Depression and self-discipline

**Trigger warning - this post discusses attempted suicide and suicidal feelings**

As I have mentioned before, I went through an extremely severe episode of depression this year. It started around the end of January after a period of very erratic mood swings, was at its worse throughout the Spring and eventually started to lift at the end of Summer. I have experienced depression many times from early childhood, but this was by far the most severe and prolonged episode.

Depression takes many forms, even for the same person at different times. My main symptoms during this period were complete anhedonia (I couldn't feel anything good at all); I had no interest in or enthusiasm for anything; I felt utterly hopeless - I couldn't imagine feeling better, my entire life seemed pointless, meaningless. I couldn't stand being awake, I was desperate each day just to make it through to bedtime when I could take a sleeping tablet and be unconcious for as long as possible. I spent most of my time thinking about suicide, at the end of February I wote a suicide note and took a combination of roughly sixty pills which I thought would kill me (I did research online), a friend who was staying with me at the time found me unconcious and called an ambulance. I regained conciousness the next day and was discharged from hospital after an appointment to see my psychiatrist was brought forward.

During this time I was in what I would call 'survival mode', I tried to take each moment as it came and did what I could to just get through. I read when I could concentrate, I watched a lot of TV as that is good for swallowing up 'chunks' of time. I found a little satisfaction in doing crossword puzzles, particulary if I got friends involved by texting clues to them. Of course I had no energy and no motivation to go out and I was in too bad a state to push myself. I allowed myself to eat what I wanted (I was certainly not concerned about my physical health at this point). I had also been put onto anti-psychotic medication which had increased my appetite and unfortunately, when I'm miserable, I have a habit of comfort eating anyway.

My mood is now considerably improved on what is was, although I would still not say I'm back to 'normal'. But I can now have fun, be interested in things and I don't feel hopeless about the future. However my physical symptoms are still the same, I have no motivation to do anything physical, I am lethargic and have no energy. I have put on roughly two stone (28 lbs) although I'm actually too scared to weigh myself.

It feels like I have developed some bad habits due to being in 'survival mode' for so long. In order to care for my mental health I have neglected my physical health. Unlike a lot of you fine people, I actually find it quite easy to be self-indulgent although after a while I feel disappointed in myself and this leads to lower mood. I need to break the cycle and start pushing myself, the motivation may not be there naturally so I'm going to have to find some self-discipline. Unfortunately, this is not my strong point, but I accept that now that I have finally emerged from the hell of my depression I have to take responsibilty for as much of my recovery as I can. I guess it's time to make some New Year's resolutions..

The whole issue has made me think about how you know that you just need to take care of yourself and get through each day and when do you know it's time to grit your teeth and do things that don't come easily. Does anyone have any thoughts on this based on their own experience?

Meltdown and get back up again.

I have taken a little break from writing my blog recently, a few weeks ago I had what is technically known as an emotional meltdown. It knocked my confidence and I've had to take stock of where I am with my recovery. I thought I’d share with you what happened and what I have learned from it.

I was out for the evening with my boyfriend, we went to see The Ladykillers at the theatre. I was feeling very good to begin with because I remembered that when the tickets were bought back in the Spring I had been extremely depressed and suicidal. I honestly didn't think I would make it through to see the play. I was very happy that I had come a long way from there and those awful dark days seem to be behind me (touch wood).

After the play (which was excellent) we went to the pub for a drink. I had been planning to go away the following weekend to accompany a friend to a wedding. My boyfriend started to ask me about my plans, and as soon as he did I started feeling very anxious. He didn't notice this at first and asked a few more questions. Soon anxiety turned to panic and I started to cry. It is difficult to remember exactly what happens in the mind during an emotional crisis but I will do my best to explain it. I seemed to have some kind of emotional flashback, to when I was very small. As a child my older siblings bullied me badly and I only felt safe with my mum, I was extremely clingy. Scream-the-house-down-if-she-went-upstairs clingy. Suddenly, sat in a busy pub on a Friday night, I felt the exact same sense of panic I felt when I couldn't be with my mum, when I felt so unsafe and vulnerable, when those feelings were so strong that they overwhelmed me and my whole life revolved around trying not to feel that way. To not be separated from my Mum. I could even see my parents in my mind's eye, looking up at them from a child’s point of view trying to get their attention.

