BPD Stigma

I was recently upset and appalled by an article in the August 2018 issue of Psychologies magazine, which I previously respected and have found useful in the past, referring to people who have borderline personality disorder as “energy vampires”. I have written to the editor, explaining how the article perpetuates stigma and thought other people might be interested in what I have to say. The article refers to a book by Christiane Northrup which I have not read (and have no intention of reading if it has been accurately represented), but my main concern is with what Psychologies actually approved and published.

 

Psychologies magazine

Dear Suzy,

I am writing in response to the “How to avoid the energy vampires” article featured in the August 2018 issue of Psychologies magazine. The opening paragraph states: “When I use the term ‘energy vampire’, I’m talking about a subgroup of people — about one in five of us — who, in psychiatry, are called Cluster B personalities, with narcissistic, borderline, histrionic and antisocial personality disorders., and there’s a spectrum; you can certainly live with someone who’s a little self-centred and has narcissistic traits and then, at the other end, there are full-blown psychopaths.”

This email shall discuss borderline personality disorder (BPD), simply because I don’t feel qualified to comment on the other conditions mentioned. I have personal experience of BPD, having been diagnosed in November 2010, at the age of 26.

Labelling people with a mental illness — which includes BPD — is always harmful and increases stigma. To label us “energy vampires” is offensive. While the article mentions a spectrum, it uses the term “energy vampire” to refer to all people in that spectrum, including all people who have BPD. I can’t imagine that this paragraph would be accepted if, instead of referring to personality disorders, it had referred to depression, anxiety (both of which I also have been diagnosed with) or a physical illness.

Unfortunately, some mental illnesses continue to receive a disproportionate amount of stigma, stereotyping and discrimination compared to other mental illnesses. BPD is a key example and part of the problem is that it’s misunderstood, rarely being mentioned in mainstream media. On the rare occasions it is mentioned, such as in this article, it’s usually in negative terms.

The extent of this stigma can be seen across the internet and social media. Whenever Mind or Time to Change publish a blog post written by someone who has BPD, there are inevitably Facebook comments which perpetuate the negative stereotypes and stigma. These comments usually say that people with BPD are a nightmare to live with, difficult to interact with and generally not worthy of good relationships. Because BPD has not received the same amount of positive publicity as other mental health issues, people cling to the old stereotype as portrayed in Fatal Attraction. Yes, the most common impression people have of BPD is garnered from a 30 year old, misogynistic film!

Given this background, it should be obvious that labelling people with BPD as “energy vampires” feeds into the existing stigma.

I appreciate the apology you gave on Twitter and welcome any efforts to educate the general public abot BPD. There is a lot of ignorance and lack of understanding surrounding BPD, so positive representations would go a long way in addressing the damage caused by negative depictions and references. Many of us make positive contributions to our friends, families, communities and societies, but this is rarely mentioned in mainstream publications such as Psychologies.

If people with BPD are difficult to deal with, it’s because they are not receiving adequate treatment, help and support. This article makes no mention of this, simply terming all sufferers “energy vampires” who have a negative effect on the people around them.

Ironically, I had bought the magazine because I was interested in the “restore your energy” dossier and as BPD makes me incredibly sensitive to other people’s moods, I identify more as an “empath” than an “energy vampire”.

I would like to see Psychologies increase understanding of BPD. The negative stereotype is ridiculous considering the range of symptoms which can be experienced: individuals who have BPD may seem complete opposites. For example, both promiscuity and withdrawing from romantic relationships can be symptoms. Of course, the name itself is difficult for the general public to understand, with its connotations of character defects — many people assume BPD means “bad personality”. A lot of people I encounter don’t even realise BPD is a mental illness.

Please show that people with BPD are worthy of love and respect. We are capable of maintaining good relationships and contributing to other people’s lives in positive ways.

For example, I volunteer with a local youth mental health organisation. Last year, I ran a crowdfunding campaign which secured £15,000 to save our peer support groups in one particular town, which had been threatened with closure. In May last year, I completed a four day trek to Machu Picchu and raised over £1000 for Amnesty International, despite having panic attacks throughout the final morning of the trek. I blog about my mental health in an attempt to inspire other people with mental health issues to achieve their goals.

However, my own contributions are very small compared to a lot of people who have BPD. On Twitter, I see amazing examples of activism and personal achievements. People who are amazing parents, partners and professionals. Yet I never see them mentioned elsewhere.

I hope this email has explained why many of us with BPD find the article offensive and worry about its potentially damaging effects.

Kind Regards,
Hayley

 

Update: Psychologies magazine’s editor, Suzy Walker, has emailed me to take full responsibility and says that she is taking steps to ensure this doesn’t happen again and to promote understanding of BPD. She also invited me to blog about BPD on the magazine’s Life Labs website: click here.

I am impressed with Suzy’s response and optimistic that this mistake will lead to positive outcomes which will reduce the stigma surrounding BPD.

.

Patience

I haven’t posted for a while because I have been going through a bad patch. The trouble with mental health problems is they can convince you that nothing you do will have an effect. There’s no point in writing a blog post, you think, because it will be crap, nobody will read it and it won’t help anyone. So you convince yourself it’s best not to do anything, which is easy since you don’t feel like doing anything. Nothing changes, of course, because you’re not taking action. You just feel worse and worse.

Rose

It’s frustrating when I feel this way, because downward spirals are hard to escape. I tell myself  I’m waiting until I feel better before I work towards my goals, but not working towards my goals usually makes me feel worse.

I’m finding things particularly difficult right now, because even when I have been working towards a goal on a regular basis, my progress seems very slow. Losing weight, for instance, is once of my priorities for this year. I have a lot to lose, so I hoped the first half would drop off quickly. It didn’t, but that was okay when I was losing weight at a steady pace. Then it stopped. For no apparent reason. I don’t think I’m a particularly stupid person, so I knew that plateaus are to be expected and I would lose more weight if I stuck to my plan, but it’s hard not to have an emotional reaction. While I knew I should lose weight again, because I was sticking to my diet and exercise plan, part of me was screaming “you are failing, you are useless, you are hopeless.”

My plateau didn’t last for very long (about a month), but I realised it reflected my attitude towards many of my goals. I find it difficult to keep going when I don’t see results.

