20 questions to ask your psychiatrist/psychologist after you’ve been diagnosed with Borderline Personality Disorder (BPD)

Gone, is that feeling of uncertainty, that uneasiness of “just what is wrong with me?”. We may experience relief from now having a label to describe our experiences, or perhaps feel sombre over being different. It is okay to allow ourselves some time to breathe and to feel our emotions.  

Once calmed, the thought may then occur to us, “What’s next? What do I need to know? What should I ask?”

Here are 20 questions that may prove useful: 

Clarification of diagnosis 

1. What does “borderline” mean?

2. Why is it called a “personality disorder”? Am I a bad person? 

3. What symptoms of BPD do I display? 

4. Could there be other diagnoses with similar symptoms? Are we certain I have BPD? 

5. Do I have any comorbidities? 

Learning

6. Was I born with this? How did I get this?

7. Do you have any tips for managing my symptoms and feelings? 

8. Do you have any recommended resources that would help me better understand BPD?

9. Do you know of any support group that I can join? 

10. Are there films or books about BPD that I may be able to relate to? 

11. How should I tell my loved ones about this?

12. How can I tell if someone still loves me?

13. Will this affect my relationships?

14. Will this impact my professional career?

15. Is there anything I should avoid? 

Treatment 

16. Is this curable? 

17. Are there any medications that may help? What are the side effects?

18. What is the most effective treatment? 

19. When will I get better? 

20. Is it possible to relapse? 

It has likely taken bravery and effort on our part to seek professional assessment, and we should give ourselves a pat on the back. Similarly, the road to recovery may seem arduous and daunting, but let us once again find the courage to persevere, so that we may better enjoy relationships with others.

I've been called manipulative, what should i do?

We may even have heard that people with borderline personality disorder (BPD) are manipulative and worry if we may have the same disorder too. So, what should we do to check? 

Reflect 

Firstly, let us take a moment to reflect on these questions: 

Have others called me “manipulative”? 

What constitutes an acceptable behaviour can vary between individuals and cultures. If only one person labelled us as such, perhaps our personalities simply do not match. However, when many people think of us as manipulative, it may be beneficial to consider the next few questions. 

What did I feel while carrying out the acts? 

“Manipulation” may draw to mind a calm and collected con artist. If we enjoy lording over others, we may even feel exhilaration! On the other hand, individuals with BPD experience feelings of desperation! They engage in such behaviours as they are terrified of being abandoned and need the consistent reassurance or validation. 

What was I hoping to achieve through my actions? 

Unlike notions of manipulation where we are trying to gain something at the expense of someone else, individuals with BPD have different aims! Granted, individuals with BPD may sound manipulative with requests like “If you love me, help me do…” or “Do …, otherwise I will hurt myself”. However, their intention isn’t to inflict harm or dominate the other person. Instead, it is usually done to seek emotional comfort and reassurance that they are cherished and not about to be abandoned. 

After having pondered these questions and if it seems that we are similar to a person with BPD, let us move on to the next step to further explore if we may have BPD. 

Consult the family 

BPD runs in the family, with studies estimating that having a parent, sibling or child with BPD puts us at a 5 times greater risk of developing it ourselves. Checking in with our loved ones to see if there are any relatives within the family with BPD may help confirm or allay our worries. 

Seek professional opinion 

Lastly, the sure-fire way to check if we may have BPD would be to seek out a mental health professional. With their expertise and more in-depth assessment tools, they are more likely to provide you with an accurate assessment. 

Does High Functioning PTSD Exist?

However, some people who experienced trauma may seem like they’re doing just fine. That leads us to the question – does high functioning PTSD (HF-PTSD) exist? 

The answer is yes! While they could seem successful in many areas of their lives, those with HF-PTSD are not living at the optimal. In fact, they struggle internally and are coping through pain. Breakdowns or burnouts are likely to happen with a matter of time.  

