Tag: mental-health

  • Bold Beautiful Borderline

    Bold Beautiful Borderline

    PODCAST DETAILS

    Title: Bold Beautiful Borderline

    Host: Sara Abbott

    Platform/Availability: Spotify, Apple Podcasts, and all major podcast platforms

    Episode: Borderline Rage “I will ruin your fucking life”

    Year: re-released 7th December 2025

    Host background: Sara is a Licensed Clinical Social Worker with lived experience of BPD.

    1. WHY I CHOSE TO LISTEN TO THIS

    I decided to see if I could find some podcasts about BPD and this was one of the first to come up in the search. A therapist with lived experience is such a powerful combination and I was keen to tap into her wisdom.  

     I picked this recent re-release episode as a starting point because I find rage extremely challenging – both my own and other people’s. And my daughter experiences a lot of rage.

    2. WHAT IT COVERS

    Sara breaks down in detail a recent argument she had with her husband: what she was feeling and why, and how it was resolved. She then goes back and gives examples from her past of when she experienced rage and dealt with it less well. She reads out responses she had from people with BPD as to what rage feels like to them. She goes into some of the theory behind BPD rage, DBT skills and guidance for people who might be on the receiving end of it.

    3. STRENGTHS

    Sara is highly articulate and speaks passionately and with great clarity about her own experience and as a therapist. I loved the ‘case studies’ from her own life.

    4. LIMITATIONS

    FYI there is the occasional swear word – in case you’re thinking of listening to it in a public space!

    Sara does give some brief advice to people who are on the receiving end of BPD rage, but this isn’t the focus of the episode.

    5. TONE AND SENSITIVITY

    She describes her podcast as raw, honest and sometimes humorous and that’s what I got from this episode. She has great empathy for her listeners who have BPD – their strengths and their struggles.

    6. PERSONAL REFLECTION

    I think I’m going to re-listen to this episode as there was so much for me to digest. Listening to her journey – things she did when she experienced rage when she was younger, to how she handled it in this recent argument with her husband left me with hope. My daughter is working so hard in therapy, but it’s a long, slow haul and sometimes it’s hard to see the progress, so it’s heartening to hear from someone who has stuck with it and is now in such a different place.

    7. WHO IT IS FOR

    I think it’s primarily for people with lived experience of BPD, but as someone supporting a loved one with it I also found it really useful.

    8. STANDOUT QUOTE

    It’s OK to feel anger for longer periods of time, it’s OK for all of those things to live there, it’s just simply what we do with it.

    9. FINAL THOUGHTS

    This podcast is now on my subscribed list!

    LINKS

  • The Pecking Order of Distress

    The Pecking Order of Distress


    I keep thinking about a conversation we had earlier, dearest daughter. The one where I told you about the recent NHS survey suggesting that as many as 1 in 10 young women may have Borderline Personality Disorder (BPD).

    I’m not sure how I was expecting you to react – I think I hoped it would make you feel less alone. But your initial reaction was disbelief. You pointed out that you don’t see hordes of young women having episodes out in public — and surely you would, if there were really 10% young women out there with the condition.

    I got defensive

    I’d spent so long looking at the report, trying to understand what it was saying, how the screening for BPD worked, that you refusing to believe it felt like you were saying my article was wrong — even though I was just reporting the results.

    And I got that familiar feeling of frustration that has come from many years of me saying something and you automatically saying the opposite. Like disagreement is your reflex — even when I’m not arguing, just reporting.

    Athough, in this instance, I think you have a point. One in ten young women potentially having BPD does seem impossibly high. But even it’s an overestimate and the real number is closer to one in twelve, or one in fifteen, that’s still a huge number of people.

    Quiet suffering still counts?

    Wanting to defend the statistic, I suggested that maybe some had a different, quieter form. After all, there are many different “flavours” of BPD — not everyone explodes in public.

    You replied with your trademark bluntness: then they don’t really have a problem and shouldn’t count.

    TikTok and self-diagnosis

    You talked about TikTok and how frustrating you find it, seeing people doing posts, self-diagnosing themselves with serious mental health conditions like BPD — the “oh I get anxious and I wanted to kill myself once so I must have BPD” brigade.