I recently read a book called Drive by Daniel H Pink, which highlights the importance of intrinsic motivation. I nodded along, recognising that focusing on external rewards is not conducive to motivation, but I also admit that I put too much emphasis on recognition. I feel insecure sometimes and need a gold star to boost my confidence. It feels pathetic to admit this, but tangible results keep me motivated and when they are absent, or not good enough (in my own opinion), I find it hard to stay the course. I start doubting myself.

I’m currently waiting for the final result of my first Psychology BSc module (I’m studying part time with the Open University) and it’s torture. My first 3 assignments got 95 apiece, so I would have to mess up in epic style to fail the module on the fourth assignment, which seems unlikely. But, again, while I realise this on a logical level, the part of me which is entangled with my mental health issues keeps shouting about how I’m stupid and must be an idiot to expect anything good to come of studying.

However, I was forced to take action in spite of these negative thoughts. I needed to enrol on my modules for the next academic year and apply for my student loan. I had to ignore the voice telling me I was jinxing myself, because the alternative would be to wait another year before continuing my studies. If I do that each year I complete a module, I would take 10 years to complete the degree, instead of the anticipated 5 years. Obviously, that would be ridiculous, so I did what I needed to do.

Taking action is almost always an act of faith. You have to trust that your actions will make a difference.

Keeping faith is especially difficult when you are working towards a big goal. I do my best to split big goals into smaller ones, acknowledging and celebrating small successes, but some goals are so big that you have to wait ages (so it seems) for even tiny signs of progress. The answer isn’t easy, but it’s essential: you need to focus on the process, not results.

Focusing on the process requires faith and patience. It’s about building the habits which will determine long term success. In short, it’s a long, hard slog.

I was googling “how to stay motivated during weight loss” earlier today and was reminded of something I already knew: motivation follows action. If you wait to feel motivated before taking action, you could be waiting forever. Time is always passing, whether you take action or not. What will you regret not doing 6 months, a year or several years from today?

So that’s why I’m forcing myself to keep going. It’s hard to make short term sacrifices without getting results, but my future self will thank me. I would rather turn down cake today than get diabetes in a few years. I would rather get stuck into studying this year than regret not seizing my opportunity 10 years down the line. I want to create healthy habits which will lead to my ideal life, or at least a better life than the one I’m living.

There’s a comment which writers often hear that has become a bit of a joke: “I would like to write a novel” — or its variant “I wish I had time to write a novel” — often accompanied by a wistful expression. The implication is that writing a novel is something people only do if they are privileged enough to have time and few other concerns, but this simply isn’t true. Thousands of novels have been written in segments of time snatched from busy days. If writing a novel (or doing anything else) is a priority for you, you can find a way to achieve it. The difference between people who say “I want to write a novel” but never do it and people who write novels is not a lack of time.

We all have 24 hours a day, 7 days a week and you can choose how it’s spent. It always passes, whatever you do.

Remembering this is, for me, a work in progress. I waste a lot of time; mental illness wastes a lot of time. But when I am well enough to take action, I try to force myself to take action. Waiting for results is frustrating, but waiting for motivation is a massive waste of time.

I will keep slogging, trying to achieve my goals, because not doing anything guarantees failure. It won’t be easy and I doubt I will ever learn to become patient all the time, but it’s necessary if I want to improve my life. Right now, it’s challenging. Maybe next week, month or year I will feel more motivated and gain more results. Either way, I plan to keep going.

I just hope Future Hayley will be grateful!

Leaping Forward

A year ago today, I started a 4 day trek to Machu Picchu. It was the biggest and most difficult challenge I have voluntarily undertaken, but also one of the best. While it didn’t immediately transform my life, as I had hoped, it has changed me in ways I’m just beginning to realise. The greatest effect is cutting through my excuses. I completed a major life goal, despite struggling with my mental health. Why shouldn’t I achieve more goals?

Parachuting
Photo credit: my dad, Darryl Jones.

In this spirit. I set myself a lot of goals this year. Some are boring and mundane (adding to savings, submitting more short stories), but a few are more exciting. One of them was to complete a tandem skydive from 15,000 feet.

As you can probably guess from the photo, I did the skydive yesterday — which happened to be my birthday. 

Last year, I spent my birthday doing an acclimatisation trek in Peru and being serenaded in a restaurant with the world’s longest version of Happy Birthday. I was surrounded by a wonderful group of people who have become my friends, but I was thousands of miles from home and had woken up very early, sobbing because I was scared I was making a huge mistake. I was worried I wasn’t capable of achieving any of my dreams, including walking miles up very high mountains.

My birthday this year was very different: I was at home and spent the day with my parents. However, I also wanted it to be as memorable as last year, so I scheduled the skydive and hoped for good weather.

Although the skydive was on a much smaller scale than Machu Picchu, it involved a lot of preparation. My first task was to get under the 210lb weight limit (the website says you can jump if you are heavier, but you have to tell them in advance and pay a surplus, so I wanted to avoid that), which was a big commitment since I started the year at 244lbs. I weighed in at 201.5lb yesterday morning and a few pounds heavier in my clothes and trainers when I got to the airfield, which was a relief!

I also needed to have my doctor sign a medical form to state that I was allowed to jump, because I have received treatment for mental health problems within the past 2 years and have a history of self-harm. I had an appointment a couple of weeks ago and my GP declared that I was at no extra risk compared to any fit, healthy person.

I understand the reasons for needing my GP to sign the form, but it feels disempowering to be told that I can’t sign my own medical form. I know my own mind very well precisely because I have mental health issues. Managing my mental health effectively involves monitoring my mood and motivation for doing certain activities. Far from being a form of self-harm or method to boost fragile self-esteem, the skydive was my way of celebrating my achievements and rewarding myself for getting through the almost constant struggles.

Because I still struggle. Every small achievement, from walking the dog on my own to completing an assignment, involves facing my anxiety, depression and BPD and managing my current symptoms. 

My symptoms are less apparent to other people nowadays; partly because they have lessened in intensity, but mostly because I am much better at managing them. I was anxious yesterday, for example, but didn’t appear more nervous than anyone about to be hurled out of a plane for the first time. I was focusing on controlling my breathing and being mindful, rather than listening to my worries and letting them escalate — though, truth be told, my anxiety disorder is concentrated on the possibility of humiliation rather than harm or death, so I was more worried about doing the wrong thing or puking!