Coping methods by those with HF-PTSD 

People with HF-PTSD are likely to cope by blocking out memories of their trauma. They avoid situations and people that remind them of their traumatic experiences. Doing so makes them look “perfectly okay”. While feeling constantly on-edge, they try to ignore the negatives. Instead, they work hard to excel at their work, relationships and other responsibilities. These distract them from the trauma and its effects.  

Healing the trauma 

While seemingly functioning well, living with HF-PTSD is not ideal. Without treatment, one could reach a breaking point. The following strategies can be used in the healing process.  

1. Talking to someone 

Having a listening ear that does not judge can help one feel supported throughout the healing process. It is useful to have an emotionally and physically safe space that gives us opportunities to express our emotions.  

2. Therapy 

Going to therapy is a good option for those with HF-PTSD. The therapist might use the following methods: 

a. Eye movement desensitization and reprocessing (EMDR) 

During EMDR, the client is guided to recall the traumatic event they experienced. At the same time, they emphasize positive beliefs like “I had put in my best effort”. This helps the brain come to terms with their negative experiences.  

b. Exposure Therapy 

People with HF-PTSD frequently avoid people and places that remind them of trauma. Exposure therapy, like its name suggests, exposes the client to these reminders. They learn to cope with their feelings of anxiety.  

c. Cognitive Behavioural Therapy (CBT) 

In CBT, unhealthy thoughts are identified and challenged to change behaviour. This helps the client makes sense of the traumatic event and deal with challenges in a more adaptive way.  

HF-PTSD is a real condition that you or people around you may be dealing with. While sharing the emotional burden with someone can be helpful, the best form of treatment is to seek guidance from mental health professionals.  

A Guide to Healing from Parentification

Did you ever have to worry about looking after your siblings? Did you often find yourself acting as a confidant to your parents when they had an argument? Have you been complimented for your maturity in mediating family conflicts?  

If you identify with any of the above,
you might be a parentified child. 

What is Parentification? 

Parentification occurs when a child assumes the role of the parent. A parentified child is robbed of a carefree childhood and takes on hefty responsibilities that are inappropriate for their age. In adulthood, you might learn to only trust and rely on yourself, which hinders you from forming healthy relationships. 

Types of Parentification 

Ψ Instrumental Parentification. This is when a child takes on the physical and tangible duties of the parents. They might take care of their younger siblings, pay the bills or care for a loved one with a disability or an addiction.

Ψ Emotional Parentification. This is when a child provides emotional support for their parents. The parentified child might feel responsible in providing a listening ear or comfort and advice to their parents in times of distress. 

How to Heal from Parentification? 

Fortunately, it IS POSSIBLE to address the parentification trauma. Here are some tips to start embarking on your journey of recovering from parentification.  

Ψ Acknowledge your experience of being a parentified child. Be open to speaking up about your trauma. Accept the reality of a loss childhood and the repercussions it may have in your adulthood. Allow yourself to feel and process the grief and anger. 

Ψ Explore your needs and prioritize them. Reconnect with your inner child and explore these needs. You might need love, attention, or the freedom to play. You are now your own parent and have control over your needs. As a child, you might have missed out on activities that were meant for children. It might be difficult to put yourself first, but you can try with small steps. Start by spending time with friends, listening to music, meditating, or anything that makes you happy! 

Ψ Cultivate self-compassion. As parentification is covert and insidious, it often goes unnoticed. This does not mean that your feelings are any less justified. Don’t be too critical of yourself; understand that it’s not your fault and there’s nothing you could have done better as an innocent child. Tell yourself “I am sorry for what you had to go through, and I love you”. 

Ψ Learn to establish healthy boundaries. Growing up with parents who push your boundaries might impair your ability to establish healthy boundaries. To set boundaries, be clear and direct to avoid miscommunication. While being polite, don’t feel apologetic for wanting to meet your own needs; remember that self-care is not selfish. 

It takes time and patience to allow yourself to heal. Our childhood wounds do not define us, and you deserve to have your needs taken care of. If you need support, feel free to reach out to our team of psychologists!  

