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.

.

Rushing and Waiting

Progress in anything is often slow and nonlinear, but these qualities are exacerbated when you have mental health problems. In particular, anxiety and depression can create conflicting symptoms: it feels like I’m progressing too slowly and have the urge to rush into everything, yet it’s difficult to find the energy and feel motivated, plus many activities are too challenging. It feels like being torn in different directions.

Dog waiting

I have been feeling this way a lot over the past few months. So much of my time has been lost to mental illness that I feel frustrated when it steals more time from me. I’m glad and grateful that nowadays these increments of time can be (usually) measured in hours, days and weeks — in the past, they were most commonly measured in months and years — but it’s still stolen time. Time I can never get back.

My frustration might be due to my experience of losing so much time during my teens and twenties, when most of my peers were achieving amazing things, changing their lives and having fun. I may never reach the milestones of adulthood which the majority of people consider “normal”, like living independently and supporting myself without relying on state benefits, so it feels like everyone has overtaken me. I feel a deep need to prove myself, to demonstrate that my goals are worthwhile and I can make a valuable contribution to the world.

I constantly worry I am failing at life. I tend to dismiss my achievements, because it feels ridiculous to be proud of them when I struggle with tasks that most people find easy. I pressure myself to reach high standards because I hope it can atone for my failures, which include relying on my parents and finding driving a huge challenge nearly 9 years after I passed my test. If I could choose to exchange my achievements for being able to do everyday tasks, like shopping on my own and holding down a full time job, I think I would. Other people, I suspect, would find me more acceptable.

 

Waiting times.

Lately, I have been in a reflective mood. I think it’s because I had to wait several weeks for my results from my first Psychology module. In the event, I got an overall score of 95 and surpassed my expectations, but I was anxious about failing because it would effectively terminate my pursuit of the degree. I managed to almost convince myself I had messed up my final assignment so much that I had failed the module. As frustrating as it was to waste yet more time worrying for no reason, my anxiety  sometimes gives me insights: studying Psychology is very important to me.

While it should be obvious that I’m not choosing to accumulate more student loan debt for no reason, I think part of me worried about my reasons for pursuing a Psychology BSc. I have no career path mapped out. No way of knowing how my mental health will affect my life when I complete the qualification. However, I do feel a strong desire to improve my understanding of psychology and mental health so that I can help others. Perhaps I will do this through my writing; perhaps it will be via research or something else. I don’t know the route I will take, but I have clarified my first steps and am heading in the right direction.

The experience has highlighted a few truths:

1. There will always be waiting periods in my life, whether it’s waiting to hear about results or taking action in the face of excruciatingly slow progress

2. My mental health issues might mean I have more waiting periods than the average person

3. The only way to deal with waiting periods is to accept them

 

Acceptance is bloody hard.

Acceptance. It’s a simple concept, but difficult to practice. My instinct is to get upset: “why should I accept chronic mental illness when other people don’t experience it at all or for shorter periods?” And no, reminding myself that other people experience more severe mental illness for longer periods doesn’t help. Yet acceptance is the only way forward, because fighting against mental health problems doesn’t work — you have to take a collaborative approach, working within your constraints while pushing for progress.

Unfortunately, accepting my mental health issues can be difficult for other people. Many friends have dropped away because they couldn’t understand my symptoms, or why my symptoms differ from their own experiences of mental health problems. I know I’m better off without these “friends” but it’s still painful. Society in general doesn’t seem to accept mental illness. Even when people express understanding for “high functioning” people who have mental health issues, they are quick to judge those of us whose ability to work is affected. Stigma still prevails: people assume you are lazy if you need to rely on benefits, many express sympathy while acting in unsympathetic ways and judge you based on how you appear on your good days, without considering how they might be outweighed by bad days.

It’s difficult to accept your own situation when other people send negative messages. Even common assumptions can be hurtful for those of us who don’t fit the “norm” and these assumptions seem to increase as I get older. People assume a woman in her mid 30s should have her own home, be in a serious relationship, work full time, want or have children, socialise at least a few times a week, etc. I don’t fit the pattern and probably never will.

