Mental Health

Why I’m training to be a Youth Mental Health First Aid Instructor with MHFAEngland

Today was the final day of my course to become a Youth Mental Health First Aid Instructor, with Mental Health First Aid England. So I thought it seemed apt to create a blog highlighting why I made the decision to put myself out there and take the plunge to become a trainer.

If you’d met me as a child, you wouldn’t expect anything particularly concerning to be happening. I was a smiley, over-confident kid who loved to learn. I didn’t appear in any way abnormal to my peers and seemed generally happy.

What you wouldn’t have known is that behind closed doors I lived in a house of domestic violence and psychological abuse. My father was highly controlling and often presented in a stereotypical Jekyll and Hyde manner. I spent nights in my bedroom experiencing severe anxiety whilst listening to my parent’s rows. I grew up in an environment where my emotions were pushed aside by my father’s dominant and ever-changing moods.

My father, as some of you may know, died when I was 9 years old. He’d been unwell for a number of years and as a result, I spent large portions of my childhood within the walls of hospitals, as opposed to playing with friends. I was often left out of invitations to activities outside of school and experienced some bullying.

When I moved to my secondary school, a typical state-school in a rural community, this bullying persisted for a short period. I did as I was told and approached my Head of Year about the matter, having been encouraged to by my mother. Her response?

Hmm. Well, I i behaved like you did [referring to my sensitivity to slights], I’d get bullied too. In fact, if I was your age, I’d bully you too.

I was 11 years old.

When I began to struggle with the overwhelming emotions associated with the loss of my father, who I both idolised and feared, this same teacher belittled me. She called me “pathetic” and repeatedly told me I should be “over it” by now.

Her response silenced me for years to come. Whenever I felt an intense emotion, I pushed it away. I felt all my emotions were wrong, and would be punished or dismissed. I learnt adults, who were supposed to care for me, would harm me, would make me feel stupid, and blame me for the difficulties in my life. As I result, I kept everything inside until I blew and suffered a breakdown age 19. My teacher’s responses reinforced my early life experiences (that my emotions don’t matter, and that people will harm me if I speak up) and ultimately contributed to my diagnosis of Borderline Personality Disorder.

I was struggling with my mental health and instead of receiving support, I was dismissed, blamed and mocked. And I will not allow it to happen to our young people today.

The reality is that 20% of adolescents may experience a mental health problem in any given year and 10% of children and young people (aged 5-16 years) have a clinically diagnosable mental problem.

We know the statistics, we know about mental health, yet 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age. We need to start teaching our teachers, parents, youth workers etc. how to support our young people in need. To provide practical solutions and educate people on how to validate and support our young people. That is what MHFAEngland provides.

I am more passionate about this than anything I have done before. My experiences traumatised me and led me to dark places, but I fought my way back. Now I want to use my experiences for change, and to help make damn sure that no young person ever has to face the response I did.

Lorna 

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borderline personality disorder · Mental Health Stigma · Personality Disorders

Having a personality disorder is not a choice

One of the biggest misconceptions I come across relating to my diagnosis of BPD, or towards my former patients with a range of Personality Disorders, is that a Personality Disorder is not a mental illness. When I worked in a psychiatric hospital, I would hear the following sentence every single day, primarily from psychiatrists and psychologists:

“No, [s]he has a Personality Disorder, not a mental illness.”

I once asked my supervisor, a forensic psychiatrist, about this and he explained it was largely due to personality disorders being a relatively new diagnosis, and only being formally recognised in the Mental Health Act in the 2007 revision (sorry, boring I know!) It also appears to come down to a traditional view of mental illness having an identifiable starting point, such as a clearly distinctive psychotic or manic episode. Further, the responsiveness of ‘traditional’ mental illnesses to pharmacological treatment (i.e. medication) is greater, suggesting a stronger physiological element to their origin. Personality Disorders, however, are often the result of early life trauma and developmental in origin, with maladaptive behaviours being learned and reinforced over many years.