    I can see why this would irritate you. The not understanding. The seeming desire to jump on a bandwagon. The undeserving taking a slice of your pie.

    But I also hate pecking orders of distress. The way people like to judge suffering and decide whether it is ‘better’ or ‘worse’ than an imaginary legion of others. It wouldn’t be so bad if these judgements were kept private, but they never are. People feel honour-bound to tell you your suffering isn’t as bad as someone else’s. You get put in your place — usually to shut you up.

    I say this because it’s definitely not just you who judges, I do it — we all do. It has been part of society since forever. Perhaps it’s worse now because of social media. I don’t know. What I do know is that it needs to stop. There has to be another way.

    A spectrum, not a tick box

    I reflected on this new way of thinking about personality disorder — how it is now to be seen as a spectrum, not a tick box. This new framework may be more accurate but I fear it will turn people’s suffering into one long pecking order of distress.

    Given that the NHS has limited resources, how will decisions be made as to whether you qualify for treatment for a personality disorder? How far down the continuum will you need to be? Will there be a magic algorithm that sifts through all the crisis team referrals and the hospitalisations and decides who is deserving? Not saying the system is any better now of course, but if the system is going to change, I’d like it to be for the better.

    TikTok and your diagnosis

    But then you talked about how TikTok was useful in your own journey to diagnosis.

    You were at college and struggling and saw all these videos where people were describing what they felt and did. They called it BPD and you thought they meant bipolar. But when you looked up bipolar specifically, you thought: this isn’t me. So you were confused, and you talked to me about it.

    I said BPD stands for Borderline Personality Disorder, not bipolar. That you having a BPD diagnosis was something I’d discussed with CAMHS a few years before, but they were reluctant to assess you at that age because emotional intensity and instability can look like ‘normal teenage’ stuff. But that maybe it was time to get you properly assessed – you were 19 at the time.

    So I found a psychiatrist privately. Things were so bad I didn’t want to wait months or possibly years to find this out. And hey presto, we’d both been correct. Or rather, the psychiatrist agreed with us. She diagnosed you as having BPD.

    Diluting the experience

    The other thing you said that gave me pause: you refused to believe the 1 in 10 statistic because if it was true, it would give people an excuse to treat it as less serious. Like the volume somehow diluted the severity of experience.

    And maybe what you were really reacting to wasn’t the statistic at all, but the risk that other people would use it against you. That they’d hear “mainstream” and translate it as: Not that bad. Not that urgent. Not worth resources.

    Bandages

    It made me think of the times we used to go to therapy after I adopted you. When we got ready for the journey home, you’d sometimes fake a fall and insist on bandages for an “injured” limb.

    Even when we all knew what you were doing, you still needed it. Because pain that can’t be seen has a habit of being doubted.

    Mental ill-health and trauma can feel brutally lonely for that reason: it’s invisible. And you found a clever way of making the invisible visible.

    You’ve fought so hard to get me — and others — to understand how serious your pain is. So I can see why anything that hints your suffering is now commonplace might feel like it’s pushing you back into being unseen.

    But what if….

    … there are hundreds of thousands of young women like you out there — suffering and not being understood?

    Maybe at the heart of this is a dialectical truth: you can be desperately unwell — and you can be one of many. Both things can be true at the same time.

    If 1 in 10 young women do have BPD, that statistic doesn’t make it trivial. It makes it very, very urgent.

  • A Dive Into The APMS

    A Dive Into The APMS

    The Adult Psychiatric Morbidity Survey (APMS) 2023/4 is a large NHS survey that gives a “snapshot” of adult mental health in England. It follows the same basic approach as the last APMS in 2014, so we can make some comparisons over time.

    The survey results were published at the end of 2025.

    This wasn’t an online poll. Researchers interviewed a random sample of adults in private households, and people answered the most sensitive questions privately on a laptop. Because it’s a household survey, it doesn’t include people living in settings like prisons or inpatient units, and it’s likely to under-represent people who aren’t in stable housing — all groups where mental illness rates are often higher.

    This post focuses on what the survey suggests about Borderline Personality Disorder (BPD).


