Originally published in Edition Three (2022) of Farrago. 

Content warnings: mental illness, transphobia, homophobia, drug use and self-harm

Sometimes, we get complacent. Even with things we care about.

A couple of months ago, at twenty years old—already seven years into my gruelling mental health journey—I was diagnosed with ADHD, generalised anxiety disorder, OCD and PTSD by a psychiatrist. As you can imagine, broadcasting this on a platform like Farrago—with a readership that I actually have to interact with—is pretty fucking terrifying. And to be entirely honest, I would rather not do it. But we’re always going on about breaking down the mental health stigma and starting the conversation, so this is me doing that. I have multiple mental disorders. I have a disability.

Oddly enough, despite all the OCD-fuelled medical researching and metacognition and obsession over what exactly all these things are doing to my brain, this does not make me an expert on all mental health issues. Sometimes, in the rabbit hole, you’re focusing so hard on how you’re going to get yourself out that you forget there are other people in there with you too.

It's mid-2021, I’m having lunch with my new friend, Tessa, and they tell me they have borderline personality disorder (BPD). The first thought I have is something adjacent to run! BPD bitches are crazy! The second is kicking myself for the fact that this sort of stigma, stereotyping and blatant misinformation exists in my brain. I think back to the thoughts I had when my high school best friend came out to me (about a year after I had come out), and it took me the entirety of the conversation to convince myself that she wasn’t faking it for attention.

Cognitive bias is real, baby, internalised homophobia and ableism too. But all we can do is try and catch ourselves and work harder to rewire our brains by feeding them the correct information. So, I ask Tessa questions and listen to their answers, and I vow that I will make a real effort to understand better my friends with mental illnesses different from my own.

This is me bringing you along for the first instalment with the help of a tarot reading.

***

Page of Cups (reversed^[1]): This card can represent a sweet-natured child who loves home life and family. This child is a dreamer, very spiritual and a lover of the arts. This card is often depicted as a child because of their symbolism of optimism and growth. With the child's less serious approach to life, they attract happiness.

"People with BPD are thirteen times more likely to report childhood trauma and neglect than those without mental health problems."^[2]

When we take the time to understand the impact BPD has on the brain, a cause-and-effect relationship emerges. Trauma or neglect at an early age can trigger chronic hyper-vigilance in the growing brain, which develops in a constant state of survival. This leads to a heightened sense of emotion. As a result, many people with BPD may, for example, feel intense grief instead of feeling sad or experience rage instead of annoyance. “Sexual trauma at a young age is not the only way to develop BPD. Anyone who feels unsafe in their home is dealing with a form of ongoing trauma. If you don’t feel safe as a kid with your parents, that’s traumatic,” Tessa tells me.

They note that the page of cups card was “the core” of themself that was beginning to materialise in early childhood. “It’s in reverse because I felt like I had to put all of it in a box and build something on top of it instead of opening to reveal. I thought that was a universal experience, and it turns out that it’s not [laughs].”

Tessa explains that the reason they were such a high achiever from a young age was because of an innate need to justify the space they occupied. Because of their general mannerisms and tendency to say everything that went through their head, they felt the need to be smaller. Their mother wanted to beat this idea out of them and encourage their ‘real’ self: outspoken, bright, opinionated and passionate. Unfortunately, these traits aren’t always celebrated in school, and it was because of this that Tessa suppressed these parts of themself.

If we come back to the primary response of survival in the brain of a person with BPD, it’s logical that the person develops the perceived skills needed to stay safe. In a high school setting, this means fitting in.

“People with BPD often have a fragmented or distorted sense of identity.”^[3]

This, according to Tessa, is “next to the truth”.

“It’s hard to find the bravery or the safety to actually explore what’s real and true when you feel like you aren’t safe or that at any point anybody in your life is going to leave you or betray you in some way. This constant underlying fear of being left or being rejected meant that it wasn’t important to me to find that true self.”

Of course, as most of us know, trying too hard to fit in can often cause more harm than just being yourself. Tessa admits this tactic led to a lot of dangerous and impulsive decision-making in their adolescence that was wrongly perceived as teenage angst.

“The reaction that your body gives is an overreaction. But then the people in your life think that you’re just overreacting. It’s very hard for them to look at your behaviour and see it for what it is, because it looks like a teenager who just wants to fit in.”

“It’s like doing everything with the bottom of the Jenga tower missing,” Tessa tells me.  “Everybody else is walking around with this basic understanding of who they are and what they want and I’m just trying to catch all these Jenga blocks as they’re falling.”

