ON THE BORDERLINE
Ursula was a happy little girl, but then a personality disorder turned her life upside down, says Joy Orpen. Her mother reveals a spiral into alcoholism, self-harm and suicide bids
‘Ineed someone to help me — because right now I feel I am banging my head against a brick wall and getting nowhere.” These are the desperate words of a Sligo mother who has been fighting almost single-handedly for nearly 13 years to get services for her daughter who suffers from a little-understood psychiatric condition.
Anne Hunt, 51, a nurse for the past 34 years, says Ursula, 29, the eldest of her three daughters, was a perfectly happy little girl who gave no indication that she was heading into a terribly turbulent adulthood. “She had strawberry-blonde curls like Shirley Temple. She was bubbly, friendly and a talented artist. Everyone loved her. Then, when she was about 12, she began to withdraw at school. We put it down to puberty,” says Anne. And, even though that trend continued, there was nothing too alarming until Ursula was 15, when she put her fist through a glass door in anger, and threatened to drown herself as the bath water had run cold.
Anne had to break down the bathroom door to get to her distraught daughter. “Even though I knew she couldn't drown herself in the bath, I had to face the fact that we were in trouble,” she says.
Their GP referred Ursula to a psychiatrist, who thought she might be suffering from post-traumatic stress disorder, as she had previously been bullied. But there was no doubt that Ursula was also clinically depressed, so she was put on mild anti-depressants.
In spite of the medication, Ursula attempted suicide some time later and she ended up in an adult psychiatric unit for six months, where she did her Junior Cert. Then, when Ursula was about 19, she began drinking “quite heavily”.
Anne says it's not that unusual for people with her daughter's condition to end up with a dual diagnosis that includes addiction. And so began a vicious cycle that continues to this day.
Ursula has been in rehabilitation for alcohol addiction at least six times since she was 19 and, even more frighteningly, there have been as many suicide attempts. When she was 21, she was finally diagnosed with borderline personality disorder (BPD).
According to Dr Keith Gaynor, senior clinical psychologist at St John of God Hospital in Dublin: “BPD is best understood as emotional dysregulation (ED). People are generally highly critical of themselves for feeling like that, leading to very low levels of self-worth. The most effective therapies are long-term, and they focus on building skills to predict and manage negative emotions when they occur.”
Ursula agrees, and says that her BPD leaves her with a sense of “numbness and a feeling that I'm worthless and no use to anyone. I know my family and friends love me, but I find that hard to accept. I feel like I can't be loved”.
Anne confirms that Ursula can sometimes give inappropriate or poorly considered responses to certain situations. “She can get upset very quickly,” Anne says. “She can be absolutely fine one moment and totally out of control the next. Sometimes it's like playing chess with a blindfold on. You have no idea what the right move to make would be.”
The worst thing about all this for Anne is seeing her beloved daughter suffer.
“It breaks my heart to see such a bewildered look in the face of someone who is just 29 years old,” she says. “Ursula has such a fear of the world.”
Anne says her daughter has many wonderful qualities. “She's extremely good with her budget. She goes to AA meetings and absolutely loves her little dog; in fact, she loves all animals. People have wonderful things to say about her gentleness and her lovely manner.”
Sometimes, especially when she is not drinking, Ursula's sisters and Anne spend a few nights with her in her house. They, as well as Anne's supportive partner, Frank, love to be with her when she is feeling well
Other times, it's not so easy. “The nature of BPD is so unpredictable; plans often have to be aborted at short notice,” explains Anne.
They all feel Ursula is not getting nearly enough help. Nonetheless, she does her very best to keep herself together, but without proper support it's an impossible struggle for her. “She tries to stop drinking regularly,” says Anne. “And sometimes she does manage. She doesn't expect much from the world, so when something good happens to her, she's gobsmacked. We've had 13 years of frustration, drinking, self-harm, mood swings and depression, yet we are getting very little support.
“Every time she seeks help, it's a new service provider and we have to start from the very beginning yet again with ‘query addiction; query depression’ — it's so frustrating,” Anne says. “If Ursula had cancer, a multi-disciplinary team would have sat down long ago and worked out a care plan for her. So why won't they do that for BPD?”
In the last 18 months, Ursula's situation has deteriorated even further, due to two traumatic incidents that left her with “high levels of anxiety”.
Recently, she experienced seizures following yet another overdose, and she has suffered two fractures while drinking. Anne is very concerned that Ursula will hit her head so badly she will end up with irreparable brain damage or even worse.
“I've seen it happen regularly in my 34 years of nursing,” says Anne.
So much so that recently Anne went on Liveline, Joe Duffy's radio