Why BPD needs a Physio

The last few months I have had regular appointments with a physiotherapist. After years of muscle and shooting leg pain my back gave way. The scans showed that I had a prolapsed disc. I had tired to manage this for a while but had been struggling.

Why? Because when mental illness is at the forefront of your mind (literally), it is really hard to attend to other bodily needs. Until one day, something went wrong, and I couldn’t stand, walk or turn over in bed. I was in agony.

Desperate for help I booked a physiotherapy appointment for the next morning… and I am so grateful I did.

So what is the link between mental illness and physical pain ?

Recent evidence suggests that people with BPD can experience increased pain such as chronic migraines and muscles aches and generalised pain. Its not unreasonable to make this connection. If you think about the effects of stress on the body we know it increases muscles tension, blood pressure, heart rate and natural strain on the body. For me personally, I live with chronic migraines and headaches. Not to mention the number of people I have meet in hospital who live with many different types of pain.

The Symptoms of Mental Illness that Contribute to Pain

There are many symptoms that contribute to pain. These are just some relevant to me.

  • Lack of sleep: Fatigued muscles, difficulty concentrating and attending to our body’s posture and position can cause strain and falls.
  • Stress: causes muscles to tighten, to strain without noticing as our body tries to protect the internal organs from potential threats.
  • Being hyperventilate and having sensory sensitivities: The result of this is feeling as if I am on guard. Constantly searching for threats or trying to process incoming noises, temperature changes, movement and smells.
  • Ruminating: Past trauma can cause internal turmoil as my prefrontal cortex screams that it is on fire.
  • Body image and self-hatred: Through years of over exercising and under eating I have put my body through extreme conditions. I have made it learn to push through physical pain and injury to continue to exercise when it needed to stop.
  • Hours spent in bed: I admit that to overcome sensory overload and my struggle with depression I have spent days in bed where my muscles have lost their strength and ability to bounce back as the used to; and
  • Through dissociation and medication I have poor balance: I have had several falls and I am only 28.

In talking with my peers, we all agree that our mental health has a significant interplay on our physical health. Most of us see a physio, attend a Pilates group, have tried hypnotism, acceptance and commitment therapy and/or have a myotherapist.

But why should we care about pain?

  • Pain prevents me from getting a good night sleep
  • Pain makes me feel more depressed and contributes to my emotional pain. This in turn increases my impulsivity and likelihood to self-harm and drink alcohol
  • At one point I was addicted to pain killers.
  • Pain makes me easily frustrated and annoyed at my husband.
  • I am less likely to problem solve my issues and feel the world’s pressures as overwhelming
  • Not to mention difficulty attending appointment, work and groups.

Why Physiotherapy?

It doesn’t have to be physiotherapy, but for me physiotherapy has been the start of a journey of appreciating my body holistically. My physio does not just provide exercises as I once thought.

  • We talk about my eating habits, and identified other healthcare professionals I should seek assistance from;
  • We talk about how to keep active when I feel like being inactive
  • She provides positive encouragement about my body and self image when I feel weak.
  • Through collaboration we discuss what is contributing to my back pain and how I could minimise these physical stressors
  • I have discovered muscles I never knew existed that are so important to my posture.
  • She is helping me find the right balance of exercise for my body and its pain.
  • Through encouragement I am utilising Pilates to help both my physical and emotional pain.
  • I am seeking regular massages which gives me a deep sense of relief from the years of trauma my body has held onto.

It is still early days and although my back pain is still quite severe at times. My headaches have reduced. I can only attribute this to giving my body the love and care it needs both physically and mentally.

If you are like me and have physical pain. Don’t ignore it. It could become much worse and you could be doing unintentional damage without knowing.

By attending to your pain it might also improve your mood and quality of life.


De Jonge, Petrykiv, Fennema, & Arts, M. (2017). Relationship between borderline personality disorder and migraine. European Psychiatry,41(SS), S490.
McWilliams, L. A., & Higgins, K. S. (2013). Associations between pain conditions and borderline personality disorder symptoms: findings from the national comorbidity survey replication. Clinical Journal of Pain29(6), 527–532.

Until then… Have a day,   

Love Laura

Founder of OT for BPD

Published by OT Trauma Tools

Founder Mental health Advocate; Phd Candidate; Occupational Therapy Teacher and Researcher Australia “As an occupational therapist diagnosed with BPD I will use this page to share about the various interventions and strategies that are helpful to those with BPD. I will also share about the positive and sometimes challenging approaches that health professionals have used in my treatment in emergency, inpatient, outpatient and community settings. I hope that by sharing my lived experience I can help improve the experience of those struggling to understand Borderline Personality Disorders (BPD) and also support those living with BPD and other mental health challenges Most importantly we will share how occupation can powerfully help change lives!" Laura

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