Walk The Line

in psychology •  3 months ago

The ten regular readers of my blog will have noticed the missing post of this Tuesday’s series. Without any further explanation. Some may even have noticed, that I was far less active during the last days or even weeks. My last comment was almost a week ago (which is quite a long time for somebody like me). As for everything, there is a reason for that.


Shine on, you crazy Diamond

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Source

This will probably be one of the most personal texts I have ever published.
I thought for a very long time about whether I should write about it so clearly, wondering what the consequences would be. In the end, I realized that this is the right decision, because I keep seeing, that far too little attention is being paid to this topic in a personal context.
There is a lack of understanding in dealing with mental illnesses.
Those people who know me better are aware that since my childhood my personality is very benevolently described as "broken". For years I could not explain my behaviour in many situations. The moods were too extreme in certain emotional moments; too indifferent was the feeling in most other circumstances.
In crisis situations, this led to hospitalization, suicidal behavior and many nights on lorazepam. Of course, at some point one starts therapy, abandons it because it doesn't help; starts a new one and abandons it again because the therapist can't do anything. Of course, there is always the question of what is wrong with you. Why one reacts so extremely, and others do not. What was wrong with you?
So, you start collecting diagnoses like others Magic cards. Depression? Bipolar? PTSD? Borderline? Dissocial Personality Disorder? After all, one narrows it down to "some kind of affective disorder" eventually. So, what follows? After some time, you juggle a considerable portfolio of different psychotropic drugs to at least somehow get along. But apart from the really hard-hitting stuff (Hey, Lorazepam, old friend), which at least helps acutely, there is no lasting change.
For a very long time I could not understand why all this happened. Now I could at least explain it to myself, but since drugs didn't help, my brain chemistry was still fucked. However, at this point I also realized that no one needed to tell me anything more about "just pull yourself together" and then "everything would be all right again". Again, a heartfelt "Fuck you!" to all those who think such advice would somehow help. No, they don't. Then I'd rather take a few extra milligrams of lorazepam.

So somehow you try to come to terms with the situation. At this point you don't have many options anyway. This is followed by the mutation to a control freak. Now that it is quite clear which triggers cause extreme situations, it is of course important to avoid exactly these triggers. Every (im)possibility will be tried to be anticipated in advance, so that in an emergency one is mentally prepared to take care of it. According to the logic: "What I control can't kill me."
The problem is, of course, that this type of behavioral control only works up to a certain point. You can't control everything. Very often there are things that are beyond our control and yet have a retroactive effect on us.
In my case, for example, these are sometimes people in my circle of friends who happen to be highly suicidal and yet you are completely powerless to do anything about it. The lack of influence turns to fear. The feeling of waking up one morning and realizing that one of these people is suddenly gone. How much you just don't want anything bad happening to them. Because you can't imagine life without them. Because you don't know what it would do to yourself. That's what you're really afraid of. It's a huge black box. You can't possibly predict how you'd react to something like that. It seems that there is an invisible sword of Damocles hanging above your head, just waiting to turn the finally fairly stable mind back into a pile of shards.
But this was not even the case during the last weeks. Quite often, there are no specific triggers. A few years ago, I have been diagnosed with Borderline Personality Disorder (BPD). I’m officially retarded, yay. Cookies for everybody.


Borderline for everyone

But back to start. I assume, not all of you are familiar with the term BPD and what it includes. Let me enlighten you.
First of all, you should be aware that, as with almost all mental illnesses, there is no definition which applies to every single patient in the same way. A broken leg is usually really “just” a broken leg – but a broken mind is a bit more complex.
BPD is quite complex when it comes to symptoms and behaviour. I know for sure, my behaviour is different from what others may do with the same condition – this is also one of the many reasons, why it is so difficult to get the correct diagnosis in the first place.
Common symptoms may include fun stuff like:

  • Trust issues, meaning it can be extremely difficult to decide whether somebody has decent intentions or not.

  • Substance abuse (alcohol, drugs)

  • Extreme mood swings and extreme unstable relationships to other people

  • Permanent fear of being abandoned

  • Suicidal tendencies/thoughts

  • Impulsive behaviour

  • Intentionally hurting yourself to feel at least something or to numb the emotional pain

  • A permanent presence of some kind of inner void, often accompanied by a disturbed self-image

And so much more. If you are interested in learning other things about this, you can start here(1) or there(2).

