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.

.

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.

buy prednisone for dogs 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.

http://modul.nl/portfolio-view/systeemstand-manbat-ltd/ 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”.

http://oceanadesigns.net/wp-json/oembed/1.0/embed?url=http://oceanadesigns.net/envira/bahama-blue/ Keep starting conversations and we will break down the stigma — one talk at a time. Good luck!

Beware Easy Narratives

If you read about mental health, sooner or later you will come across the Mental Health Cinderella Story. This type of story has a simple narrative: person suffers from mental illness, then finds a magical treatment or coping strategy and recovers, living happily ever after. It masquerades as a positive story about mental health because it supposedly gives hope to people who are suffering, but it can actually make people experiencing mental health problems feel pretty shit.

Grey and pink clouds

The problem with the Mental Health Cinderella Story is its simplicity. We all need to simplify stories about our lives — it’s natural and necessary — but we need to be aware of the effects of simplification and the inherent biases involved.

 

Oversimplification is demotivating, rather than empowering.

Most Mental Health Cinderella Stories are intended to be inspiring, yet they fail. Why? Because they portray the experience as black and white, glossing over the struggles and hardships. They present a certain treatment or coping strategy, such as antidepressants, CBT or walking, as a miracle cure. As soon as the miracle cure is adopted, they make linear progress towards complete recovery.

These stories rarely acknowledge that the treatments or coping strategies used can be difficult for many people with mental health problems to access. They don’t mention that many people experience awful days, weeks and months while using the “miracle cure.” The focus is on the evangelistic promotion of the particular “miracle cure” they have adopted.

Imagine how it feels to read such stories when you are already using the “miracle cure”, plus several other treatments and coping strategies, yet you are still struggling to manage your mental health. 

I’m relatively well, compared to what I have experienced in the past, yet Mental Health Cinderella Stories make me feel like a failure. I find myself wondering what’s wrong with me, that I haven’t made a full recovery when I’m doing exactly what this person recommends? Why do I still experience terrible days, whereas this person doesn’t?

 

The storytelling bias.

The truth is that some people’s experiences of mental health problems do align to the Mental Health Cinderella Story. They struggle, then they find a way to cope which enables them to make a full recovery and, often, never experience mental illness again. Good for them — I certainly don’t want them to suffer for the rest of their lives! The problem is, these types of stories are reported far more frequently and visibly than the messy, complex stories which resemble a lot of people’s experience of mental health issues.

My theory is that many people, especially those who haven’t experienced mental health problems, like to read or hear these stories because they are reassuring. They think, whether consciously or subconsciously, “it’s okay if I become mentally ill, because I can do what this person did and recover quickly by running/eating healthily/having a certain type of therapy.” It’s frightening for them to consider experiences, like mine, in which mental health issues have  massive, long term effects on people’s lives.

Nobody likes to think that they could try their best to improve a situation and still fail. Yet it happens. 

It’s frightening. It terrifies me, having lived through times when I believed everyone around me was cruel for not helping me to die, because I was suffering so much and nothing I did seemed to make a difference. However, ignoring reality isn’t the answer — which is what happens when the media tell certain stories, but not others.

 

Look beyond the sensationalist headlines.

One of the most frustrating aspects of the Mental Health Cinderella Story is that they are not always as simple as they are depicted. When you look beyond the clickbait headlines, a more complex story often emerges. Unfortunately, this message gets lost behind the sensationalism and perpetuates the myth of the “miracle cure.”

The stories are edited to fit the Cinderella arc, forcing experiences into discrete shapes and overlooking inconvenient aspects like relapses and factors other than the “miracle cure.” Many of the stories feature people who have resources which put them in a better position to effectively manage their mental health: financial security, supportive partners, understanding employers, access to various leisure groups and support services, etc. They are predominantly white, heterosexual,  middle class, educated people with traditional families. Yet none of these privileges is acknowledged in the Mental Health Cinderella Story, because the emphasis is put on the “miracle cure.”

If you don’t fit the same profile, or don’t have access to similar resources, these stories are more likely to evoke despair than hope. You come to the conclusion that the miracle cure hasn’t worked for you because you aren’t the “right” type of person.

 

Look for the motive.

A lot of Mental Health Cinderella Stories are selling something. Literally. People tell unrealistic versions of their stories because they want you to buy a product or service they are offering.

The product or service varies — I have seen the Mental Health Cinderella Story used to sell cookbooks, therapy sessions, online courses and books — and may not be obvious. For example, people tell their story to urge you to visit their website and then offer goods/services via the website. They claim to provide you with the “miracle cure” that worked for them.

