Tag Archives: Borderline Personality Disorder

In Between Mental Illness and Wellness

I have often talked about recovery on this blog. Particularly, I have talked about recovery from my disordered eating habits and to a lesser degree self-injury. I wanted to get rid of my binge eating and stop self-injuring. Today, as I gave this some more thought, I took recovery one step further. So what if I stop bingeing and self-injuring? Would that then mean I’d be cured of my mental illness?

Of course, strictly speaking it wouldn’t. However, what if it did? What if I were cured of my mental illnness? After all, I exhibit far fewer destructive and aggressive behaviors than I did years ago. If I were to check mysel finto a mental hospital just as I am now, with no history of acute mental illness, the registrar would laugh at me. I wonder even if I’d be sick enough for outpatient mental health care if I presented with jut the symptoms I’ve been having lately. My overeating may or may not meet the criteria for binge eating disorder or eating disorder NOS. My self-harm does meet the criteria for non-suicidal self-injury, but then again these crteria are quite vague. My mood does not meet the criteria for a disorder. Heck, even when I was suicidal in 2007 and was clearly in need of acute psychiatric care, the only diagnosis the psychiatrist could come up with was adjustment disorder. Adjustment disorder is no longer covered by health insurance. In other words, under DSM-IV, which doesn’t include binge eating or self-injury as diagnoses, I would hardly if at all qualify for psychiatric care.

Of course, I do have borderline personality disorder and Asperger’s Syndrome – I still meet the criteria for these. However, no general practitioner would come up with the idea that I’d have these if I asked them to refer me to mental health services, and the vague referral letter my GP wrote in 2007 would not be enough now. So if I’m not sick enough at first sight for mental health care, am I then recovered? I don’t think so.

Mental health care has in recent years been more and more reduced to mere crisis intervention or other interventions directed at averting people becoming a pain in the neck. Now I won’t say I can’t be a pain in the neck, but a GP writing my referral letter from scratch now would not know. If you aren’t a danger to yourself or others, you most likely won’t get mental health services paid for through insurance. As such, mental health treatment is focused on curing the symptoms of severe mental illness (which is in most cases impossible), whereas recovery is more than that. Recovery, after all, is getting your life back on track.

As a long-term institution patient, I struggle with this. I am relatively well mentally speaking – probably not as well as I describe in the above paragraphs, but still -, but I don’t have a life. When I was admitted to the mental hospital in 2007, I was a university freshman in a new city. Now I’m nearly 30 and have little that could fulfill my life. I have my blog, but that’s about it. It makes me depressed. Not suicidal-type depressed (or should I say “adjustment-disordered”), but it does definitely make me slightly depressed. If I am not sick enough for mental health services and not well enough to get my life back on track without help, then where do I find help in recovering my life?

I hope that outpatient mental health services aren’t really as bad as I now think they are. I can only hope the recovery model still hasn’t been killed by the push for budget cuts. It however makes me sad to read in memoirs of mental health consumers about the recovery model and using mental health services to get your life back on track. After all, I’m afraid you can’t get mental health care for that now even if you’re severely mentally ill like myself.

Advertisements

S – #AtoZChallenge on Mental Health

Welcome to day 19 in the #AtoZChallenge on mental health. We’ve arrived at the letter S. Here goes.

Self-Injury

Self-injury or self-harm is the deliberate infliction of wounds upon oneself. Some scientists make a distinciton between self-injury and self-harm. Self-injury is then seen as leaving relatively minor, local wounds such as cuts or burns. Many people with depression, anxiety or emotion regulation issues such as in borderline personality disorder self-injure. Self-harm then is the infliction of grave harm onto the self, such as amputation. This is seen more often, according to these scientists, in people with psychotic disorders such as schizophrenia. In reality, of course, only a small portion of even the most severely psychotic patients engage in severe self-mutilation.

In DSM-5, non-suicidal self-injury was introduced as its own mental health diagnosis. Prior to that, many people who self-injure were misdiagnosed, often with borderline personality disorder. The DSM-IV guidelines even said that, if someone self-injured to cope with overwhelming emotions, BPD should be diagnosed, even though BPD has nine criteria, five of which must be met for a diagnosis.

