TW: Eating disorder; suicidal ideation

Since I started my journey in academia, completing a BSc in Psychology in 2008, increasing focus has been placed on wellbeing and raising awareness of mental health conditions in students and academic staff. Unfortunately, that usually focuses on common mental health conditions deemed more ‘palatable’, and rarely provides additional support to those entering academia with a pre-existing mental health condition. Employee Assistance Programmes typically offer limited counselling, that is barely sufficient for providing the minimum support for struggling students or staff.

But before I go off on my favourite rant about how ‘wellness walks’ for mental health awareness week are extremely ineffective in raising awareness or reducing stigma, I should mention that I have been diagnosed with Emotionally Unstable Personality Disorder, EUPD, formerly known as Borderline Personality disorder. After years of never quite fitting a diagnosis, this almost came as a relief but in a sense was also overwhelming. Given I am already trying to navigate a notoriously challenging career field, to be told now there’s something inherently wrong with me and my personality? This was a blow, and in a way felt like it was my fault rather than a consequence of the trauma I experienced.

The long road to diagnosis

Looking back, I started my undergraduate degree in the depth of a major depressive episode, battling the remnants of my eating disorder and desperately tried to cope with my ever-increasing anxiety. I sought out doctors, attempted talking therapies and tried to escape the bitter depths of suicidality. Despite obtaining my BSc (2:1) and my MSc with distinction, and successfully applying for a PhD program, my mental health never did get better. Mood swings, paranoia, depression and panic attacks interfered not only with my studies but also my personal life. None of the diagnoses—and subsequently, the treatments—I received ever seemed to entirely fit. When receiving treatment for my eating disorder, my therapist told me in my fourth session that I needed to connect with my emotions, but as soon as I started talking about traumatic experiences from my past I entered a dissociative state. Predictably, I stopped going as I didn’t know how to stop myself from disassociating when confronting trauma.

Despite all the challenges that came with completing a PhD, it provided a stable framework, in large part due to my extremely supportive supervisors. I still had a breakdown, but at the very least the therapist I saw for my 6 allocated sessions from the university suggested that I should be referred to NHS complex need services as a result of my childhood experiences. Unfortunately, I was also told that I was not suitable for the group therapy they offered as a follow up to the therapy sessions, as I might inadvertently trigger the others. Once again, this left me in a position without mental health support. 

Waiting lists for mental health treatments on the United Kingdom’s National Health Service (NHS) are prohibitively long for any condition, but once I had finally been referred to complex needs services who assessed me for personality disorder, I found that it was impossible for me to attend treatment if I wanted to continue postdoctoral work. I live outside of London, so my doctor and mental health services were not based near the laboratory where I was working, and I would have had to attend two weekly sessions around lunch time. After more than a year (or even two?) on the waiting list, this was devastating. Employee Assistance Programs provided for university staff wellbeing were not suitable for me due to the ‘complex’ nature of my diagnosis, and I ended up scraping money together to afford private therapy. This was absolutely invaluable and I had a great therapist, but I was also lucky enough to make ends meet financially. I know many are not as fortunate. 

Research and EUPD: Dialling up the difficulty 

I find it extremely difficult to interact with other people. During my PhD, this got so bad that I would wake up at 4am so I could complete experiments before anyone else was in the lab. I struggle to read others and interpret social interactions, which often leaves me feeling like I have done something disastrously wrong. Emails are the bane of my existence, although I’ve learned to cope with this by getting my friends to ‘peer review’ my responses in exchange for chocolate and drinks. Therapy has helped immensely with putting coping mechanisms in place, but the heavy focus academia places on networking is a massive obstacle to me. It’s not just the social anxiety, but also the paranoia setting in over perceived faux pas that only exist in my head. 

I want to be open about mental health towards my colleagues, because it has shaped, and still impacts who I am. However, whilst I find it easy enough to discuss depression and anxiety, it’s much harder to outright say that I have been diagnosed with EUPD. EUPD is a diagnosis associated with significant stigma not just from the general public but also healthcare professionals. There is very little awareness of personality disorders amongst the public, and EUPD especially is associated with many negative stereotypes. Those diagnosed with EUPD are often viewed as difficult, untreatable, or resistant to treatment. There’s a pervasive idea that ‘we’ are manipulative. When I was going through a rough patch at work, I was trying to find helpful articles about accommodating employees with BPD in the workplace. Most articles warned that the employee with EUPD may be manipulative and playing other employees against each other, thus creating a toxic atmosphere. Not really very helpful in dispelling negative stereotypes, or helping me in any way. 