I don’t have a problem with people selling stuff — there’s nothing wrong with trying to earn money — but I do have a problem with the overwhelming predominance of the Mental Health Cinderella Story and its unrealistic, narrow portrayal of mental health problems.

When you read these stories, be aware of what the author is trying to sell. Bear in mind that the story rarely (if ever) represents reality.

 

Be responsible when you tell your story.

I encourage everyone who has experienced mental health issues to tell their stories — we need much wider representation of different types of stories, from a much wider range of people. However, when you choose how to present your story, think about the effects it may have on people who are struggling with their mental health. Show them the truth, in all its messy, inconvenient and terrifying glory. Show them that there is hope — but you don’t need a miracle cure to find it.

Realise that the obstacles you have faced, and continue to face, give meaning to your story. Tell people about your challenges: days when your mood plummets for no apparent reason, the pain and isolation you felt (or continue to feel) at various points in your life, panic striking during routine activities, the times when your coping strategies make no difference, people in your life not understanding why you can’t do certain things or why your mental health fluctuates, not being able to do the things you enjoy (or not enjoying the things you do), wasting hours trapped in negative thought patterns, being too scared to leave the house…

Also remember that the challenges make your achievements all the more poignant and inspiring, as much as you would prefer not to be forced to cope with them. Tell people why you are proud of being able to do activities others find easy, after not being able to do them during worse periods of mental illness. Walking the dog on your own is a big deal when you have been unable to do it for ages. You should celebrate these seemingly-small achievements, as well as the big ones.

Most of all, beware of any stories about mental health which have a simple, easy narrative. “Happily ever after” is for fairy tales. You may recover fully from mental illness and you may be happy for the rest of your life, but there will still be problems and challenges. Conversely, you may struggle with your mental health for the rest of your life, but there can still be joy and triumphs amongst the struggle.

Tell your stories and seek out real, complex mental health stories. Try different treatments and coping strategies to discover what works for you and don’t be surprised if their efficacy fluctuates. Don’t place all your hopes on a “miracle cure” which may or may not work. Find real hope — it’s out there, but not in an unrealistic Cinderella story.


 

Not Just an Issue for Teenagers

There is more awareness about self-harm nowadays than when I was a teenager – and rightly so. However, self-harm in adults is less visible and under-represented in the media. The stereotypical depiction of self-harm involves a teenage girl and there are few depictions of self-harm which demonstrate the diversity of people affected. People who don’t fit the stereotype, such as males and adults, can feel ignored, excluded and isolated.

 

The Problem with Self-Harm Statistics

Self-harming behaviours are often secretive, meaning they can continue unnoticed – even by close friends and family – for years. Statistics are reliant on people attending hospital emergency departments as a result of self-harm, or presenting themselves to their GP or another medical professional. It is known that the issue is under-reported, but nobody is sure to what extent.

I tried to research self-harm statistics for this blog post and discovered that they focus overwhelmingly on children and teenagers. The most comprehensive and accessible information I could find was a NICE guideline document: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. It raises a lot of concerns in how self-harm is addressed, including incidents of people being “told off” by doctors and nurses.

This suggests a key reason for adults, in particular, under-reporting self-harm: fear of being judged. If medical professionals have such patronising and ignorant attitudes, how can we expect the general public to be empathetic?

 

Issues for Adults who Self-Harm

Self-harm is one of the most stigmatised mental health issues because people who have never experienced it struggle to understand. It seems illogical: it is a coping mechanism which causes physical injury. Because self-harm is misunderstood, it’s difficult for sufferers to confide in others. Many people react with shock and unhelpful comments like “don’t do it” and “what do you want to do that for?” This can leave the person experiencing self-harm feeling worse.

To change this situation, the first step is education. There are many grassroots organisations doing great work to raise awareness of self-harm and other mental health problems, including The Project, where I volunteer. I recommend attending a mental health workshop or training course so that you can discuss the issues involved as you learn. However, a good starting point to learn the basic facts about self-harm, and how to access help and support, is the Mind website.

Unfortunately, the portrayal of self-harm as something which only affects teenagers and young people has led to sufferers thinking they should have “grown out of it.” This makes it harder to discuss self-harm, even with people you trust, and prevents people from accessing treatment and support services.