Self-Medication

Self-medication refers to the abuse of alcohol or drugs with the goal to cope with mental health problems. It can also refer to the use of prescription medications that haven’t been prescribed to that specific person. Many people “self-medicate” with alcohol, even though alcohol does not have any medical benefits (except in mouthwash). In fact, it can make symptoms worse. Same for drugs. For instance, many people with psychotic symptoms use cannabis because it seems to calm them, even though it is in reality thought to worsen psychotic symptoms.

Of course, some drugs sold on the streets actually do help with certain symptoms. For example, people with undiagnosed ADHD might start using stimulant drugs to counter their symptoms. It is for this reason that self-medication needs to be taken very seriously. In my post on dual diagnosis last October, I addressed the complicated relationship between alcohol or drug use and mental illness

Survivor

Many people were and still are treated for mental illness against their will. In the antipsychiatry movement, people who come out of (forced) psychiatric care are seen as survivors. Many mentally ill people have indeed endured traumatic experiences at the hands of professionals. Many also have had other traumatic experiences, which may’ve contributed to their mental health condition. As such, they’re also survivors.

B – #AtoZChallenge on Mental Health

Welcome to my letter B post in the #AtoZChallenge on mental health. This is a much harder letter than A was, but I still found some interesting terms in mental health starting with the letter B.

Behavior

Behavior is defined on Wikipedia as “the range of actions or mannerisms by individuals in conjunciton with themselves or their enviornment”. Well, it does not include just individuals, but also animals, artificial entities, etc., but the full definition is way too complex to go into here. The bottom line is that behavior includes all actions a person (or animal, artificial entity, etc.) conducts in interaction with themselves or their environment. Everyone exhibits behavior, sometimes not even consciously.

In mental health care, however, “behavior” has a different meaning. It refers not to everything a person does, but to specific actions that are supposed to say something about their mental health. “Behavior” then becomes a sign of mental illness. Worse yet, when a mental nurse says something is “behavioral”, they usually mean it’s willful. “That’s behavior”, is a mental nurse-ism for “you are willfully acting inappropriately”.

Biomedical Model

This is the model which sees illness as a direct result of dysfunction in the body. The biomedical model, when applied to mental illness, sees mental illness as purely a chemical imbalance or a brain disease. Proponents of the biomedical model use only medications or other biological interventions (eg. brain surgery) to treat mental illness. There are hardly any doctors who subscribe exclusively to the biomedical model, especially in mental illness.

Bipolar Disorder

Also known as manic-depressive disorder, this disorder is characterized by alternating episodes of major depression and mania. Mania is a state of elation where a person is overly active, reckless and impulsive and/or irritable. Some people in a manic phase spend thousnads of dollars they don’t have on things they don’t need. Bipolar disorder is not about mood swings. Rather, the depressive or manic phases last for at least a week for mania and two weeks for depression, often longer. Some people in manic states experience psychosis too. Then we get the well-known delusion of gandeur. Please note that being convinced you are Napoleon does not make you bipolar per se. Bipolar mania, as I said, also includes increased activity, impulsivity and irritability.

Borderline Personality Disorder

I have this diagnosis and it’s really one of the most misunderstood mental illnesses by mental health professionals. The lay perception (and perception by some professionals) of BPD is one of a woman who threatens suicide when a friend doesn’t answer the phone within five seconds. She has one boyfriend after another, with whom she picks fights then five minutes later makes love. She doesn’t show up for therapy appointments, but demands her therapist make time for her whenever she does show up, then when they refuse she runs in front of a slow-moving car saying she’s going to kill herself. That last one was a true example from my psychology textbook, seirously.

Surprise: this is not what BPD is like in most cases. Firstly, BPD occurs almost as often in men as in women but is underdiagnosed in men and overdiagnosed in women. Secondly, BPD is characterized by emotion regulation difficulties, which means a person’s emotions can shift rapidly. People with BPD often do engage in self-injurious or suicidal behavior. They also have an intense fear of abandonment, which leads some to fall in and out of love very rapidly. Borderlines do outwardly look like they are manipulative bitches sometimes, but inwardly, they suffer tremendously from their rapidly shifting emotions. They do not demand excessive attention per se (like people with histrionic personality disorder do) Learn more about what it’s like to suffer from BPD.

On long-term mental units, you don’t see many people with BPD, because standards of care dictate they can only be admitted very briefly for crisis intervention. Us borderlines are supposed to get dependent otherwise. Well, I can tell you, I know people with other diagnoses who are much more dependent than I am.