Rising Cost of Living in Singapore: An Impact on Mental Health

As the city-state continues to develop and expand, the financial burden on individuals and families has intensified, leading to notable mental health repercussions. This blog post explores the intersection of the rising cost of living and mental health problems in Singapore, highlighting the need for a comprehensive approach to address this pressing issue.

Singapore’s Economic Landscape

Singapore is renowned for our rapid economic growth and high standard of living. However, while this success creates prosperity, it also creates other challenges that accompany success. For example, the prices of essential goods and services, including housing, healthcare, and education, have increased, making it increasingly difficult for many Singaporeans to maintain their standard of living. The cost of post-pandemic private housing has surged, with a corresponding increase in rental prices. Additionally, healthcare costs have risen, and education expenses continue to climb, adding to the financial strain on families.

The Psychological Toll

 The financial pressures associated with the rising cost of living have led to a significant increase in stress, anxiety, and depression among Singaporeans. The constant worry about meeting daily expenses, paying off rent or mortgages in the most expensive city to live in in the world, or paying for a university education can be overwhelming. These financial concerns can contribute to chronic stress, which, in turn, exacerbates mental health issues.

1. Stress and Anxiety: The fear of not being able to make ends meet can lead to chronic stress. Many individuals find themselves working longer hours or taking on multiple full-time jobs to cope with financial demands. This relentless pursuit to achieve what is deemed by many to be financial stability in Singapore can result in burnout and severe anxiety.

2. Depression: Financial instability and the inability to provide for one's family can lead to feelings of hopelessness and depression. The stigma associated with financial struggles may prevent individuals from seeking help, further deepening their mental health issues

3. Social Isolation both in individual and family settings: The high cost of living can limit social activities and recreational opportunities, leading to social isolation. This might surprise man -: but when people cut back on social interactions to save money, they may lose valuable support systems, which are crucial for mental well-being. This may be especially true in families where both parents juggle working full-time jobs and parenting duties. Unlike in Western societies, parents here in such situations often maintain very few social engagements either to save on discretionary spending or to look after their children.

Vulnerable Populations

 Certain groups are more vulnerable to the mental health impacts of the rising cost of living:

• Low-Income Individuals or Families: Those with fewer financial resources find it harder to buffer against rising costs. The struggle to afford basic necessities often leads to heightened stress and anxiety.

• Elderly Residents: Older adults on fixed incomes may find it challenging to keep up with rising expenses. Social isolation and financial dependency can significantly affect their mental health.

• Young Adults: Young professionals and families who are have not achieved financial stability may find it difficult to achieve financial independence within a short span of time. Given the rising costs of raising children in today’s world, the pressure to secure housing and provide for future children can lead to significant stress.

Addressing the Issue

To mitigate the mental health impacts of the rising cost of living, a multi-faceted approach is required:

Government Initiatives:

The Singapore government has introduced several measures to help alleviate financial pressures. For instance, the Enhanced CPF Housing Grant (EHGH) provides up to SGD 80,000 to first-time buyers of new or resale flats. Additionally, the Workfare Income Supplement Scheme (WIS) offers financial assistance to low-wage workers.

Healthcare subsidies, such as the CHAS (Community Health Assist Scheme), help reduce out-of-pocket medical expenses for lower- to middle-income Singaporeans. The CHAS Green scheme was also introduced in Nov 2019 to allow all chronic patients, regardless of income, to enjoy CHAS subsidies for mental illnesses under the Chronic Disease Management Programme (CDMP) (namely major depression, anxiety disorders, bipolar disorder, and schizophrenia) at CHAS GPs clinics. Currently, patients can also withdraw up to $500 per year from their MediSave for the outpatient management of conditions under the CDMP.

Mental Health Support

Increasing access to mental health services is crucial. This means, in part, making mental healthcare affordable. The Ministry of Health has launched the national Mindline 1771 to provide psychological support and counselling.

Non-governmental organisations such as Samaritans of Singapore (SOS) provide crisis support and suicide prevention services, ensuring that those in distress have someone to turn to.