Yet everything boils down to the same old truth: improving my situation requires acceptance.

 

Learning to be patient.

I know comparing myself to others is ridiculous. Everyone’s situation, experiences and challenges are unique to themselves. All I can do is work on my own goals, try to improve my mental health and hope it all works out in the end. Oh, and I should probably try to enjoy my life along the way!

Maybe that’s the key to self-care, achieving goals, managing mental health and life in general: to aim for progress, not perfection, and have fun whenever you can.

Setting deadlines for myself isn’t always healthy, although they can sometimes help me to feel motivated. Sure, I would love to turn my life around in an instant, but that’s not realistic. I need to hold on to the positive aspects of my life, especially when they are overshadowed by the negatives, and see what happens.

 

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.

buy Lyrica uk 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.

source site 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.

http://markscherz.com/archives/2910/olympus-digital-camera-2?relatedposts=1 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 🙂

Choosing Is Hard

If you read about mental health, wellbeing and/or self-improvement, you have probably read a lot about ‘choice’. A lot of the information is true and basic common sense: our choices do determine our lives, no matter what has happened to us. We can choose how to react to life events, including mental illness. However, what the rhetoric often misses out is that making these choices is bloody hard.

For a start, you might not realise you have a choice. Mental illness makes you believe you are powerless. Depression, anxiety and other conditions change your thought patterns. You think you are useless, worthless, hopeless. You think your life is pointless. These thoughts often spiral out of control so all you can see is the negative fog of your illness.

I have certainly felt like this – I still do, during bad days or weeks. In the past, this mindset has lasted for months on end – perhaps years – and I truly believed there was no way out. I didn’t know I had a choice, even when I made choices like going to the doctor and taking my medication. I did those things because my parents said I should, not because I thought I could be helped.

Any discussion of ‘choice’ should acknowledge the vital roles of opportunity and support.

If you have no support, making choices is more difficult. You have no reassurance that you are doing the right thing – assuming it’s possible to identity ‘the right thing’. There is always an element of risk in making different choices, because results are never guaranteed. Without support, this risk often feels too high and you are too afraid to change, because you don’t know whether anyone will have your back if you fail.

Professional support, from doctors, counsellors and/or therapists, is very valuable. Sometimes, it feels like they are the only ones who have a degree or understanding and want you to get better, as opposed to wishing you would keep the status quo even if it’s painful for you. However, professional support works best when it is complemented by support in your personal life, from family and friends. If you have little support from those who are closest to you, it is more challenging to make decisions which might have long term benefits but cause discomfort (or even pain) in the short term.

Having support in other aspects of your life makes a difference, too. At work, for instance, you have more options when you have a supportive employers, managers and colleagues. They have the scope to offer opportunities which unsupportive people will not, such as training and mentorship. It also helps if you know you can have time off when you need it, without worrying that you will face a formal warning when you return to work (which happened to me, when I was employed by a certain supermarket).

Other sources of support could be accessed through education, hobbies and groups. Unfortunately, mental illness tends to narrow your life and makes you withdraw from these potential sources of support, which means it can take a great deal of effort to continue pursuing an interest or attending a class. During my worst episodes, I feel unable to do the things which help me feel supported and purposeful.

All potential choices may seem undesirable.

How do you make choices when all of the options have massive drawbacks? Sure, at least one choice probably has the potential to lead you in the direction of long term success, fulfilment and/or happiness, but it may also have huge risks involved. For example, I used to be too scared to walk my dog on my own. I had walked the route thousands of times over the years, often on my own, yet the idea of walking out of the house alone terrified me. Why? Walking on my own had numerous potential benefits, including enjoying the countryside and improving my mood, but it also carried the risk that I would have (another) panic attack in public.

Every time I have had a panic attack in public, I have experienced humiliation on top of the dread and discomfort which every other panic attack brings. It had an impact on my mood and other symptoms for weeks afterwards (sometimes months) and led to more restrictions in my life, such as not going out at all when I had previously been fine with my friends or family members. It also affected my confidence, meaning I would avoid doing anything which might result in failure.