    Boxes vs Spectrums

    The report notes that personality disorder diagnosis is changing. Older systems tried to put people into categories (like “BPD”), even though many people don’t fit neatly into one box. Newer thinking treats personality disorder more like a spectrum: traits become a “disorder” when they’re so intense or inflexible that they seriously disrupt everyday life and relationships.

    The APMS sits between the two approaches — it reports both category screens for BPD and antisocial personality disorder (ASPD), and a broader screen for general personality disorder traits.

    The report also notes a debate: critics worry a broad “general personality disorder” label could widen the net and increase stigma and pressure on services, while others argue personality disorder has been underdiagnosed and better recognition could improve care.


    What Screened Positive Means

    The APMS did not check people’s NHS records or diagnose them in clinic. It used questionnaires designed to work out if it’s likely someone has a condition like BPD.

    So these figures do not mean a confirmed diagnosis after a full assessment — they mean screened positive on a questionnaire.


    Key BPD Numbers

    • We can compare data regarding numbers who screened positive for BPD with data from 2014
    Bar chart comparing BPD screen-positive rates in adults aged 16–64: 2.4% in 2014 and 2.5% in 2023/4.
    BPD screening hasn’t budged much in a decade (16–64): 2.4% → 2.5%.
    • If you look at all adults 16 years and older, 1.9% screened positive for BPD
    Infographic showing 1.9% of adults aged 16+ screened positive for BPD, equating to around 900,000 adults in England (illustrated with people icons).
    1.9% sounds small — until you realise it’s about 900,000 adults in England.

    Young Women: A Standout Finding

    One of the most striking sets of results is for women aged 16–24. They suggest that young women are experiencing personality disorder and self-harm (a common feature of BPD) at among the highest rates in the survey.

    Infographic listing women aged 16–24: 35.3% screened positive for general personality disorder traits, 9.8% screened positive for BPD, and 31.7% reported lifetime self-harm without suicidal intent.
    Young women (16–24) are the outlier: PD traits, BPD screening, and self-harm all spike.

    The BPD statistic alone is cause for concern.

    Infographic stating that 9.8% of women aged 16–24 screened positive for BPD (approximately 1 in 10).
    About 1 in 10 young women (16–24) screen positive for BPD.

    The report also notes that some critics see “personality disorder” labels as a way of medicalising understandable responses to trauma, inequality, and social pressure.

    Are we diagnosing a biological disorder — or measuring the weight of modern society on young women?


    A Big Caution: Overlap And “Diagnostic Overshadowing”

    The report points out that BPD and general PD criteria can overlap with autism and complex PTSD, which can contribute to “diagnostic overshadowing” (thinking a symptom is linked to one condition when it’s really caused by a different one).

    However, the report doesn’t publish a breakdown of any overlap between people who screened positive for BPD and autism or complex PTSD. Presumably because only 99 people in the survey screened positive for BPD, which limits how much detail you can reliably analyse.

    For me, this is a key area of concern. How can the right treatment be given, if we don’t fully understand what is causing the behaviour?


    The Soup Of Distress (What Tends To Cluster With PD Traits)

    What the report does show clearly is that people screening positive for general personality disorder traits are more likely to be facing wider pressures — including unemployment and financial hardship, and higher rates of depression/anxiety and limiting physical health conditions.


    The Treatment Gap: Pills vs Therapy

    The report suggests a mismatch between recommended care and what people report receiving.

    Horizontal bar chart for people screening positive for BPD: 47.8% reported no treatment, 43.8% reported medication, and 21.6% reported psychological therapy; note that treatments can overlap
    Nearly half get no treatment — and meds beat therapy by about 2 to 1.

    The report concludes this points to a need to improve treatment and service provision (while also noting the small BPD sample size means we should be careful about over-interpreting).


    One Hopeful Note – And One Hard Reality

    A hopeful note is that the much lower screen-positive rates in older age groups challenge the idea that BPD symptoms must be lifelong for everyone (though the APMS can’t track individuals over time).

    Chart showing BPD screen-positive rates are highest in younger age groups and lower in older age groups.
    BPD screening peaks in young adulthood — then drops with age.

