TW| this post mentions SH & suicide
When I scroll through my Twitter feed, a certain type of post comes up a lot – mental health advocates comparing their life to what it was a year (or any other time) ago. From a pit of despair, feeling suicidal everyday and trips to A&E to them now studying their dream course at university smashing life. Whilst these posts make me incredibly happy for those writing them (mental illness sucks and you all deserve an award for fighting it) I can’t relate. I am all of these things at the same time. Not only because my BPD means I can be having the best times with my friends on a Friday and wanting to cease to exist on a Saturday but also because I have always been good at slipping on a mask.
‘You are always so happy and smiley’ – a girl in my class said to me when I was going through one of the darkest periods in my life, firm in the grasp of depression. I became ill when I was 14 and graduated from school when I was 18. In these 4 years, no one ever asked me if I was okay except for my maths teacher after I nearly failed his exam – I lied to him then but in retrospect I appreciate the question. At school I was outspoken and high-achieving, getting along with almost everyone. What people did not see was the girl who wanted to escape all of it, the girl who could not look at herself in a mirror, the girl excusing herself to go to the bathroom to numb emotional pain with physical one. Fast forward to when I finally asked for help, I received treatment for anxiety and depression. However, I knew that wasn’t the whole story, partly because that only explained a small section of my difficulties and partly because even though treatment did help both my anxiety and depression, I was only doing better for a short while and felt like treatment had scratched the surface but omitted the root of the problem. When I sought help again, my problems were first dismissed as self-esteem issues because I seemed to be functioning just fine on the outside.
However, the same therapist eventually realised I needed more help than short-term CBT and referred me to the community mental health team for an assessment. That’s where it really went down-hill. (Not that things had exactly been going uphill in terms of my mental health.) I saw the CMHT for a series of assessments whilst I was in crisis and my experiences with them were some of the most invalidating I had ever faced by services. Not only did they tell me I “wasn’t suicidal enough” to receive help, they also told me that all I needed was to focus on my strengths and basically wait for my problems to just disappear. Spoiler alert: they did not. Another one of my favourites was offering me therapy I did not meet the criteria for and that was very much ‘tough-love’ focused. I recently discussed this concept with my best friend and we both agree how detrimental this treatment can be to people with BPD, but I will soon dedicate another post to that.
Probably the worst session of all was the one in which I finally received my diagnosis, with a lot of reluctance as the consultant did not understand the concept of having friends, going to university and still struggling with mental illness. I have said it before and I will again: being high-functioning does not equal low risk. It’s quite the opposite for me: when I am somehow holding myself together every little thing is threatening to break me apart. When I am very achieving, I am more impulsive, more prone to using bad coping mechanisms for the sake of keeping going. Being a perfectionist definitely plays into that one. You can be very functioning on the outside and absolutely crumbling on the inside. Being high-functioning does not make your illness any less valid. Just like being low-functioning does not mean you should feel guilty, we all deal in different ways, need different things in order to recover. Despite my struggles, my degree has been the one thing keeping me going.
The invalidating experiences with the CMHT had me spiral even further. If you are a mental health professional please note that telling someone with BPD (or anyone for that matter) they are not sick enough will make things worse. Because at our core, we crave nothing like validation and are willing to go above and beyond for it, mostly subconsciously. This will deserve an entire blog post on its own but eventually I reached a breaking point where I realised I had to put a stop to this downward spiral and fight with all I have in me. Maybe my experiences with mental health services were a blessing in disguise in a twisted way – they gave me the push I needed to take control, to realise that no one would come and save me. That the only person who could save me was myself. Still, I wish I would have come to that epiphany before reaching crisis point and I sincerely hope services will improve. If we fight together, our collective impact won’t be as easy to dismiss.
So let me just repeat my main message of this post: whether you are low or high-functioning, you deserve help and support. If you are high-functioning and are struggling to be believed, you are not alone. Lastly, let’s stop making mental illness a competition, validate each others’ experiences and fight this together.