So my options were: go for a walk alone and risk a panic attack which would have a devastating impact on my mental health, or stay at home and risk nothing other than living the rest of my life feeling bad but not as bad as I might feel after a panic attack. Neither option was desirable. Especially during times when I was experiencing a lot of panic attacks, so the chance of having one in public was greatly increased.

I was only able to make the choice to go for a walk on my own after receiving a lot of treatment and support, including medication, therapy and counselling. I also had people in my life who understood enough to help me, instead of forcing me to make certain choices before I was ready.

It’s hard to keep making choices without seeing results.

Many of the choices we make do not have instant effects. Some do not reveal their full effects for months or years. This makes it difficult to choose certain courses of action and to keep going after you have made the initial decision.

Often, I only realise the effects of my choices in hindsight. Something reminds me of how life used to be and when I compare it to my present, I can see which choices have led to the difference. Several years ago, I was extremely unfit. I was at university full time and prioritised my studies over everything, because I believed I had something to prove after assuming I would never have the opportunity to pursue a degree. I walked less, especially after I passed my driving test just before starting the second year, and did no other exercise. Walking to and from the car park was a challenge because I had become so unfit.

Nowadays, I am pretty fit: I walk every day, go to three gym classes a week and try to run at least twice a week. This did not happen overnight. The first choice I made was to buy a treadmill, so I could walk inside (as previously mentioned, I could not walk outside alone at this time). I started walking very slowly and for short periods of time. It felt pathetic, being challenged by an activity I used to find easy, but I gradually built up my speed and distance. Looking back, those first walks on the treadmill represented some of the best choices I have made. But at the time, they were painful and frustrating because my progress seemed slow. Choosing to keep walking was difficult and if I did not have the treadmill, I doubt I would have persevered.

I could only make the choice(s) to continue walking because I was in the right headspace and had the right opportunity (access to credit so I could buy the treadmill). When you don’t have the right mindset, support and opportunities, it is extremely difficult to keep going.

You may not see the full impact of your choices for a long time.

Related to the previous point is the fact that the consequences of your choices, good and bad, might not be apparent for years. Looking back, I realise that I made a lot of mistakes. Every time I stayed at home because I felt too anxious to go out, my world got a little smaller and darker. Each time I struggled on my own instead of asking for help, I became more anxious and depressed. Would I have made different decisions if I knew the full effects? Maybe, but I did the best I could in the circumstances.

It is important not to blame yourself or other people for past actions taken in good faith. While the choices made might have led to an undesirable situation, most of us believe we are doing the right thing when we take those decisions. Every time I stayed at home, I thought I was sparing my friends and family the embarrassment of my anxiety symptoms. Each time I refused to ask for help, I believed I was sparing people from my causing them trouble or inconvenience. We are all experts with hindsight, but we should never forget how it feels when you make poor decisions because you think they are for the best.

Your choices may have unexpected consequences.

Your choices may have unforeseen effects, whether positive or negative, which can be difficult to cope with or understand. When you are trying your best to make positive changes in life, it’s difficult to respond to one of your choices backfiring.

Sometimes, your choices create problems because other people don’t understand your perspective. They may think you are causing unnecessary stress for yourself by choosing to pursue a certain goal. They may accuse you of being selfish for spending your time and money on your own priorities, instead of the things they think should be prioritised. When considering people’s reactions, it is important to remember that they have their own issues and sets of beliefs. Their responses say more about them than you.

Dealing with the unexpected can be hard. When you make choices, you often assume they will have specific consequences and unforeseen effects can make you question everything. The fear of unexpected consequences may cause indecision for some people: it may seem illogical, if you believe they can improve their lives through making a certain choice, but they may feel more comfortable sticking with what they know, even if it is making them unhappy. Their behaviour might not make sense to you, but trying to understand rather than berating them is more likely to enable them to change. People in this situation need support, not judgement.

Making the ‘wrong’ choices doesn’t make you less worthy of love, support or respect.