Victim to Survivor to Thriver

Last week, one of the Friday Reflections prompts was about being a victim or a survivor. I didn’t have time to write about it then, so I will write about the topic now. I’m pretty fatigued and quite emotional today, so I hope my words make sense.

About ten years ago, I wrote on a mailing list for former preemies asking whether those born prematurely are survivors in the way that abuse survivors are. I mean, literally speaking of course we are survivors, because we survived against all odds. I was at the time still in a very early stage of figuring out my childhood and why I have always felt like a lot of my experiences were traumatic. I was beginning to discover the fact that I dissociate and learning about attachment and its dfficulties. The group owner, herself also a trauma survivor, replied that to survive means to endure hardship, so that in this sense, of course preemies – and most people with disabilities – are survivors.

As a child, I considered myself a victim of many of the experiences I endured. They were still happening, so how could I see myself as a survivor? In the same way, I can now see myself as a victim of mental illness. I don’t, of course, because no-one inflicted my mental illness on me and, besides, I don’t consider my craziness an altogether bad thing. It sucks sometimes, of course – well, most of the time it sucks. My point in saying I could now consider myself a victim of mental illness, is that it’s not over yet – I haven’t survived it as it’s ongoing.

I did survive my childhood trauma and do consider myself a survivor. Being a survivor does not mean having completely healed from your experiences, but it means having come out the other side alive literally and figuratively.

When describing the recovery process for people who endured trauma, we generally use three steps so to speak: victim, survivor and thriver. A victim is still in the midst of an experience. For instance, someone enduring domestic violence who hasn’t left the relationship yet, can be considered a victim. A survivor has escaped the direct effects of the trauma but is stil suffering from post-traumatic symptoms. A thriver has moved beyond their trauma and is living as healthy as possible a life.

The steps are not rigidly divided. For example, if a domestic abuse survivor has left their abuser but has not gone “no contact”, they can be both a victim and a survivor. Thrivership is also a continuum, where some people have no post-traumatic symptoms at all anymore and others can manage in spite of them. I will most likely always have borderline personalty disorder, which is in a way a post-traumatic condition. However, I want to someday have a meaningful life in spite of it.

Bar of Expectations #MondayMusings

Last week, I was readig the book Believarexic by J.J. johnson. I have not been able to get far into the book, because I got easily triggered. The book is about a girl, Jennifer, probably the author as a teen, who has an eating disorder. She eventually decides to tell her parents and have her Mom call a hospital for help. At the intake interview, Jennifer’s Mom is skeptical that Jennifer really has an eating disorder and isn’t just seeking attention. The psychologist tells them that only time will tell whether Jennifer’s eating disorder is legitimate. Legitimate. As if it were some rite of passage. In the hospital world of course, it is: without a mental illness, you aren’t admitted to a psychiatric unit.

This all reminds me of my own experience being admitted into the psychiatric hospital in 2007. The psychiatrist had to practically make up a diagnosis to get me admitted. That is, she diagnosed me with an adjustment disorder, which is really an extreme, debilitating reaction to stress. It is serious, but it is not a severe mental illness. Basic health insurance in the Netherlands as of 2012 no longer covers care for it. Of course, there are exceptions. I was suicidal, so I probably would still get care under these new insurance guidelines.

The story goes on with Jennifer being admitted to the eating disorders unit. One of the rules of the unit is patients having to resign complete responsibility over their eating habits. That was another trigger. In today’s treatment models, patients are usually required to take a lot of responsibility for themselves. Certainly patients with eating disorders are. So are patients with, well, borderline personality disorder, which is what I’m diagnosed with.

It isn’t that I’d like to resign all my responsibility. In truth, if I could, I’d be completely self-reliant. But I can’t, and I’m stuck in the middle between self-reliance and dependence. This is terribly hard. It means I constantly need to negotiate the right kind of help and the right level of independence and assistance.

Today, as I was on the edge of a meltdown, I told a nurse I’d rather be sent to the locked ward and stay there for the rest of my life. Regardless fo the fact that no-one can just stay on a locked ward without any sort of participation in their treatment being expected of them, I’ve not had good experiences on locked units. I rather meant that I’d finally like to make a choice between being completely self-reliant and responsible and being completely dependent. As I can’t choose complete independence, I’d choose dependence instead.