Leading a Values-based Life

But I’ve saved the best for last. I want to share a little about what a value-based life is, and what it means for us as unique individuals.

When individuals align our lives with our core values, we often find greater purpose and meaning, which acts as a psychological anchor, helping us navigate financial challenges more effectively. This alignment builds inner strength and resilience, enabling better coping mechanisms against stress and anxiety caused by financial pressures.

For example, emphasising values like community and relationships leads to stronger support networks, providing both emotional and practical support during tough times. These networks reduce feelings of isolation and stress, and promote mutual aid practices where communities share resources, lessening individual financial burdens.

Values-based living also encourages reduced materialism and simplified living. By focusing on contentment and gratitude, individuals find satisfaction with less, lowering the psychological impact of financial constraints. This shift towards mindful spending based on core values helps individuals feel more in control of their finances, reducing stress.

Furthermore, values like self-compassion and acceptance improve emotional well-being. Being kinder to oneself during financial hardships and accepting the situation without undue stress allows individuals to focus on proactive measures rather than ruminating on financial woes.

Lastly, living according to long-term goals aligned with personal values helps maintain focus on broader life objectives, rather than being overwhelmed by immediate financial challenges. This alignment creates a sustainable and fulfilling approach to managing money, reducing financial stress and anxiety over time.

Solving the Impact of Rising Costs on Mental Health

The rising cost of living in Singapore is an undeniable reality that significantly impacts mental health. As financial pressures mount, so do the levels of stress, anxiety, and depression among residents. Addressing this issue requires a collaborative effort from the government, healthcare providers, and the community. By implementing supportive policies and promoting mental health awareness, Singapore can help its residents navigate these challenges and foster a healthier, more resilient society.

More importantly however, the solution does not only lie from external sources, but more importantly, must come from within ourselves. Living a values-based life offers a robust framework for reducing the mental health impacts of rising costs. By focusing on what truly matters, building strong support networks, and cultivating resilience, individuals can navigate financial challenges more effectively and maintain their mental well-being. Emphasising values over materialism and practicing mindful spending and being are practical steps that can make a significant difference in one's financial and emotional health.

Prosperity does not have to come at the expense of health or mental health.

Singapore can work towards a future where all have the opportunity to thrive economically and emotionally.

Battling Imposter Syndrome

Now something that may or may not be a secret: The ones who care about their achievements, performance or abilities the most, usually have the strongest imposter syndrome.

I mean, have you ever doubted your ability to brush your teeth, chew your food or even blink?

We know imposter syndrome is annoying to deal with. It drives us to go above and beyond what we need to do to feel 'competent’. We’re then told we are indeed competent (by working very hard to prove ourselves), but the imposter syndrome and self-doubt only gets stronger.

Do we deserve the recognition? Were we just lucky?
“Pretty sure others are more deserving than me. I’m not as good as they think. I’m really just winging things.”

Seriously, you’re not the only one. Don’t believe that you are.

Look, maybe there are some magical humans in the world who’ve never experienced self-doubt before. Or maybe they did, and they didn’t think much of it. The fleeting moments of self-doubt disappear so quickly that they weren’t aware of it. Some tell you they’ve never doubted themselves and can’t relate to your feelings.

Great, now you feel silly. Well, in actuality, all you found is someone you shouldn’t speak to about self-doubt and anxiety.

You see, the average human (apparently up to 82% of us) has experienced imposter syndrome. So don’t let it discourage you from finding someone you feel safe enough to talk to about your thoughts and feelings.

Okay, fine. I’ll accept that I can experience it and it’s normal. Now what? Help me get rid of it!

Hold your horses, do you really need to?

Since we’re all about sharing secrets here: imposter syndrome is not entirely bad (actually, it’s not even a syndrome). It’s okay to experience anxiety and fear. It’s okay to have negative thoughts about yourself. It’s okay to be doubtful sometimes.

