Positive vibes only please.

I screwed up. But maybe I need to stop saying it like that…I crumbled and everything became too much.

Last Monday I was sectioned. I was arrested under section 136 of the mental health act by the police (for anyone who does not know much, it is not a crime but for safety and a mental health assessment) and taken to a “place of safety”. At said place I was assessed by two psychiatrists and a social worker, put on a section 2 and admitted to an acute ward.

I am not sure I want to disclose what happened. I have not really spoken about it at all to anyone, nor how I feel about it now. I keep telling myself I should be glad that a police officer saved my life, but then I think that sounds ridiculously dramatic and it does; but then it is also true. If the police officer had reacted even just 5 seconds slower than he did, I would be dead right now and I want to be glad. I do. But right now I am just confused. I think wanting to be glad is a good place to start. When the incident happened the police knocked me to the ground; broke my nails, bruised my side and bum, ripped my coat and scratched my face. He was holding me, almost hugging me. He was shaking and he kept saying that we were safe and that it was all going to be ok, that the worst was over. I wanted him to get the hell off me and I tried to get away. But I also remember this little part of me that could see how relieved he was that he had made me safe, and I was jealous. Bad choice of words there, but I wanted to feel his relief. I was crying because I could not feel it. All the officers were relieved and happy, talking about it being a good outcome, and I was laid there on the floor wishing I felt the same – I take that as a sign that something in me wanted to be alive. Well, wanted to want to be alive, and when I remembered feeling this way on Friday, I realised I have to fight.

I only spent a week on the ward. It was a rubbish week. I have only been on an adult acute ward once and I acted fine, and “displayed no signs of mental illness” mostly because I was trying to get myself out, and I did within 3-4 days. This time I was not quite the same. I had to be medicated which I hated, because it feels like every time you get distressed and they cannot handle you, they just want to knock you out…I was restrained which has never happened before, I was attempting to escape, I was on 1:1 a lot, I had all of my stuff taken off me…given back, taken off me again.

But I am home. I came back home yesterday and I am home for a week, and if I keep how I am/improve, then I will be taken off the section next Monday and freeeeeee. And I am pretty proud of myself for picking myself up so quickly rather than ending up having a long admission. I cannot stand hospital and while I know most people can’t, I particularly can’t. I cannot handle feeling trapped or not getting space, or fresh air. I cannot manage to eat in hospital so I went 7 days without food. I get worked up and even my Mum knew that hospital was not the right place for me.

That is not to say it was the wrong place neither. What I did, what I nearly did…there was no other option. I could not go home. And yesterday afternoon I had an absolute meltdown. On my way home from the ward I went to see my mental health worker at uni, and I just lost it. She rang the ward and the consultant suggested going back, but I pushed through and I am still at home. I have cleaned, dealt with some physical health issues, I am eating again THANK THE LORD and I am engaging with home visits even though I tried to refuse them. I know if I refuse them I will be recalled aka back in hospital, but that is not why I am engaging. I am engaging because I want to, and because this is an opportunity for me to learn how to communicate how I feel and get things out, rather than bottling things up and exploding.

Two weeks ago I was struggling, but I would never have predicted this to happen. It has been horrible, and at time, traumatic. I could still be on the ward right now, on 1:1 with none of my belongings, hurting myself, arguing, kicking off, not eating and destroying any chance of returning to outpatient therapy. But I have another two and a half months to show I can regain control and be “stable” (bloody hate that word), so I can do the therapy, and so that is my goal.

There are lots of issues at the moment, and things that contributed to this, and consequences of this last week that I have to deal with. But ultimately I know all things can be dealt with. While I am finding it difficult to say I am glad the police saved my life, I am glad I am still here to have the chance to engage in therapy and perhaps one day be glad.

I am focusing on looking after myself physically, reading some positive books and focusing on positive things. Having positive conversations with friends, generally talking to friends to be distracted, working on putting my feelings into words and just, helping myself. It started with eating; I knew I was not going to be able to pick myself up and do the things that would help me, if I was not eating. So yesterday after my meltdown I had my trusty rice krispies, and since then I have been eating “properly”, and it is just a case of one foot in front of another. I do truly hope I can go to my ward round on Monday, surprise them at how different I am (better!), get discharged and resume life, but for now we shall focus on today.

 

Just keep swimming!

Pretty good quote from Disney there.

When I last posted on here I thought I was coming out of a blip, and then said blip continued. I 100% thought I could positive think myself out of the hole. I don’t really recall what happened but it worked very temporarily, perhaps a day, and then things became worse again. I ended up in hospital a couple of more times, but only overnight…and then slept a lot in the day time. I mean positive thinking is vital and I 100% believe that what we think, we become. That being said mental illness and being low is not exactly the same as being negative, and positive thinking can only do so much. I think when you are at rock bottom, it takes more than positivity to help you, but once you are beginning to feel a little better, positivity can really help.