Tandem skydive
Photo credit: my instructor at Skydive Buzz

In addition to being a celebration and reward, skydiving was also a reminder that I need to take chances in order to experience fun and excitement. I need to leap forward, despite being anxious and having other obstacles in my way. I may never “recover” from my mental health problems, but I can manage them alongside achieving goals and chasing my dreams.

I think the main difference between my life now and the episodes during which I was trapped by my mental illness, is that my fears have shifted. I am more afraid of not trying to achieve my goals than the potential for humiliation. I’m more scared of spending the rest of my life confined to the house than chasing my dreams. I’m still fearful of failure and rejection, but my greatest fear is living without trying to create a better life for myself.

Which is another change: I believe I’m worth the effort.

I used to hate myself and thought I deserved nothing, but that has gradually changed over the past 10 years and the change has accelerated since I trekked to Machu Picchu. It started with asking for help when I needed it and investing in myself, going to university after thinking I had “missed out” on the opportunity. Then I realised I could contribute to the world, through volunteering and using my skills to help local charities/organisations. Most of all, I gave myself permission to dream again, to consider the possibility of a different life.

Along the way, I have met more people who believe in me. I have had small successes which confirm that I’m worthy of support and investment, contribute a lot and can achieve things I once considered impossible for me. 

Sure, my life looks very different to how I expected and what I would have chosen, but you work with what you’ve got. I still struggle, but the truly awesome days I enjoy make the weeks and months of struggles less important than the triumphs. When I look back on my Machu Picchu trek, I don’t dwell on the panic attacks, throat infection, rain and altitude sickness: I remember arriving at the Sun Gate with my fellow trekkers, achieving our goal.

Changing Set Points

I have been finding things difficult lately, which feels strange to admit because my life is, in general, better than it has been for years. While I still have bad days (and some really awful days), my typical daily mood has been turned up a few notches.

Apple blossom and sky

This means I can (usually) practice basic self-care without huge effort, such as going for a walk and cooking healthy meals instead of grabbing junk food. Other tasks are harder to accomplish, like finding the confidence to submit my short stories and attending appointments on my own. It seems my “set point” of mood and ability has increased.

An improved set point is, of course, a Good Thing. I have no idea whether I will ever recover completely from my mental illnesses, but this improvement is an encouraging sign. It gives me hope.

Life is also easier to bear, because my bad days are less intense than they were at the end of last year. Feeling lethargic, unmotivated and low in mood isn’t great, but it’s preferable to being suicidal and self-harming on a daily basis. It might take a huge effort to get out of bed, but I can do it. That’s progress.

But there is a darker side to an increased set point and the hope it brings: I feel more pressure to do better.

Acknowledging Progress

A conversation I had last week highlighted this issue. I was asked if I had had a good week and I replied that it was neither good nor bad. Nothing terrible had happened, but nothing particularly good had occurred. I felt as if I hadn’t achieved anything. I was then asked about my week in more detail. I can’t remember my precise response,but it was something along the lines of “oh yeah, I walked the dog and went to gym classes, did some writing, studied… the usual.”

“The usual.”

Not so long ago, these things were not “usual” for me. Even a year ago, I was not going to gym classes or studying. Longer ago, I couldn’t walk the dog (let alone on my own!) or sustain any kind of regular writing practice. I realised that I wasn’t giving myself credit for how far I have come and that I expect more of myself.

Expecting more of yourself can be empowering. It has motivated me to challenge myself. The possibility that I can manage my mental health well enough to prevent it from limiting my life encourages me to dream, to plan, to take action.

On the other hand, expecting more of yourself can bring disappointment. Failure is inevitable in life, but raising your hopes enough to expect the odd success can make constant failure harder to handle. In many ways, it was easier when I expected nothing good to happen to me.

Accepting The Positive

Perhaps the problem is a disconnect between accepting myself as I am and wanting more for myself. Maybe, on some level, I still consider those things a paradox. It’s a kind of superstition: if I accept myself as is, I might be jinxing the possibility of a better life.

Paradox or not, in my experience, acceptance is usually necessary before I can change things for the better. When you are fighting against your current situation, it’s difficult to achieve anything. Once you accept where you are, you can create a map and move forward.

I tend to think of acceptance as admitting and owning the negative aspects of my life. A lot of the work I did in counselling last year was about accepting my mental health issues, plus the problems that have been directly or indirectly caused by them (finances, work, relying on my parents, etc). I might not like having mental health problems, or the effects, but I need to accept them as part of my life.

However, thinking about my recent weeks has made me wonder whether I am making enough effort to accept the positive aspects of my life. I suppose my default is to think of my achievements and successes as anomalies; brief, glorious moments rising out of the dross of my everyday life. I rarely acknowledge them, especially if I consider them to be small and insignificant.

Yet the small things are important. Vital, in fact.

During my worst episodes, I couldn’t enjoy the very activities I now consider “small”. I didn’t read much, because I couldn’t concentrate. Ditto watching films. If someone did something nice for me, or even if the weather was good, I would get upset because I believed I didn’t deserve anything good. Back then, if you had told me that I would be where I am now, I would have scoffed because it seemed impossible.

I need to be more mindful about the good things in my life right now, as well as being hopeful that I can achieve things I currently think of as impossible. A few years ago, I would never have dismissed the past few weeks as “neither good nor bad” — I would have considered them to be fabulous, amazing, wonderful! Instead of letting my new set point skew my reality, making me dismissive of the positive aspects of my life, I should celebrate reaching this new version of “normal”.

Maybe this is how recovery will work for me, increasing my set point until mental illness is no longer a controlling shareholder in my life.

Taking It In Your Stride

“Just take it in your stride.” Good advice, right? Nobody wants to be derailed by obstacles and challenges. However, those of us who have mental health problems can find it difficult (often impossible) to take things in our stride.

Even small and/or anticipated problems can knock us off course. Setbacks seem to confirm the negative beliefs we hold or have held about ourselves:

“I am a failure and always will be.”

“I’m not good enough.”

“I can’t cope.”

We feel people are judging us for making mistakes or not being able to cope with our problems. Our thoughts can spiral out of control, so that a tiny setback leads us to think our entire lives are catastrophes.

 

So how can you help someone gain perspective?