    But the report also notes that this isn’t a trivial condition. It cites earlier UK research in people treated by specialist NHS mental health services (beyond GP care) where life expectancy was estimated around 18 years shorter than the general population, and notes many were likely to have had a BPD diagnosis.

    Conclusions

    My conclusion is that it’s great to have this big-picture overview of mental health in England — but the survey now raises questions that need much more granular research.

    For example, my daughter has first-hand experience of diagnostic overshadowing: there are services for other conditions that won’t engage with her because she has a BPD diagnosis. That has been a major barrier to her getting better. The authors of this report suggest she isn’t the only one — but where is the data to confirm this pattern, measure its impact, and show what improves outcomes? Without clear evidence, it’s harder to push services to change.

    The figure of around 1 in 10 young women screening positive for BPD is a wake-up call. Even allowing for the limits of screening tools, this is too common to ignore. It should trigger urgent research into what’s happening for young women — and why.

    And the treatment picture won’t surprise anyone who has tried to access therapy for themselves or a loved one with BPD. It’s also not surprising that medication is used so often, even though there isn’t a drug that specifically treats BPD. When waiting lists are long and therapy is hard to access, people in crisis understandably want something — anything — that might ease their pain.

    Now that this report is out, the question is: will we treat these findings as a headline, or as a prompt for real change — better data, better access to psychological help, and fewer people falling through the cracks?

  • Handstands

    Handstands

    Trigger Point

    It was 8pm. We were on the sofa, watching television as usual. The dog crouched on the floor, quivering with excitement, waiting for you to throw his ball.

    Fleabag had just said I love you — and goodbye to the hot priest. A lovely end to a brilliant series. I said “all done” to the dog and walked out into the hall to put his ball away.

    When I came back, you were off the sofa and furious.

    The dog had ruined everything, you said. No — I had ruined everything. You’d wanted to do handstands. I’d ignored what you wanted, got the dog’s ball out instead, and now the moment had passed. You’d lost your motivation and it was all my fault, because I always put the dog first.

    You were getting louder and louder. I asked you to stop shouting. You said I only listened when you shouted. You’d asked me nicely to put the dog in his crate so you could do handstands, and I’d ignored you. Why should you make all that effort — keep trying with your DBT skills — if they didn’t even get you what you wanted? If I was going to carry on being so fucking useless?

    I stood there trying to catch up. It all felt like it had come out of nowhere, but it hadn’t.

    The Set Up

    It had started twenty minutes earlier, while you were still eating.

    Or maybe even earlier than that when I decided to eat without you. I was post-migraine hungry and couldn’t wait for your appetite to kick in. So I ate on the sofa alone.

    A Routine Disrupted

    Eating separately shifted the whole rhythm of the evening. It meant I’d already done the after dinner dog routine — ball throwing, kibble hiding, peanut-butter LickiMat — the routine we’d devised to try and put a limit on his relentless demands to play with us in the evening. The routine we usually did together.

    Then I was back on the sofa again, keeping you company while you ate your dinner. Sausages and mash, broccoli and green beans, everything swimming in gravy. One of your favourites.

    The Ask I Missed

    We were watching Fleabag when you said you wanted to do handstands, after you finished eating. These post-dinner handstands were a new thing. You said they gave you that strong feeling in your joints — like when you used to swing from the chin-up bar when you were little.

    You said, basically: he’s had his ball — put him in his crate so I can do handstands in peace.

    But I wasn’t so sure. The dog was staring, fully expecting the ball to appear again. And I wanted a quiet life — because when the dog got frantic, you shouted, I snapped back, and everything went to pot.

    I didn’t say any of that out loud. I just went to the kitchen and came back with the Nutella jar and a big spoon — your favourite pudding — and the dog’s ball.

    The Spiral

    You stared hard at me and silently flicked two middle fingers while you licked your Nutella spoon. I let it slide. I was focused on trying to please both of you: a quick play with the dog, then the handstands.

    Except the dog didn’t want to play with me. He kept delivering the ball to you.