These “Jenga blocks” are what Tessa uses to determine what they know for certain about themself and it’s often difficult for them to discern between useful, misleading, or harmful thoughts. “You’re going to assume all the thoughts in your head are real... and it’s so black and white, it’s either true or it’s false, so I feel a bit like fucking Peeta Mellark with his memory missing being like ‘you love me, real or not real?’, but it’s like ‘I know how to brush my teeth real or not real?’”

They’ve gotten into the habit of fact-checking every thought they have, but it’s hard work: “I get this back log, I feel like I’m doing admin all day long.”

Tessa was first misdiagnosed with depression and insomnia at age twelve. By fourteen, they were prescribed Prozac, a drug that made one of their major symptoms of dissociation increasingly severe. “It feels like I don’t ever get to live in the real world, and it’s no wonder I dissociate all the time because how do I live in the real world when I have to check everything at the door?”

People with BPD are more likely to engage in impulsive or risky behaviours. This can include unprotected sex or sex with strangers, binge eating, shoplifting, gambling, and abusing drugs or alcohol. ^[4]

As a result of their increased dissociation, Tessa was unable to attach consequences to their actions, leading to risk-taking behaviour. Six months after the initial prescription of Prozac, they had been hospitalised multiple times for drug and self-harm-related incidents. “I sought out dangerous things and then those things put me through more trauma … and it was sort of like this snake eating its own tail.”

Frequent hospitalisation meant Tessa’s attendance rate didn’t surpass thirty percent and their academic performance (and subsequent validation) suffered. They were forced to find a new crutch: self-medication with marijuana—a tool they still use today to manage their symptoms in lieu of effective medication.

After one too many admissions, Tessa was committed to a psychiatric ward where their Prozac dosage was doubled, yet again worsening the issue. “I was in so much pain and I didn’t know where to put it and nobody was recognising it or acknowledging it or trying to help me because they all thought that they had found the problem and were treating it and they weren’t … the prominent feeling was just frustration.”

It wasn’t until another year and another overdose later that Tessa’s medication prescription was reassessed and they were given SNRIs, an anti-depressant that does not induce dissociation. Finally, after two years and around a dozen hospital admissions, Tessa received a BPD diagnosis.

“Studies show that even some mental health professionals have more stigmatizing views about BPD than any other mental health condition.”^[5]

“[Being diagnosed with BPD] has a massive impact on my access to medications because a lot of professionals will refer you rather than treat you,” Tessa says. “Those who do [treat BPD] will be so careful because it’s very easy to prescribe someone with BPD the wrong thing and then feel responsible for their death.”

***

Knight of Cups: Represents change and new excitements, particularly of a romantic nature. The Knight of Cups is a person who is a bringer of ideas, opportunities and offers.

“A soul-expanding quest,” they read from the tarot booklet, “I think that’s what now is.”

A string of happy events followed Tessa’s diagnosis: they came out as a lesbian, they started dating their now girlfriend, Holly, and soon after, they came out as non-binary.

I ask Tessa what impact their diagnosis had on their relationship with their sexuality and gender identity. They look at me wide-eyed, as if I had just asked the world’s most obvious question and say, “Every decision I’d ever made, made sense.”

Tessa goes on to explain the feeling of liberation their diagnosis offered: “I felt like at that point I didn’t have to perform as much. I didn’t have to perform femininity and heterosexuality anymore—I felt like that was very heavily connected to the way that I grew up hiding myself … particularly because in our society [your sexual orientation and gender identity] are very close to who you are as a person.”

Thinking back to how BPD can manifest, it’s understandable how a person who is struggling with their identity and a chronic fear of harm and abandonment would look outward to see what is an acceptable identity to assume. In Tessa’s case, a straight cisgender woman.

“[I wanted to] look just enough like the other girls that they’d approve of me but just different enough that they’ll recognise me … I thought every girl grew up deciding what their femininity was going to be.”

Aside from Tessa’s BPD, there was an additional factor during this period of gender realisation that confused things further: TikTok fame. Tessa has been posting videos since 2020, but as of March 2022, their account has over ninety thousand followers. The large queer and gender-diverse community of TikTok meant that users often referred to Tessa using they/them pronouns, which made them feel affirmed and comfortable on the platform. 

After months with barely any followers, they hit 10k in a matter of days. There was a slow incline in the months following and then in another couple of days, they hit 50k. The jump from 50k to 90k only took a few weeks.

“As soon as you surpass about fifty comments per post, they assume you’re not reading it, which is not true.”

‘How can you identify as a lesbian if you’re not a girl?’ and ‘do you find it difficult that you don’t pass?’, are just a few examples of the personal, insensitive, and speculative questions Tessa received.