First of all, please don’t contradict what they are saying. You may think you are showing the person concerned that they don’t need to worry, but minimising and dismissing other people’s problems is unhelpful and potentially harmful. They are already judging themselves for not being able to take the situation in their stride; suggesting their problems are unimportant and they are therefore overreacting piles on more judgment. It may not be your intention to belittle them, but that’s how your words can be perceived.

By not being sensitive to how the person in question feels, you imply that their emotional reaction is the problem. This can be easily translated as “I am the problem”, thus confirming their negative beliefs and leaving them feeling worse.

Instead, try a more compassionate and productive approach:

1. Acknowledge how they feel. They are entitled to their emotions and none of us can control our emotional reactions, though we can learn to control how we express our feelings, emotions and thoughts. Don’t start giving advice straightaway — listen.

2. Try to understand their perspective. Keep listening. Ask questions to clarify how they feel. Try to connect and empathise, so that you can learn why they believe the problem, challenge or setback is a disaster.

3. Support them. Let them know you will help in any way you can and reassure them that they can improve the situation. If they ask for advice, give it, but don’t dictate what you think they should do. Ask them questions which help them consider their options and plan their own course of action — if they feel able to take action.

 

Check your language.

An issue I have encountered a lot when talking about my problems is people dismissing my concerns, often implying that because my life has improved since my worst periods of depression and anxiety, my current situation shouldn’t bother me. I’m sure most people don’t intend to make me feel worse, but many phrases which are supposed to be reassuring can have darker implications.

For example, “look how far you’ve come” can be motivating if someone is in a positive frame of mind, but can also be interpreted as “you should be grateful for the improvements in your life and not expect more.” I find it especially patronising when spoken by people who have led relatively “normal” lives, usually when they try to tell me that my current situation is better than I think — as though I have no right to be frustrated about my mental health, financial situation and living with my parents.

Other phrases which people think are motivating or reassuring, but actually leave a lot of us feeling worse, include:

“There are plenty of people worse off than you.” True, but there are many people better off than me — including the people who like to “remind” me that things could be worse.

“Things will change soon.” Maybe, but often nothing significant seems to change for years on end.

.”You’re lucky to have X.” Again, braodly true, but when X is my dog or parents who haven’t chucked me out on the street, it feels like whoever says this is scraping the barrel.

Before you try to reassure someone, consider:

1. Are they in the right frame of mind to hear this without misinterpreting it? Often, people just want to be heard. They aren’t expecting you to solve their problems or give them a pep talk. They may want to vent or express their emotions without being told they should feel differently.

2. Would hearing this actually help them? In most cases, especially when emotions are high, the answer is no. When I’m depressed, the most inspiring stories can make me feel worse because I feel so pathetic and unable to change.

 

What can you do if you can’t take things in your stride?

Try to stay afloat. Practice self-care and do what you can to stop things getting worse.

If you can, that is. Sometimes problems and setbacks can make us feel as though we are drowning and we can’t stop struggling. Instead of letting go and hoping we rise to the surface, we try to cling to things in desperation — though clinging to them will keep us trapped underwater for longer. We cling to unhealthy relationships, harmful habits and negative beliefs. We can keep clinging, or we can let go and accept our current situation.

Acceptance is bloody hard, but it’s the only way we can stay afloat. And unless we learn to stay afloat first, our attempts to swim against the tide and change our lives will keep sucking us under. It’s a lesson I’m learning over and over.

Berating yourself (and the world in general) gets you nowhere, because you get sucked down into the same old negative thought patterns. Practicing self-care and self-love lead to acceptance. Unfortunately, as the word “practice” suggests, it’s difficult to learn to love and care for yourself, so you need to pay attention and take active steps on a regular basis.

If you feel unable to cope, please seek help and support. Your GP is a good first port of call, but there are also various helplines, therapists and counsellors. Talking to a trusted friend or family member and asking them to help you access appropriate sources of support is a good idea.

 

Long term strategy.

When you have chronic mental health issues, feeling blown off course by life events which others seem to take in their stride is a frequent occurrence. I think the trick is to recognise when you need to stop swimming and float for a while.

Doing this can feel like you are taking a step backwards, but it actually prevents you from losing progress.

Constantly swimming against the tide is exhausting, so we all need a break sometimes. If you are experiencing mental health problems, you may need more breaks than other people — perhaps more than you would like — but it’s essential to float when you need to float. In fact, it’s the best strategy for your long term success and fulfilment.

Self-care helps you to swim further in the long run 🙂

Winterproofing

I tend to think of the clocks going back as a negative event: winter has always been a difficult time for me, bringing both physical illnesses and a decline in mental health. The past two winters have been particularly awful. Last winter, I was ill for nearly four months solid, with the flu, throat/chest infections and other viruses wreaking havoc. I couldn’t use the coping strategies I had put in place, as even the easiest took too much effort. My depression and anxiety got worse.

Sunrise

This year, I hope things will be different — but last winter has taught me that you can do almost everything “right” and still succumb to illness. 

There has been one benefit to the clocks going back that I haven’t appreciated/experienced in past years: the lighter mornings. Since I get up at 5am nowadays and take the dogs out around 6:10am, the change is obvious. We could walk up the lane again this morning, after being forced to take a different route (with streetlights) for the past few weeks. As you can see in the photo, the sunrise was glorious.

Prioritising Self-Care

While I can’t control everything, I am making sure I stick to my coping strategies and self-care activities. In particular, I am being strict about using my SAD lamp and exercising. I know it probably seems ridiculous to people who don’t understand how important these activities are in managing my mental health, but it’s necessary.

Sure, I feel like I’m being awkward when I tell my friends I can’t go out on the evenings I have gym classes, but I don’t want to risk damaging my mental health. My routine, combined with the physical exercise, helps me stay healthy. When I feel guilty for being so selfish, I remind myself that when I got ill last winter, I couldn’t socialise for weeks — being unavailable a few evenings a week is preferable to being unavailable throughout the winter months.

I’m also being stricter with strategies which I should implement more regularly/frequently than I do at present. Wanting to avoid a repeat of last winter is a great motivator! I’m trying to eat healthy meals, even if I eat junk as well, and making an effort to meditate. I know I could do better, but stressing out about not doing better is counterproductive…

Finding Pleasure in Winter

I have being trying to focus on my strengths and the positive aspects of my life recently, so I’m trying to take the same approach to winter. It can be difficult to appreciate the pleasurable side of the cold, wet and dark months, but it’s not impossible.