Things are better now though! I went through a couple of days at the weekend where I was looking after myself better, but I felt incredibly low, which is the usual process after a blip. It’s like you are letting go of the ways you have been coping, so it’s relatively “normal” to feel a bit rubbish and it’s a lot like when you have been physically ill and it takes a few days to get your energy back, but here we are!

I can’t say I am entirely sure how things have turned around. On Friday I was in A&E from about 3am-7am…but I was determined to still go to work, but then I fell asleep. I was so angry with myself when I woke up. I woke up 15 minutes before I was due at the hospital for an appointment that I was planning to go to on my lunch break. I had to practically run to the hospital and I was not exactly wide awake. The clinic was running an hour late, and I basically slept in the waiting room for another hour and then saw them. They asked a lot of questions and were worried about me, so they wanted me assessed by the crisis team but I managed to avoid it. I walked home in a daze and really disappointed in myself. I think sometimes you get to the point where you are drained, tired, and sick of letting yourself down. I spoke to the mental health team I am under for a planned phone call and I attempted to act “fine”…but the plastic surgeons, police and the university mental health team had all contacted them within a day so the “I’m fine” routine didn’t work. When I got home I rested all afternoon/evening, and my pain levels were so high that even with prescription painkillers, I was struggling. It helped me to keep safe because the idea of more pain was, to be honest, intolerable.

I am still on extra meds, plus the pain killers and antibiotics. Apparently it’s harder to get antibiotics these days but I swear I’m given them so often! It can’t be healthy!

I’ve been to work, and the gym for the last 3 days. On Monday I saw my MA supervisor, and I’ve also been super challenging myself with food. At home especially. I had been eating the same things every day for all meals including my evening meal, and then having set rules about lunch at work that I won’t go into, but I’ve had different meals every evening, eaten foods I haven’t eaten in a long time (cheese, avocado, salmon, cous cous, houmous, crisps and more), and also eaten different things at work. Every time I start panicking about it and my head wants to go back to eating the same old things I actually get really angry with the thoughts and I feel like, and excuse the swearing, “f**k you, you don’t get to dictate my life any more” and I love it when I am able to have this attitude.

I actually feel like my recovery from my eating disorder has had two stages; stage one was forced treatment as a child, stage two was actively choosing to “recover” as an adult, and I feel like I am entering a third stage where I am no longer accepting what I previously have. I’ve not been “ill” in terms of my anorexia for a few years, but I have been making a deliberate effort to keep my weight at or just below the target weight range eating disorder services set for me, doing as much cardio as possible, eating at certain times, eating the same foods, avoiding a lot of foods and other similar things…and I feel like I am beginning to challenge that.

If I gain more weight, who cares?! I’d rather be happy. Just because my current weight is what I need to be to be regarded as “healthy”, doesn’t mean it is my bodies healthy weight. I mean BMI isn’t the most reliable of measures, everyone’s weight/BMI varies, and a minimally healthy weight doesn’t have to be the end goal. A BMI of 20 is healthy, but so is a BMI of 21-24. I choose a little extra weight, happiness and being able to eat dessert any day! More than that, I choose being mentally healthy over spending my life restricting what I eat, not eating things I enjoy and having to put so much energy into not gaining weight. There are far better things to be putting so much effort into, and some food is good for your body, some food is good for your soul!! A healthy body is important, but so is a healthy mind.

I am a big believer in lifestyle changes for anyone who has weight related issues, rather than dieting. I am a big believer in body acceptance – body positivity is great, but actually you don’t have to love your body all of the time, but you can accept it and not criticise every aspect of your appearance. I despise the money making diet industry. I despise the guilt that so many women (and men), feel over their bodies and what they eat. I despise body shaming of any description albeit fat shaming, or thin shaming, and I absolutely hate that some people feel they have to adhere to certain standards. I hate that we are bombarded with messages such as ‘fat is bad’, ‘low calorie = healthy’, and ‘no pain, no gain’ – and I want to practice what I preach!

AMEN.

A Reminder of Why I Gained Weight

Sometimes I still catch myself looking back and wondering why I “let” myself gain 40lbs. Who does that? Who chooses to gain 40lbs? I feel like a failure. I cannot figure out why the hell I ever chose to do that. I regret it. But then I push those thoughts away and focus on the here and now.

