Joseph Capaldi was diagnosed with borderline personality disorder at the age of 23. He talks to PharmaTimes about his experiences with the condition.

What were the first signs that you had BPD, and at what age did they start showing?

I suppose the main ones were after a break-up when I was 18, my life stopped. I quit college, refused to see any friends, cut my wrist and chest, would get drunk every day alone, crying. Then a few years later my boss at the time told me he thought I had bipolar disorder. I’d be at work, with no regard for social rules or convention, putting my shoes up on the manager’s desk, bursting into tears at work, taking 45 minutes to leave after my shift because I couldn’t decide which sandwich I wanted and sneaking next door to down pints on my breaks, even on breaks as short as fifteen minutes.

When were you officially diagnosed with BPD?

I was 23 and it was at a walk-in centre in central Bristol.

Are you on any medication? If not, have you been prescribed any in the past?

I was prescribed Quetiapine, an antipsychotic used for things like schizophrenia, bipolar and depressive disorder. I’m also a bit of a hypochondriac, however, so after reading the leaflet and seeing one of the side effects was ‘Instant Death Syndrome’, which despite the fact it was 1 in 10,000 chance, in my mind I convinced myself I would definitely be that one person.

Can you describe the symptoms you experience, and the way they impact your life on a day-to-day basis?

I get very black and white thinking, which makes it hard to know how I feel about things and people. It also makes managing relationships really hard. I feel all emotions very strongly, which makes me erratic and intense and people find it hard to understand, but however hard it is for other people it’s also very draining for me. I also get symptoms of mania; this is amazing, I get all sorts of intense manifestations of it, for example thinking I’m having a telepathic conversation with God, and that they’re beaming down well-wishes from the heavens, blessing me with my favourite of all my personalities.

What is your greatest hope/fear for the future?

Hope: That I can get a full grip on my hypochondria, paranoia and jealousy.
Fear: That the disease will escalate so far that I will go through with it and kill myself, or it develops to the point that it stops me getting the life I want.

Do you think the information publicly available on BPD is adequate?

In terms of information on the internet, it’s rubbish. There are many YouTube videos of people who are currently or used to be romantically involved with BPD sufferers, talking about the experience to their webcams. I completely respect it’s hard for those around the sufferer, especially loved ones, but it’s a thousand times harder for the BPD sufferer, which is something that people can forget. Videos like that make it hard for me to believe they ever loved them or understood them, as they seem so content to paint the BPD sufferers as monsters, rather than people that are exceptionally sensitive, broken and ill.

Are you happy with the NHS related care you’ve received so far?

No, I’m not particularly. It took ages for me to get diagnosed initially, and the first therapist I had was not that effective. My latest therapist who I just finished twelve sessions with however, was very good. Neither were privately funded.

What message would you give to people newly diagnosed with BPD?

Be open, be honest – this goes for being honest with others AND yourself; being honest with yourself is probably the hardest part. Cry loud if you need to and definitely talk to a therapist. Try K.U.W.S (knowledge, understanding, wisdom and strength), which is a really effective method of rationalising that my therapist taught me, and do as much research as you can so you’re well equipped.

Do you think the support on offer to patients with mental health conditions is adequate?

No, it takes a very long time to be seen or to get therapy. I saw many doctors and two therapists on and off for as long as five years before I was diagnosed. People also put mental illness below other illnesses, because it’s not visible. Although, I would say perception of mental health is definitely moving in the right direction.

What do you find the most difficult aspect of the disorder?

The intense jealousy, the paranoia, of which mine leads to hypochondria. Also the fact that I feel some people around me are guarded and not 100% genuine or honest because of fear of upsetting me, and I find it can make it hard to form a relationship with people.

How do you manage the disorder/keep it under control?

I try to use the rationalisation techniques I’ve been taught by my therapist under the K.U.W.S method, which helps me work through each of those things and ground myself. Also speak honestly to everyone, and drink as little as possible

What do you think are the most common misconceptions about BPD?

That borderline means you’re on the borderline of having a mental illness rather than it being an actual condition in itself.

Borderline personality disorder (BPD), which is also known as emotionally unstable personality disorder (EUPD), is a disorder of mood and how a person interacts with others. Generally, someone with a personality disorder will differ significantly from an average person in terms of how he or she thinks, perceives, feels or relates to others. Symptoms can be grouped into four main areas: emotional instability, disturbed patterns of thinking or perception, impulsive behaviour and intense but unstable relationships with others. These can range from mild to severe and usually emerge in adolescence, persisting into adulthood. Treatment may involve a range of individual and group psychological therapies (psychotherapy) carried out by trained professionals working with a community mental health team. Source: