Please be aware that some of the content may be triggering. Please take care 💚
Last week after a while of not feeling anything or pushing emotions down I was suddenly overwhelmed with them. It is an experience I know many people with a mental illness feel at times, especially those who have a diagnosis of Borderline Personality Disorder (BPD).
I don’t understand my emotions most of the time. Identifying them is an extremely difficult thing for me. When they overwhelm me this is harder to do and harder to deal with as well. People will ask what’s wrong or what you’re feeling and not being able to explain it is so hard to deal with and seems to add something into the emotions that makes it all the worse. I feel I just want to be a “normal” person for a while.
Those with a BPD diagnosis find emotions are heightened. They are often described as being emotionally like third degree burns victims without an emotional skin. It’s like touching wounds when we feel emotions. The pain of them is strong and this can be felt physically in the body. And by god is it painful at the extremes. When most people would have a small emotional response, ours tends to be more intense or bigger. Therefore when a person without the diagnosis has an event that causes them extreme emotional pain, well for those who have a diagnosis of BPD it is just unbearable.
When the emotions overwhelmed me I just wanted to tear my skin off. I wanted to hurt myself to an extreme extent. I wanted to escape it all. Death felt like the best idea but I felt trapped as it wasn’t an option. This added to the distress. The hatred for myself is strong. It’s always strong but in that moment it was extreme. It was unbearable and I could not even work out what I was feeling.
This happens more often than people realise. A lot of the time I just hide away. My friends cope with a lot. I feel sorry for them. I hate what I do to them. They deserve better. I try my hardest to not inflict myself on them but in the moment it’s harder. This isn’t the healthiest way to cope.
I don’t have much advice for coping. Dialectical Behavioural Therapy (DBT) offers some skills for dealing with distress. These include the TIPP skills and STOP skills that are detailed in the images below. However it can be hard to remember to do this when the emotions are so high. It’s like they are blinding. It could be useful to let someone close to you know about the skills so they can remind you of them.
If you have any other tips for coping with overwhelming emotions then feel free to share in the comments or on Twitter, Facebook or Instagram.
“Mental resilliance” is a phrase that keeps cropping up. But it is a phrase I have come to hate with a passion, especially with the way it is being used. It’s connotations make me uncomfortable and I cannot accept it.
First of all I think we need a definition of the word resilience. I’ve found a definition of it in psychology: “The ability to adapt well to adversity, trauma, tragedy, threats, and even significant sources of stress.”Better Help, 2019
This doesn’t sound too bad. It suggests that we can learn how to get over issues more quickly. However this has led to people taking the phrase and believing that people with a mental illness should be more able to get over a mental illness quicker if they are resilient or even not suffer in the first place. This has been shown by comments made by prominent people in the media.
The problem with these comments is that they imply that if you get ill mentally you are not resilient enough. It gives a sense of failure and that you are not a strong person. This couldn’t be further from the truth. Quite often people with mental illnesses are strong and resilient for too long. They don’t seek help straight away as they feel they should be able to deal with it. This talk of resilience reinforces it.
So what should we be doing?
I’m not saying there is no place for teaching skills to help with mental resilience as it is useful to deal with stressful situations in the short term. However we need to make the narrative clear that mental resilience is not a concrete prevention against mental illness. It is still possible to become unwell even if you are resilient. It does not mean you are weak if you become unwell. Mental illnesses are often caused by things outside our control and for that we need treatment.
Instead, as well as teaching true mental resilience, we need to be saying that it’s OK to talk about our feelings in times of distress. It does not make us a “whiny snowflake”. It is a strong thing to do and will help with our resilience in the future. We need to be helping each other. Just because your younger and suffering does not mean you are less resilient than someone older. All it shows is that I’m the past people couldn’t speak about mental illness and now they can. That is resilience but in a different way.
I think what we need to do is reclaim the term mental resilience and educate people on what it means. We need to take on these people who seek a generational divide about living with a mental illness. We need to change the language we use.
So my question today is what do you think we should be teaching in terms of mental resilience? Feel free to share in the comments or on Twitter, Facebook or Instagram.
Please be aware that some content may be triggering. Please take care 💚
Today’s session started off with asking me to look back on last week’s session and how I felt. I admitted I felt angry but found it hard to discuss the causes of this anger. I think for me, even though I know she is a professional and I don’t feel we get on very well, I’m still scared that she is going to stop the therapy and abandon me and I’m scared to say anything that may cause that. I’ve waited a long time for this and pinned so many hopes on it that I’m terrified of losing it and losing hope, though some of that feeling is already creeping in.