Things have been slipping for months though. You see despite weight restoring I have never really “normalised” my eating; I still choose the lowest calorie sandwich in the supermarket, I still check the calories for restaurants and choose accordingly and I do not know the last time I chose something because I WANTED it. I avoid dessert unless I can “make up” for it, and I have a huge heap of food related rules. I do not eat things that my disorder stupidly labelled as “bad”; chocolate, burgers, sweets, white carbs, pasta, high fat foods (except peanut butter haha), crisps, non-diet versions of things you can get diet versions of, potatoes, milk, ice cream, chips…you can probably guess the kind of things. I eat the same breakfast, lunch and tea every day, and the same snacks, and the only variation I have managed to add in is different sandwiches at work so long as they are from the healthy living range, and different protein with my evening meal sometimes..but which is still limited to a few options.

I have been at my target weight of a BMI around 20 for a while now, but the food related rules have been plentiful. Eating out still scares me, Christmas still terrifies me although to a lesser extent…and I still often wish I could eat what the other people I am with are eating. I still avoid social situations involving food, I still long to eat certain things and I still feel like I deprive myself. And I convince myself it is ok because my weight is “fine.”

A year or two ago I started exercising again in the form of the gym. I have stuck to three times maximum mostly, with the occasional increase before reducing it back down. Three times is fine, I convince myself…while ignoring the thoughts I have. The panic at not being able to go because it is bank holiday, the panic that I might not fit in three times if I go home. The desire to go every day and the irritable mood I find myself in on my days off. The increased frequency of going an extra day. The obsessive thoughts about burning fat and building muscle.

It has gradually worsened. And in the last 6 months it has completely deteriorated. I had a few weeks where I was running three times, going to the gym three or four, and I ended up triggering an old injury and I felt suicidal. I know that sounds dramatic, but that is what happened. I have been weighing myself daily again, and when I was arrested and placed in a cell (don’t ask!), I was not bothered about the prospect of a criminal record so much as I was bothered about not being able to go to the gym; when I was released I rang my Mum crying that I could not go to the gym (it was too late) and that I was in so much pain I could barely even walk. (By the way I was not charged and I hadn’t committed a crime..it was mental health related and complicated – I will explain if anyone wants to know, but not on here!) I have been going to the gym extra days per week, doing a lot extra cardio and walking 10-20km every day, even if it means walking in the middle of the night.

I should have seen how bad things were getting but I wanted to ignore it. Or rather, because I am a healthy weight, I felt like I had to just act fine, pretend to be fine, get on with it. It was like I did not deserve to feel like I had a problem, and I know that the one person who really knows how things have been has been irritated with me for trying to pretend there is not a problem when it is blatantly obvious that there is, but the underlying issue has been the weight part. How can I need to cut down my exercise or eat more, or challenge my eating rules, when I am at a healthy weight?

But the thing is, being in that semi-recovered but still pretty damn disordered state leaves you not just miserable, but also very vulnerable to relapse, and while I feel like I only relapsed last weekend, it had been coming for a while. Last weekend I decided to lose weight. I was in bed when I made the decision and I planned to simply cut down a little on what I was eating, but then I got up the next morning and ate less than planned for breakfast, then skipped lunch and snacks, ate less than planned for tea, and skipped supper. I went to work without breakfast and had no lunch, I just ate a fiberone bar. Roll on to yesterday and I had a glass of unsweetened almond milk, some egg whites and veg…burnt 500 calories in the gym and 600 calories walking.

And guys, it worked. In 6 days I lost 6lbs. YAY WELL DONE NATALIE (not). How I feel reminds me of a quote by Marya Hornbacher:

“And when, after fifteen years of bingeing, barfing, starving, needles and tubes and terror and rage, and medical crises and personal failure and loss after loss – when, after all this, you are in your early twenties and staring down a vastly abbreviated life expectancy, and the eating disorder still takes up half your body, half your brain, with its invisible eroding force, when you have spent the majority of your life sick, when you do not yet know what it means to be ‘well,’ or ‘normal,’ when you doubt that those words even have meaning anymore, there are still no answers. You will die young, and you have no way to make sense of that fact.
You have this: You are thin.”

You are thin. And that is all you really have.

You are depressed, anxious, isolated, suicidal and empty. But you are thin. And at times your head convinces you this is what you want, especially at the start…but then one day it hits you. I remember a moment where it hit me in my last major relapse. It was 2011, I think. I was on an acute medical ward for refeeding in a general hospital. I took my first shower in the bathroom there and they had a full length mirror. I had been avoiding mirrors, and the sight of my own body reduced me to tears. I was thin, and that was all I was. I was nothing else. I was empty, and dying, and I cried. Usually I was pleased to lose weight, to be told I looked sick, to be wasting away…but it was like suddenly my eyes opened up to the reality, and I knew that this was not a life I could carry on living.

I remember looking at my body, seeing that I really was just skin and bones, and crying. I remember thinking “what have you done to yourself?” I remember having to crawl to get to bed because I could not walk at home, and as soon as I was in hospital, not being allowed to go anywhere except in a wheelchair. How can you be 19 years old and in this state for the third time?

