I am starting to invite and ask some of my friends, family and acquaintances if they would like to and feel able to write something for this blog. I will still keep writing articles for it, however, it is important to me that many people get a platform to express similar things about what they know about mental health and all that encompasses. So, with great pleasure I am giving my first guest post slot to a former schoolmate of mine with whom I share many great memories playing brass together and especially as this comes a day before Remembrance Sunday when we used to play at the services together, it is well timed! I found what he has written incredibly moving and insightful and I trust that all who read this article will too.
Enjoy my guest series!
Hi, my names Jack. I am six foot six, twenty stone, I work a normal office job, and have a girlfriend. I live as “normal” a life as it is possible to when you are twenty two and living in Shoreditch. Unless I’m wearing short sleeves you would have no idea that I suffer with mental health. In face you would have no idea that many of my close friends, from periods I have spent in hospital, suffer from mental health.
I must precede this by saying I find it very hard to explain what I go through to people. I also find it very hard to remember when things have gone bad what has happens. Sometimes I disassociate or hallucinate, and the world becomes a blur. If you knew me you would know that my thick Essex/cockney accent does not lend itself well to being a man of words.
Pippa asked me to talk about my experiences with bipolar and borderline personality disorder. I’m not going to talk about bipolar, I make no apologies; it is a well documented, reasonably well understood condition. Maybe I will discuss if I receive a further invite from Pippa.
Being diagnosed with Borderline Personality Disorder is the first time mental health made sense to me. Many people I am friends with dislike diagnoses, and at first so did I, but it has enabled me to understand myself better.
BPD is an awful name for a condition. The borderline comes from the border between neurosis and psychosis, which I would argue is not true of the diagnosis now; I would also argue it is not something that affects personality completely; nor would I say it’s a disorder. In Europe it is called Emotionally Unstable Personality Disorder. Maybe this is currently the most accurate depiction of the condition, although still far from perfect.
There are nine borderline traits, but really what we are getting at is the idea of someone who is all-or-nothing emotionally, empty or full. Typically this is categorized in several areas of life. Doctors might look at addiction (all), suicide (all and nothing – dialectic), self harm (the same as suicide), unstable relationships (normally as a result of all and nothing) and emptiness (nothing).
This is most effectively treated with dialectical behavior therapy. A type of therapy that basically stops you reaching one (out of ten) when your down and self harming or attempting suicide, and helps control yourself and your impulsivity at nine (out of ten). This is because a “normal” person may move daily between four and six. A person with depression may spend a long period of time at two or three, before a period of time moving between four and six, and then return to two or three. A person with bipolar may spend a period at two or three then a period at seven or eight. And a person with BPD is constantly moving between one and nine, the extremes.
You may think that my mentioning of self harm and suicide is excessive. Self harm is very common in people with BDP. I have some very close friends with BDP, and I do not know anyone with BDP who has not self harmed in some way. It is worth noting that a therapist would not only consider cutting or burning yourself as self harm, but restricting eating would also be considered. There are many ways to self harm. 10% of people diagnosed with BDP die from suicide, and up to 80% of people diagnosed with BDP attempt suicide. I have attempted suicide twice and I self harmed. I have a huge amount to say on self harm. It is a fascinating topic and an example of someone being incredibly aggressive to themselves.
When I work with Time To Change and talk to people about BDP I talk to people about the everyday problems I come up against. I think to talk straight away about the suicide and self harm is going in at the deep end. Now, I do not self harm every day, and I do not buy pills and attempt suicide daily either. I have spent a relatively long period of time in therapy as an inpatient and an outpatient at hospitals. I have gone through a relatively short period of DBT (it recommended that DBT is developed over a two year period and I am currently six months into my DBT course).
I struggle with the little things daily. I do not want to generalize, and stereotype myself by a label or a condition, but people with BPD struggle to regulate emotions, as would be suggested by the European name given to the condition. It can only be a little thing at work that can set me off on a very quick downward spiral. I miss out the stage of feeling just sad. I go from okay to working out where I can buy pills and how to commit suicide very quickly. I am at a stage where I do not act out however. Through skills like mindfulness I can begin to regulate my response, in the hope that one day my emotions will middle out. It equally happens the other way. It only takes the first three seconds of Alive by Chase & Status to send me to a place of pure ecstasy. I start jamming away in the corner of the office where my desk is and I start planning where I can get a drink or start wondering if it might be a good idea to start taking drugs again. It really is all or nothing. I very rarely spend any time in the middle. Through mindfulness I really can control my responses though and it would be almost impossible to someone that did not know me to tell where I was between one and nine. I almost never act out on my impulsive or negative thoughts now. I was once at a stage where I would self harm or buy pills, and equally I have had periods in my life where I would use drugs excessively.
The fact that I will come up sharply from any down I experience I really consider to be a blessing that people with depression unfortunately do not experience, and I think that is a shame for them. I never spend a day completely down. In fact I am so in tune with myself emotionally that I know I will probably come up at about three o’clock every afternoon. And with a couple of double espressos and a dose of Chase & Status I can pretty much guarantee it’s going to happen. My therapists tells me I should be careful when I turn (as a bipolar may describe it) “manic”. But I promise you it is a great experience, and if you can control the impulsivity, I think it is there to be enjoyed. I definitely try and kick myself into, and maintain myself, in a “manic” state when I get the opportunity.
Another trait is the constant fear of abandonment. She may not know it but I am lucky to have a very understanding girlfriend who helps me control this. It is something I have suffered from badly in the past and as a result can make me a very intense person to spend time with, and without. I become scared if someone I am close to does not reply to a text within five minutes, and never expect just one missed call, I will call until you answer. Even going to the toilet when I am in a club alone will spark a fear that I will come out and everyone has disappeared. I hate doing anything alone on the fear that I will return to no one. Unless I am desperate I would rather not go. It might seem like a little thing, a daft thing, but it’s the little daily things that I think make mental health difficult.
Every story must finish with a good ending however. BPD is a condition with a very good prognosis. Once diagnosed, psychiatrists can begin to medicate through drugs and therapy. Drugs can take some time to get correct. I am not sure where psychiatrists stand on anti-depressants for BDP, but for Rapid Cycling Mood Disorder (the type of bipolar I suffer from) anti-depressants can destabilize. Anti-psychotics and mood stabilizers are the drugs of choice for BPD, and once the right combination for the patient is found, these can be very affective. And, of course, a course of DBT is hugely affective. Once treated there is a very prognosis that it is a condition that the person can deal with, with the skills learned. And that is the good news. It’s not easy, but it’s achievable.
In conclusion BDP is a fascinating condition that I would advise you to look into. With the help of people like Brandon Marshall (an American Football player for my beloved Chicago Bears), and Time To Change it is becoming an increasingly talked about subject. And I hope that continues. And finally I refer to my first paragraph. I stated how I appear “normal” and you would not know that many of my friends suffer with mental health. I said that because I truly believe that suffering with mental health makes someone no different from someone else. It is why I dislike the word disorder in BPD. Everyone is different and sometimes we require help with our differences but I reject the notion that there is something wrong with my personality, and I reject the notion that people with any mental health disorder should be subjected to any form of stigma. Suffering with mental health is not something to be afraid of, and it is not something others should be afraid of witnessing. It is fundamentally just the beautiful spectrum of humans and life.