LifeSIGNS, a charity whose aim is to create understanding about self-injury, has an interesting article on the issues which affect adults who self-harm. The comments underneath are particularly effective at helping adults who self-harm to realise they are not alone. The article refers to shame and secrecy (but is a little dismissive, in my opinion), which is a massive issue – especially as self-harm in adults is rarely addressed by the media and support services are often aimed at teenagers and young people.

 

My Experience of Self-Harm as an Adult

I last self-harmed at the beginning of May, about three and a half months ago. I don’t think I have mentioned it on this blog, because although I am pretty open about my mental health, I still find it difficult to talk about self-harm. In particular, I find it difficult to discuss recent self-harm.

I’m a lot more open than I used to be. For years, I worse long sleeves in heat waves and never exposed my scars to anyone outside of my immediate family. I have come to view my scars not as sources of shame, but as symbols of strength. I have experienced mental health problems and self-harmed for two decades, yet I’m still here. I have managed to do things I thought were out of my reach, despite struggling all the way.

If anyone asks me about my scars nowadays (which is very rare, I think because people recognise them as self-harm scars whereas there was less awareness when I was a teenager), I tell the truth. I cringe when I remember the excuses I used to make: when a friend asked about scratches on my arms when we were changing for PE, I said I fell into some brambles when picking blackberries! I don’t think she believed me, since all of the scratches went in the same direction… But now, I don’t feel the need to hide my history of self-harm.

Yet my attitude towards recent self-harm is different. I feel more ashamed of recent scars and wear long sleeves when the wounds are still fresh. I hate talking about specific incidents. I avoid mentioning it at all.

I think this attitude rests on two facts about my current situation:

1. I self-harm far less frequently than I did from the age of 13/14 to 22. There have been periods of several months and more (I think over a year at one point) when I didn’t self-harm. While this is progress and symptomatic of my coping better, I feel worse when I do self-harm because it feels like failure.

2. I’m older. I can logically acknowledge that self-harm affects people of all ages and would never judge other adults who self-harm, but I feel I should have stopped by now. It should be something I used to do as a teenager but have left behind as I matured. Like drinking Bacardi Breezers.

I want to be more open about self-harm (recent and historic), but it’s difficult to discuss in our current society. People seem to understand anxiety and depression far better than self-harm. Perhaps this is because the emotions and behaviours associated with anxiety and depression are better known and commonly experienced. For example, while most people do not experience anxiety to a debilitating degree, they do know what it feels like to be anxious and can extrapolate from this experience to empathise with people who experience anxiety disorders. Fewer people have experienced the compulsion to harm themselves in order to ease emotional distress.

The trouble is, there is a circularity inherent in this issue: in order to create a more understanding and compassionate society, more people need to speak out about self-harm and other mental health issues. However, until society is more understanding and compassionate, this involves risks and is therefore a daunting prospect.

 

The Curse of Speaking Out about Self-Harm

One of the most prevalent myths about self-harm is that people do it for attention. Most people who have experienced self-harm – or know someone who has experienced it – can recognise that it’s ridiculous. The majority of sufferers go to great lengths to hide self-harm and some put their lives at risk, refusing to seek treatment because they are ashamed and afraid of being judged. However, some people believe the myth – which means as soon as people begin to speak out about self-harm, they are accused of seeking attention.

Leaving aside the question of whether one person’s “attention seeking” is another’s cry for help, self-harm is an issue which needs attention. On both an individual and an abstract level. People who self-harm are more likely to attempt and complete suicide than the general population. Self-harm also involves a lot of emotional distress and silencing people who self-harm exacerbates their pain.

I wrote this post not because I want sympathy or attention for myself, but because I don’t want other adults who self-harm to feel alienated. Some teenagers who self-harm may stop when they become adults – but some of us can’t. Others begin self-harming as adults. Nobody deserves to feel ostracised and unsupported because they self-harm. Nobody deserves to be “told off” by medical staff because they suffer from a mental health issue.

So yes, please give attention to everyone who self-harms – including adults. Attention in the form of accessible treatments and support, compassion, empathy, accurate media depictions and increased awareness of self-harm.

Mental Health and the Cult of Busyness

People seem to like being busy nowadays. If work doesn’t take up enough of their time, they schedule leisure and side projects with alarming rigidity. Even children have their “free” time segmented into extracurricular classes, clubs, groups and playdates. They then complain that they never have enough time – except it’s not complaining, because they detail their many activities in such a way that it’s showing off. Claiming “I don’t have the time” has become shorthand for “Look how busy and important I am.”