 

 

So yes, I spent the last week losing weight as quickly as I could, taking diet pills that used to be prescription only on the NHS but were then banned for causing heart failure, and feeling moody as hell. I had a rubbish appointment with my mentor at uni. I have laid in bed making weight loss plans. I have worried about managing my degree and work, and doing pretty much anything. I have cancelled plans, avoided going home for my sisters birthday, and to be honest, been a wreck all while hiding what I was doing from everyone.

And then today I got up and I ate breakfast and I walked to Tesco and bought food, and I ate lunch and tea. I took the day off the gym, and after I had walked so far, I forced myself back home…and it was literally force. And I do not know how I have managed it. My stomach hurts. I have cried. I feel like I am about to gain a stone in the coming days and weeks, and I think I need to make the decision that a BMI over 20 is not the end of the world. That if I want to minimise the risk of relapse and stop living my life by so many damn food and exercise rules, I have to accept my body wants to be at a higher weight than eating disorder services told me to be.

Back to wondering why I ever let myself gain weight:

I did not gain weight because I wanted to gain weight. God if I had waited for that day, I would be in a grave by now. And that is the thing. An eating disorder is not a diet. There is no ‘end’. You just keep on going and I am one of those people who either eats nothing, or eats 3 meals and a snack every single day without failure. I am obsessive, and very rigid and that is how I go. There is no middle ground.

I have remembered why I gained weight.

  1. Social stuff! When I am losing weight and restricting I avoid people. I avoid family and friends and anything that might involve food. This is my biggest reason to eat; I am focusing on wanting energy for work and to help at an event on the 7th of June. I have arranged to see friends on both Monday and Tuesday, and my sister for the day after her birthday. This will be challenging, especially with food, but I know that being able to remind myself that eating = being able to spend time with the people I love will help me manage eating properly again. And I am not going to just try and return to where I was a few weeks ago…I want to start eating what I WANT and not trying to maintain a minimally “healthy” weight. I do not want to spend my life micro-managing my eating and weight.
  2. Because when I starve myself and become severely underweight I am an awful person. At my worst, as a teenager, I attacked my family, smashed windows while cooking, threw plates of food that my Mum was trying to force me to eat at her, and hid food in socks, pockets…anywhere. But beyond that…I was silent, empty, dead. I know if I relapsed I would sit with my mentor every week in silence, or talk and feel as rubbish and as guilty as I did yesterday. I do not want that life back. I do not want the life back where nothing is important except avoiding food and losing weight.
  3. I really, really, want to go back into treatment, and USE it. GET BETTER. If I go back there at the end of this year, two stone underweight, I will not be able to use it to get better. (It is not for eating disorders) I will struggle; I will struggle to talk because I will be a zombie. I will struggle with eating there. I will struggle to manage to physically cope with getting there and being there all day. Managing just to sit there in silence would be an achievement. I need to be better than that; I need to be able to make the most of it.

There a whole heap of other reasons; enjoying food, being warm, not wanting my osteoporosis to get worse, concentration, Christmas, energy…but those three are my main reasons.

It feels strange admitting what the last six months have been like, and what it has accumulated to in the last week. It feels scary to admit that I am not as “recovered” as I would like to think, or as I would like other people to think. It is hard to say that I have a lot of things I need to change, and possibly some weight to gain, when I am not really underweight and nobody can see that there is a problem.

But there is a problem. I do not care if you are under eating, or over exercising, or not; I am telling you that if you are psychologically obsessing over food, or have rules surrounding food and exercise that cause anxiety, make you depressed, and that dictate your life to you, you deserve more.

You deserve so much more. And I deserve so much more, and if I want to get anything from this week of hell, it is to get truly better for the first time ever, and make other people aware that being at a healthy weight does not mean you are “recovered”, or that you cannot gain more weight. And that being “fine” does not have to be the end. You are worthy of more than “fine” and I am here to tell you that just like me, you can fight for more. You can fight for more than just “fine” and for more than managing, and for more than having to follow your life with rules. I am here to tell you that being weight restored does not mean you cannot still be struggling, and does not mean you have to pretend to the rest of the world you are ok when inside you are still fighting a battle.

Borderline Personality Disorder and Emotional Dysregulation: Part One

There is a frequent debate about the term ‘Borderline Personality Disorder’ (BPD).

The term ‘borderline’ was coined in 1937 when it was believed that patients with the disorder were on the borderline between psychosis and neurosis. This is no longer seen as necessarily the case, and definitely not the case for everyone with the diagnosis, and today people prefer to call BPD ‘Emotionally Unstable Personality Disorder (EUPD).