More so, I don’t want people’s expectations to constantly exceed my abilities so much. Currently, I’m constantly reaching for a bar of expectations that, no matter how high on my toes I stand, I just can’t reach. I’m thinking of jumping to the bar so high I fall flat on my face. Then at least people have to lower the bar.

#MondayMusings

Seven Things

Last week, one of Friday Reflections’ prompts was to list seven things about yourself. I was at my parents’ for the week-end, where the desk I had my computer on was uncomfortably high. I also I had a hard time concentrating with my parents, husband, sister and her boyfriend in the room. For this reason, I didn’t write a post this week-end. (On Friday, I attended a concert so didn’t have the time to blog at all.) I’m still not very inspired today, so I just choose to use last Friday’s prompt. Here are seven keywords that describe me.

1. Preemie. Last week was World Prematurity Day, so I just got to choose “preemie” as my first descriptive word. I was born a little over three months premature in 1986. I was very lucky to have been born in the city of what I believe is the oldest children’s hospital of the Netherlands and even luckier that the Netherlands is a developed country with good health care. Read this article on Preemie Babies 101 to find out more about preemie care in developing countries. This made me realize how fortunate I am.

2. Intelligent. This is the first thing my parents would say if they had to describe me, or at least it was when I grew up. When I was twelve, my verbal IQ was measured at 154 (my performance IQ cannot be measured because I’m blind). This means I may be intellectually gifted. At least, Mensa considers a verbal IQ of over 130 to suffice for membership if you’re blind. Yes, I did at one point consider joining Mensa.

3. Blind. Okay, let’s start the collection of disability labels here. I am blind. I have always been legally blind and have been practically totally blind since age eighteen, although I still keep noticing that my vision can get better or worse. I notice even tiny changes that are not measureable by ophthalmologists. I am clasified as having light perception only and have been classfied as such ever since 2004, but I still use the tiny bit of vision I have for orientation sometimes. Maybe I shouldn’t, but I can’t shut it off.

4. Autistic. And possibly otherwise neurodiverse. I wasn’t diagnosed with autism till age twenty but suspected it from age twelve on. My parents didn’t want to hear of it, so after they voiced thir strong disapproval of my “hypochondriasis”, I pretended I was completely neurotypical. I failed, of course. Even though my autism diagnosis has been questioned a few times, most professionals are sure that I’m not neurotypical.

5. Mentally ill. After all, I have a mental health diagnosis. I am not one of those neurodiversity activists who believe that a psychiatric disorder is completely separate from a neurodevelopmental disorder. That distinction is, in my opinion, entirely political. I however do sometimes wish I didn’t have the diagnosis of borderline personality disorder, but that’s because BPD is one of the more stigmatized mental health diagnoses.

6. Blogger. I have been a blogger since 2007 (or 2002, if you count my online diaries that have been republished on my old blog). I don’t like to be associated with my old blogs though. I have this idea in my mind that I need to blog regularly or i need to start over and not associate with my old blog at all. It’s really surprising that this blog has been active for over two years, because I’ve started and restarted my Dutch blogs half a dozen times in the last year.

7. Wife. I don’t like this word, although I do like to refer to my husband as such. It’s probably because, in Dutch, the word “wijf”, which sounds like “wife”, is an insult for a woman. I always feel that the word “wife” sounds slightly submissive. However, I like being my husband’s wife.

Then and Now: A Timeline of My Mental Health

It is often hard to see how far we’ve come on our journeys in life until we look back at where we came from. I am no exception to this. I tend to feel that I’m not improving in my coping with my mental health issues. There’s still this hurricane in my mind, after all. It is also hard because, whenever I seem to improve in my behavior, people’s expectations rise even higher. To shed light on the positive changes I’ve made on my journey through life with mental illness, today I will write a timeline of events related to my mental health.

2007: I was hospitalized on the acute ward on November 3 of this year. I was not allowed to leave the ward without someone accompanying me. For the first few days, I even had to have a nurse accompany me. After those first few days, any adult could accompany me, but they had to sometimes assure the nurses I was safe with them.