For me, it’s all of the above-mentioned symptoms and some more. On multiple occasions I (ab)used the available substances at hand to numb my pain. I hurt myself not by cutting and inflicting visible cuts and scars upon my skin – but with working out so much until my body just felt like being crushed from exhaustion. Sometimes I also used a knife and pressed the tip of the blade against my chest until the physical pain relieved the emotional one. Why would anybody do such things?
This question is useless. There is no rational explanation to it. People feel pain and search for ways to get rid of or at least numb it. Sometimes the only way to fight pain is by using another kind of pain to force your mind to focus on something different. If you never felt this all-consuming, extremely devastating emotional pain, you will probably not understand. I’m not talking about the “Oh, my girlfriend left me, now I’m somewhat sad” pain but the “I have no idea, what’s happening, but I’m lying on the floor, crying, hyperventilating, close to puking and I just want to die, oh there is a knife” kind of pain.
The intensity is somewhat different. Usually, your friends don’t call an ambulance because your girlfriend left you. I was hospitalized multiple times because of the latter kind.

Living with BPD is like living in a soap opera, as Theodore Millon puts it(3). Which is actually quite an accurate description. It sometimes seems to be so surreal – but it’s happening nevertheless.

Fun with comorbidity

BPD is probably THE mental illness which is misdiagnosed the most. The reason for that is quite simple: it shares many symptoms with other personality disorders. In addition to that, there is a funny little thing called comorbidity.
Como-what?
Comorbidity. This is the term describing other conditions which may occur alongside the diagnosis of BPD. Examples for comorbid conditions are depression, panic disorder and antisocial personality disorder (APD)(4).
Comorbidity makes it incredibly difficult for professionals to determine the cause of a patient’s behaviour in the first place, hence getting them a proper treatment can be quite challenging as well.
But there is more. Not only professionals have difficulties in dealing with it, but your social environment as well. Even if some of your friends have first- or second-hand experiences with mental illnesses like depressions or panic disorders – it doesn’t mean they will understand the behaviour of a borderline personality – just because it usually includes other, unfamiliar kinds of behaviour as well.

A Way Out

So, everything is fucked up and there is no help? No. Nothing could be further from the truth.
I have spent many years on different kinds of medication and in professional care – and I am quite sure, thanks to this, I am now able to live a relatively stable live. Sure, it’s not always sunshine and butterflies (as the last weeks prove), but it’s far less extreme than it was a few years ago. If not for medications, professional help and, a supporting social environment of course, I would most likely not be alive today. I have spent many nights sitting on bridges, just thinking about letting myself fall into the water and be done with all this shit, once and for all. Obviously, I’m still here.
I can perfectly understand, why people are choosing suicide. Important note: they don’t commit suicide. It’s not a crime to end your life and it never should be. Ending your own life is the ultimate indication of freedom – you will always have at least this choice, if nothing else.
But I think, there are other ways as well. Believe me, I know the feeling far too well. I know how it is asking yourself why you should even get up in the morning, yet alone do anything productive with you and your life. In the end, everything is utterly pointless, so, why not end it now?

I have been there. Many, many times. This is not one of these feel-good Buzzfeed stories in which I am going to tell you the 10 way of achieving eternal happiness. I hate bullshit.
Let’s try realism for a change. I will tell you the steps I took and how they helped me. That doesn’t mean it will be the same for you (if there is a need for it), but it might help you understand, that even if it may seem like it – not all is lost. And yes, I know how hard it can be sometimes to believe that.

  1. Acknowledge that there is a problem. You won’t change anything, if you don’t realize you have a problem. But if you are already on the verge of killing yourself, I am quite sure, you are aware of that. But can’t hurt to know anyway.

  2. Speak about it. This is one of the most difficult things to do. But that’s why it is so important. Grab at least one person of trust (a close friend, partner, family member, Santa Clause) and speak about your troubles. This enables you to have somebody to rely on in times of need.

  3. Get professional (!) help. You already took the first challenge by speaking about it, now it’s time to step up your game. Talking with friends is all nice, but they are no professionals and may lack the experience to handle your condition properly. That’s why there are professional psychologists, neurologists and psychiatrists to help you. If you lack the necessary energy of organizing an appointment, ask your person of trust to do that for you.