I was actually asked which I prefer my diagnosis to be called, and I chose BPD. I know so many people hate this and choose EUPD, but being called ’emotionally unstable’, while probably accurate, just does not sit comfortably with me. To me, I think EUPD is a much more stigmatising label. ‘Emotionally unstable’ makes you sound, well, like an overly emotional mess and like someone to be avoided. It also sounds much more like one symptom of the disorder, albeit a major one, rather than a collective term for a set of symptoms. Ignoring that issue, I would prefer the term ‘Emotional Dysregulation Disorder’ which is occasionally used, but I actually think that BPD is more of an attachment disorder than anything else. There is a disorder called ‘Reactive Attachment Disorder’ but this is usually only diagnosed in children. I wonder what they think happens to these children when they hit 18? I think they probably, if their problems continue past that age, get diagnosed with BPD (which is usually only diagnosed in over 18’s).

That bothers me. Under 18 and I have an attachment disorder. Over 18 and I have a personality disorder, which is far more stigmatising.

Emotional instability, usually referred to as ’emotional dysregulation’ is a huge part of BPD. But this instability goes much further than emotions; it can be instability in a person’s sense of self/identity, and I think this can stem from being brought up in a very unstable environment. I think people would find out things about my childhood and call it pretty bad, and it was, sometimes. And sometimes it was not. Sometimes we were like any other family; happy and sad in “normal” ways. But things changed quickly and suddenly, usually without warning. I reckon growing up in that kind of environment, where you do not know what things are going to be like hour to hour, it makes you feel like nothing is safe, and that you do not know where you are going. One minute I had two solid, grounded parents and then in a blink of an eye one was back to abusing alcohol and the other was violent and would disappear off the face of the planet for a few days. There would be periods of stability in my Mum’s mental health, and then in the blink of an eye she would be carted off back to the psychiatric ward.

And to be honest, it felt normal. It was our normal. And when you live your life always ready for things to get worse, not knowing when it is going to happen, you become incredibly hypervigilant, and you develop ways of coping with it. Sometimes these coping mechanisms are unhealthy and dangerous, but regardless of that, they serve some kind of purpose. With regards to my anorexia and self-harm, I have often felt like those two things were always going to be there for me, that they were not going to abandon me, and so I clung onto them, sometimes with all my might, and other times just loosely, in case I needed them – never able to fully let go.

Education was my one positive coping mechanism, as I have wrote about before. School and college were always going to be there on a Monday morning at 9am. The supportive tutors, lecturers and support workers were always going to be there too. It was a safe haven, and especially during my time at school, it was the one place I did not have to pretend. This is quite different to some people’s experiences, where school is a place where they put on a mask, but for me school was where I could let myself feel my emotions and express them, and home was where I concealed everything. This was at times problematic as things would spill out uncontrollably. I would fall apart. But it was also needed at times. As I have become older I have gained a lot of control over this and while that seems like a good thing, it does mean that university tends to be a place I wear a mask to some extent – but I have a support worker within the university who I do not do this too. I guess it is more controlled now.

So, what is emotional dysregulation?

Emotional dysregulation (ED) is a term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response. ED may be referred to as labile mood (marked fluctuation of mood) or mood swings.

This is something I have become increasingly aware of in myself over time. When I was in a child and adolescent psychiatric unit aged 15, I was diagnosed with cyclothymia, which is basically (and this is very simplified), a form of rapid cycling Bipolar disorder. This has never been mentioned again, and this is because while cyclothymia means that your moods change more frequently than found in typical Bipolar cases, my moods change much quicker than in cyclothymia, and approximately 50% of the time, in reaction to something happening around me.

It can be quite scary. Last Friday I ended up in A&E as I mentioned in my last post. I felt like I was at one of my worst points in a long time, and that was fair to say. Now, five days later, I am at one of my best points. It is a very unpredictable thing, that makes living difficult. I know that while I am feeling pretty good at this moment in time, in a few hours I could be laid in bed trying to sleep and having really negative, dangerous, thoughts and urges. While thoughts cannot hurt me, they can lead to me acting on them, which can hurt me. Learning to have these thoughts and feelings, these urges, and not act on them is one of the hardest parts of ‘recovery’.

When I am in the mindset of wanting to act on those thoughts, practically none of me can see any reason not to. I mean it varies; sometimes I can. Sometimes I can be very rational and recognise that feelings will pass, but other times the feelings are so intense and I lose grip of what I would call my “true self”, and there really is no talking me around when I am in that place.