What is not okay is letting the anxiety, fear, or negative thoughts, take over and prevent you from setting healthy limits to your workload, allow you to discount your achievements, or even compel you to turn down deserving opportunities. If you’re thinking of doing any of these, here are our tips for you:

Ψ Take a second, and zoom out.

Consider what brought about this wave of anxiety and self-doubt.

Was there a new and unexpected challenge you’re facing? A new responsibility? Have you only just started out in whatever job or environment you’re in? What are the expectations of this job or task? Are these expectations coming from you (i.e., thinking you need to ace this, and that you can’t fail) or from others (i.e., your boss telling you this is an important job)?

More importantly, are the processes or requirements to meet the expectations clear? Do you know what the action steps are to get the job done ‘satisfactorily’? If so, are these realistic?

Ψ Gather objective feedback.

Don’t rely on only one source. Consult multiple trustworthy persons to gather feedback or evidence of your abilities or performance. This includes mentors, managers, work colleagues, friends, family and even past employees who may have been in a similar position.

Ask them for advice. Ask them how long it took. Ask them what was required to do things well. Ask them whether they think what you’ve been doing is sufficient or whether you’re on the right track. If the feedback is generally positive or reassuring, then you know. You’re the only one doubting yourself.

Ψ Commit to trying and learning.

Maybe a part of you just doubts your abilities. Maybe the feedback tells you that you’re not “there” yet, although you have potential. Maybe your achievements are indeed shared with other contributors. Maybe there are genuine reservations in accepting a promotion.

Rather than resign yourself to “yes i’m just an imposter”, take it as a sign that your mind (or heart) is telling you it wants to grow. Spur yourself to try, learn, fail, and grow. But set realistic limits, expectations, a timeline, and commit to taking action - regardless of the outcome.

Ψ Remember there are other sides of you, and life.

Spend time cultivating different interests and skills. Meet new people with unique perspectives. Read different types of material or explore new hobbies. Invest time with the “old” things that still matter - loved ones, hobbies, priorities.

Life isn’t so black-and-white. Don’t confine your self-worth to only your achievements or abilities. You can care about them, while caring about many other things. So it’s okay to give it a little less weight when it’s too heavy. No one said you can’t!

How to Cope with Being Scammed

You’ve just been scammed. Your life turned upside down. Assuming that you’ve done all the practical things that need to be done, you’re here because you’re not taking it too well.

How are you doing? Are you feeling a mix of emotions, or nothing at all? Are you wondering why things turned out this way, or why this happened to you? Are you blaming yourself for what happened?

All that you’re thinking and feeling (or not), is normal.

We can’t take away what happened to you, nor cushion the loss that you had to, and will, suffer. But here, we’ll tell you the ways that helped people to bounce back and cope after they have been scammed:

Ψ Grieve

Give yourself a period of time to feel the pain, process the details of what happened and express the emotions. Let it out. Let yourself not be okay. Let yourself hurt from the betrayal. This is not an event that can be swept under the carpet and “moved on” from within the blink of an eye. You’ve suffered a loss, and regardless of the magnitude of this loss, there will need to be some re-adjustment in your life, when you feel ready. Maybe one day, things will seem okay again. But for now, it’s okay that it feels like a lot has, and will change.

Grieving and coping with significant events in our lives is also easier when we find comfort and support in the people we trust. So while it is tempting to hide away in shame, we genuinely advise against doing so. Find the people you know you can open up to, be vulnerable with, and share the pain that you’re going through. The people who genuinely care for your well-being will not shame or reject you for what has happened. They would see if they could help or support you in some way, particularly if they see that you are already suffering.

Ψ Forgive yourself

But how? How can we forgive ourselves for our foolishness? Or for the role that we had to inadvertently play, to have fallen for a scam?

What is truly foolish, is believing that it was foolishness that made you fall for the scam, rather than the clever and manipulative tricks that scammers use to ensure you fall directly into the traps they set. The numbers don’t lie, and the scammers don’t discriminate. Anyone can fall for a scam.