    So I leaned over and picked it out of your lap, trying to save you the trouble of throwing it. You flinched as I got close. That stung, but I ignored it, not wanting to provoke you.

    Eventually I put the ball away. And then I came back to find you furious, and I got that familiar stomach-dropping feeling as your rage ramped up.

    Part of me was cross because it felt like it was over nothing — like I was being attacked out of nowhere.

    I told you I wasn’t a mind reader, and that if I’d known the handstand thing was time-critical, I would have handled the dog differently. You looped through your anger again: I should have known what you needed.

    As you raged I flipped between trying to defend myself and mutinous silence. Eventually I pushed back — telling you it was impossible to be open and reflective about my own actions while you were shouting at me.

    Lessons From Childhood

    You said this was no different from what had been expected of you at school — the teachers had shouted you into overwhelm, and then expected you to reflect on your behaviour and apologise.

    Hearing those words, my heart broke. I knew you’d been challenging at school, but no one should be treated like that, especially a child.

    You said it wasn’t just teachers. It was me too — I always made you apologise and rarely apologised myself.

    It was an uncomfortable truth. For all the stories I could tell myself about your “bad” behaviour, things usually escalated because I lost my temper.

    And then you looped back to the same old point: I never listened.

    The Repair

    You’d said it many times before — the not listening — and it always hit a nerve, because I did listen. I just didn’t always agree. But in a moment of inspiration, I tried something different. I asked if I could repeat back what I thought you’d told me, to check whether I’d understood. You could correct me if I’d got anything wrong.

    I said something like:

    So you were eating your dinner and you decided you wanted to do handstands when you finished. You could see that might be difficult with the dog jumping around, so you suggested putting him in his crate. I ignored that and got his ball instead. He kept bringing it back to you, and then I invaded your body space by leaning over to pick it up, which wound you up even more. And by the time I put the ball away, you’d lost the urge to do the handstands. That was frustrating because you’d genuinely wanted to practise. And it felt like I’d ignored you and put the dog’s needs before yours — and that wasn’t fair.

    As I said it, I could see — and feel — you calm down. And as you calmed, I felt myself shifting too. I could see it more from your point of view. I felt empathy for your frustration. I saw that little girl — taken into foster care — who’d never felt she’d been put first.

    I waited a moment then said that part of me still thought waiting could have worked — but I could see why it hadn’t for you. I was half-expecting you to explode again. You didn’t.

    See Me

    How quickly you calmed down surprised me. It gave me pause. I’d assumed it was obvious that I understood why you were angry, but it wasn’t. I’d already been moving on to the next thing — trying to solve the problem — when what you wanted first was to feel seen.

    You told me how frustrating it was when I looked away, or made what I thought were sympathetic noises while you were trying to explain how you felt. How it made you feel ignored — like I didn’t care or understand.

    I asked if I could do the repeating-back thing again in future — so I could check I’d understood, and you could feel me listening properly. You agreed it might work. It felt important.

    You suggested I write it up as a journal post.

  • Review of the Aeri Breathing App

    Review of the Aeri Breathing App

    1. App Details
    Name: Aeri
    Type: Breathing / nervous-system regulation app
    Platform: iOS / Android
    Cost: Free and advert-free

    2. What the App Is Designed to Do
    This app provides five different breathing routines designed to support sleep and calm the nervous system.

    3. Why I Tried It
    I’m always on the lookout for tools that might help me calm down and unwind after work, and to help regulate myself after my daughter has had an episode—a time when I often get palpitations, headaches, and generally feel pretty dreadful.

    4. My Experience Using the App
    I found the app easy to understand and straightforward to use.

    The five breathing routines are:

    • LVL UP breathing – to increase your resilience
    • Resonance breathing – to calm your mind
    • Breathing to reset – to centre yourself
    • Calm breathing – to relieve tension
    • Breathing for sleep – to drift into sleep more easily

    Once you press start on any routine, a line appears on the screen. It travels upwards as you breathe in, goes flat when you hold your breath, and moves downwards when it’s time to breathe out.

    This visual is paired with sound cues: a rising tone as you inhale, a soft blip when you hold, and a descending tone as you exhale. You can also enable phone vibration for additional guidance.

