By Annie Makoff MembersWorking with Borderline Personality Disorder2 Oct 2023 Being supported at work can make all the difference.Journalist Annie Makoff-Clark was diagnosed with borderline personality disorder (BPD) in 2009. At the time, it was such a stigmatised diagnosis she was advised never to disclose it to employers. Today, BPD is no longer such a taboo. Now she speaks to Joshua Wilson MAAT AATQB, winner of AAT’s Triumph Award 2023 about how he’s thriving at work while living with BPD.If someone offered me a high salary to work elsewhere, I wouldn’t take it – I’m really happy here. Joshua Wilson MAAT AATQB“BPD can be exhausting – you can experience big emotional changes several times a day,” says Joshua Wilson MAAT AATQB, Assistant Management Accountant at Veolia UK. “You might feel normal one minute, then experience anger or extreme sadness the next. It can be the tiniest thing that can trigger intense emotions.”Symptoms of BPDBPD is characterised by emotional instability, impulsive behaviours and distorted thinking. Some people with BPD experience suicide ideation (suicidal thoughts, ideas or behaviours). Other symptoms may include:Self-harm.Cognitive distortions/all-or-nothing thinking (seeing things in absolute termsAn unsuccessful job interview may be interpreted as “I will never get a job” or “I am a failure” or being snapped at by a colleague may be interpreted as “they hate me and want to me to leave my job.”)Fear of abandonment and rejection.Destructive behaviours (self-harm, gambling, taking unnecessary risks).A pattern of unstable relationships.Anxiety.Paranoia.Understanding this condition has improved considerably thanks to societal shifts in mental health awareness, and it’s no longer as stigmatised as it once was.There’s more recognition for instance, that individuals with BPD have difficulty in regulating emotions such as sadness, guilt or anger and there may be an intense fear of abandonment or rejection.In many cases, BPD develops as a result of childhood trauma or where a child’s emotional experience has been constantly invalidated.Facing difficultiesJosh’s mother passed away when he was 13. Josh began self-harming and tried to take his own life. “It was an absolutely awful time,” he recalls. “I went off the rails. At school, I went from doing really well to really badly. I threw my life away – or thought I had.”I started at Veolia doing admin and invoicing. Now I’m looking after my own contracts and I have a lot more responsibility. I’m loving every minute of it.He managed to secure a few retail jobs once he left school, but was still struggling emotionally.Then one day, completely out of the blue, Josh realised things had to change. “I used to get straight As and I was top set in everything. I’d have done A-levels if I hadn’t gone off the rails, so I knew if I carried on as I was, it was wasted potential.”Since his father was an accountant and it was a career he could imagine himself enjoying,Josh decided to study accountancy with AAT.Josh threw himself into his studies and discovered new-found determination. Self-studying turned out to be the making of him.Turning it around“When I started studying with AAT, that’s when I really started thriving,” he recalls. “Having both BPD and ADHD, it can be really hard to stay with one emotion, not act on impulses and stay focused. But I began developing skills and coping strategies to ensure I succeeded.”One way of ensuring Josh remained focused was to remove any potential distractions while he was studying. He removed his smartphone and TV from his room and constantly reminded himself of the rewards he would enjoy once he passed his exams.“Focusing on the end game really motivated me. I kept telling myself, ‘If I study now, if I pass my exams, I’ll get my qualifications and I can get a good job. But if I let my BPD win, I wouldn’t make my parents proud and I wouldn’t make myself proud.’”Ten years later, Josh looks back at how far he’s come with immense pride. He has AAT Level 4 under his belt along with an AAT bookkeeping qualification, and is currently studying for ACCA. He’s also worked for three accountancy firms including Veolia, where he’s been for the past three years.“I started at Veolia doing admin and invoicing. Now I’m looking after my own contracts and I have a lot more responsibility. I’m loving every minute of it.”Josh’s success is all the more incredible given the second trauma he experienced just last year when his father died from Covid-19. This time, Josh was determined to deal with his grief differently.Coping strategies“I built up a barrier when I lost mum but when my dad died, I knew I had responsibilities, like making funeral arrangements and looking after my younger brother. And I was determined to see my studies through and continue with my career even though I was grieving. My employer has been so supportive and let me take all the time off I needed.”Josh explains that losing both parents made him ‘immune’ to many things, but ultimately, going through that and coming out the other side demonstrated his inner strength.He’s since found the inner resilience to manage his BPD and ADHD symptoms and develop coping strategies. “It’s about knowing yourself better and identifying what triggers you,” Josh explains. Sometimes you can’t always avoid triggers so it’s about learning how to deal with your reactions to things. Sometimes I go for a walk or the gym, or simply sit with the feeling until it subsides.”In March, Josh was awarded the AAT Triumph Award, part of the first 2023 AAT Impact Awards in recognition of the challenges Josh has overcome. “I’d never won anything in my life so to receive the award was incredible,” says Josh. “It showed me how much my story had changed and that I’d done it myself through hard work and perseverance.”Success and confidence at workJosh is lucky to have a particularly supportive employer, too.“Veolia have been amazing from day one – they’ve been flexible and understanding when I’ve needed to take time off, allowed me to work flexible hours and have given me time and space if I’m having a bad day. If someone offered me a high salary to work elsewhere, I wouldn’t take it – I’m really happy here.”Josh says BPD affects his personal life more than work – navigating relationships can be particularly difficult and he sometimes overspends. For others with BPD however, it can sometimes be a challenge to regulate intense emotions during the working day. But as with everything, having the right support in place is key.Practical supportSo what can accountancy firms do to ensure employees with BPD feel supported?“There needs to be more understanding if someone with BPD is having a bad day or a bad moment. Offering a mental health day or an hour away from the office if they’re struggling can really help.”Josh suggests having quiet spaces available to help with emotional regulation or allowing employee to put themselves on Do Not Disturb mode for 15 minutes if they need space.BPD can bring great challenges, but can also be treated well. A therapy known as Dialectic Behavioural Therapy (DBT) has been developed for people with the diagnosis, and has a high success rate. Allowing employees to attend the twice-weekly DBT appointments will set them on the path to recovery.“Yes, mental health is a big thing but people shouldn’t let it define them,” Josh explains. “Everyone has their own battles to fight but they can always become a better version of themselves. Whether that takes five or 10 years, never give up fighting for that better version of yourself because everyone deserves happiness.”ResourcesReasonable AdjustmentsWhat employers need to knowBPD charitiesBorderline ArtsBorderline Support UK CICSpecialist therapyDialectic Behavioural Therapy (DBT)DBT is a one-to-two-year programme available on the NHS which equips individuals to navigate challenging life events and difficult situations with practical skills, mindfulness practice and individual therapy.Mentalization-based therapy (MBT)MBT is a form of psychotherapy which helps individuals to understand and make sense of thoughts, feelings and emotions (of themselves and of others) and linking these to actions and behaviours. It can help individuals gain more control over their emotions and reactions to difficult situations.Training workshopsCPD UK Borderline Personality Disorder Awareness CourseSelf-helpThings you can do Annie Makoff is a freelance journalist and editor.