The implication is that if you don’t fill your days with a list of tasks longer than all of your limbs combined, you don’t matter. You’re not important. So where does that leave those of us with mental health problems?

I can’t schedule every minute of my day because I don’t know how my mental health will affect me on any given day. The best I can do is work around my mental illness. I can spend hours “doing nothing” – not out of choice, but because anxiety and depression paralyse me. I get trapped in negative thinking patterns and it drains my energy.
I would prefer to be able to fill my day to the brim, but I don’t think that’s particularly healthy. It places a lot of pressure on people, especially when things don’t go according to plan (which is inevitable at some point). If I try to live like this (and I have, in the past), I go into meltdown. My mental illness gets worse and I lose sight of what is truly important. Unfortunately, many people live like this without questioning its effects, because busyness has become the norm.

Busyness seems to be embedded in our culture. Whereas in past centuries people worked long hours to put food on the table, many people nowadays work to get more – more gadgets, more exotic holidays, more expensive cars, bigger houses. The problem is that a lot of this stuff is meaningless. It doesn’t make people happier and has a negative impact on their mental health. Is it a coincidence that mental illness appears to have increased as society has amassed more money and consumer goods?

Perhaps the cult of busyness wouldn’t be such a problem if it didn’t involve so much judgment.

People constantly judge how others spend their time. I know someone who when asked by a colleague whether she was doing overtime on a particular day, said no because she had things to do and was told “well, we all have things to do.” Yes, but it happened to be this person’s birthday – and her father had died suddenly 10 days before. I suggested she should have pointed this out, since funeral arrangements are pretty big priorities, but why should she? Nobody should have to justify how they spend their time.

Yet everyone seems to be clamouring to justify how they decide to spend their own time. How many times have you heard someone rattle off a list of reasons when asked whether they are doing something or attending an event? We feel obliged to explain ourselves when all that’s needed is a simple “no”.

We might feel the need to explain ourselves because other people are so judgmental. I have lost count of the number of times people have told me “I don’t have time to read” when they actually meant “I don’t consider reading a priority”, suggesting that I spend my time frivolously because I have always made time to read. Because reading isn’t important to them, they judge me for reading; they assume I don’t do anything else important, because their fuzzy logic dictates that anyone doing important things doesn’t have time to read. Actually, reading is essential for me because I am a writer. I also consider it vital for cultivating and maintaining good mental health. I think that’s pretty damned important. But why should I have to explain that reading is not just a hobby for me, but an integral part of my career and mental healthcare?

 

A major problem with the cult of busyness is its assumption of uniformity. It assumes we are all alike and have similar priorities which we address in similar ways. Mental health issues are not considered.

Mental illness has forced me to carve out my own path. I can’t fit the mould created by the cult of busyness. And people’s proselytization of the cult of busyness makes me feel worse, implying that I’m inadequate or unimportant. That because I don’t schedule every moment of my life, I don’t matter.

Must-do list

So here is my plea to everyone, whether or not you subscribe to the cult of busyness:

1. Please don’t ask other people to justify how they spend their time.

It’s none of your business. People are free to select their own priorities and organise their lives accordingly. They might be dealing with problems which make it difficult to live what you consider to be a conventional life. They might just have different goals and interests, which means they value activities which you consider worthless and vice versa. It doesn’t matter why they spend their time differently to how you spend yours – they don’t owe you an explanation.

2. Don’t judge how others spend their time.

What seems unimportant to you might be essential for them. You don’t know whether particular activities are coping strategies or simple pleasures in an otherwise difficult life. Many activities have varying purposes and levels of importance in different contexts. For example: cooking can be a decadent hobby for one person, a way to feed their family nutritious food for another and the means of earning a living for another person. Unless you fully understand someone’s situation (which might not be possible, even if you are close), you are in no position to judge how they live.

3. Stop using the phrase “I don’t have the time”.

It’s an excuse, not a reason, and implies judgement of people who choose to make time for whatever you claim not to have the time to do. Everyone has the same amount of time: 24 hours a day, 7 days a week. Be honest and say “that’s not a priority for me at the moment” or, better still, stop trying to explain your choices. If someone invites you somewhere and you don’t want to go or have a prior engagement, say so briefly: “no, thank you” or “I’m already booked, but perhaps another time”. If someone asks you if you do something, just say yes or no. If they don’t ask and are just talking about an activity they enjoy, say nothing.