We went back over the self harm issue again and how I’m loathe to let it be the main goal of my therapy to stop it. We went through wise, reasonable and emotional mind from DBT (Dialectical Behaviour Therapy) skills to look at where I’m at. Apparently even when I think I’m being reasonable I’m not. After this we left it to go on to discuss other things, taking away from this being a large goal.
The main part of therapy today was to look at the voice I hear. I was trying to explain how even though I’m aware that it is either a chemical imbalance or trauma based phenomena it does not stop the impact it has on me. I did start to feel invalidated here, which felt ironic as later when looking at something else she stated part of my issues come from being invalidated.
Overall there is not much to discuss from today. I was very frustrated through a lot of it as I felt I wasn’t making myself understood and I couldn’t find the words to make myself understood. There are many things I struggle with and get upset with and this is a big one. It’s why many times in my actual life I don’t talk to others in case I’m misunderstood. Speaking, for me, seems to take away my ability to use language affectively. And even if I write down and read it I try to alter it and again become frustrated.
I was given my first piece of homework today as well. After I informed her I was not worth anything she decided that was not the case and wants me to find ten things that would be different I was worth something. She has no idea of the evidence I have to back up the statement that I am not worth anything.
There is an amazing account on Twitter called Dear GP where people write letters to their GP about their encounters with mental health professionals in the same way mental health professionals write letters about their patients to their GP. You can visit the website here. I thought I would have a second go at this below after an encounter during lockdown. My first attempt is here.
Today I had a telephone consultation with care coordinator M due to the current lockdown conditions. This was an unscheduled appointment and was preceded by a text message which stated that she wanted to talk to me straight away and was demanding of immediate contact without considering my prior commitments.
When we spoke to each other on the phone, M was in a jovial and friendly mood. She seemed to need reassurance about our working relationship due to comments from other staff members based on what she had said. She denied she had said anything to other staff members about our working relationship and stated “we work well don’t we?”. Her need for reassurance shows, I believe, an insecurity and possible fear of abandonment.
We then discussed my mental wellbeing. Here M was keen to show that everyone is struggling and dismissed suicidal ideation. Her concentration during this part of the conversation seemed to dip and she appeared to want this to end quickly.
Her next actions I believe confirm her fear of abandonment. She decided to put an end to our working together stating a too high workload. She did however say that I could always let her know good news. She seemed not to wish to cut ties completely showing difficulty with endings.
Overall I think M may need to work on her social skills but I do not wish to see her again and feel she will be fine under your care. Please do not rerefer.
Please be aware that some of the content may be triggering. Please take care.
When I feel suicidal I know that my answers to questions and what I say in general change. How I act may also seem to differ from “normal”. Here I thought I’d discuss some of my tells and some I have learnt about from others. Being aware of when someone is feeling suicidal means we have a better chance of helping them before we lose them. Everyone is different but hopefully this may help us identify the signs and give us the courage to ask these people “are you feeling suicidal?” and get them the help and support they require.
1. I’m fine/I’m tired
A huge thing is that when I’m doing really bad I say I’m doing good. Or I say I’m tired. It’s a sign my mood is rapidly dropping. I might not be at the suicidal zone yet but I’m heading that way most of the time. There are other phrases I’ve heard other people use that are signs they’re struggling which have included “not too bad”, “plodding along” or “up and down”. Obviously people use this when they aren’t heading into the suicidal area but it’s worth being alert.
This is a huge tell of mine. In my head I’m thinking that I’m helping people get used to me not being around and showing them they don’t need me in their lives. I convince myself it’s for the best. It takes a lot to drag me back from this without me making an attpt although that has become less frequent in the last couple of years.
3. Suicide memes/quotes
I may start to spend a lot of time on Tumblr looking at the suicide hashtag. It’s normally something I will do without others being aware so not always a sign but occasionally I will share one or two of these.
4. Googling methods
Again this is something I may do on the quiet so not always obvious but I may admit it to others. It may be that other people don’t hide it as much and it is a sign to look out for.
5. Being really happy after being really low
Sometimes I will go to the total opposite. I will desperately try to hide behind humour. I will try and be really bright and help everyone and not answer when they ask how I am. I become really generous and do lots.
6. I don’t answer how I am
Yep I hid one in above. Did you notice it? See how easy it is to miss? Sometimes the signs are so hard to see. I dont always see them. I’ve had a friend make an attempt later the same evening I’ve been talking to them and never twigged how awful they were feeling. It brings its own guilt but it is not your fault.
There are other signs I have written about before but I thought these would give an insight into the less well known. And ones I’ve experienced. For others please look at my other blog post here.