I really want to end treatment and “get on with my life” as I keep saying. My support worker at university told me that while that would be very lovely for me to do, I need to think realistically about my ability to handle the responsibility of a full-time job right now. On my good days, I would be fantastic for a full-time job, but on my bad days, or during my rough patches, it would be a disaster. Right now, being a full-time student and working part-time is perfect for me. Work is absolutely perfect. I will admit I feel like I stumble my way through university. How I managed to get a degree, sometimes I really do not know. But it is manageable, and I am really lucky to have really accommodating lecturers. But in the working world, especially a full-time graduate scheme, this would be less likely to be the case which is why I am spending the next two days deciding whether it would be best to pull out of the graduate scheme assessment centre and focus on continuing with my treatment plan.

Does this mean someone with BPD can never have a full-time job? Of course not. I am sure thousands do. There are many extremely high-functioning people with BPD. BPD is often categorised into low functioning and high functioning (and I am pretty sure people can be a combination of the two). I think I am a combination of the two. Just the other day an A&E doctor told me he had never met someone with my diagnosis who was doing as well as I am, nor doing a masters. I reckon he would be surprised how many other people with BPD are doing high level qualifications, but that most of the people with BPD who find their ways into emergency departments are the ones who perhaps are not.

 

  • Low Functioning Borderline – The “Low Functioning” borderline is what most people think of when they are first introduced to the condition. Low functioning BPDs are a living train wreck. They have intense difficulties taking care of their basic needs, are constantly experiencing mood swings. They also have an extremely hard time managing any sort of relationship with another human being. Low Functioning BPDs are often hospitalized more than other BPD types, for the very reason that they can’t live productively without constant coaching and supervision. These patients are challenging for all but the most experienced psychiatrists. Unless otherwise treated, low functioning borderlines lead self destructive lives and attempt to manipulate those around them with desperate acts, including self harm (cutting, etc.).

(The comment regarding manipulation is not necessarily accurate. Often what appears like manipulation in BPD is just a person’s lack of ability to get their needs met, or express themselves, in a normal way – someone without BPD might need some extra support, and turn to a close friend and ask for it, whereas someone with BPD may struggle to recognise what they need and therefore find other ways to manage their feelings i.e. self-harm. Contrary to believing self-harm is a manipulative and attention seeking behaviour, self-harm is usually a very private, secretive thing – and any way, needing attention is not a bad thing. We all need attention.)

  • High Functioning Borderline – The High Functioning Borderline Personality shares many core aspects of the low functioning borderline personality, except for the fact that they can manage their lives, appear to be productive, and generally keep their relationships civil (even diplomatic in nature). High Functioning borderlines can appear to be normal, driven people one moment; then moody, inconsolable, and manipulative the next. Somehow, there is a mechanism within the minds of High Functioning Borderlines that allows them to lead somewhat “competent” lives, despite the fact that they are in a constant battle with BPD. High functioning BPDs are no better than low functioning: it’s basically the same face wearing a different mask.

 

 

These two “categories” are a bit too black and white for my liking. I am high functioning in terms of work and academically with my current workload. If I had a full-time job this would probably reduce. I am very low functioning in terms of mood swings, social functioning and self-destructive tendencies.

The thing about emotional dysregulation is, you can learn ways to manage it – and there are a huge number of ways that may or may not work for you personally, which I will discuss in a following blog (because I am on 1800 words and quite frankly that is ridiculous!)

Between rock bottom and recovery.

Everyone talks about rock bottom, and talks about being better but it feels like nobody talks about the in-between. Everyone talks about rock bottom as being this one particular solid place you hit. This one particular solid place you hit right before you get better.

I have spent some time searching online to find something I could read that did not just talk about this, but nothing seems to really come up. I want to understand. I want to be understood. How do I manage this stage? How do I put it into words? How do other people do this? I want to read someone else’s words, and feel less alone.

I cannot find them.

I do not know if it is specific to certain mental illnesses, like borderline personality disorder, which are more long-term and up and down, up and down… but rock bottom for me is not one time or one place, nor does it always look how you would imagine.

I have the kind of rock bottom times you read about a lot when people talk about their mental illness. The hospital admissions following serious attempts at harming or killing myself, like New Year. On December 30th I took all of my prescription medication I had been collecting, and I woke up in hospital on January 2nd. I think about that a lot. I woke up with no recollection of the paramedics taking me to the hospital, and no recollection of being in hospital. I woke up in a different year. To this day I have no idea where I was in the hospital or what treatment I had. That sounds like a rock bottom place, right? The sort of rock bottom you read about and think “Oh my, that is bad.” The sort of rock bottom that would make a good real life story. Or what about when I sat with my legs over the edge of a multi-storey car park? That was definitely a rock bottom kind of moment. Sadly what made it rock bottom for me was the fact that fear was forcing me to stay alive. It was a moment where I realised I had little choice in living, and walking down from the car park was far from a moment where it all clicked and I suddenly wanted to be alive. I took three more overdoses instead, and ended up in hospital on a drip each time. One time I ended up in the psych ward. It must have been awful, right?