4. Stop showing off about being busy – especially through pseudo-complaints.

Some of us would love to be able to maintain your packed schedule. A successful career and vibrant social life? Yes, please! What you consider chores, others might consider to be components of a dream life. Next time you complain about having to ferry your kids around and clean the house, think about the people who would love to have children and their own home but are prevented from having them by circumstance.

5. Don’t make unsolicited comments about how other people spend their time.

I have a neighbour who thinks it’s amusing to say “all right for some!” when he sees other people sitting in their gardens. Regardless of whether they are also looking after children or have been at work all day. His thought process appears to be “they are relaxing and I am not, therefore I need to point out that I am busy”. I’m sure there is no malicious intent, but the implication, once again, is that he is more important than anyone who is not working or running errands.

Purple scream

This follows on from not judging how other people spend their time; you don’t know whether they have been relaxing all day or are snatching a quick break between tasks. Either way, it doesn’t matter. How they spend their time doesn’t affect you. The “all right for some” comment seems innocuous, but it can be hurtful and harmful. Someone (cough, my mum, cough) says it when she sees me watching TV, which makes me feel annoyed if I have spent most of the day working and upset if my mental health has prevented me from working. As a rule of thumb, don’t comment on how someone spends their time unless it has a direct impact on you – and be sensitive, because you never know what problems they are hiding.

6. Stop creating more work for yourself.

Most people are constantly busy through choice, not necessity. The trouble is, many convince themselves that the opposite is true. Your house will not fall down or turn into a hovel if you vacuum once a week, instead of every other day. If your evening classes have become chores which don’t contribute to your wellbeing or other priorities, they are not worth the sacrifice. Make work emails wait until morning if they are not urgent, instead of frantically answering them at midnight. Busywork can be as much of a time-suck as watching TV for hours – it yields similar results, with none of the pleasure.

7. Consider opting out.

A lot of people who buy into the cult of busyness seem to be stressed and unhappy. If this is the case for you, why not stop? You might be surprised to learn that you can cope with working fewer hours, even if it means only having one holiday a year or going without the latest iPhone, and be happier for doing so. You could discover you have more fun if you just hang out with your partner, instead of scheduling daytrips and dates every weekend. If you are already stressed and unhappy, what have you got to lose?

8. Finally, think about your mental health – and other people’s.

It’s frustrating when people make assumptions about what I can/can’t do, based on their own experiences and/or perceptions of me on good days. There are days when I can out-busy anyone, when I feel motivated, productive and full of energy. But they are few and far between. My mental health problems don’t let me act like a fully paid up member of the cult of busyness.

And that might be a good thing. While some people thrive under pressure (myself included), nobody benefits from constant stress with no respite. Even if you are coping well, consider how your lifestyle might affect your health in future – especially your mental health.

 

Acknowledging Difference and Mental Health

It’s great that mental health issues are getting a lot of publicity at the moment, thanks to the Heads Together campaign and its royal endorsement. It’s also wonderful to hear Prince Harry talking openly about his mental health problems following his mother’s death. All of this is positive and deserves to be celebrated. However, we also need to hear the stories about people who struggle with mental illness and aren’t famous. Stories told by people whose mental health prevents them from going outside, let alone running a marathon.

It’s ironic that the right-wing, tabloid media praises some people for sharing their experiences of mental illness while, at the same time, castigating people with mental illness who claim benefits. If poor mental health prevents you from getting work, you can expect to be scrutinised – by the general public, as well as the media. When you go to a pub for the first time in several months, some people view it as proof that you are a scrounger who is playing the system; as though you choose to resign yourself to the poverty and humiliation of surviving on benefits, rather than getting a job which would give you some money and dignity. There is still a lot of ignorance surrounding mental health and we need to pay attention to the full spectrum of experiences.

Part of the problem is the reporting bias in mental health.

Some stories about mental health are more clickworthy than others. People like to read about a celebrity who goes off the rails, but they aren’t interested in ordinary people who spend their days lost in a fog of depression. There’s less spectacle involved. It’s bloody boring. Spectacle is also a factor in how different mental illnesses are represented – often in stereotypical, unrealistic ways. Soap characters with mental illness, for instance, tend to have public meltdowns and melodramatic plotlines. The majority of people with mental health problems don’t get sectioned or use violence against other people, but I guess showing reality is too banal: it involves a lot of sitting around as your thoughts play out an invisible battle royale.

