people on a daily basis.

Accordingly, my doctor recommended upping my dosage of Mirtazapine and Clonezapam, and it seems to be helpful. Instead of waking up each morning nervous, I feel a little more in control and not as physically drained as usual. Some of the nausea created from running has gone away, although my stomach still churns when I’m pushing myself up a difficult hill. The adjusted medication regimen is only for the next 2 months until I’m settled in the USA again and ready to continue forward with my life. For now, it is a much needed psychological Band-aid.

The lingering concern I have is that even though medication can help tame anxiety, the true cause of it is in the brain. My thought patterns, BPD, depression, or some other system is producing the anxiety. If the chemical reactions producing nausea in my body were caused by my thyroid or pancreas, it would be a purely physical problem that could be treated.

Instead, I’m left feeling better for the moment, but wondering how I will conquer my anxiety and take my life to the next level. For now, I’ll leave that alone for another 2 months until I’m back into a regular routine. Still, I can’t ignore the fact that getting ahead in life requires competition, and if I’m constantly anxious about competing, I will never perform well. Those among us who are “natural” performers are truly gifted mentally and physically, because these worries don’t seem to affect them. For the rest of us, anxiety must be conquered once and for all to truly release the greatest potential we have.