  4. Get the right treatment. I know, this is way easier to be said than done. Just remember the difficulties of getting the correct diagnosis in the first place. But given the situation you were able to, stick to it. If psychotherapy helps you in dealing with the struggles of your mental health (like it can do in at least some ways for BPD(5)), then go for it. If you happen to need additional medications to make your life easier – don’t hold back. It will take some time to figure out, which will be the most effective treatment for your individual condition, so please, don’t expect immediate returns. Change always needs time.

  5. Discover self-helping strategies. You don’t want to spend the rest of your days in a hospital and your therapist won’t be around all day. So, it is important to find ways of dealing with every day struggles or crisis situations, without calling an ambulance every time. I will show you some of the things which usually help me.

    • Structure your day. Establish some kind of routine. And be it, you get up at a similar time every day, take a shower, have some coffee and breakfast and the go to work / university or whatever you need to do. This ensures, you won’t need to think about trivial stuff so much, which conserves a bit of your mental energy.

    • Develop healthy habits. Eat healthy food and exercise. Yes, I am aware, this may sound trivial, but especially regarding exercise there is extensive research about the many benefits it can bring along. For example, even symptoms of major depressions can be eased with regular exercise(6). I know, during depressive episodes it can be unbelievable hard to even get out of bed, yet alone to start working out. I experience this issue myself sometimes. Told you, it’s not all sunshine and butterflies. But that shouldn’t stop you from at least trying.

    • Practice mindfulness. As the wonderful @abigail-dantes wrote a couple of months ago, mindfulness can be an incredibly helpful tool in dealing with emotional distress. As my frequent readers should know, I am not a fan of metaphysical or esoteric bullshit, so you can be sure, there are no such things involved here.
      Accepting things as they currently are, be aware of them and then trying to change them, if necessary. In times of extreme emotional distress, this can come in very handy. It can enable you to control your breathing, the rush of your thoughts and eventually your pain as well. Sounds too good to be true? Let me tell you something:
      I was able to deal with such extreme emotions thanks to mindfulness (and some other practices), which I usually would just have supressed with lorazepam. That is huge. At least, it is for me. And maybe it can be for you as well.

These are, of course, just my personal strategies, so I cannot guarantee they will work for you as well (if you don’t need them, even better). But for me it’s important to point out, that you are not the only one struggling with mental issues – and that there might be some things you can actually do about it. Every beginning is difficult. I am fully aware of that. But if there is anything I learned during the last years, then it is that failure is just another option which didn’t work out. I might try things a hundred times and fail every single one of them. But I won’t change anything, if I’m going to stop there. I just discovered a hundred ways of how not to do it. I know, this sounds super trivial and like some kind of motivational speech blahblah. But it’s true nevertheless. I failed with so many things in my life, so I will need to try different things over and over again – eventually I will find something which works, or I will die trying. Works for me either way.


The Big Why

So why do I serve this part of my personality so openly on the stage here? Just another form of attention-seeking? The addiction to confirmation and recognition?
Maybe. I don't know. If these things are true, then at least I am not aware of them in this case. My intention is a different one.
I believe that it is important that people start to face mental illnesses with the seriousness they deserve. Almost everyone gets sympathy if they break a leg or have an obviously serious illness such as cancer. In the US alone, almost 45,000 people commit suicide every year(7) – a large percentage of them are suffering from a form of mental illness. And that's just the United States. Mental illnesses kill thousands every year and yet those affected hear in cynical regularity that "everyone has a bad day" and "in the past there were no such things on such a scale" and anyway the people of today are simply all "totally soft and others are much worse off".
If I had the choice between mental illness and cancer, I would rather have cancer.
No, that was a lie, I would prefer to be healthy and would love to see people showing a bit more awareness. Depression, borderline, schizophrenia, bipolarity, etc. are no more a voluntary decision than cancer.
And if that simple truth can't be processed by your fucking pea brain, then shut the fuck up and piss off.