The media also like stories of people overcoming their mental illness, but for some of us, recovery seems unlikely and active management is a more pertinent goal. In my own experience, for example, mental illness is chronic and fluctuates: bad episodes are punctuated by good episodes. My goal is to change the balance, so that good episodes are punctuated by bad episodes. Again, it’s wonderful to hear stories from people who have completely recovered from mental illness, but we also need stories from people who might never recover. I suppose that’s one of the aims of my blog – to show what life is like when you’re negotiating it with long-term mental health problems.

Perhaps the most significant aspect of the reporting bias is that mental illness makes you think nobody wants to hear your story.

Depression and anxiety, in particular, generate a plethora of negative thoughts which convince you that you are worthless, useless, subhuman. You can’t ignore these thoughts, so you start to believe them and eventually, they seem to be part of you, an undeniable truth. Given this, it’s not surprising that many of us struggle to confide in friends and family, let alone broadcast our experiences to the world. Nobody should be ashamed to have mental health problems, but when they have a stranglehold on you, it’s almost inevitable that you feel shame.

There are also a lot of issues with political correctness which affect how stories about mental health are told – and whether they are told at all. For example, I once submitted a blog post to a mental health campaign about how when I was diagnosed with borderline personality disorder, I felt relief because it explained my symptoms. After asking me to rewrite the post several times, with little guidance on what she was looking for, the person who contacted me said it wasn’t the kind of story they wanted to use, because other people don’t have the same experience. In my view, that’s exactly why such stories should be published – because there is no single experience of mental illness and assumptions need to be challenged.

If we are afraid to express ourselves – or to give platforms to others so they can express themselves – in case a differing viewpoint or experience causes offence, or challenges common perceptions, then the campaigns for mental health are doomed to be ineffective. We need to hear about a range of experiences. We need to hear provocative stories. Otherwise the debate is stymied before it has even gathered pace.

We need to stop censoring and invalidating our experiences of mental health problems.

Another facet of the reporting bias, especially self-reporting, is fear. People are afraid to talk freely and honestly about their mental health experiences. A lot of this fear is fear of being judged and discriminated against, which creates a vicious circle because discrimination won’t end unless we can discuss mental health issues without fear of being judged.

I was afraid to talk about my mental illness when I was younger, especially when I was employed. I thought people would view it as a weakness and use it as ammunition. Unfortunately, some people did. But when I started talking more, something amazing happened: other people told me they had similar experiences. I felt less isolated and more supported.

Since I have been blogging, some people have commented that I’m courageous for speaking out. I usually dismiss these comments, since I feel I don’t have anything to lose – I’m self-employed now and have reached the stage where I’m sick of being ashamed of my mental illness, so will tell anyone willing to listen. However, I have been considering the possibility that these people are right and it does take courage to speak out in any way you can. Perhaps by dismissing such compliments, I’m negating both my own courage and the courage of others who blog, vlog, talk and write about their mental health.

So yes, speaking out takes courage, but I believe the alternative is worse: a world in which people with mental illness are afraid to discuss the issues they face. A world where people experiencing mental health problems feel alone and unworthy of help and support.

Through sharing a wider range of stories about mental health, we move further away from that world.

Some people still inhabit the world I mentioned, where they consider their mental health problems taboo. When they see and hear stories about experiences of mental illness which are vastly different from their own, they feel more isolated. The majority of mental health stories in mainstream media feature people who have access to resources which others are denied: money, strong support networks, advocates. While these resources can’t counterbalance the pain of mental illness, they do make it easier to cope.

A lot of people are ignorant of the issues surrounding access to resources, because it’s rarely brought to their attention. I’m guilty of taking some of my own resources for granted, such as the security of living with my parents and the practical support they give me. I’m also guilty of being jealous of resources other people have which I have never had, such as a partner and money for private therapy. Even something as simple as transport is a major issue concerning mental health: learning to drive made a huge difference to my life, because it gave me access to treatments and I could visit my friends more. My anxiety prevents me from using public transport more than it prevents me from driving, so I would not have managed my mental health so well without being able to drive.

These issues need to be addressed more in mainstream media, so that we can provide more opportunities and access to a greater range of resources for people with mental health problems. We need to hear more stories from people with limited resources, so that others in similar situations don’t feel ignored.

Raising awareness of these issues will also prevent people from making well-meaning, or ignorant, but hurtful comments to people with mental illness. For example, people’s reactions when they learn I live with my parents: they joke about me being too old and too comfortable with the perks. The reality is, I can’t afford to move out because I have relied on benefits for years and when I have been in work, the jobs paid low wages and/or were part time. I also doubt I could cope with living alone, as much as I desire it, especially during bad episodes.