2008: I started out the year with a setback: I was given a seclusion plan, which meant I could be secluded if I was a burden to other patients or staff. By early February, however, my privileges were finally extended so that I could go off the ward unaccompanied for fifteen minutes. By early March, my privileges were quite suddenly extended to four hours of unaccompanied time off the ward, which is the maximum you could get at that unit. If you had this privilege, you could ask for extended leave if you had a reason for it. My seclusion plan was also lifted, only to be reintroduced again by June. Fortunately, I never had to actually be secluded, but the nurses frequently used it as a threat. The plan was lifted again in September, but only so that I could be moved to the resocialization unit.

2009: I transferred to the resocialization unit in March of 2009. I did mostly okay until September, when I had a major meltdown which elicited another patient’s aggression. The possibility of moving me to the locked ward for a few hours if I acted out was introduced into my treatment plan.

2010: I was sent to the locked unit for the first time. This did lead the staff to consider medication, and I agreed. I started on a low dose of Abilify, an antipsychotic, in late February. It had to be increased to a moderate dose by the summer and by September, Celexa, an antidepressant, was added. Both helped calm my anxiety and irritability. In November of this year, I was diagnosed with dissociative identity disorder and PTSD.

2011: I was on the waiting list for an autism-specialized group home and went there to stay over for a week-end in October of 2011. Unfortunately, the group home had changed its target population and there was too little support by the time I stayed over there. I didn’t end up going.

2012: I started planning to live with my husband by this time, originally pretty much solely because I didn’t have any suitable alterantive. I don’t mean this to insult my husband, but I didn’t feel I should be burdening him with care duties if at all possible. We moved into our aparetmetn by December. Meanwhile, I was trying to get treatment for my DID/PTSD.

2013: I had an intake interview with a psychiatrist who thought she could treat my DID/PTSD. She ultimately ended up turning me down. It had nothing to do with me, but she was too busy with her physician duties. I moved to my current institution, where i was soon diagnosed with borderline personality disorder. I started schema-focused therapy, but this had little effect. My Abilify also got increased some more.

2014: I continued to struggle, but for the most part was quite stable. My Abilify had to be increased one last time in late 2014 (I am now at the highest dose). I did improve in my behavior and got a more cooperative relationship with my staff. I spent a few times in seclusion, but always voluntarily.

2015: I decided I wanted to live with my husband for real this time. We have been making arrangements, though it’s been slow-going. We will be moving to the tiny village sometime in December, so concrete arrangements cannot be made till then. I have been trying to get a med review for a few months now. Though my mind is still very unquiet, particulalry as my discharge out of the institution draws closer, I don’t tend to act out as much as I used to. I was in seclusion for a while last Monday, but before then it’d been over six months.

As I look back, I see that sometimes I take steps back and sometimes I take leaps forward, but in general, I’m moving up. I’ve never had to be moved back to a more restrictive unit, though I’ve sometimes wanted it. My medication did have to be increased a lot, but I don’t see that as entirely negative.

I am linking up with the 1-word blog challenge hosted by Lisa and Janine. The word choices for today are THEN and BREAK.

Hurricane #WotW

Yesterday, I bought the book Women and Girls with Autism Spectrum Disorder by Sarah Hendrickx. I have been on the verge of crying as I read it. Hendrickx starts the book by recounting her meeting with her son’s autism diagnostician, whom she tells that she herself has autism too. The doctor doesn’t believe her, because she can hold down a two-way conversation. Wham! I heard that exact same stereotype countless times before. Hendrickx replied that maybe it’s because she’s an adult and a woman.

Last Wednesday, I was trying to communicate the mind-blowing chaos of thoughts and emotions and sensations in my head that is casuing me to have great difficulty functioning. I’ve tried to communicate this ever since I entered the mental health system in 2007, but it doesn’t seem like this is of any importance to my staff or treatment team. My psychologist put it down as rumination in an E-mail to the psychiatrist, because I asked for a med review. The “hurricane in my mind” led to a crisis yesterday. For whatever reason, a psychologist – one I hadn’t met before – was sent to talk to me today. Usually this means I’m in big trouble, but he didn’t threaten any consequences.

I’m not sure whether an unquiet mind is common with autism or whether it’s purely a borderline thing. I sense that it’s more to do with my autism, because it is not the content of my thoughts that is distressing, but the chaos the thoughts, emotions and sensations create. As such, it is particularly hard to communicate.