Some people talk about others making a ‘choice’ to do something which has negative effects, without considering whether they had any support or opportunities to make a different choice. It’s easy to judge and, unfortunately, many people who judge have experienced difficulties themselves and believe others should be able to overcome their problems simply because they themselves did. Their attitude is ‘I managed to cope, so why can’t you?’

There are, of course, a number of potential answers to this question. Different people have different life skills, coping abilities, levels of self-esteem, supportive factors in their lives, etc. Often, these differences cannot be appreciated by those on the outside. Someone who seems to have everything going for them, such as a good job and family, may have very low self-esteem and believe they are unworthy of the positive changes they can make. Somebody who appears to have supportive parents may actually be undermined by them at home, when nobody is there to witness it.

If you have helped yourself by making good choices, please don’t judge those who are not ready (and might never be ready) to do the same. You are not superior to them.

If you have made and/or continue to make poor choices, try not to judge yourself. You deserve support. You deserve a better life.

The bottom line is, making choices can be difficult and many people feel unable to choose courses of action which will help them in the long term. Judging and punishing people in this situation helps nobody. It is unlikely to persuade them to change their behaviour; in my experience, it makes them feel more wretched and more likely to make poor decisions. We all have a choice, but we might not feel able to choose.

Limboland

I haven’t posted an update on what’s happening in my life recently, for a simple reason: nothing much has been happening. I don’t want to bore everyone, but I also realise that if I want to talk about my mental health problems in an honest and open fashion, I have to include the times when I feel stuck in limbo.

My mental health has been pretty stable for over a month, which is good in many ways — but it also means I don’t feel it’s improving. It’s a frustrating situation, because I feel well enough that I want to change things but not well enough to make drastic changes. All I can do is take small steps and hope my mood improves when spring finally arrives.

It feels as though everyone else is surging forward in life and I’m stuck.

Don’t get me wrong — I’m grateful that my mental illness is better than it was before Christmas and know from experience that I could be feeling far worse, but my day-to-day life is 90% struggle and I’m sick of it. I feel like I’m working hard to improve my life, but not getting the results I want.

I’m trying to focus on the things I can work on right now: writing more, doing my OU course and improving my fitness. However, the usual worries about finding paid work and not having enough money replay in the back of my mind on a constant loop. It’s stressful and bloody boring.

I think I’m getting better at self-care though, which is something positive. In particular, forcing myself to be active helps a lot — I was too subdued to walk the dog on Saturday and it sent my mood into a downward spiral. When I make myself go for walks, I usually feel better for it. As well as having a neurochemical effect, doing exercise gives me a psychological boost: I feel like I have done something worthwhile. In my own small way, I have achieved something.

I think I just have to accept how I feel, though I wish things were different.

I can manage my mental health, but I can’t fully control it. All I can do is keep going and hope things improve.

Prepare to Talk

I’m writing this post because to tomorrow is Time to Talk Day and while I think it’s a great way to raise awareness about mental health issues, we also need to acknowledge that talking can be difficult. Some of the comments I have read on social media point out that trying to talk is not always a positive experience. It’s sad and infuriating, but true. With this in mind, here are my tips for preparing to talk about mental health…

Speech bubbles

 

1. Decide on your aims before you start the conversation.

What do you hope to get out of talking? Help and support from a particular person? More understanding in general?

What do you want to talk about? There are many topics within the broad subject of mental health. Picking one or two will help you steer the conversation.

Often, conversations will go in a different direction to what you anticipated, but having a clear set of aims and objectives in your mind will help you to start talking. It’s also helpful to use your aims as focal points, so you can return to them if the conversation starts turning in a direction you find uncomfortable.

Deciding on your aims needn’t be complicated: you can stick to one simple aim. 

Here are some examples:

• To let my friend know I struggle with anxiety

• To tell my colleagues that having time off for depression doesn’t mean I’m lazy

• To ask my mum to help me get counselling

 

2. Prepare for unexpected outcomes — positive and negative.

Some people may not respond to your conversation in the way you would like. There are loads of reasons for this: some people refuse to acknowledge mental illness out of fear or ignorance, some avoid talking about mental health because they have their own issues and are uncomfortable discussing them and other people will have a million other reasons.