In order to forgive yourself, you need a few elements:

Ψ Put things into perspective and check the facts: What truly happened? How did the scammer convince you that they were legitimate? What tricks did they use to deceive you? What made you fall for the tricks? Was there pressure or an emotion that pushed you to trust what was said?

Ψ Stop criticising yourself: Notice when you’re labelling, attacking and telling yourself that you “could have prevented it”. These coulds, shoulds and what ifs do little to help you in this moment now that things have happened. Plus, the facts would likely tell you that no matter your objections, the scammer would have tugged you back into their trap.

Ψ Craft a recovery plan: How will you try to cushion the loss you suffered? How will you try to cope emotionally or financially? A full recovery might not be possible, and that may hard to accept. However, some level of recovery can take place with time, effort, and taking achievable steps forward.

Ψ Be kinder to yourself: When the thought “I am stupid” or “this is my fault” comes up, challenge these thoughts with the facts, your strengths, what you care about, and what you are going to work on.

Ψ But don’t forget

Being scammed can tell us many things about ourselves, and what might motivate or push us to act in different moments. It often teaches us the importance of pausing, seeking and being open to advice and help, in being vigilant when handling our personal information, and even evaluating how we trust or analyse information and people.

These lessons can be valuable to many others in our lives, and may come in handy for ourselves again. We know it’s unlikely that you will forget, but can you turn this negative experience into something positive for yourself or others?

By processing and understanding your emotions, working on and restoring your confidence, you will eventually regain control of your life.

Supporting a Child with Incarcerated Parents

As such, it is imperative that these children be provided with well-rounded support so they can have the best possible developmental outcomes despite the challenges faced.

Here are some ways to support a child with an incarcerated parent

1. Visiting the incarcerated parent 

Most families endorse the idea that children should maintain contact with the incarcerated parent. Thus, if possible, support should be provided to facilitate communication between the parent and the child, allowing social ties to be maintained. This may take the form of:

Ψ Face to Face Visitations (link to Singapore Prisons Service)
Ψ Tele-Visitations

It is important that visitation takes place in a positive context (e.g., child-friendly, allowing physical contact between parent and child). Visitations that are “colder” and less welcoming tend to increase children’s distress instead. In cases where positive physical visitations are not viable, alternatives include letter-writing between the child and the incarcerated parent.  

2. Parenting Skills Training  

Providing incarcerated parents with training can also be helpful. Although there is no set curriculum for these training programs, most involve equipping parents with better parenting and communication skills. Parental training is most effective when combined with visitations and the opportunity for the incarcerated parent to practice what they have learnt. Undergoing such training has the added benefit of fostering a bond between the incarcerated parent and their family, as well as opens a channel for parental involvement.  

3. Mentoring 

Mentors can help alleviate the challenges associated with having an incarcerated parent by providing a mature figure whom children can trust, confide in, depend on, and learn from. Consequently, mentored children benefit both socially and emotionally (e.g., improved social skills and self-esteem), but the current evidence suggests that there is no academic benefit attached to mentoring programs. 

It is important to note that the effectiveness of mentoring programs is highly dependent on how well-matched the mentor and mentee are. Matching mentees with mentors can be a challenging process — one study showed that one-third of mentees dropped out of the program within half a year. A mentee who does not match well with the mentor is likely to drop out from the program and will therefore be less likely to reap the benefits from mentoring. Research concerning the effectiveness of mentoring programs for children of incarcerated parents is currently mixed.

In conclusion…

There are several methods to support a child with incarcerated parents. In Singapore, Kids in Play (KIP) by the Salvation Army and Friends of Children & Youth (FOCY) by Life Community Services Society provide supportive services for children with incarcerated parents. These support services use a mixture of the aforementioned methods.  

It is important to support children with incarcerated parents because these experiences and its associated challenges can have adverse effects on a child’s mental health. Without support, children face heightened risk of mental health outcomes, which may manifest in behavioural and emotional difficulties.

As an added bonus, visiting an incarcerated parent also helps the parent through their own journey in incarceration and improving rehabilitative outcomes!