“I think that if I had been in the place that I’m in now where I know exactly who I am it wouldn’t have bothered me that other people were trying to decide who I was,” Tessa says. “At the beginning, it all felt so positive but once you start putting stock into what people say, they start saying mean shit and then you can’t take it back—you can’t take back that emotional investment.”

Being perceived, judged and misgendered by so many people online was already becoming too much for Tessa. But their dedicated fan base then took things a step further by attacking the influx of ignorant and careless people and replying to comments on Tessa’s behalf—often with misinformation. Tessa felt responsible for the negative environment festering under their videos but was unsure of how to deal with the situation without spending hours fact-checking and moderating the comments section. “What can you really do in that situation except for walk away?” 

Not long after this decision (and the subsequent privating of all their previous TikToks), Tessa and Holly moved in together with three other housemates, all of whom Tessa is very close with. These intimate relationships represent something their doctors told them they would be unlikely to ever experience given their BPD diagnosis. “To have those four people who I love so much sit on that balcony with me and say, ‘what is going on? How can we help you? How do we recognize what is happening with you? Tell us everything. Don’t put up a wall,’” is the opposite of abandonment—something many people with BPD (particularly Tessa) really struggle with.

“[When I was younger] I’d just burn friendship after friendship, have fight after fight … I would always perceive peoples’ behaviour as an indication that they didn’t care about me. I would continually project abandonment onto everybody in my life and then as soon as they slipped up that would be my way of being like, “Aha! You were a bad person all along and I don’t trust you anymore!”. Obviously, it’s very hard to be friends with a person like that and so I understand why I lost friend after friend, but it also sucked … I ended up just settling for friends who … didn’t actually care about me.”

Despite these obstacles, Tessa is a living example of how the issues that stem from BPD can improve over time. Their relationship with Holly doubles as real, tangible progress: “The better I get, the better our relationship is … I can feel my recovery having an impact on something that’s important to me.”

“People with BPD commonly experience relationships that are chaotic, intense, and conflict-laden. This can be especially true for romantic relationships.”^[6]

This idea frustrates Tessa: “For a person that knows somebody with BPD, it’s sometimes difficult to separate their behaviour from how they feel toward you. I love Holly so much but when you get to a certain emotional intensity it is not a time to be sitting down and effectively communicating with somebody … I think it’s very easy for a partner or a loved one of someone with BPD to see them in that state and just feel like they don’t love you.”

Tessa feels as though this misconception could be prevented with a better, more widespread understanding of personality disorders. “People see symptoms, they don’t see what’s behind the symptoms. I think that’s where the stigma really comes from.”

***

Five of Swords (reversed): Upheaval. Conflict. Loss. There is a battle that rages on within you. It leads to self-destructive habits and both inner and outer conflict.

The illustration on the card shows a sword with a snake wrapped around it, its tongue flickering above the tip of the blade.

“The five of swords in reverse shows that you want this period of fighting to be over so you can forgive and forget and focus your energies on more constructive activities,” Tessa reads.

Alongside Tessa’s hope for the future, they resent the lingering stigma that surrounds mental illness which made their period of fighting harder than it already was. They wish more people understood how mental disorders can impact decision-making. For example, fostering coping mechanisms like substance abuse, hypersexuality, and eating disorders.

They pull another card.

Three of Cups: Celebration, friendship, creativity, and collaboration.

“It’s saying there’s going to be more of that in my future. Hopefully where I will be able to connect with people creatively and emotionally,” Tessa says.

I think back to everything we discussed and reflect on my own experiences: the space, time, and energy living with mental illness occupies. To me, these final two cards go hand-in-hand. Once you learn to live alongside everything you’ve been through, once you acknowledge and learn to manage what it’s caused, it shrinks; it stops flashing so brightly and you can see ahead of you—you can see the space that surrounds you and move into it.

“It also feels like the internal and the external—I can heal internally and give and receive externally,” Tessa adds. “It started low and ended on a high—it’s always nice to resolve with hopefulness in the last card … ‘cause I think it’s true. I think you get to a certain point with self-destruction where you realise that you can’t win and that it’s really hard to let it go; I think it’s a lifelong task to let go of all the baggage but that’s exactly what I’m doing.”

“You know the ‘I saw the angel in the marble and carved until I set him free’ quote? It’s pretentious but that’s kind of what I’m doing... pulling back all the layers of plaster that I’ve kind of haphazardly stuck over my actual self … I’m going to try and turn this deformed woman into the person that I actually am at my core.”

With limited options because of the pandemic, Tessa is currently struggling to find a psychiatrist, particularly one that specialises in BPD and will agree to take them on as a new patient. But like all of us, they’re trying their best.

You can follow Tessa on Instagram and TikTok at @soulessrats and find their new weekly newsletter at https://www.soulsighs.net/.