Oh hey this new kickstarter is so romantic…
I am at a difficult crossroads with what I say about my mental health.
I’ve been tossed from shrink to shrink for about six years now. Lots of things have helped a bit, but nothing has dismantled the big problems. I did that thing one is not meant to do, and diagnosed myself on the internet with Borderline Personality Disorder.
It’s been the best mistake I’ve made in years. I told my shrinks this is what I thought I had, and suddenly they went from asking me the depression questions to asking the BPD questions, which are far closer to what is going on. Why shrinks don’t routinely throw in those questions, I don’t know.
My doctors have stopped asking whether I have difficulty motivating myself and feel sad, and started asking far better questions like:
do you have an intense fear of being left alone caused you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody?
do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they are wonderful to hating that person and thinking they are terrible?
do you ever feel you do not have a strong sense of your own self and are unclear about your self-image?
While I have had periods of intense depression, these questions describe far more accurately the patterns and problems which come up again and again, even at times I am essentially functioning. As a result of my research, the shrinks have referred me to a new group with 13 weeks of practical skills, like learning how to say no to people, coping with intolerably strong emotions, and so on.
I’m now unsure what to say about my brain.
I don’t want to say I have BPD, because I haven’t been diagnosed with it, and I don’t want to appropriate someone else’s condition just because it sounds cooler and more dramatic than what I have. At the same time, even without a diagnosis, my shrinks have agreed this is a group I will benefit from; and I also feel like I am in the right place. At some level saying “I don’t have this thing, I merely have the symptoms of it” is willfully pedantic. I also I don’t want to fall into the trap of accidentally saying “I have these symptoms, but I don’t have BPD (because people with BPD are proper lunatics, and I’m better than that)”.
There is a mental health hierarchy, where everyone looks down on people who are madder than they are. I helped my friend into an emergency psychiatric ward, and was pretty scared of some of the people who were there, which is a complicated feeling. Because saner people than me probably view me with the same feelings, and because I was there to visit a friend, so what did it mean for her if I was judging her ward-mates in this fashion? Personality disorders come lower down than stress, depression and anxiety, and above psychosis. I don’t want take up space and appropriate a condition, but I also don’t want to cling to my place on the ladder and contribute to stigma about those underneath me by refusing to identify in this fashion.
It is, in short, a conundrum.
(and this is also how I feel about trans things. There is a similarly fine line between the noble “I don’t want to appropriate other people’s identity, and take up room when my problems are comparatively slight” and the cowardly “I’m not one of Them/I want to dodge my share of systemic disprivilege”.)
When it comes to personality disorders, there really isn’t a way of diagnosing it for sure – it’s whether a given shrink thinks you meet all the criteria – and the criteria are just an amorphous, Barnum collection of traits (“There are no physical tests that can be carried out to diagnose someone with a personality disorder – there is no blood test, brain scan or genetic test. This can be argued to undermine the existence of PD; if there is no objective test to make a diagnosis, then the basis of that diagnosis is questionable.” Source). So maybe it doesn’t even matter.
But I feel like I am suddenly getting targeted help for my big problems, and I’m pretty excited about that. It is perhaps best to say, I am now in a group specialising in Dialectical Behavioral Therapy, which is best known for alleviating symptoms of BPD, and leave it at that.
That horrible moment of realisation when…
You ask someone out via invoking the fact you don’t want to be Charles Ryder in ten years time, still obsessed with a thing he lost at university.
You lose it anyway.
You have a horrible moment of clarity ten years later that you were never Charles, you were Sebastian; and you haven’t come out of the relationship with aching nostalgia and Catholicism, but with alcoholism, an inability to function in the real world, familial-estrangement, a teddy bear, and with feelings for a person who views you as an innocent, adolescent homosexual phase, and who now intends to go on to do that exact same thing, only with someone marriageable.
Dear world, I hate you.
Some self-absorbed statements about gender:
1. I have discovered that I feel most anchored in my body and birth gender when I am entirely happy and content; when I am in a depressive patch, that’s when I feel like it’s just a flesh-tube which carries me, and the idea of womanhood feels really far away.
1b. I am constantly in a depressive patch.
1c. “You’re not dissassociating from your body because you are depressed, you are depressed because your body is wrong” is an alternative to my interpretation of this, albeit a really scary one.
2. I am trying to not poke my genderwibbles with any kind of stick, because I am worried where they may lead. There’s nout wrong with being trans, but it is manifestly difficult, and if I get any choice in the matter I want to stay on the cissexual side of it – purely for coincidence. A non-dysphoric afab GQ person has a fuckton of privilege over pretty much anyone else under the umbrella – I’m not going to leave that lightly.