Unfortunately, my unit is not equipped to deal with autism and I appear to function too well to be getting autism-specialized support. The autism center’s entire recommendation was thrown into the bin by my psychologist and now I’m stuck being sent to a treatment team for personalty disorders. I won’t say I don’t have BPD too, but I also have autism and need support for this. Unfortunately, because I can hold down a two-way conversation, the team thinks I’m not all that autistic at all. Maybe that’s because I’m an adult and a woman.

After all, I was utterly incapable of holding down a two-way conversation even when in high school. As I’ve shared before, I am perhaps the opposite of the old DSM-IV autism criterion which says that autistics do not spontaneously share their feelings or interests. Hendrickx does point out that autistic girls may superficially appear quite sociable, but show self-centeredness on a deeper level. That’s exactly me.

But I don’t care about behavior, at least not anymore. Medication has sedated me enough that I don’t exhibit many troublesome behaviors anymore. Perhaps this means I can now come across relatively normal, but I don’t feel normal at all.

Another thing that’s annoying about this is people constantly attributing thought processes to me that aren’t there. For example, when I reacted with irritability at a psychotic man on my unit who constantly talks to his voices, I was told that I should try to imagine what it’d be like to hear voices all the time. I can’t imagine what that’s like, though I do understand it must be very distressing, but my irritability was not out of anger with this guy. It was just that I was utterly overwhelmed. And just so you know: thinking that the hurricane in my mind is just a breeze, doesn’t make it disappear.

Due to the stress of making arrangements for moving to the tiny village, the hurricane, the chaos in my mind, has been particularly strong this week. Therefore, I choose “hurricane” as my word of the week.

The Reading Residence

Breakdown: My Crisis of 2007 #Write31Days

31 Days of Mental Health

Welcome to day 30 in the #Write31Days challenge on mental health. Today, I discussed the details of the mental crisis that I had in 2007 with a nurse. This helped me feel heard but it also was a bit unsettling. I vividly remember many of the details. I feel compelled to share my story here, but I don’t know how safe a public blog on the Internet is to do so. I shared the details in a post on my old blog (which can still be more easily found by googling my name than this blog) about a month after the crisis happened. I published the raw story back then, complete with every detail of where I was and what I did. I edited it more than a year later for fear it’d ruin my chances of ever having a normal life. If future employers (of which I think I’ll have none) ever read that I’m a nut case and spent eight years in a mental institution, they’ll reject me no matter how vividly I describe the crisis that led to said institutionalization. That being said, the original story was quite badly written. I don’t want to read even the edited version now. I’ll just share what I feel like sharing now.

I remember the crisis state started right after daylight saving time ended on October 28, 2007. Of course, I was spiraling down into crisis from the moment I started livign on my own in August and I had a minor crisis about once a week. The week of October 29, I started completley losing my mind. I wandered about in the dark each evening. The police took me to the police station a couple of times that week and called the crsis service, but they couldn’t do anything.

In the afternoon of October 31, I was called by the crisis service. I still remember the name of the crisis service nurse calling me and if I ever run into her again, which is unlikely, I’m not going to be pleased. She told me that I just had to find ways to distract myself and that a hospitalization would mean I needed to go back on medication. (I’d quit an antipsychotic three weeks prior. No-one later on drew the connection.) I didn’t care about going on medication one way or the other, but I couldn’t mutter a proper response.

On November 1, I took a trip to my parents’ city to collect a landline phone. I don’t have a clue why I had to sleep over there for a night just to collect a phone. On the way back to my city the next day, I had a huge meltdown. This wasn’t unusual for me when returning to my city from my parents’, but for the first time, the railroad service employee who was assisting me to get on the train back to my city, called the police. I hardly realized I was speaking to the police when they told me to leave the station. I wasn’t sure what to do at first, so wandered around. I remember somoene, no clue who, told me that if I could behave, I could come back to the station and get on the train to my city.

I decided to go to the training home which I’d been a client of before going into independent living. I was allowed in, but once the staff found out the police had been called on me, they asked me to leave. I can’t remeber what I did throughout the afternoon. I was supposed to have an early train, but didn’t end up in my ultimate crisis till 8:00 PM. I remember getting some French fries at a cafeteria near the training home and calling my independent livign support worker that I’d forgotten to pay my rent for November the day before.