If you have anything to add feel free to use the comments or you can find me on Twitter, Facebook or Instagram. If you are feeling suicidal you can contact the Samaritans in the UK or go to the page called crisis lines in the menu for help in other counntries.
Currently having experiences of some form of mania on a regular basis. It can be part of Borderline Personality Disorder (BPD) as well as bipolar. Tonight it’s awful. I can’t keep still. My thoughts are racing. I’m irritable. I want quiet but I want noise. I want to move but I want to lay here. I want to do things. But I don’t. Nothing is keeping my attention long. Everything is either very amusing and causing me to try and make things seem funnier to everyone else or I’m apologising profusely for being a pain. I hate this. It’s exhausting but I can’t sleep. Typing is hard. Words are in my brain but typing them out they have extra letters or are spelt wrong or put together in a way that I thought made sense but doesn’t. Luckily autocorrect is a thing and I can still see where I’m making mistakes and change them as I go but it’s frustrating me. I know my writing is probably rubbish. My swearing barrier is also less of a thing though I’m trying to restrain myself from swearing here. I’ve been trying to calm all evening. Doing calming activities but it’s all rubbish and I feel rubbish and frustrated. Nothing works. I’m trying so hard. The mania I have now is linked to a course of steroids I’m on for a physical health issue. I’ve not had mania like this in years. I realise I’m using the term mania a lot and it’s not like with bipolar I don’t think. It doesn’t last solidly. It comes and goes. Normally my mood stabiliser keeps me more stable with dips into depression. I forgot how exhausting this is. And I’m not a teenager anymore. People don’t expect this. As a teenager it could be hidden as just a teenage thing to many. Just someone who was passionate and had lots of ideas and a screwed up sleep pattern. Now as an adult it’s not so easy. My mum notices it. She put it to good use this afternoon moving soil and emptying pots. She saw I couldn’t settle to anything or think for myself so she provided a little routine. It helped. I felt less frustrated. But it’s back and I will go to bed soon to try and keep a routine but I’m not hopeful. The scariest thing though isn’t being out of control (though I hate that feeling) but the thought that what goes up must come downand this applies to my mood too. I will crash. Its inevitable. And I know it will hurt.
Please be aware that some of the content may be triggering. Please take care when reading.
People always want to know what it’s like to have Borderline Personality Disorder (BPD). They want to know how I live with it and what’s going on in my head. They want to know what is me and what’s the illness. So I thought I’d try to put into words some of these things and few other bits. It may not be succinct or always easy to follow but that probably says as much about this disorder than anything else.
I hate being in my head. Life is exhausting. I second guess myself all the time. I know there is something wrong with me. For years now people have officially known that doctors see my personality as screwed up. Thanks!
The thing is I’ve thought I’m screwed up for a long time. I’ve always felt on the outside. I’ve never felt a part of the group and for years it’s bothered me. I couldn’t work out how people made friends so easily and even more how they kept friendships without coming across as totally needy and to be called “a sheep”. Believe me it’s happened.
To begin with I tried my best to fit in. I rejected things I liked in favour of what others liked. This included music and television shows. It included the way I behaved with others. I just wanted to be “cool”. It didn’t work. I was seriously unhappy and it was totally unnatural. I hated myself. And I lost myself.
That’s part of BPD, lack of a sense of self. Knowing what I like and who I am is hard. Do I like something or is it just because someone else says they like it? Obsessions come and go often depending on other people’s feelings towards them. With age there has been a bit more stability in this area but it can still fall apart. I will allow myself to like things that others close to me don’t now. It’s quite freeing but hard as I fear my likes will make others dislike me.
The fear of being disliked is strong. The fear people will hate you and leave you very much in evidence. This can lead to desperate behaviour. This is where the term “manipulative” comes out. We can appear manipulative because we are desperate to hold on to people so can make what appear as threats of harming ourselves. But we don’t use it in a manipulative manner. We are scared. We don’t know how to keep our fear under control (and this fear is strong and terrifying) so we want to hurt ourselves as we can’t imagine being without the other person and we are hurting so much. We don’t want to hurt you really. We want to stop the pain. However we can learn to deal with this better but it takes time. And the fear doesn’t seem to ever leave. At least that’s my experience.
I talked about overwhelming fear above. All our emotions though can be overwhelming. I can feel physically sick with fear over something others would feel vaguely scared about. If something apparently trivial goes wrong that can lead to suicidal thoughts taking over. It may seem silly and overdramatic to you but to me these are my real feelings. Saying they’re silly and overdramatic to me just invalidates me. I already do this to myself. I know it sounds silly to you. I know I sound overdramatic. But it’s how I feel and it takes me time to work out if that’s justified and change the feeling. For most people this is an automatic process. For me and others with BPD it takes using therapy skills and many checks. We may even have to get notes or a book out to help us deal with it.