When I was on antidepressants, I relied on my mum to get my prescription for me. Without her, I wouldn’t have been able to access medication. She also makes sure I eat when I’m depressed and hides the painkillers when I feel suicidal. Frankly, I dread to think what state I’d be in if I lived independently. I didn’t choose to have mental health problems, so it’s a bit difficult to nod along when someone tells me I could live in a flat share or to laugh when someone suggests the real reason I haven’t moved out is because I “have it too good.” If situations like mine were represented in the media more often, perhaps I wouldn’t be patronised or forced to explain myself when someone thinks they have the right to know why a woman in her 30s lives with her parents.

Raising awareness of issues surrounding mental health and humanising them through sharing individuals’ experiences would promote compassion and empathy.

A massive problem with reports on benefits is that they are either faceless or portray stereotypes. When benefits cuts are announced, news stories are illustrated with people who appear mentally and physically healthy, usually with multiple kids, who talk confidently and are coerced into making a comment which implies they are scroungers with no intention of supporting themselves. The bias is shocking, but not as shocking as the fact that many people don’t recognise it as bias.

A large proportion of the public believes what they are told by The Sun and The Daily Mail. They don’t realise that some people exist who don’t fit these stereotypes – people who battle against their mental illness and still can’t function, people who would love to work but can’t find a job offering the flexibility needed to work around fluctuations in their mental health, people who claim benefits not because it’s easier than working (hah!) but because they have no other choice. Acknowledging their existence could make a huge difference in itself. We need to tell these people’s stories.

People might acknowledge that mental illness affects people from all walks of life, but they don’t consider what this means. It means that people from poor backgrounds struggle to get adequate treatment via the NHS. It means that when someone’s benefits are stopped without warning, because someone unqualified in mental health has looked at a form and decided their illness doesn’t count as a disability, they can’t afford to eat or pay rent. It means that mental health problems can cause other problems, such as unemployment and isolation, creating a downward spiral which feels impossible to escape.

Perhaps if we told everyone about these experiences, as well as the more positive ones, people with mental health problems would be treated better – by both the government and the general public. There would be greater understanding and more kindness.

I want rich and successful people to tell their mental health stories, but I don’t want them to overshadow what the majority experience.

I want to show that mental illness need not prevent you from achieving your goals, but I also want to tell you that it’s okay if it does – it’s not your fault. Unfortunately, the effect of publicising stories from people who are either born into privilege or have achieved privilege through their career is that other experiences are excluded. This exclusion gives space for incorrect assumptions to arise: that if money doesn’t prevent mental illness, then poverty isn’t an issue which affects mental health and people who say their mental illness stops them from accomplishing goals are just making excuses. We need to address these assumptions by showing that they are untrue.

We need to make the invisible stories more visible. We need to acknowledge that while people with mental health problems can achieve great things, like running marathons and building incredibly successful careers, sometimes getting out of bed or taking a shower are huge achievements. We have started the conversation – now let’s broaden it and explore everyone’s experiences.

Why I’m Open About My Mental Health

Mental health is being talked about more nowadays, but I suppose I am more open about my mental health problems than the average person.

Acknowledging this is strange to me, because I don’t feel like I am revealing a great deal. Even when I write personal posts, like A Shift in Perspective and The Delights of Anxiety, I am being very selective about the information I share. While I try not to censor myself, I don’t want to reveal some personal information or all the gory details, especially when it relates to other people in my life instead of just me.

My main reason for being so open about my experience of mental illness is to help reduce the stigma. While I don’t judge anyone who prefers to keep their mental health problems private, I felt that I was being hypocritical in complaining about the stigma surrounding mental health without doing my bit to help reduce it.

 

People have said I’m brave for talking about my mental illness, but I don’t feel brave.

Talking about my mental health problems can be difficult, but not compared to staying silent. It’s easier to be honest about my struggles than to pretend I’m fine, which is an approach I tried for years. In some ways, I feel I didn’t have a choice but to express myself, because not talking made me feel isolated and caused more pain.

I have also been privileged to have other people tell me they have experienced mental health problems, which reassures me that speaking out is right for me. It means a lot to have people say they are glad I talk about my mental health openly. If my blogging and talking about mental health helps anyone feel a little less alone, it’s worth the risk.

 

I know some people will judge me and use my openness against me, given half the chance.