This distinction, between ‘traditional’ mental illness and Personality Disorders, is incredibly stigmatising. With ‘mental illness’ growing to be increasingly understood as on par with physical illness, Personality Disorders have no such respect. Distinguishing them as somehow separate from mental illnesses, coupled with the use of the term Personality Disorder in and of itself, suggests a level of blame to the sufferer. The implication being that instead of an illness, which develops without the individual’s choice or often knowledge, the Personality Disorder sufferer is made to feel damaged at their core, their very being, their personality.

Similarly, professionals, loved ones and friends appear to disregard the diagnosis in its entirety at the sight of challenging behaviours, viewing sufferers as ‘difficult’ or ‘dramatic’. They imply the individual is choosing to behave in such a harmful manner, in order to obtain control and attention or to manipulate.

The reality is far from this. I developed a personality disorder largely because of the behaviour of other people; my father’s violence, my teacher’s invalidation, my peer’s bullying. All of this occurred at an age when I was far too young to be seen as in any way complicit or responsible for such behaviours. These behaviours seeped into my unconscious, teaching me I wasn’t good enough, that love had to be earned, and that all people would eventually leave. I had to develop unconscious behaviours to navigate this dangerous and hurtful world. I learned to stay silent in the face of conflict, to never stand up for myself, to be suspicious of other’s intentions and to punish myself when I felt I had done wrong before other’s got the chance. I was constantly looking for someone who might harm me, be it physically or emotionally, my vigilance to threat continuously heightened. These behaviours kept me alive. As my young brain developed, these behaviours weaved their way into my very neuroanatomy. They became unconscious, beyond my control. My brain changed. It adapted. And now, these adaptations are no longer helpful and are classified as a disorder.

So having this collection of behavioural and emotional symptoms, the very same ones that equate to a diagnosis of Borderline Personality Disorder, is not my choice. I am not trying to manipulate you, I am not trying to make your life harder. In fact, more often than not when I behave in the ways you find difficult, I am scared, scared you will leave me, or hurt me (and quite often I’m unsure which would feel more painful) and I am trying to show you how much I need you.

I would love to be normal. I would love not to feel every single emotion, good or bad, like a spear through my heart. I would love not to spend every moment expecting the people I love to leave me or harm me. I would love to never again feel so unworthy as to take a blade to my own skin. I would love to not feel empty every day. I would love to have a consistent view of whether I am a good person or not. I would love to be able to maintain close friendships. I would love to be able to be around others without feeling paranoid.

I would love that choice.

But I don’t get one.

Lorna

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Mental Health · Mental Health Stigma

Stop telling people with mental illness to “just go outside”

Spring is here – the lambs are out, it’s staying light until past 5pm and shops are stocked full to the brim with Easter paraphernalia. Most importantly, the sun is shining!

For most of us, the arrival of Spring is a welcome sight; we put away our winter coats and start planning our summer. But for some of us living with mental illness, myself included, the arrival of good weather brings with it an unwelcome pressure – the pressure to go outside.

My own family are very much sun-babies. They love being out in our garden in the Shropshire countryside be this gardening or reading or playing with the dogs. They continuously tell me to “just go outside” and “enjoy the sunshine.”  I know they mean well, and they struggle to understand why I don’t want to, but being outside for me isn’t really something I enjoy all that much.

I find that being outside, with no purpose or reason, fills me with significant anxiety. Sure, I’m all good if we’re out for the day and doing something, but just sitting or being outside is not a pleasant experience for me. I feel lost, my mind starts racing and I want to flee back to the safety of my house. Home, or indoors, feels safe to me, and for a reason I can’t quite figure out, outside doesn’t. Perhaps it’s having to be alone in my own head, with little stimulus to distract me which feels scary.

I also resent the implication that sunshine will ‘fix’ my issues. I appreciate evidence suggests it helps lift low mood but this research is generally relevant to mild to moderate depression. For me with BPD, anxiety and various early life traumas swimming around my brain, sunshine ain’t gonna do that much, hun. Even for those with mild to moderate depression being outdoors might help marginally, but when it feels like the most mammoth effort in the world to even get out of bed, attempting to force someone to go outside might do more harm than good.