And it was.

But this world between rock bottom and recovery is worse, I think. It is longer. It requires so much more. It is painfully slow. The bad times are horrific. I wish I could point out a particular time and say this was rock bottom and that it does not get any worse; but rock bottom is not some fixed tangible place. Rock bottom is where you make it. For me, the car park does represent a rock bottom, but rock bottom could have gone further. It could have changed. It could easily have ended up being somewhere else.

I hate that rock bottom moments in people’s stories within the media need to have the shock element to make them newsworthy. I mean sitting on the edge of a multi-storey car park and being found by security was pretty rock bottom. And people would be interested in that, maybe shocked, and sad. People are not so bothered about the in-between world.

The world where I do not wash for days upon days. The world where the sofa and my bed are the only two places I feel ‘safe’ (and I do not really feel safe at all). Nobody is so bothered about the nights when I cry myself to sleep, miss deadlines, withdraw myself from everything and everyone, or have to seek emergency support to stop me from self-harming, or overdosing, or finding myself back on top of the car park. It is not so interesting when the person does not actually do anything. I think people think it means it is not so bad, or perhaps I wrongly assume that. But it does feel that way. That by not hurting myself, things must be better or easier or somehow less painful.

I will tell you now, not hurting myself is much more painful than hurting myself.

It is like with eating disorders. Everyone is fascinated and interested in shocking images of underweight bodies. Stories that tell readers that this girl was on deaths door. They would be interested in the parts of my story where I would not even drink water or brush my teeth for fear of gaining weight. The bits where I ended up in hospital. People are less fascinated by the battle of eating, but eating any way. The battle of not wanting to gain weight, but gaining any way. They think that means that the problem is better, or easier, or perhaps even over.

Everyone with an eating disorder knows that is not true. I have not had any serious issues with my weight or eating, apart from small lapses, in years. It does not mean it has gone away, but nobody is really bothered that I had two months where things got a bit worse again and I lost a bit of weight. Nobody is really bothered that I struggle to eat out, or eat the exact same things every single day. It is not life or death stuff.

My previous psychiatrist was the first professional who made me feel like there was someone in my life that knew that gaining weight, eating more, and not hurting myself, was the harder option. I recall some of the things she said. She told me that I did not need her support to destroy myself, that I had proven I was perfectly capable of doing that by myself. She told me to eat, was to choose the harder path. She told me that to not take an overdose, to not cut my skin, was harder than giving in. She saw my weight going up, and she did not think everything was fine. She knew it was not. She knew inside I was falling apart.

By her understanding this, she probably saved my life a million times. Her understanding of the struggles I was facing when I was doing all of the “right” things, is what kept me doing the right things even when they felt incredibly wrong. If she had thought that my weight gain meant I was happy and absolutely fine, I would not have been able to explore just how difficult it all was. I would have kept it all inside, and I would have, in the end, gone back to restricting and losing weight. Her understanding that I needed her support most when I was looking after myself, and keeping myself safe, helped me to keep going. If she had assumed things were great purely on the basis that I had not self-harmed since she had last seen me, I would have slipped backwards.

The biggest thing I have ever needed to get better, is for someone to recognise that “getting better” is more painful and more hard work than not. That the time I needed the most support was when I was fighting against the thoughts inside of my brain. A brain that is very often trying to kill me. All I have ever needed is someone to see that I am managing to look after myself, but still sit in front of me and tell me they know I am not ok.

Right now I am in a good place with my eating. A genuinely good place, but that is not to say my eating disorder is not present every single day, it is. There are some real shit times still; probably at some point every day. But I have gained so much knowledge and understanding, and so much help, that even now my previous psychiatrist is no longer present in my life, in the moments where I could easily slip backwards, I hear her words in my head. They are no longer just her words, they are mine too. Her retirement did not hit me that hard. I wondered why for a while, but then I remembered something she said; that one day I would have got what I needed from her and be ready to move on. I got what I needed, and it is inside of me for life. I am ready to move on and work on the rest of my issues elsewhere.

The self-harm and suicidal thoughts side of things is a work in progress. Bloody slow progress. Painfully slow. Sometimes so slow I feel like I am sinking. My focus right now is on stability and I swear to god I am sick of hearing that word. I head the word ‘stable’ and my eyes automatically roll back. I have, in the last week or so, come to acknowledge that right now I am not really aiming to “get better” as such. Not really better. Right now I am aiming to survive. I know, it sounds defeatist and depressing, but it is not. Not for me. I mean, just surviving is crap. But it is also essential. Sometimes, temporarily, it has to be enough. Sometimes just surviving is brilliant. My plan is to survive for now; to be stable and reduce/minimise/stop my destructive behaviours. The “getting better” bit will come after that. Aiming for my end goal right now just leaves me feeling deflated and defeated. Aiming to cope and survive is best for me right now. It means that I do not feel disappointed in myself for still feeling so god damn sad every single day.