Winter creates the perfect atmosphere for reading ghost stories, which I enjoy. It’s also a good backdrop for hot chocolate, warm puddings and spicy curries. Brussels sprouts are in season, which I adore (seriously) and I can watch films or read without feeling I should be outside, enjoying the sunshine.

I like a lot of things about Christmas, too — though it can bring its own challenges. Seeing Christmas lights when walking the dogs, buying presents and listening to cheesy Christmas songs are all fun. It marks the winter solstice, so brings hope that spring will come. The days will get longer again and it feels like I’m progressing with the changing seasons — in theory, anyway! In the meantime, it’s back to ghost stories and hot chocolate.

Facing Down the Fear

I’m terrified of getting ill again. I dread feeling like I did last winter. However, worrying and getting stressed will only increase the likelihood of getting ill.

Instead, I’m attempting a more pragmatic approach. I will do everything I reasonably can to avoid getting ill (hence I got a flu shot last week, for the first time!), but I can’t beat myself up if I get ill. Whatever will be, will be.

It’s the same old story, really: there is no point in worrying about stuff which might or might not happen. Of course, knowledge and practice are different things — especially when you have anxiety…

I refuse to fixate on whether or not I will get ill. In fact, I accept that I probably will get a few viruses and colds. I accept that my depression will become more difficult to manage. But I can focus on what I’m able to do and put contingency plans in place.

Coping with winter is difficult, but I’m not completely powerless. I can choose to accept the possibility of illness while doing my best to keep it at bay. It’s my best chance of staying mentally and physically healthy.

Decluttering

Every so often, I get the urge to declutter. Not just to get rid of a few things, but to completely reassess and overhaul my possessions. I find it cathartic.

Note: Milo is not being recycled as part of my decluttering drive.

Decluttering is both mental and physical.

As you take stock of what you own, you take stock of your life. As you notice which objects are most important to you right now, you realise what is working well in your life – and what isn’t. You find that things which used to feel vital to you no longer matter and you can discard them without regret. Other stuff is hard to get rid of, although you know it’s for the best, because it means giving up a long-held notion of yourself and your life.

Hoarding has a strong psychological aspect; it stands to reason that the same is true for decluttering. In the western world in particular, we are brought up to measure our self-worth through what we own. More stuff = more value. Even when we think this through logically and realise it’s bullshit, this ideology keeps a stranglehold on us.

We can accept that we have far more stuff than we need, yet we cling to it. Even stuff which we know we will never use. Our stuff is something physical which we can point to and say “look, I must be worth something, because I have all this stuff.”

 

But you are valuable regardless of what you own.

Stuff doesn’t determine your true value. Many very rich people have lots of stuff but act unethically, harming others; many very poor people dedicate their lives to helping others. Who is worth more?

Of course, I’m not saying that all billionaires are bad and all poor people are good: I’m saying that everyone’s value is separate from what they own and how much money they earn. For every Philip Green who avoids paying a fair rate of tax (legally, though immorally) and conducts dodgy business deals (again, legally but immorally) while lavishing money on himself, there is a Bill Gates who donates substantial amounts of money to charity and uses his wealth to help make the world a better place. I don’t care what their bank accounts say – their actions determine their true worth.

The same is true for you and me: our actions are better measures of our value than our money and possessions.

 

Decluttering is a process – and a learning process.

I have read about extreme examples of decluttering and these examples can be intimidating. You find out that some people can fit all they own into a backpack and compare the idea to your mounds of clutter, which makes it seem like you are fighting a losing battle. But decluttering doesn’t have to be about your quest to become a minimalist.

My own decluttering process has been gradual. I started in earnest three years ago and while I continue to make small improvements regularly, I still have too much stuff. It doesn’t matter – it’s all progress.

Decluttering makes you consider your lifestyle and your ideal lifestyle. Sometimes, especially at the beginning, it feels like you will never marry the two, but as you declutter you will get closer. Decluttering also alters your spending habits as you become more considerate of the possessions you want in your life.

These changes may be gradual and you might not notice them for a long time, but they occur as decluttering changes your way of thinking. Your habits are likely to fluctuate, but there will be an overall improvement. For example, I still overspend sometimes (compulsive spending is a common symptom of borderline personality disorder), but less frequently than I used to and on things which I genuinely want. I no longer buy designer shoes just to cheer myself up or order thirty books from Amazon at a time.

 

Decluttering makes you consider your priorities.

Some of the stuff I have found most difficult to let go is stuff which represents a fantasy I had about myself. For instance, I kept my guitar for far too many years despite never learning to play it properly, because I liked the idea of playing guitar. In reality, it was never a priority. Decluttering forces you to look yourself in the eye and admit that many of the ideas you hold about yourself are untrue.

It’s hard, but when I let go of these untrue ideas about myself, I feel relief. I don’t have to learn to play guitar! I don’t have to live with the embarrassment of owning a musical instrument I can’t play! I no longer feel guilty about owning something I’ve barely used!

I don’t think it’s a coincidence that I have amped up my decluttering as I emerge from a difficult time in my life. Decluttering can be a way of coping. When I don’t know where to start, I pick a category (often clothes, since they wear out quicker than other possessions and my weight has changed a lot over the years) and get stuck in. Some things obviously need to be discarded, so the decision is easy. Other things I feel more ambivalent about and the decision is difficult, though feeling ambivalent is usually a sign I need to get rid of something, no matter how painful.

In this way, decluttering often mirrors decisions I have to make in life. It teaches me to trust my intuition, even as I cling to things which need to be discarded. It shows me that I can trust myself to make choices without regret.

 

Decluttering makes room for opportunity.

I love reading decluttering books, although I pick and choose what works for me rather than following some guru. I bought Marie Kondo’s second book, Spark Joy, at the weekend and loved reading her anecdotes about how clients’ lives have been changed through decluttering. She says that decluttering makes space for new opportunities, relationships, career changes, lifestyle transformations, etc. I agree – I feel less stressed on average and more focused since I started my decluttering crusade.

I like the analogy of decluttering as weeding your garden, allowing what you want to blossom. If you ignore the weeds, they will choke the flowers and vegetables you want to grow. Likewise, living with possessions which mean little to you and are rarely (or never) used makes it more difficult to enjoy the possessions and activities which mean the most to you.