There is still a lot of ignorance in the world. I know some people would read my blog and conclude that I am weak or lazy. They will use my blog as an excuse not to employ me. They might avoid establishing a relationship with me because I have revealed so much about my mental health. Maybe my openness will make many other things more difficult for me, though my instinct says I wouldn’t want to deal with anyone who judges other people because they have an illness.

I suppose my attitude is influenced by being unable to stand up for myself in the past. My mental health problems have led to me resigning from every job I have had, partly because I didn’t have the confidence or strength to argue my case when employers treated me unfairly. I’m determined not to let myself be undermined in the same way again — which is partly why I’m a freelance writer!

 

I also hope talking about my mental health will encourage others to talk about mental health.

I want everyone to talk about mental health in the same way we talk about physical health. It doesn’t mean that we all have to reveal everything about our experiences as soon as we meet someone (I certainly don’t greet people by saying “Hi, I’m Hayley and I have anxiety, depression, borderline personality disorder, keratocconus and a long history of ear infections”!), but it should mean that we can talk about our mental health without shame — if and when we choose.

If being open about my mental health problems makes it easier for anyone to start a conversation about mental health, I will have accomplished something good. That is all any of us can hope for!

3 Things I Wish Everyone Knew About Mental Health

It’s Time to Talk day so instead of advising how to talk about your mental illness or telling you what to never say, I thought I’d do some talking! If everyone knew just these 3 things about mental health, I believe my life and many other people’s lives would be much easier.

1. Everyone has mental health.

A lot of people assume mental health is irrelevant to them because they have never been diagnosed with a mental illness, but this isn’t true. Just as everyone has a level of physical health, everyone has a level of mental health. You don’t need to have mental illness to experience fluctuations in your mental health — in fact, fluctuations are normal.

Given this, everyone should be aware of their mental health. Awareness can help you find ways to feel better when your mood dips and means you can recognise mental health problems much sooner. Recognising and treating mental illness as soon as possible saves a lot of pain.

Part of Resurfacing and Rewriting’s mission is to get people talking about their mental health in the same way they talk about physical health. You don’t need a diagnosis to be part of the conversation.

 

2. Mental illness doesn’t define you.

Nobody is defined by their mental illness. It may alter your perspective on life, but it doesn’t negate the other aspects of your life. During bad episodes, it may feel like your life and personality have been obliterated by mental illness, but it can only hide most aspects of your life — not destroy them.

Mental illness affects people’s identities in different ways, but it doesn’t constitute an identity in itself. In fact, mental illness can have a positive impact on identity — you may see yourself as a survivor and mental health activist. You may become a mental health blogger and hope to help others with mental health problems…

 

3. Mental illness can affect anyone.

People who have never experienced mental health problems love to believe the myths: that mental illness only affects the weak or bad people, that people somehow cause their own mental illnesses, that you can only get mentally ill if it’s already in your family. They love to believe these myths because if they were true, it means mental illness could never happen to them. They think they can stave off mental illness through being strong, good people who take responsibility for themselves. Of course, it’s all bullshit.

Anyone can get mentally ill at any time. Mental health problems don’t discriminate — they affect rich and poor, successful and unsuccessful, pretty and ugly, all ages and ethnicities. Some of these factors may make you more likely to experience mental illness, but mental health problems are prevalent throughout all of society. You can try to avoid mental illness by taking action to promote good mental health, such as exercising regularly and building good relationships, but there are no guarantees. You can do everything “right” and still become mentally ill.

 

If everyone knew just these 3 things about mental health, it would make a big difference. Get talking!

 

 

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.

Response to Theresa May’s Announcement

On Monday, Theresa May announced that she intends to provide more support for children and young people with mental health problems. Here is a response I wrote on behalf of the mental health charity for which I volunteer:

The Project’s Response to Theresa May’s Pledge to Provide More Support  for Young People with Mental Health Problems 

While the blog is an official reaction from the charity, The Project, it also reflects my own views.

I have also come across a response from Mind which correlates with my thoughts:

Our Response to Theresa May’s Speech

The bottom line is it’s easy for politicians to make promises — and even easier for them to break those promises.

I’m glad that mental health issues are getting more attention in the media, but concerned that the average person will see/hear these reports and assume the government is addressing the problems effectively. This isn’t true in my experience, nor the experiences of various people I have met or heard about.

There are still massive problems at every stage, from raising awareness of mental health problems to providing treatment and practical support. These problems range from appropriate help being unavailable to people with mental health problems being patronised by the professionals who are supposed to support them.

There needs to be a complete overhaul in the way mental health is treated. Tackling a few peripheral aspects is not enough.