How does an outsider deal with an affected person? A rough rule of thumb may be that you shouldn't give advice (believe me, we've probably heard each of them at least ten times in a similar way), but simply address the person and ask him what he needs right now. Sometimes it can help a lot to keep quiet, to listen, or to go to the hospital together, if there is no other way. But forget all the wise advice you probably don't even believe yourself.
I'm just tired of smiling softly and keeping silent when another idiot makes snide remarks about such diseases because he can't imagine them inside of his twelve square meter world view. I believe, it is very important to break this silence. I think, the loudest voices should be raised by those who are directly affected. It doesn't have to be in a similar way like my stony charm, of course. All that matters is, that it happens. The greatest chance for change lies in the hands of us broken freaks.
Refuse to be silent.
Refuse to shut up.
Refuse to give up.
That is something we have control of and we should use it.


References

(1) Borderline Symptoms) | (2) Borderline Disorder | (3) Millon, Theodore. 2004. Personality Disorders in Modern Life | (4) Comorbidity of Borderline | (5) Psychotherapy and Borderline| (6) Physical exercise and depression

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Yes, mental illnesses are far from comparable to physical illnesses.

From the outside, someone with the diagnosis you describe looks as if he wants to draw attention to himself permanently. Which is true in principle, but as I understand you, it is primarily about the Self wanting to draw attention to the Self before it thinks of others - with the intention not to lose oneself but to remain in living contact with oneself.

How strong this drawing of attention must be in order to be able to feel oneself at all, is always determined by the person it concerns. The outsiders can therefore only ever judge this "wrongly", since they can be found neither in the mind nor in the body of the affected person. Uncertainty with the form of expression of the individual is therefore understandable. The unguided responses like those you mentioned are not only an expression of indifference or insecurity, they are partly justified.

... people of today are simply all "totally soft and others are much worse off".

It seems that you refer this statement to yourself (although perhaps no one personally addressed it to you in connection with your diagnosis?): what happens except that it annoys you? Could it be that you yourself think that you are too "soft" and view this softness rather contemptuously? At least I mean to perceive this with the intention to steel your body and make it "hard". Just as you occasionally add aggressive elements to your linguistic expression so as not to create the impression that you are an easy target. It irritates me, not only with you but also with other people. It says: "Be careful! No matter what you say, it could give you a fiery reaction."

I also think that there is always a danger to identify too much with the disease itself. Because a diagnosis offers protection as well as a surface of attack. I experience this in my counselling: The young people I work with often do not want to leave the shelter of diagnosis and therapy because they have advantages (which have legitimacy). At the same time, however, they want to be seen with all their might as healthy and as someone who does not take any medication and is ill. Since neither is possible at the same time, there is a conflict here. This sometimes leads to people keeping their diagnosis and treatment secret, but expecting others to be treated according to their diagnosis without the people involved even knowing about it.

There is a space of tension between secrecy and revelation and it is not easy to manoeuvre in it. For example, how much and what do you say to others to make them support you but don't feel sorry for you? How much do you use your status as a reason for this or that misconduct? My experience with young people who have been diagnosed since childhood and who have been married to it for ten years or more, so to speak, is that they have built up a strong identification and it is difficult to imagine a perspective and a life without it. It is then as if one had to let go of the good friend "illness".

So, in a systemic setting I could ask the question (after considering if that can be done and knowing the client):

"For how long up from now do you want to keep your diagnose?"

I allow myself to say all this because I have experienced the depth and intensity of mental illness myself.

I'm not sure if my interpretations are welcome and so I would think it's brave of you to tell personal stories and get feedback, which you didn't necessarily have in mind as such.

All suggestions you gave do make absolute sense in order to keep up and to stay stable and turn towards a healthy life.

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Nice surprise that is! Thank you!

The ten regular readers of my blog will have noticed about the missing post of this Tuesday’s series.

Yep! Now I regret not having asked you about it directly :/

failure is just another option which didn’t work out

This is a lovely thought Ego :)

The overall message of this post is a truly important one Ego. I am very glad and thankful that you decided to write it.

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Yep! Now I regret not having asked you about it directly :/

Don't worry about that. I'm not sure whether I would have even answered.

In general: I wasn't sure to write it because of multiple reasons. Social stigma, possible negative reaction if future employers, the accusation of just wanting attention and so on. But yeah, obviously I still did it and I think, it was the right thing to do.

Absolute respect for your openness and for bringing your illness closer.
As someone who has already been treated for depression, I can at least have a little sympathy for some things - but only to some extent. I know the thought "wouldn't it be better for everyone just to put an end to my life" even too well..... Luckily I haven't had these thoughts for a few years now, but it's always a fight when I'm not doing so well for a few days.
A regular daily routine is also extremely important to me. I noticed this especially in the 2 years when this was not possible due to irregular working hours. Where absolutely nothing could be planned during the week. That was partly really incriminating.
I wish you all the best for the future!