Decluttering seems like such a small change, yet it can transform your life. I now live in an environment I love, instead of one I hated because it was crammed full of furniture and all kinds of crap – despite it being the exact same room. I can concentrate on achieving my goals and enjoying life when I can, instead of being obsessed with accumulating more stuff and then stressed about how to make a tiny bedroom accommodate that stuff. It costs nothing and is accessible to everyone – give it a try!

The Truth About Borderline Personality Disorder

It is difficult to explain borderline personality disorder adequately in a sentence or two, which means it doesn’t get talked about enough. I am guilty of failing to mention I have BPD, despite being open about having anxiety and depression, because it exposes me to ignorant, incorrect comments — sometimes by people who mean well — and people tend not to listen when I try to explain about BPD. So here is a very basic guide to the facts about borderline personality disorder and some of the most common misconceptions.

What is BPD?

Borderline personality disorder, or BPD, is a mental illness. The NHS website describes it as “a disorder of mood and how a person interacts with others.”

There are a range of symptoms associated with BPD, which are often grouped into 4 main areas:

• Emotional instability

• Disturbed patterns of thinking or perception

• Impulsive behaviour

• Intense but unstable relationships with others

It’s important to remember that everyone with BPD is individual and their symptoms manifest in various ways. Some symptoms seem to be opposites, such as promiscuity and withdrawal from relationships, although they may have similar roots and effects — such as avoiding long-term relationships.. For this reason, stereotypes of people with borderline personality disorder are particularly inaccurate and offensive.

 

What are the criteria for diagnosing BPD?

There are broad symptoms of which at least 5 must be present over a long period of time and/or have had an impact on your life in order to receive a diagnosis of borderline personality disorder. These include:

• Intense emotions which can change quickly (and often for no apparent reason or reasons which seem trivial)

• Fear of abandonment

• A weak and/or changeable sense of identity

• Impulsive behaviours, such as binge eating, drug taking and mindless overspending

• Suicidal thoughts and/or self-harming

• Difficulty establishing and maintaining stable relationships

• Chronic feelings of emptiness and isolation

• Feeling angry and struggling to control anger

• When very stressed, feeling paranoid, experiencing psychosis and/or feeling dissociated

For a fuller explanation see Mind’s website. Diagnosis can be made only by a mental health professional — in my case, it was a psychiatrist. Diagnosing BPD requires assessment of a complex range of symptoms, so it often takes a long time to be recognised. I was diagnosed when I was 26, for example, despite having displayed the symptoms since my early teens.

 

Does having BPD mean there’s something wrong with your personality?

No. Borderline personality disorder doesn’t refer to character or traits which we think of as constituting someone’s personality. Neither is BPD a personality type, such as those indicated by the Myers-Briggs test (I’m an INFP on that, in case you were wondering!). The term “personality disorder” refers to a pattern of thinking, feeling and behaviour. The  connotations of “personality disorder” are unhelpful when people don’t realise what the term means, but this can be countered with education and information.

Some symptoms of BPD may be thought of as personality traits, such as impulsiveness, but it isn’t necessarily the case that people with BPD are naturally impulsive. You can be impulsive when your BPD symptoms are worse, but the opposite when your symptoms are under control. In this instance, impulsiveness is a behavioural symptom rather than an innate tendency.

Most aspects of people’s character or what we describe as personality are not affected by BPD, though symptoms may overshadow them. Even during my worst episodes of mental illness, my underlying personality remains the same.

 

Can BPD be treated?

Absolutely. Depending on the symptoms exhibited by an individual, there are a range of treatments which can be helpful in managing borderline personality disorder. These include medication, such as antidepressants, and talking therapies.

Dialectical behaviour therapy is noted for being particularly effective and was developed in order to treat BPD. Personally, I have found drama therapy and counselling very useful. I also use CBT (Cognitive Behavioural Therapy) techniques to cope with some of my symptoms.

There are many self-help strategies which can help. For example, I have found exercise and meditation very useful. I have learnt what works best for me over the years (and continue to learn). Lots of self-care strategies which are used for other mental illnesses are useful for people with BPD, so it’s worth doing some general research around mental health management to find ideas.

As with mental health problems in general, finding treatments which work for you is often a case of trial and error. Different treatments may work better at different times, depending on your symptoms and situation. This means it’s important not to dismiss possible solutions which didn’t work for you in the past.

 

Busting myths about BPD.

The amount of ignorance and misinformation concerning borderline personality disorder is a constant source of frustration. I have written previously about how annoying I find it when people call it a “terrible label” rather than a mental illness, which perpetuates these myths.

Here are some more common myths:

People with BPD are manipulative. Some symptoms of BPD may come across as manipulative, but that doesn’t mean they are intentionally manipulative behaviours. Even when someone’s behaviour is intentional, it’s still a symptom and they didn’t ask to have BPD — nobody would — so set boundaries and offer empathy rather than judgment.

People with BPD are a nightmare to live with. There is a degree of truth in this myth, because anyone can be a nightmare to live with sometimes — but this doesn’t mean all people with BPD are difficult to live with all of the time. Many people with BPD are good partners, parents, children and housemates. Lots of us have qualities which make us delightful to live with most of the time.

All of us have bad days, regardless of whether we have been diagnosed with a mental illness, yet people with BPD get accused of being “nightmares” with more vehemence and less compassion than is shown towards most people. It’s a stigma which doesn’t seem to be shifting as much as the stigma surrounding other mental health issues.

If someone with BPD is exhibiting severe symptoms, they need help and support, not condemnation. Other people’s failure to deal with symptoms effectively can also exacerbate the situation, creating a “nightmare” situation which is not the fault of the person with BPD. It’s especially concerning that this attitude seems to blame people with BPD for their own illness, as if we want to suffer from an often painful and debilitating condition.

People with BPD are bad people. Not at all: they have a mental illness. Being mentally ill doesn’t make you a bad person (though it may feel like you are during bad episodes, especially when you are exposed to unsympathetic attitudes). This is stating the obvious, yet it’s shocking how many people forget and prefer to characterise people with BPD as merely bad people who are being difficult on purpose. This is never the case.

 

How you can support someone with BPD.

Make an effort to understand. Don’t make assumptions about the behaviour of someone with BPD. Read about the condition and the experiences of people with borderline personality disorder. Ignore the damaging comments people without BPD write on social media, which tell you more about their authors’ ignorance and lack of compassion than BPD.