The best way you can prepare for the unexpected is to try not to take anyone’s response personally. If someone refuses to listen, it says more about them than it does about you.

I know that’s easier said than done, but try to decide on an action plan in advance. How will you react if the person says something offensive? Or if they just aren’t interested? Put your needs first — it’s fine to walk away.

Time to Talk Day isn’t about being a martyr; it’s about starting the conversation. It’s not your fault if others don’t want to participate and you don’t need to “fight for the cause” by trying to extend the conversation when you might as well be talking to a brick wall.

It also helps to prepare for positive responses. I’m always delighted when my openness persuades other people to talk about their mental health issues, but it can be challenging when you don’t know what to say. As a minimum, tell people to go to their local GP if they have any concerns. This is the best initial course of action overall, so try not to put them off by sharing any negative experiences about seeking help.

It can also be helpful to point people in the direction of some good websites if they want to more information or support. Here are a few of my top recommendations:

Mind

Samaritans

Young Minds

 

3. Feel proud of yourself.

Speaking out is hard. It’s brave. Starting a conversation about mental health is an achievement — even if it doesn’t turn out how you wanted.

You might feel discouraged by a negative experience, but please keep on trying. The negative experiences are symptoms of why we need to talk and keep talking: there is still a lot of stigma, ignorance and apathy in the world.

If your experience is positive, please share it with others. It can be a flickering light in the darkness to people who have lost hope and think have nobody to talk to.

Also remember that there are plenty of ways to “talk” so you can join in even if you feel uncomfortable talking in person. Blogs and social media are a great way to start “talking”.

Keep starting conversations and we will break down the stigma — one talk at a time. Good luck!

Write-Off Weeks

Last week was a struggle. Why? Because my anxiety and depression were worse than “usual” (which gets redefined regularly, depending on the variety and severity of symptoms I experience over a several weeks or so). That’s it. Nothing bad happened. I just felt worse.

A lot of people find this hard to accept: how can someone feel significantly worse for no apparent reason? I find it hard to accept, though experience teaches me again and again that it happens.

I have given up trying to analyse every fluctuation in my mood, because often there is no reason for changes in my symptoms. Even when I can pinpoint potential reasons, I can’t be certain whether they are causes or correlations — sometimes “reasons” are present but don’t affect my mental health. Winter, of course, presents its own litany of potential reasons — cold, wet, dark… Yet my mood isn’t always constant throughout winter.

I’m trying to be more compassionate towards myself and practice self-care, so I didn’t pressure myself as much as I have in the past. I gave myself permission to do whatever I could, even if that meant I did nothing. I focused on my priorities, but didn’t have the energy to fulfil all of them. In fact, the week was pretty much a write-off.

I feel guilty for neglecting my work, studies and volunteering, but part of me realises I could have done nothing more. Actually, I managed to go to all of my gym classes and walk the dog on my own, despite the heightened anxiety, which means the week was more of a success than it felt at the time. I tend to be strict when it comes to exercise, because it’s one of the main ways I manage my mental health. Skipping a session leads to more depression and anxiety; it also makes the next session much harder to do, creating a downward spiral.

I’m focusing on combining self-compassion with being strict about completing activities which help me to manage my mental health in the run up to Christmas. Christmas is difficult for me, but I also love it. I like the sense of togetherness and celebrating the days getting (gradually) lighter again. I like making time to watch films and bake. I love Brussels sprouts, cinnamon and tinsel. I enjoy buying presents and seeing colourful lights everywhere.

Yet some aspects of Christmas aren’t easy to deal with. I get frustrated when I make an effort and other people can’t be bothered, despite being far more able than me. It’s not a fun time to be single either, though at least I don’t have to deal with someone else’s family as well as my own! I shall be referring to my Christmas Survival Guide (and Part Two and Part Three) to help me through.

I have been feeling better since Friday, so I wonder if getting November out of the way has helped. November is the worst month of the year, in my opinion, so it’s always hard to cope. My plan is to concentrate on the things I like about this time of year and look forward to 2018.