My biggest realisation is that the help I could return to mirrors (I think and hope) the attitude and understanding of my psychiatrist; that not engaging in a behaviour is much harder than engaging (or a different kind of hard at least). And that support is still VERY much needed after someone stops hurting themselves regularly. And my belief that the people who I might return to for help in the future know this, gives me an insane amount of hope, and an insane amount of trust, in them and in eventually getting myself where I want to be. I just hope that everyone can find someone who gets this, and if you can’t, I hope you can be brave enough to tell someone, and give them that chance to be the person who supports you when you are roaming in the no mans land between “ill” and “recovered”.

rock bottom

Self-Injury Awareness Day

It is self-injury awareness day today, and I want to say something. I also want to say nothing.

I feel like out of all of the issues that have happened in my life, this is the hardest to be open and honest about. It feels easier talking about my eating disorder, perhaps because it is more historic, or perhaps because eating disorders (to me) feel more socially accepted now – and yet personally I feel like my eating disorder was a form of self-harm.

Except I think people “get” eating disorders to an extent. I think even as someone without an eating disorder people can understand/think they understand. I mean probably because they think it’s the same as dieting (which it isn’t) or because body dissatisfaction is just so common, or because many people find their eating is affected by their emotions.

But the idea that someone could physically injure themselves just probably is not so relatable. It is like any addiction. People abuse or use all sorts of things to cope that are not necessarily healthy; alcohol, drugs, exercise. Again, a lot of people can relate to those things to an extent. You do not need to be an alcoholic to be able to relate to the idea of having a drink to cope – but most people do not inflict direct harm on themselves.

Self-harm is messy. People respond in so many ways. Some literally grimace. I have had all sorts of responses. All these responses are from professionals, because that is the thing about self-harm; it is hidden. I’ve had people nearly fainting at the sight of me, people being overly sympathetic. People treating me like a child. Often it is well intended, but people often take it too far. Yes, I have self-harmed, but it doesn’t mean I am someone who should be felt sorry for. I do not really want people to feel sorry for me. You cannot look at my self-harm and think you know me. It’s not my whole story.

I was in hospital yesterday and a nurse said to another nurse “I know, bless her” like I was not there. I would rather that than be judged. But my self-harm is also one part of my life. They do not see that I am often happy. I work hard. I am at university.

Certain things led to me self-harming at a very young age – violence, alcoholism in the family, family mental illness and being a ‘young carer’ (not a fan of saying that). This is the thing about self-harming…it does not go away easily. It is an aspect of my childhood that turned worse as I was a late teenager/young adult and it is not going to go away over night. Often I feel I get judged a lot more as an adult, that I did as a child, and I just wish people would remember that the adult sat in front of them was once a young child who experienced certain things that led them here – it is not about attention, wanting sympathy or having a ‘bad’ life now.

And it really is just one small part of my life. It is not who I am. And I am getting better step by step. The steps are small, but I keep on taking the next right one.

 

 

 

Eating Disorder Awareness Week 2017 – Not your typical “before” and “after”

It is Eating Disorders Awareness Week (EDAW) this week.

Originally I was going to get people onboard to make alternative “before” and “after” images – get people to submit photographs representing before and after in a way that was not using images of emaciated bodies. This felt complicated; what images would do that? An image of someone alone, then surrounded by people? It did not feel completely right nor possible.

Then I gave up on doing anything for two reasons; number one, because I was feeling deflated. What is the point in raising awareness? It does nothing. I felt sick of hearing about mental illness. I struggle with it every day and I want it to go away. Why talk about it? I want to run away from it. Number two, what is the point of any of it? I felt like help does not help, and that all these campaigns do is glorify eating disorders and other unhelpful things. I did not see the point – to understand where I am coming from, this article is partially helpful. I really advise you read it as it makes many of the points I feel we need to become more aware of; it is a problem in the mainstream media, but increasingly more so on social media. It is what my message is for EDAW 2017 (and probably every EDAW ever).

I have also wrote three other posts – the last one being my favourite:

This year to tackle the issue I have with EDAW images I have decided to focus on making posts via graphics on social media myself. There will be two different types:

  1. Alternative “before” and “afters”
  2. “I have to learnt to…” – which talk about things I have learnt in recovery to show was recovery is really about, beyond food or weight.

To see these posts, and to share them, take a look:
Instagram
Twitter

They are also available on my personal Facebook account, and on Friday 26 March I will post a collection of them on here.