Listen. Be there for them. Let them express their feelings without cutting them off or making assumptions about how they feel. If it’s hard to listen, remember it’s even harder to experience. If you want clarification, ask questions. Let them know you care — it might be simple, but it means a lot.

Provide practical help. BPD can be debilitating, especially since anxiety and depression are common co-morbidities. People with BPD might need someone to collect their prescriptions or prepare proper meals. It varies from person to person and between different times. If you are unsure of how to help, just ask at regular intervals and make it clear they are not being a burden.

Never blame someone with BPD for their own problems. Many symptoms of BPD are self-sabotaging behaviours, but that doesn’t mean they are intentional or that the person exhibiting these behaviours can control them 100%. Pointing out that some problems have been caused or exacerbated by these behaviours is usually unhelpful — people with BPD can recognise their self-sabotage and often beat themselves up about it without external admonition.

I know it’s frustrating to see someone make their situation worse, but blame doesn’t help. If you want to help someone with BPD control their symptoms and take responsibility for their actions, offer emotional support instead.

Support, don’t push. Everyone learns to manage mental illness at their own pace and different treatments or strategies work for different people, and at different times. If you find out about something which could help someone with BPD, mention it to them and let them know you will help them access the treatment, but don’t pressure them into trying it out.

 

If you remember nothing else from this post, please remember this: borderline personality disorder is an illness and people with BPD deserve support and compassion, not judgement and stereotyping.

Self-Intervention is Part of Self-Care

Knowing when you need extra help is a crucial part of self-care, although it can be difficult.

Learning to recognise when a worsening of symptoms becomes a need for extra help and support is vital for long-term mental health management. However, it can also feel like admitting failure. When your symptoms have improved, a decline in your mental health can feel like it’s your fault — that you have done something wrong which has caused your symptoms to get worse.

Everything feels darker and you are trapped into the “old” pattern of mental illness you thought you had come through.

The logical part of your mind knows this is wrong and nobody is to blame for their mental health problems, but the messed-up parts of your mind constantly tell you the same old myths: it’s your fault, you fucked up, you are doomed to be miserable forever.

 

You may try to ignore the situation, but it’s important to get help sooner rather than later.

I speak from experience. Over the past 3/4 months, my mental health has declined. This came after a fantastic summer during which I did things that were previously impossible for me (going to jive classes, for example) and felt well enough to stop taking medication after over a decade.

I came up with excuses for not going to my GP: I was stressed out because major renovations had turned my home (and life) upside down. I felt more depressed because I had been hit with one virus after another. These excuses were true, but my assumption that things would go back to normal when the workmen left and I regained my physical health were not.

I wasn’t coping and by delaying getting help, I suffered more and my mental health got worse.

I finally went to my GP on Monday. He is referring me to an organisation which offers counselling, which I believe will be most beneficial for me right now. I told him I would prefer not to go back on antidepressants at the moment, but I would never rule them out as a possible treatment. He was brilliant and accepted my insight into my own mental health — I had been a little wary of feeling pressured to take medication again without trying counselling on its own first, but that turned out not to be an issue.

If you aren’t so lucky and your GP pressures you to try a course of treatment which you feel isn’t right for you, remember you are entitled to a second opinion. However, it’s also worth examining your reluctance to follow the suggested course of treatment — some people resist medication, for instance, because they believe myths perpetuated by the media. Do some research, always asking whether your sources have an agenda which is at odds to your wellbeing, and make an informed decision.

 

Self-intervention, like self-care, is different for everyone.

For me, self-intervention was about recognising that I needed professional help and would benefit from counselling, which I hope I will receive. For other people, it might mean enlisting the support of family or friends, altering their lifestyle or adopting more self-care strategies. It could mean something entirely different, which I might not consider.

It’s about recognising when your mental health has dipped enough that you need extra strategies in place to prevent it from getting worse.

Ideally, this will lead to an improvement of symptoms, but the initial reason for self-intervention is to stop the situation declining further. The signs that you have reached this point vary depending on your recent mental health history and self-knowledge. Symptoms which may not concern one person, may be very worrying to another.

For example, I wasn’t concerned by a slight increase in my depression, because I know it gets worse in winter. However, while my low mood was normal for me, the increase in anxiety to the point where I was having panic attacks more often is a red flag. For someone else, the increase in depression could be a red flag whereas if they were already regularly experiencing panic attacks (as I did in the past), an increase in their frequency might be considered a small change.

Knowing your red flags is important in managing your mental health.

If you don’t have a high level of self-knowledge and self-awareness, keeping a record of your symptoms is helpful. I try to do this when my mental health problems get worse because whereas I normally have a high degree of self-awareness, this gets skewed by anxiety and depression: I tend to think things are fine until they get so bad I can’t deny it any longer. By keeping notes on my mental health, I could have noticed the worsening of symptoms before things got so bad.

Like so many things related to mental health, this is easier said than done, but keeping even a rudimentary record of symptoms can be useful.

 

Self-intervention is needed because many mental health symptoms aren’t noticed by other people.

There are plenty of reasons why other people might not recognise your symptoms worsening:

A lot of symptoms are internal. Negative thinking, headaches, low mood, etc. aren’t always apparent on the outside, especially if they are not expressed.

It can be difficult to distinguish when an already-present symptom is getting worse. If someone knows you experience a specific symptom, such as feeling nervous around other people, they may think all signs of this are normal for you and can’t tell when it’s worse or better.

Nobody is with you 100% of the time. Many symptoms are most apparent when you are alone and many may not seem concerning when glimpsed by someone who doesn’t realise how frequent they are. Under-eating or over-eating, for example, are often secretive behaviours and might not worry people who only see you displaying the behaviour over a limited period of time, such as your working hours. They don’t know whether this continues when you get home, or whether these behaviours are balanced out by other ones.

People might not know if something is a symptom of mental illness. There is a lot of ignorance around mental health and some symptoms might seem unconcerning to people who consider them merely quirks. Some symptoms might be considered normal by some people, such as dismissing a persistently low mood as pessimism or chronic under-eating as a low appetite.

Even if other people do realise your mental health is deteriorating, they might not know how to tell you.

They may assume you already realise or that you would feel uncomfortable if they brought it up. They might tell themselves it’s none of their business or that you might get better without their intervention. These assumptions may or may not be correct — the point is that you cannot rely on someone else to recognise your red flags and tell you to get help.