When I stay indoors when people are continuously telling me to “just go outside” I end up feeling guilty and like a failure. I long to be able to just enjoy ‘being’ outdoors, but I just can’t, and the constant focus on my inability to enjoy such a basic pleasure really doesn’t help.

Lorna

 

anorexia · borderline personality disorder · eating disorder · Mental Health · Personality Disorders

Why I don’t really mark recovery milestones

Please note this blog contains discussion of self-harm.

If you’re part of an online community surrounding mental health, be this Twitter, a Facebook group or Instagram, you’re likely to have stumbled across a few posts that celebrate the length of time people have been in recovery. Be this being self-harm free, sobriety or days in treatment.

Don’t get me wrong, I genuinely love seeing these posts. I love seeing people celebrate their successes and feel proud of their achievements. It also fills me with a sense of hope, that people can and do overcome the darkest of times and go on to recovery.

But for me, this has never felt like something I could do. I mark one, and only one, milestone relating to my mental health, and that is the very first day I admitted I needed help. For me, this marked a significant shift in my life, one where I stopped running from my issues and began embracing a need to dedicate myself to recoverin – although even then things got significantly worse before they got even slightly better.

I have no idea when I officially stopped being anorexic, I never woke to an epiphany that I couldn’t continue with a life of obsession and restriction. I never committed to changing my life on one cold winter morning, swearing to treat my body better. My reality is that recovery has, and continues to be, a long and messy ride.

Having BPD means I never truly go into a remission phase. I don’t relapse for long periods, more hours or days at most. I could go months without self-harming, and then suddenly feel no other way to cope and the smallest things can cause me to relapse for days on end, a phrase I currently find myself trapped in.

Marking recovery milestones doesn’t work for me because this pattern of instability, so typical of BPD sufferers, would lead me to constantly feeling like a failure. Each time I would count a further day free from self-harm or restriction I would have this knowledge that it wouldn’t last. That in reality, I should be counting down to the next outburst, the next cut, the next skipped meal.

So instead, I mark the day my outlook changed. The day I decided to stop hiding, stop fearing, stop lying. The day I embraced the need to ask for help and accept it when it is given. To admit to my struggles, and reflect on their beginnings. To learn new ways of managing my emotions and interacting with others. Because no matter how many slip-ups I have, no one can take that change away from me.

Lorna

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anorexia · eating disorder · Mental Health

What happened when I bumped into the GP who refused to diagnose me with anorexia

This is a spontaneous blog following something that happened today.

Earlier this morning I walked into the dementia unit at the care home I work in and walked into the very GP who refused to acknowledge that I had anorexia 4-5 years ago. The same GP who every few weeks forced me onto the scales, often as I wept and begged not to, before declaring I was “still fine” because my BMI wasn’t quite low enough.

The same man who showed no concern when I discussed in depth my obsession with calories, my obsessive pacing as a means to lose weight, and my avoidance of nearly every meal. The same man who ignored my mother’s pleas to help me as she watched her youngest child waste away.

As you can imagine, this encounter left me feeling a range of overwhelming emotions. I have no doubt that this doctor is a kind man, who wants to help his patients and cares for his loved ones, but in my story, he is a villain.

I immediately felt an overwhelming anger, one I never experienced during our time extrallenged in a patient-doctor relationship, and appreciate now. I wanted to scream at him, to demand answers there and then. To tell him how stupid he had been in ignoring my symptoms and to make him realise he had caused me years of unnecessary suffering and potentially risked my life.

I also felt a deep sense of shame. A shame at my recovery. I suddenly wanted to be sicker than I was before. So I could show him how wrong he was to fail in his duty of care. To blame him for my ever decreasing weight and the physical complications accompanying it. I felt my current weight-restored body would somehow validate his choices all those years back. I worried he’d think “see, she’s fine now. There was nothing wrong. I told her she was fine.” He was unable to see the years of therapy and continuing battles I have with weight and food, and I wished I have the physical appearance to demonstrate this.

The reality is more than likely that my old GP didn’t even remember me. I moved away to return to university and now have a different GP at his practice, my hometown medical centre. But that stings too. For me, he is a significant part of my struggle with mental illness and to consider that to him I was no more than another young adult experiencing mental illness sits uneasy.

