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
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
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
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.
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.
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.
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.
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.
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.
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.
(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