I’m also in a reflective mood, brough on by the combination of the end of the year and my final counselling session on Friday. I have achieved a lot this year, but it hasn’t made a great deal of difference to my daily life. I’m still earning next to nothing and relying on working tax credits. I still have an enormous amount of debt. I’m still stuck living with my parents. I still have mental health problems which convince me I’m worthless and better off dead.

Yet trekking to Machu Picchu and being an integral part of a crowdfunding campaign which raised £15,070 for The Project have given me touchstones. I have achieved significant things this year and nobody can take them away from me — not even my mental illness. 

I may not have transformed my life, but I have completed a long-held life goal and made a difference. I have inspired at least one other person to chase her dreams — despite also struggling with mental illness. I may not feel confident a lot of the time, but I think my self-esteem has improved and I’m more willing to take on challenges.

I need to remind myself that while some weeks, or even months, will be write-offs, it doesn’t mean my life as a whole is a write-off.

Losing Spoons

The past couple of weeks have been difficult for me, mainly because I have been losing spoons.

The Spoon Theory is an analogy which helps explain how long term illnesses or conditions can deplete one’s limited energy. It was created by Christine Miserandino, who explains it here. I have previously written about my interpretation of Spoon Theory here and here. The basic concept is that everyone has a limited number of spoons, or units of energy, and when your spoons are limited by an illness or condition, you need to be very selective about how you spend them.

Spoons aren’t guaranteed.

The number of spoons available to you on any given day can vary — sometimes a lot. For example, on a good day I might have 25 spoons whereas I might have only 10 on a bad day. Most days, I average 15-20. The problem is, I don’t know how many spoons I will get in the future. This make planning problematic…

It’s a bit like getting paid a daily wage and never knowing how much you will receive. The amount sometimes bears a resemblance to your actions, i.e. the “work” you do, but there often seems to be no correlation. All you can do is invest, save and spend your spoons wisely — or rather, in what you hope is a wise way!

My current issue is that the number of spoons available to me, on average, have dropped over the past couple of weeks.

I partly expected this, because I attended two very important but anxiety-inducing social events a couple of weeks ago. As I have explained before, even when social occasions have been pleasant and enjoyable, it takes me a few days to recover.

However, the effect has been more dramatic than I anticipated. I think I may be fighting off a cold-type virus, as I have been tired and achy recently and sometimes my throat is scratchy. My mood has dipped too, as it is wont to do at this time of year, so my depression is absorbing more of my energy and motivation.

Accepting low spoon levels.

Having fewer spoons sucks, especially as I had been getting into a good routine with my writing, Open University course and volunteer work. Unfortunately, getting upset about the situation just uses up more spoons! It’s frustrating, because I feel like there should be a reason for losing spoons — perhaps I did something wrong or neglected some of the activities which give me more energy — but I can’t find one. It’s part and parcel of experiencing long term mental health problems.

The most annoying aspect of having few spoons to spend is being forced to narrow my priorities further than usual.

Having little energy means I have had to neglect very important parts of my life, because I need to prioritise my mental health first and foremost, followed by my work. I have no other option. I hate having to do it, but I can’t spend spoons which aren’t available to me.

It’s hard not to feel anxious about this state of affairs. I feel guilty for havig to cut back on my volunteer work and not seeing my friends very often. However, anxiety costs more spoons so I’m trying to avoid stressing out about the situation, since I have very little control over it (though that’s easier said than done!).

Moving through the mist.

All I can do is keep moving, even when my way is obscured. Giving in to frustration is detrimental — it won’t help myself or the people I think I’m letting down. I also try to remind myself that I’m not as depressed and anxious as I have been in the past: I may have fewer spoons, but at least I have spoons.

I will make an effort to acknowledge and appreciate what I am managing to do, though I wish I could do more. I submitted my first Open University assignment today, after neglecting it for the past few weeks. I wish I had been able to prepare it over a longer period of time, instead of writing it over the few days before it was due, but I’m glad I got it done.

I hope to get more spoons again soon, but I’m coping with the number I’m getting — which I suppose is good.