A housemate from the training home offered me to stay with her for the night so that we could find a solution the next morning. The staff went into her apartment and told me to leave. They initially gave me some time, but I left instantly and had the hugest breakdown I’ve ever had. I was hardly aware of my surroundings as I told some people’s voicemails that I was going to commit suicide. I inferred the time from what the bus driver, on whose bus I’d embarked, told the police. It was the 8:01 PM bus around the eastern part of the city (in that city, buses go in circular routes or at least they did back then).

I was taken to the police station by the police again. This time I was in my parents’ city so the route to crisis services was even longer. The police had to call a community physician who was the most umempahtetic jerk of a doctor I’d met by that time. (I later was treated by an authoritarian psychiatric resident, but she never had to talk to me in the midst of a crisis.) The doc told me I was making people feel responsible. While I can see eight years on that he was right, I couldn’t grasp this back then. I don’t remember my response. The community physician called the crisis service. I have recurrent dreams about the psychiatrist, the only one whose name I remember. In my dreams, I run into her again as I get treated at the mental health agency near the tiny village I’m moving to.

I am a million times thankful that this psychiatrist didn’t stick the BPD diagnosis on me, even though in retrospect my crisis could be interpreted as a typical BPD thing. Instead, she talked to me – she showed much more empathy than the community physician and eventually labeled me with adjustment disorder, which basically means an extreme response to stress. She suggested I be admitted and right away clarified that a suitable living solution would need to be found for me while I was in the hospital. No-one could’ve known back then that it’d take eight years and I’d be going to live independently once again after that.

Post Comment Love

What My Mental Illness Feels Like #Write31Days

31 Days of Mental Health

Welcome to day 29 in the #Write31Days challenge on mental health. Phew, we’re almost done. I truly find it a challenge and unfortunately don’t find it particularly rewarding.

Today, I’ll give you a glimpse into my unquiet mind by describing what it feels like tohave my mental illness. I have been diagnosed with borderline personality disorder, which is characterized by self-regulation difficulties. It also overlaps with other disorders.

Once, years before I had been diagnosed with any mental illness at all, I read a description on a Dutch site of the “borderline feeling”. It described a starting point at which you are feeling fine, or at least appearing as though you are fine. Then, a minor annoyance occurs. You start feeling frustrated, angry, infuriated. Then you feel sad, depressed, depserate. Fear and then panic also comes in. Finally, all feelings tumble over each other and create a big emotional whirlwind. That’s what the experience of BPD is like.

I can illustrate this with an example. This afternoon, I was feeling slightly on edge because it was time to make afternoon coffee and no-one was available to assist me. Then, when I noticed the nurses were flipping through some seemingly unrelated photos at the nurse’s station, I completely lost it. They had told me they were busy and now they were just chattering! I can’t even remember how the situation progressed, but within minutes I was banging my head, screaming and then ran off. When I came back to the unit (I had the sense of rationality to find my way back myself), I accused the nurses of faking being busy and ignoring me. They had truly ignored me (or been oblivious to me at least) when i stood at the nurse’s station and I still cannot be sure what thing was keeping them so busy. That being said, I couldn’t politely ask them whether they truly didn’t have time to help me make coffee.

We had a group discussion, in which I was again relatively calm. Then we had dinner, after which I went on the computer for a bit. I still was feeling slightly on edge but not over the edge. I wanted to talk to the nurse, so made use of my daily talk time to discuss my tension. However, I couldn’t get it out clearly what I was feeling and why. At that point, all emotions started coming together and I became angry and depressed and fearful at the same time. I went outside, accompanied by the nurse, to blow off some steam.

Usually, this feeling I had in the evining for me is triggered by some flashbacks or relivings of past “trauma”. I put that between scare quotes because the events I am reliving can be relatively minor. However, they can cause distress nonetheless.

During such episodes I also often feel dissociated. I used to completely regress into a child mode, but now I just feel as though I’m small and start speaking or babbling incoherently but don’t fully act like a child.

When an episode is severe, I may resort to self-destructive behaviors such as binge eating or self-injury. Usually, these behaviors temporarily relieve the tension but obviously they aren’t the solution. I often relapse soon after I engaged in destructive behaviors. With PRN tranquilizers, especially benzodiazepines, the same used to be true: they temporarily calmed me down, but when they wore off, I was increasingly agitated. Research shows that borderlines often become more agitated and may become aggressive when given benzodiazepines, because benzodiazepines reduce their anxiety and thereby their impulse inhibition. I do not personally experience this.