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.

.

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.

follow link 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.

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.

source url 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://oceanadesigns.net/sitemap-pt-page-2015-02.xml 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!

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.

Don’t Label Me by Calling My Diagnosis a Label

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

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

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

 

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

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

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

 

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

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

 

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

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

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

 

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

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

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

 

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

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

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

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

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

 

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

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

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

 

 

 

Flinging Away The Crutch

I recently made a big decision: to stop taking antidepressants. I have been on medication for most of the past 14 years — continuously for the past 11 — and they have helped me a lot. They have been a vital tool in helping me change from someone so controlled by her anxiety and depression that she rarely left the house to someone who actually has a life. I just don’t feel that I need to take them anymore.

Deciding to take or not to take antidepressants is a a personal choice.

I have read a lot of people’s opinions on antidepressants, ranging from those who think they are evil and that the side effects are worse than the illness they treat, to those who advocate taking as large a dose as possible for as long as possible. In my experience, neither of these extremes are true or helpful. Antidepressants don’t work for everyone and even when they do, it can take a lot of experimentation to find the correct type and dosage for you.

I decided to take antidepressants in the first place because my doctor thought they would help me and I was desperate to grasp at anything which might make my life more bearable. Too many people judge others’ decisions to start or continue taking antidepressants; whereas nobody judges people for relying on medication to treat physical illness, even when that illness could theoretically be controlled through other means, a lot of people feel the need to voice their (often misinformed) opinions on antidepressants. Perhaps it would have been “better” for me to have used other methods of managing my mental health, but these simply weren’t available to me when I was at my lowest points. Medication was available and I’m very grateful.

I should stress that I am in regular contact with my doctor and reduced my antidepressant dosage according to his advice before stopping completely. This was important to prevent withdrawal symptoms, but it also enabled me to gauge whether my symptoms worsened as the dose decreased. They did not, so I decided that coming off medication was the right choice for me.

One of the key reasons that I am able to cope nowadays is because antidepressants helped me access and implement other ways of managing my mental health. When my mental illness was at its worst, I simply couldn’t do things like taking regular exercise and using CBT techniques to challenge my negative beliefs. Antidepressants were the crutch which allowed me to take steps forward.

It’s scary, but I have contingency plans — including going back on antidepressants if needed.

I will never be anti-medication, as much as I advocate using other therapies and activities to manage mental health, and I will take antidepressants again if required. I know that I have to monitor my mental health so that I can observe and address any changes — I still have mental health problems and they will never magically disappear. I hope to manage my mental health well enough that I can be considered “recovered” in the future, but I’m taking things one step at a time.

I know that my progress won’t be linear. Everyone has good days and bad days in terms of mood and mental health, regardless of whether they have ever been mentally ill, and recovery from physical illnesses and injuries os rarely straightforward. I think it’s important for me to keep this in mind. While I’m confident in my decision, the uncertainty still terrifies me. I don’t know what will happen — whether there will be a dramatic deterioration or improvement in my mental health or, as I suspect is more likely, whether things will change gradually.

So being congratulated for coming off medication is tricky.

For one thing, I don’t know whether I will have to take antidepressants again in the future. I feel unable to claim this as an unmitigated success because I have no idea if the change is permanent. I’m happy to be able to try life without medication, but it feels like being congratulated for starting to learn to drive — it’s a step in the right direction, but I don’t know whether it will turn out well.

The thornier issue is that congratulations imply that you have achieved something through hard work and while I have worked hard to control my mental illness, I was struggling a lot more when I was on antidepressants. I worked hard even when there were no positive results. It comes back to the idea of being judged for taking medication: congratulating me now implies that I was doing something wrong because I needed to take antidepressants. That makes me uncomfortable because it’s not true — needing medication doesn’t mean you are weak or a failure. Regardless of how you choose to treat mental illness, battling it takes courage and strength every day.

More than anything, I’m curious about the future — and a bit excited!

I have no idea whether I have suffered side effects from my medication for a start, though I have my suspicions. I don’t know precisely how much my antidepressants helped me, or in which situations, so I don’t know how (or if) anything will change. I never felt that the medication blotted out my personality — though my mental illness did — but I have no idea whether it affected certain behaviours or personality traits. I can’t wait to find out what life without antidepressants is like.

Having said that, coming off medication is just one of the changes I have made this year and my curiosity and excitement about the future owe more to these other changes. I may be taking tentative steps now I have flung my crutch away, but hopefully I will be skipping ahead someday soon.

 

 

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