301.83

for my final essay in advanced creative writing – my final essay i will ever write in my undergraduate degree, my final essay before i start my thesis next year – i am writing about bpd, which is number 301.83 in the diagnostic and statistical manual of mental disorders fifth edition.

this is how it starts:


To diagnose a personality disorder there must be significant functional disturbance of an enduring and inflexible nature of long duration leading to undue distress and psychosocial impairment. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition(DSM-V) classifies ten distinct personality disorders into three clusters based on descriptive symptomatic similarities: A – odd or eccentric; B – dramatic, emotional or erratic; and C – anxious or fearful.

Borderline Personality Disorder (BPD) is a Cluster B psychiatric condition with difficulties manifest in persistent patterns of disturbed cognition, emotional experience, emotional expression and maladaptive coping mechanisms. The typical features of BPD are instability in the areas of self-image, personal goals, and interpersonal relationships. Characteristic dysfunction is therefore apparent in areas of identity, empathy, and/or intimacy with accompanying impulsivity, hypersensitivity, and/or hostility

In a clinical setting, borderlines are notorious for a pervasive pattern of abrupt mood swings and affective instability. Thus, extreme care should be taken when handling such patients, particularly during suicidal crises which are often both regular and prolonged. Implementation of the 2007 NSW Mental Health Care Act is recommended for treatment-resistant individuals who present as a danger to themselves and/or others. Physical restraint is preferable to chemical sedation when treating these revolving-door patients.

Ultimately, BPD is an emotional dysregulation disorder with marked impulsivity and instability across a variety of emotional and social domains emerging by early adulthood, as indicated by the presence of five or more of the following symptoms.


it’s supposed to be tongue in cheek but i don’t know if it’s quite tongue in cheek enough.

the rest of the essay is made up of memories / crises according to symptom. so i talk about my worst dissociative episode and that section of the essay is called SEVERE DISSOCIATIVE SYMPTOMS AND/OR TRANSIENT, STRESS-RELATED PARANOIA AND/OR PSYCHOSIS-LIKE EPISODES IN SITUATIONS OF EXTREME AROUSAL and i’m trying out a new style of writing and i want to know what you think of it, it’s inspired by a memoir i’m reading by james frey called a million little pieces and its un-put-downable.

today i drank coffee for breakfast and wine for dinner.

i’m going to be thin again.

blergh

stopped cutting; restarted drinking. except for tonight, when i have both cut and am drunk.

writers block. stream of consciousness.

critical essay for a creative writing course.

useless bitch.

can’t sleep. i go running in the dark, by which i mean to say, i go running in the wee hours of the morning and also i run on the unlit side of the footpath since i feel more at home in the dark.

i’m always running from something. when will i have something worth running toward?

i should probably go back to therapy, but things are fine, things are good – it’s all comparative, right? and i’m not suicidal, so things are fine? i’m waking up, i’m going to work, i’m not in the hospital, i’m safe. so why do i feel so bad? why don’t i feel safe? my own mind is a maze, it’s a trap. i don’t get it.

i don’t get it. idontgetit.

i read somewhere that for alt text and the visually impaired, capital letters are really important. so #idontgetit looks like gibberish but #IDon’tGetIt makes perfect sense. well, i just don’t get it; what about those of us who have eschewed punctuation and grammar for #theaesthetic?

i was hoping that some word vomit would kickstart my brain and i could get some essay done (i keep telling myself i’ll ‘smash it out tomorrow’ but i tomorrow keeps coming and and going and the due date just keeps coming and coming and coming) but it’s just making me sad instead. or maybe that’s the vodka. it’s hard to tell, tbh.

i wonder about being a lucid dreamer. i wonder about inception, remember that? sometimes, i can’t tell if this is real. i don’t know if this is real. idontknowifthisisreal. IDon’tKnowIfThisIsReal.

we’ll have to check. we’ll have to die, because then if i wake up, then i will know it was all a dream.

i don’t like being sick.

i wish i had some drugs.

i wish i had someone to hold me close, and snuggle me with their nose and their warm breath, nudge the hair from my nose, and whisper in my ear

it’s going to be alright my love.