It took me a long time to build confidence in my abilities as a scientist, and I was very lucky to have incredibly supportive supervisors throughout my time in academia for the most part. I love science and research, but sometimes I do wonder whether I’ve chosen a career that’s entirely incompatible with my diagnosis. The constant rejection, instability because of short-term contracts and the precariousness of trying secure fellowships are tough for everyone, but I also feel that my EUPD has a major impact on my ability to cope with these challenges. Failure, or perceived failure, and rejection tend to be extremely difficult to deal with for those with EUPD; so why have I chosen a career where frequent rejection is on par for the course? Self-sabotage? Or a desperate need for approval as I am trying to prove to someone, anyone, that I am good enough?  

Who am I beyond the neuroscientist?

Experiences of failure and burnout are so common in academia, but I find it hard to pinpoint what  exactly it is that makes these experiences so catastrophic for me. It’s easy to blame the old EUPD stereotype that my distress is simply attention-seeking behaviour. I often wonder, Really, why am I reacting so badly to something everyone is experiencing? Is it a sign I’m just not suitable for academia? But I think my emotional instability is really the crux of the problem, and unfortunately not every supervisor or line manager is able (or happy) to offer constant reassurance when something inevitably goes wrong. I often find my emotional state throughout any day somewhat of a rollercoaster. There’s no consistency; I can go from being ecstatic over some great results to the depths of despair over a minor error, let alone fellowship rejections. I have gotten better at emotional regulation and putting coping mechanisms in place, but the rollercoaster remains. 

I’ve frequently heard academia being described as a cult, especially by those who have left. If you’re spending ten hours a day in the lab, it’s very easy to make research your whole personality. One of the common symptoms of EUPD is a feeling of emptiness or a lack of personal identity. I have definitely fallen into the trap of tying my sense of self to being a researcher. In a way, it keeps me going but it’s probably a terrible strategy in the long run, as the challenge of obtaining a faculty position gets more and more difficult. Who am I going to be if not a neuroscientist? It’s difficult untangling myself from trauma, but now I feel like I’ve wrapped myself up too tightly in a system that is not set up to support those that don’t fit into the rigid box of what a researcher should be. 

There is significant debate happening about whether EUPD as a disorder actually exists. It tends to be diagnosed more frequently in females, or at least has been so historically. Medical history has shown that ‘misbehaving’ women easily get certain labels and disorders attached to them, such as hysteria. There’s also significant overlap between EUPD and mental health conditions, such as Bipolar Disorder or complex PTSD; and neurodivergence. I’m not sure where I stand in this debate in terms of EUPD, but I did find the diagnosis helpful and I am finally on medication that seems to make a difference, unlike the various antidepressants that I tried. I’m also approaching therapy differently and have developed a better understanding of what triggers ‘bad’ periods, even though that doesn’t mean that I can always avoid them. Although EUPD has a characteristic course starting in childhood, personality disorders are largely not diagnosed until adulthood, when one’s personality has become more ‘fixed’. However, this can then result as personality disorders being seen as untreatable, which especially for EUPD is not the case. 

Conclusion

Have I managed to fix my personality yet? I’m afraid not. And the longer I stay in academia, the more I question whether I am damaging myself and my mental health irreparably. I have learned a lot about who I am and have been actively working on myself, yet actual healing seems far off.

At the same time, I want to stay and prove that you can succeed with EUPD. According to some studies, only 20% of those diagnosed with EUPD manage to stay in full-time employment, which likely also reflects a lack of support in the workplace. Although, as I’m trying to transition from postdoctoral researcher to independence, maybe I should focus more on whether my position and workload is tenable for my mental health, rather than if I have what it takes to succeed in a system stacked against me. I try to remind myself that my path is a very different road from many other postdocs, and if my pre-PhD self could see how far I have come, she would be incredibly impressed. I love the science, and that I get to keep learning new skills and techniques, which definitely helps with not getting bored. And despite my ‘flawed’ personality, I have managed to find a great community within academia of people who support each other and lift each other up.  I’d like to think there’s hope and a little room in academia for me, and others grappling with a personality disorder diagnosis.

Dr Jenny Lange is a postdoctoral researcher whose primary research interest revolves around neuron-glia interactions in neurological disease. She initially studied BSc (Hons) Psychology, however during that time became interested in psychopharmacology and undertook an MSc in Neuroscience at University College London, graduating with distinction. After completing a PhD on Neuron-Glia interactions in Health and Disease at King’s College London, and has since returned to UCL as a postdoctoral research fellow studying the role of astrocytes in neurological disease using stem cell models. Jenny has served on academic boards and committees, and has a keen interest in science outreach. 

This blog is kindly sponsored by G-Research