So this evening I sit here, still feeling an underlying anger, and I keep reminding myself it’s okay that mine and his realities are different. I keep reminding myself that I know, wholeheartedly, that what he did was wrong.

Lorna

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Mental Health · Mental Health Stigma · University

I thought I couldn’t be mentally ill because I was functioning

Two days before my breakdown I sat in a lecture at university on Anxiety & Depression for my psychology degree.

I felt very spaced out, but remember listening to the symptoms of each disorder being rattled off by my monotonal lecturer. He spoke of how people with anxiety felt hyper-vigilant to threat & those with depression might often think others would be better off without them. He explained how long someone would need to be exhibiting symptoms for before they could be diagnosed and highlighted that symptoms would need to cause significant impairment to functioning to be classified as a disorder.

Over the months leading up to this lecture I had been expericing these exact symptoms. I was paranoid that my housemates secretly wished I died, as there lives would be better without me, and I couldn’t sleep as every night any slight noise caused me severe panic attacks. But I wasn’t able to recognise these symptoms as problematic. I sat in that lecture and vividly remember thinking ‘but everyone feels like that. I feel like that but I’m not mentally ill.’

I felt like this because I was functioning well. I was making all my lectures, didn’t miss a deadline, was exercising regularly (although now I accept this was the early stages of my anorexia) and was doing normal things with friends. I believed you couldn’t do these things and be mentally unwell, mental illness was exclusively reserved for those at the extremes, the ones who couldn’t work or leave the house or get out of bed.

I knew that everyone feels a little overwhelmed from time to time and that feeling anxious or low was part of a normal spectrum of human emotion. I firmly believed that only those who were unable to function could be diagnosed as mentally unwell.

I had never heard of high-functioning depression and anxiety. I had no idea that you could be a normal student, continuing with everyday life and still be seriously unwell.

Why is it that we accept people can have hidden physical illnesses, such as diabetes or even cancers but not a mental illness? Why do we go along with this myth that mental disorders are reserved for those in institutions or on benefits?

It was as a result of this misbelief that I delayed seeking treatment until I broke down. Until I couldn’t hide my symptoms any longer. Until I became unable to function. Perhaps if I was more aware of the different ways in which depression and anxiety could impact upon people I might have been able to recognise it worming its way into my life sooner.

I really believe we need to stop forcing people to such extremes before accepting they have a mental illness, because for so many this isn’t the case. We need to accept and acknowledge that it is possible to function whilst mentally unwell. We need to teach people that mental illness can affect the CEO of a million pound company, or the doctor treating you for the flu and not just the homeless man you walk past each morning. Because otherwise, we force people to wait until they are unable to function. And that is downright dangerous.

Lorna 

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borderline personality disorder · Mental Health Stigma · Personality Disorders

Please don’t call me ‘Borderline’

When I set up this blog, and my associated social media channels, I deliberately chose my name, Living Beyond The Borderline, for a specific reason.

Since being diagnosed with BPD in 2015 I have had multiple people refer to me as ‘Borderline.’

I’ve had comments such as “you’ll know, you’re Borderline” and “You’re the Borderline one”.

Just no.

Let me explain… To me, Borderline Personality Disorder is not my identity. Sure, it’s a part of it, and a big part at that, but it is not me.

I am a person. A person who loves all things mental health but who also loves dogs, coffee & the countryside. A person who fears birds, and who hates going to sleep in silence. I have hundreds of thousands of little quirks that make me me, and by referring to me as ‘Borderline’ you reduce all these teeny factors, all these unique quirks down to one factor, a diagnosis.

If I had cancer, no one would ever say to me “oh hey, you’re cancer” so why should I find it acceptable to be called ‘Borderline’?

I’m fact, many of my characteristics, my little tics, my likes and dislikes are formed in spite of my diagnosis of BPD. They are the things that formed and are maintained despite by emotional state, despite my urges to hate myself, despite my constant anxiety about the world and despite my diagnosis.

So I am, and always will be, Living Beyond The Borderline.

Lorna

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