Self harm and suicidal thoughts can be a daily occurrence. For me they definitely are. I wake up wanting to die and go to bed wanting to die. I can be smiling but planning my suicide inside. I can be making plans for the future while wondering if I’ll be alive for them. Self harm feels like my main coping mechanism. It’s been there most of my life now. Losing it in favour of other skills is hard work. Self harm works for me in a way they don’t. It’s easier than going through multiple skills or sitting with the feelings. And when feelings are overwhelming it can feel like you want to be rid of them as fast as possible. I’d rather feel the pain physically than sit with an emotion that is painful.
Another reason sitting with emotions or dealing with emotions is hard for me is that I struggle to identify my emotions. I can maybe go as far as good or bad emotion but finding other words is more challenging. It’s frustrating not being able to express yourself and how you feel. To only be able to guess at an emotion. I want to tell you how I really feel but how? What. Words do I use? Will you truly understand how I feel? What if you don’t and it all gets confused and taken out of context? How do I sort this mess? Easier to keep it inside and deal with it how I normally do. It’s nothing personal. I promise.
There’s a lot of things from the past I’ve expressed here. The thing is they all build on each other until it becomes a complicated web. Untangling it by using different skills takes an awful lot of time. I want to make it so these skills are second nature and I don’t have to sit up with a big manual so I can discuss and deal with emotions, or interact with others, or stop myself trying to kill myself. I feel an idiot.
The thing is I feel a screw up but it is an illness. It’s the illness that makes me feel that way all the time. That’s the main thing that’s hard living with it. The self hatred. The constant need to apologise. It’s hard to break down these walls.
So that’s a small insight into what is going through my head a lot of the time. It can all be in there. There is also probably a lot more that adds in too. It won’t make you feel like I feel. No one can do that for anyone else fully. Even others with BPD will have different experiences. But this is me.
Please be aware that some of the content below may be triggering. There is discussion of suicide and self harm. I’m safe. This piece was originally written several days before publication. The content has not been edited.
Today I was told I need to learn to live with my suicidal thoughts for the rest of my life. It’s made me question a lot. It’s caused a number of emotions. I can’t lie that it hasn’t left me in a bad place.
I understand that living with an illness is something a lot of people have to do, physical or mental. I’ve always been fairly sure that mental illness will be part of my life continuously as well. So why has this hit me so hard? Why? I feel I should be OK. I’m not.
I think at the moment my mental health is particularly poor. Suicidal thoughts are there an awful lot of the time. Sometimes it’s continuous. Dealing with them seems near on impossible in a healthy way. Self harm is my go to. It’s far from ideal, though currently I’m not trying to stop the self harm (there are many reasons behind this). The idea of living with the thoughts forever just makes the feeling of wanting to die stronger. Why would I want to live like this?
But that wasn’t exactly what was said. It was that I need to learn to live with them and I guess I should think about what that means. Is it reducing their frequency? Or their intensity? Or the hold they have over me? Or does it mean I push them down and try to ignore them until I explode? (This last option seems like my current approach). I don’t know.
As some may know I’ve done DBT (Dialectical Behavioural Therapy) skills training. Not the full DBT programme as is suggested but the basics of the skills. I also go to a DBT peer support group which helps me apply the skills to my situation. It’s been helpful in some areas. But dealing with suicidal thoughts has not been one of them. The distress tolerance skills seem great, when I’m not in a crisis. I’ve tried them in crisis mode and it has not helped me de-escalate the situation. I know many people find them helpful to stop impulsive behaviours but I think that’s the problem for me: my attempts are very rarely impulsive and the desperate need to do something can linger at its height for a very long time with nothing seeming to bring it down. Believe me I have tried.
So I don’t know where to go from here. I’ve recently heard I’ve been put on a waiting list for individual therapy which I’m truly grateful for. Maybe it will help. But the thought it may not is there. I feel so guilty that it’s there. I know I am lucky I will get these 16 weeks at some point. But I’m terrified of failing and being in the same situation. A hopeless case.
That’s exactly how I feel. A hopeless case. Someone who will never improve and will be fighting forever more. Someone who, if they live, will be old and mad. The worst thing to be in this world when you need help. I can cope with the idea of being on medication for life, if I feel it will help me have a life. But the thought I’ll be suicidal forever is something I’m not sure I can live with. Why live when you want to die all the time?
