Before I became ill, I had started working as a secretary to an executive vice president at a mid-sized advertising agency in Manhattan. After 18 months he promoted me to an assistant to a woman they hired to run the Consumer Promotion Department (pre-Internet that was coupons in Sunday newspaper inserts). From that job I worked my way up to Consumer Promotion Development Manager at Lever Brothers, part of Unilever, one of the largest packaged goods companies in the world.
When I became ill with anorexia for the second time and was hospitalized for an extended period, they let me go. (This was before the Americans with Disabilities Act.) I was bereft. I’d worked so hard to get to where I’d been. In 1990, I attempted suicide for the second time and was diagnosed with BPD.
My old consumer promotion manager from the advertising agency called me at some point and offered me a job at Kraft, another huge, packaged goods company. Taking this job was a mistake. I was still in the throes of my BPD diagnosis, as well as the anorexia and depression. Consumer promotion was transitioning to using computers and I couldn’t keep up. I lasted a year, only because my manager urged me to hang in there, but I ended up quitting, feeling inadequate and ashamed.
I earned my master’s degree in social work in 2000 and immediately landed a job at an outpatient clinic in Westchester. One didn’t have to be super organized to be a clinician. I followed the schedule that was laid out for me to see patients and when I had the time, I wrote session notes.
It was at the job following my first at an outpatient clinic in Queens, NY, that I again needed to rely heavily on my organizational skills and attention to detail. Only it had been quite a while since my brain had needed to think in that way. After about two years there, the Executive Director tapped me to perform some administrative tasks, some more challenging than others. I had to work hard at completing tasks on time, getting reports ready to present to the Executive Director in meetings, reviewing my co-workers’ charts, and other responsibilities. At times I felt overwhelmed. My caseload of patients continued to shrink, and my load of admin tasks grew exponentially. I knew this meant that she (the Executive Director) liked my work, but this also activated my perfectionistic tendencies and my anxiety that my work would not be perfect: What if I ended up getting fired?
A 2019 study on borderline personality disorder and employment states “much of the research examining employment in individuals with high levels of BPD pathology focuses on the extent to which occupational or vocational functioning is impaired in these individuals. Follow-up studies of BPD patients in general show poor employment outcomes.”
When I reflect on the jobs I’ve had and at which I’ve succeeded, organization and attention to detail has always been my foundation. I’m fortunate that these skills come naturally to me, however, they can be somewhat more elusive when I’m stressed or depressed.
A new study focuses on the strategies people with borderline personality disorder use to maintain their well-being and performance at work and notes that “to maintain well-being and performance at work, participants reported using strategies that involved balancing work and daily life through stable routines and health-supporting lifestyle habits. Key strategies enabling work functioning focused on self-regulation, cultivating positive workplace relationships, as well as task and time management.”
I wish I could say I use all the strategies listed above. Is my work life and daily life always balanced? No, I often write notes from 3 AM to 5 AM because I don’t have time to write them during the day and I’m too exhausted to write them in the evening. I know from experience that when I try to write notes after a certain hour, they literally don’t make sense. Have I cultivated positive workplace relationships? I work in our midtown office two days a week There are a couple of people I say hello to and chat with but I wouldn’t call them workplace relationships. We all have different lunch hours in our schedules and I know I take my lunch hour to write as many notes as I can so I won’t need to do them at 4 AM. Task and time management? It’s difficult to manage your time well when you only have five minutes between sessions, barely enough time to use the rest room.
The strategies described above are ideal but perhaps not so realistic. I understand that for people diagnosed with BPD the strategies are not optional; they are a necessity. At my job as a clinical supervisor last year where I was responsible for three jobs (one of the reasons I left), these approaches were absolutely necessary.
Today, I manage. Perhaps in not the most ideal way or the healthiest way. I wish could take the strategy from the playbook of the participants in this study, but it’s difficult for me to think of varying from the routine that has worked for me at this new job for the last almost fourteen months. The question is: Is my current lifestyle sustainable?