This means you have to make an effort to recognise your own red flags early, so that you can take action and get the help you need.

 

It’s better to plan self-intervention before it’s needed.

When you are relatively well, it’s the best time to make decisions abot what to do if your mental health declines. Don’t wait until worsening symptoms cloud your judgement.

I wish I had a clear plan in place. It would have made things easier and enabled me to get help sooner.

I had some vague ideas about what it would take for me to go back to my GP, but nothing written down. There was no list I could refer to, which would probably have convinced me to see the doctor when my symptoms got worse, rather than a few months later. This is something I plan to change.

While so much of self-managing your mental health is about focusing on positive change, having contingency plans is essential. If you have close friends and family members you trust, you can ask them to help. For example, you may ask them to flag up when you are displaying certain symptoms, such as withdrawing from social events. You can also indicate the kinds of treatment you would prefer in various situations, so they can help you get the treatment which is best for you.

I wish my mental health had continued its upward trajectory, but it hasn’t and self-intervention was necessary to prevent my health from deteriorating further. It’s a potent reminder that mental illness is not linear and for many of us, self-care involves preparing for episodes of worse mental health — perhaps for the rest of our lives. 

Don’t Label Me by Calling My Diagnosis a Label

When I scroll through the comments on Facebook posts about mental illness in general and borderline personality disorder in particular, there will invariably be at least one remark along the lines of “that’s a terrible label to have to live with.” Even if the subject of the post hasn’t expressed any concerns regarding their diagnosis, some random stranger claims that this diagnosis is a label.

In doing so, they are the ones labelling the person living with borderline personality disorder or other mental illnesses.

I have been diagnosed with borderline personality disorder and while I understand that some people feel their diagnosis is a label, I have never viewed my diagnosis as anything other than an acknowledgement that my symptoms fit the criteria for a specific medical condition. If you have been diagnosed with BPD (or any other mental illness) and regard it as a label, that’s your prerogative. However, you do not have the right to claim that my diagnosis is a label. Only I get to decide whether that is the case.

 

You might think you are helping by calling a mental illness diagnosis a label, but you are not.

If you insist on referring to a medical diagnosis as a label when there are people who have been diagnosed with the condition who don’t accept this interpretation, you are belittling their experience. It implies that you don’t believe they have a real illness and that their mental health problems are therefore their own fault.

Defining a mental illness as a label reinforces the divide in attitudes towards mental health and physical health. Few people would refer to a diagnosis of a physical illness as a label; it is just as ridiculous and insulting to refer to a mental illness as a label. By referring to mental illnesses as labels, you are perpetuating the stigma surrounding mental health.

 

When you call a diagnosis a label, it suggests that the illness is somehow invalid.

You may have your own complex, political reasons for thinking a certain diagnosis is a label, but most people who hear you refer to mental illnesses as labels will not be aware of them. They will interpret your opinion at face value and assume you mean that certain mental illnesses are not real. This is very damaging.

 

When people start to think of mental illnesses as labels, they overlook the suffering experienced by people who have mental illnesses.

With personality disorders in particular, they assume that people who have been diagnosed are merely eccentric or unconventional and are labelled as having a personality disorder in order to single them out. They think the diagnosis means that people with personality disorders are being told that their personality is flawed. This is not the case: diagnosis of personality disorders, like any medical diagnosis, is based on the presentation of specific symptoms.

These symptoms are frequently distressing and cause pain. They are not aspects of an eccentric personality. Referring to personality disorders as labels ignores the pain and distress caused by the symptoms.

 

Personality disorders are widely misunderstood – and referring to the diagnosis of a personality disorder as a label propagates this misunderstanding.

I am ashamed to say that I avoid mentioning my diagnosis of borderline personality disorder when I first meet people, though I talk openly about anxiety and depression. The reasons for my uncharacteristic taciturnity are that borderline personality disorder is difficult to explain in a few minutes and the name conjures up a lot of assumptions, misinformation and prejudice. Including the notion that it is a label rather than an actual medical condition.

I have had people make comments along the lines of “well, we all have different personalities” which demonstrate that they believe my mental illness is some type of personality definition, in much the same way as the results of the Briggs-Myers test (I’m an INFP, by the way). The name borderline personality disorder doesn’t help, but the lack of awareness is exacerbated by people referring to it as a label on social media.

 

Whether you consider your diagnosis a label is up to you – but mine is not.

What makes me angry is that I wouldn’t have to put up with this crap if borderline personality disorder was a physical illness. There may be a few crackpots who refer to diabetes and cancer as labels, but people pay less attention to them. The stigma surrounding mental health means that those who refer to mental illnesses as labels get an unjustified amount of attention; people are less likely to disregard them because thinking of mental illnesses as labels feeds into old prejudices about mental health.

Regardless of whether you intend to reinforce the myths that mental illnesses aren’t real and people should just get on with it, that is the effect you create when you refer to a mental health diagnosis as a label.

Of course, if you consider your mental health diagnosis a label, you have every right to voice your opinion. But that doesn’t mean everyone who has been diagnosed with the same condition considers it a label. When people tell me my mental illnesses are labels (which happens with anxiety and depression, though less often than with borderline personality disorder), it is disrespectful and potentially harmful.

Being told my illnesses are labels reminds me of myself pre-diagnosis, when I felt isolated and thought I was a freak; when I thought my illnesses were signs of some inner flaw. Diagnosis helped me move past that. You might feel labelled by your diagnosis, but I felt acknowledged. People were finally listening to me and I was reassured that I was suffering from mental health problems, rather than being some kind of mutant. It gave me hope that I could manage my mental health and perhaps recover. When you refer to my conditions as labels, you threaten that hope and reassurance.

 

Maybe diagnosis was a negative experience for you, but for many of us it is a positive step. By calling all diagnoses of a particular mental illness labelling, you negate our experience and silence us.

Don’t project your issues onto me or anyone else with mental health problems. Don’t assume that everyone’s experience is similar to yours and that everyone regards their diagnoses in the same way. Also be aware of the effects of referring to mental illnesses as labels: every time I read a comment like “that’s a terrible label to live with” I think “yes, because of people like you belittling my experience and perpetuating prejudice.”

Please don’t call my diagnosis a label – for me, it’s not.