I realise I’m probably overreacting (notice the probably, I’m not 100% about this at all). But in some ways it feels like a kick to just get it over with. To be gone. To stop being a constant burden to everyone. Because if I’m going to be suicidal forever isn’t that what I’ll be? (If you’re suicidal you are not a burden, it’s how I see myself).
At the moment I’m still processing this. It was said to me eleven hours ago. I don’t know how or what to feel. Apologies.
Please be aware this post will be discussing self harm so some content may be triggering.
There is a lot of thought about whether self harm is a decision or not. I know it’s a highly controversial topic and it’s something I’ve been thinking about for a while. As someone who self harms it can be a difficult thing to consider.
The definition of self harm is deliberately hurting yourself. This suggests that self harm is a choice but how much is that true? When we consider self harm as a symptom of a mental illness is it really a choice?
If you had an illness like cancer would you consider your symptoms your choice? Quite obviously the answer would be no. So is self harm any different? If you ask anyone with self harm about what happens when they need to harm most will say its an uncontrollable urge. It is something they feel forced to do. This is especially common as you go deeper down the self harm hole.
The urge to self harm, for many, is intense. It takes over. It’s hard to think clearly. The urge is made stronger by the fact that many who self harm have low self esteem and don’t feel deserving of care. Whatever has been a trigger will bring up all sorts of feelings that are hard to deal with. Everything can feel overwhelming. Sometimes we are not totally there, maybe dissociated. Then it’s not really a choice is it?
But in some ways it can be a choice. We decide to inflict the harm, don’t we? I honestly don’t know. This is where I’m hugely torn. And why I’m torn is based on how I see others and how I see myself. For others, and this is probably the most important part, I don’t think it is a true choice. There is a lot leading or pushing you in that direction. It is a symptom of an illness so is never a true choice. Then I look at myself and berate myself for choosing to hurt myself in the first place.
I don’t give myself a break on the decision making idea. I blame myself for self harming every time. I blame myself for making that “choice”. I see myself as truly being the reason I’m hurting myself. Even the name makes it seem like that. Especially when medical staff call it deliberate self harm.
And this is where the issue becomes more apparent. We are treated by medical staff, including in mental health teams, who see it as a choice rather than a symptom. Yes I may pick up the blade etc but there is something pushing me to that. I am unwell. My choices are not truly my own always. It’s not an excuse but an explanation. I’ve been told I’ve made the choice to hurt myself. This in a time when I was so distressed I couldn’t see any other choice. So surely it isn’t a true choice?
There is hope with this though and this is where it gets more into the dodgy area of being a choice. Learning through therapy of other ways to cope instead of self harming means we do start to have a choice between self harm or using our new coping methods. I start to see why they say its a choice. They’ve given us other options and we’ve gone for self harm. What they don’t seem to realise is we probably chose their new methods first but it takes time for them to be an effective choice for us. It’s all about time.
So these are just my views on self harm as a choice, I’d love to hear yours. Feel free to connect in the comments or on Twitter, Facebook or Instagram.
Psychosis! What do you think it means? Does it mean schizophrenia? Does it mean being locked up? Does it mean there is no hope? These things are things I thought before I experienced psychosis and I know many still think this way. This is why we need to talk about psychosis.
So what is psychosis?
Psychosis is made up of many different symptoms. Some people will have many, some only one. They include:
Hallucinations (these may be visual, auditory, tactile or related to smell and taste)
Delusions (having strong beliefs not shared by others, for example, people are going to hurt you)
Does everyone with psychosis have schizophrenia?
It’s a common assumption that the only people that experience psychosis are those with schizophrenia. This simply isn’t the case. Many mental illnesses may cause a person to experience psychosis. These include bipolar, depression and BPD (Borderline Personality Disorder). Psychosis can also be a result of physical illness or trauma.
Will someone with psychosis recover?
There is hope for those with psychosis. Many people will only have one episode of psychosis. Psychosis can also be managed with medication. There is a variety of antipsychotics. Of course as with any medication there can be side effects but these often are often outweighed by the benefits. It can also be a process of finding what works for you. Sometimes, when the psychosis is caused by trauma, psychosis can be helped by therapy.
What does someone with psychosis look like?
There is no specific way that someone who experiences psychosis looks. The term “psychotic look” which is often used to describe a way someone is looking is a work of fiction. Those with psychosis look like everyone else. The signs are more likely to be in their behaviour.
A last thought
People with psychosis experience extreme stigma. We are made out to be “crazy” and someone to be feared. In fact we are more likely to be a danger to ourselves or be at risk from others. It can be scary to see someone dealing with psychosis but remember they are probably scared too.