3. This post by janitorqueer is the most, most envy-making thing I have ever read. I’ve been in a state of despair for coming up to ten years. My brain chemistry is just screwed up in some way. The idea that there could be a chemical which would fix that nebulous misery is the most tantalising thing. I don’t think it is T I need, but I wish there was something.
4. But last night I was unable to sleep for gender-based unhappiness.
4b. But maybe I am just needing a new thing to worry about. I worry about everything.
5. I don’t buy the born-this-wayness, for me at least. I think my brain got screwed up in the crucible of teenagerhood, and in the absence of words and concepts I needed. But I know lots of queers go through this process, and come out the other side as sane cis lesbians, so maybe I was born-this-way and I am creating a false etymology for my feelings. The only model for folk who liked ladies were men and lo! I “became” one in what I watched; thank you male gaze. Either a straight man or a gay man, it flip-flopped a bit, but the point is – if there had been more “female gaze” films where women are staring at men or at women, would my gender feel more straightforward?
5b. In any case, there’s no way of knowing for sure, so I don’t think it’s worth worrying about. Time cannot be turned back.
I know why biphobia is a thing, because monosexual people confuse me. As someone who has no fixed gender identity, nor is gender a factor in who I fancy. Getting rejected by people who don’t like ladies feels like getting rejected because I keep pet spiders in my bedroom. My brain goes huhhh, because intellectually I can see why “spiders in the bedroom” could be a dealbreaker for some people, but at the same time – I don’t have pet spiders, or any pets at all. I think I understand how people could not like an entire gender – given that there are so many unique gender expressions…and types of gendered bodies…and no, I guess I don’t understand, but let’s pretend I do. I understand that people have preferences – I have preferences about the types of folk I date – and I suppose it makes sense that these could run along gender lines. But when that applies to me, I feel very un-anchored, because I feel like “none of the above”. My internal sense of self morphs into whatever that person wants.
Being sane is a full-time job.
I am trying to keep conscious track of people who I think hate me, who turn out not to have done so (the total this week so far is 3, though that number represents a far larger number of panics and wibbles in between.) I hope that each time I wibble in future, I can remember my total number, and that will set against the number of people who have done the slow-drop-secretly-hate-you thing.
Now I am listening to my grandma and grandad try to resolve a slightly awkward, slightly tense situation, and trying to remember that I’ve never heard either of them get angry, that this is a safe house and nothing is wrong, but not entirely succeeding.
I am bored of medical professionals telling me I am wasting their time/telling me I am insufficiently in danger to access any mental health services; and then saying if I am in trouble, it’s very important I attend A&E or phone Samaritans.
I just…when I take time off work to see a doctor, that’s me reaching out for help? If the only result of me rehashing my neuroses with a stranger again is a referral back to my GP, why would I expect them to give a fuck at A&E? If the result of an hour-long consultation is that I need no additional help, and that you think I am managing my own health rather well, then why would I take up valuable space on a crisis line? My problems are so self-evidently small.
I wish docs would trust their patients better, and outline in advance of a consultation what they are looking for. It strikes me that I could have saved today’s doc a lot of time if she had cut straight to the crucial question (“Are you planning to kill yourself this evening? If not, we literally do not have a shit to give about your wellbeing or safety at any future date.”), without my entire backstory first. If the doctor who referred me had specified this was what she needed, I wouldn’t have taken up space on her rosta, taken time off work, or put myself in a position where I feel more isolated from help.
I’m just…sorry I am insufficiently suicidal? I’m coping now, or at least the nurse tells me I am; but I want a plan in place when things get bad. I want more from my life than going directly home and sitting on Tumblr, because that is the only way to numb out the pain. I wasn’t self harming last year, and now I am – and I feel like if I’d had some decent care any time in the last, y’know, six years, I could have arrested that slip. And these feelings are brought on by despair, but the less and less I believe in a cure or medical intervention, the truer “I will never be well or happy” feels.
Don’t tell me I’m doing really well – I haven’t seen all your other patients, I’ve only seen myself lapse into the worst three months of decline and I’m scared and want some help with that. Give me homeopathy, I don’t care. Just – don’t make me go through my problems, tell me you will not help, but in the same breath expect me to reach out for help from other doctors.
Sure I’ll call the Samaritans.
Dear sweet baby Jesus, this book has a whole chapter on asking for what you want & how to say no…