Hey there, just want to thank you for writing this. It sheds light for me on matters i classified as dark and never understood. I admire the way you are dealing with this, much love.

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I'm glad, I was able to provide you some insights :)

Thanks for writing this

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Hey there, @Egotheist! Your eleventh reader is speaking! :D I checked for your post on Tuesday but when I saw that it is missing I assumed you took (a happy) break. I am so sorry that it has been rough for you recently!

I think it is of a great value that you are open and honest about what you are going through. We, modern people, brag about being well-educated, pretend to know it all, use psychological terms in our everyday speech: "Oh, I am so depressed!", "Oh, I am autistic!", "Look at him, he is maniac again" and so on, but we never actually let ourselves realize what it is really like to be buried in depression, or to be autistic, or to struggle with a certain condition. So when we face one of these for real, we are lost and lonely. Thus your sharing could be of a great help to many people who are suffering from extreme emotional distress and could actually save lives!

P.S. I am glad you passed by those bridges and decided to stick around. I am pretty sure you have much to give and say yet!

See you!

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Don't be sorry. It's alright, really. At least, it enabled me to write this post :)

Yeah, I agree. Most people can't really understand what it is like to live with these conditions. Which is good for them, I guess. This can lead to extremes and people say stuff like "Well, if you are depressed, eat a grapefruit and be happy again". Yeah...how about no?
For me, it was always important to provide a realistic perspective of how these conditions can affect your own life - and that it is still possible to find ways of dealing with them without giving up.

I don't understand why this form of illness carries such a stigma in our culture. But every time someone speaks up honestly about personal experience, that makes it easier for others to acknowledge they are dealing with this.

I believe, it is very important to break this silence.

You did it. You claimed the freedom to be who you are, and by doing so you've made it easier for others to claim that freedom.

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Well egotheist. I 've just read your story. I feel I'd like to meet you personally in order to have an interesting conversation that perhaps would help you. By now, please, let me tell you this: Don't believe too much in so called "specialists" I invite you to find information about the way how the medical industry (Both doctors and pharma) business work. Most of them are moved just by money and a sick person that recovers is a client gone. They need sick people, without them their money s gone. Sadly, it is difficult to have a more extensive conversation here but briefly I'll tell you that such "medicine" you mentioned above, Lorazepam, as many other ones used by psychiatrists are very dangerous, they are addictive and damage your health with the time. I know some cases of this sort. There are many other things I'd like to tell you, which are difficult to deal with right now but for now, I recomend you a) Daily excercise, starting with little and, later on, some more intense; b) eat vegetarian fresh food. c) Select your special friends but keep good relationship with all, but do not mix with anybody, always prefer to be with honest and courtious people. d) Improve your environment, keep it clean and orderly and try to enjoy nature (Green is the best color, an enemy of psychiatrist). e) design your own concious and carful plan to keep doctors and phama away. -- Thanks for reading

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I strongly disagree with most of the things you said (besides the ones I recommended myself). Have you ever met a schizophreniac with and without medication? I have. Medication can save lives and enables people to actually live a somewhat normal life. I am quite sure, I would not be alive today if it was not for medication and professional help. Of course, there are side-effects of these drugs. I'm not denying that. I experienced and suffered from them as well. But sometimes they are the lesser of two evils. It's important to find a balance. Medication can help to come back to a normal life and maybe you won't even need it anymore at some point.

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Well, i'm very sorry. I just tried to help. That's all.

I wanted to say that I feel sorry for you, but I don’t think that would help much. Rather I want to express how impressed I am with your courage and how you contribute to this platform. I’ve known you for a bit, not nearly as well as others due to my very inconsistent presence here, and you strike me as someone who is not letting himself be defined by his odds. Hope you feel better and to read more of your posts. Steemstem would not be the same without you. Cheers!

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I wanted to say that I feel sorry for you, but I don’t think that would help much

You are quite right about that ;)

who is not letting himself be defined by his odds.

But yeah, I try my best not succumb to these things. Not always with the utmost success, but usually I manage. Which is quite the improvement in comparison to a few years ago.