    A timer is displayed so you can see how long is left in the routine.

    5. What I Found Helpful
    The routines last around 10–12 minutes, which is long enough for me to feel a noticeable physical shift. If they were any longer, I think I’d be put off doing them.

    My favourite routine is the Calm Breathing session. It’s incredibly simple, and every time I use it I wonder why on earth I need an app for something so basic. But the truth is that it’s much easier to keep to a steady rhythm when something is guiding you.

    6. Limitations or Things to Consider
    It’s not a magic wand that will make all your problems disappear—if only!

    If I’ve felt particularly trapped or started dissociating when my daughter is episoding, I often need to move my body first— go for a walk, or perhaps do a bit of yoga — something to discharge some of the stored up stress, before I can settle into a breathing exercise.

    7. Who I’d Recommend It For
    I’d recommend it to anyone who wants to see whether a short, structured breathing routine might help them calm down or improve their sleep.

    8. Final Thoughts
    I like this app because I find it effective, it’s easy to use, and it is completely free and advert-free (at the time of publishing). However, there are plenty of other breathing apps out there to explore, if this particular one doesn’t work for you.

    Download the app:

  • Me and the Voice in my Head

    Me and the Voice in my Head

    Title: Me and the Voice in My Head
    Channel: Channel 4 (available via Channel 4 Player)
    Year: 2024
    Production Company: Hungry Bear Media
    Format: Documentary


    1. Why I Chose to Watch This

    It seems that, at present, the only way to get a documentary about mental health commissioned by a TV channel is to attach a celebrity to it. I find this frustrating — the whole celebrity thing makes me less inclined to watch something, not more.

    This documentary is another in that ilk, however the good news is comedian and actor, Joe Tracini is absolutely brilliant and has something genuinely important to say about Borderline Personality Disorder.


    2. What It Sets Out to Do

    Joe is brutally honest about his experience of life and the way he thinks about himself and others, helping to illuminate what it actually means to live with BPD.

    This could easily have been a very dark and overwhelming watch, but Joe has a gift for comedy and highlighting the absurd. There are laughs and lighter moments even when he’s tackling incredibly tough topics, including suicidal thoughts.


    3. Summary of Content

    The documentary follows Joe over ten weeks as he tries to get his career back on track by preparing and performing a stand-up routine about his mental health. Alongside this, he speaks to a therapist to learn more about BPD, introduces us to his girlfriend and parents, and explores his childhood in search of clues as to why adulthood has been such a mental-health struggle for him.


    4. Strengths

    The standout moments for me were the scripted sections in which a man behind the camera interviews both Joe and his alter ego, Mick — the name he gives the voice in his head that says cruel things — together on a couch. It was interesting to hear Mick say so many of the things my daughter has said over the years. I thought that voice was unique to my daughter, but it seems not. And Joe’s performance, conveying the brutality of what it says with humour, is an incredible feat.


    5. Limitations

    Joe does visit a clinical psychologist who specialises in BPD to learn more about the condition, but overall the documentary focuses on his personal experience rather than exploring current research or the full range of available therapies.


    6. Tone and Sensitivity

    The tone of the programme is unlike most portrayals of mental health on television. It is frank, dark, irreverent, and surprisingly funny.


    7. Personal Reflection

    As the parent of a young adult with BPD, I found myself reflecting on my daughter’s childhood while watching Joe reflect on his own – painful to do, but it gave me new insights.

    My daughter is the bravest person I know, and seeing Joe stand up to Mick showed just how brave people with BPD are. Choosing to keep going when you have a voice like Mick’s in your head is an act of great courage.


    8. Who It’s For

    The documentary is designed for a general audience, but will be especially meaningful to people with lived experience and their loved ones.


    9. Standout Moment or Quote

    “The more I talk about how f*d up I am, the less f*d up I feel — which is mental.”


    10. Final Thoughts

    I’m delighted that Me and the Voice in My Head won Best Documentary at the Grierson British Documentary Awards 2024. Joe and the team at Hungry Bear Media deserve recognition for creating such a brave, unique, and enlightening look at BPD.

    You can find Joe on social media