I have been aware for a long time that when I got into my teens I transferred that addictive attachment I felt for my mum onto pretty much any boy that showed an interest in me. Feeling wanted emotionally and sexually soothed my intense need to be safe. It eased that terrible emptiness inside. I still have the same attachment issues now although I make wiser choices about who I ‘attach’ to. I have learned to cope with boyfriends going away and leaving me for a little while, but it seems I have not come to terms with voluntarily leaving them. The thought of choosing to leave my beloved when I could be spending time with him sends me into a panic.

The trouble is, on this night the panic didn't end there. It seemed to induce the good old BPD black and white thinking and catastrophising to maximum effect. Suddenly my entire life was pointless, I was only kidding myself that I was recovering, I was a mess. The friendships that I’d started to make on Twitter were just my attempt at gaining the popularity and approval I never got at school. My blog was a nonsense, arrogant nonsense. I had no right to try and help anyone.

By the time all these thoughts had gone through my head my boyfriend had bundled me into a taxi and got me home. I sat and cried like a child on the sofa and then took a sleeping pill and crawled into bed. At some point I also deleted my most recent blog post and would have deleted the whole thing if I could have figured out how to. The next day I couldn't face my new view of the world, everything was completely broken and wrong and I couldn't cope. I took sleeping pills to keep me unconscious all day.

But now I am back to feeling as well as I did before the meltdown, in fact better. After my Saturday in bed I started to think over the dreadful conclusions I had come to that night. I decided that I didn't have to go to the wedding because it was important to take care of myself, although I did feel guilty for letting my friend down. I realised that I am seeking approval on Twitter but that is ok, it is a basic emotional need to feel accepted and valued by others and I have lacked that to a large degree in my life until now. I accepted the fact that I am highly sensitive, and have a damaged inner child who needs care and understanding (as well as boundaries where appropriate). I considered that in order to write a blog that might be useful to others with BPD it has to reflect the whole experience of recovery, it isn't a straight path and there are a lot of obstacles on the way but you have to keep looking forward. This isn't the first time I've stumbled and it won’t be the last, but each time I pick myself up, learn something from it and move on feeling stronger. We can do this!

Why I have been too successful (;p)

In my last post I made a commitment to review a number of books that over the years have helped me overcome a variety of mental health problems. At the simplest level, I would posit that my poor mental health has been caused by distortions in my thinking and that I have slowly gone about correcting these distortions by reading and thereby retraining myself to think differently. The problem is (and I wish I had more problems like this) is that I have been very successful. I no longer think the way I used to. I am not claiming to be wholly healed or ‘fixed’ but I am definitely a lot closer to a healthy mental balance than ever before.

To give an example, I used to suffer from extreme anxiety and panic attacks. I could not leave the house for long periods of time, I was afraid of people in general (assuming that they were having hostile thoughts towards me). I had a problem with stairs, escalators and lifts (you can see that that caused a bit of a problem). I was really a wreck during this period of my life and it was the main reason for the breakdown of a very good relationship (he eventually told me that he dreaded coming home to me). The end of that relationship was possibly a catalyst for my recovery to some extent, it was a rock bottom that shocked me into re-thinking my attitude. I had to get better. I had to find the strength from somewhere. After a month of hiding under the duvet in my old room at my parents’ house I gave myself a kick up the arse and started going out into the world.

Now, it wasn't easy. I very distinctly remember narrowly avoiding a huge meltdown in a clothes shop when a song was played on the radio that triggered me. Often all I wanted to do was run home to Mum and I didn't even live with her any more  But one thing was different – I was determined. I was not going to give in to all these neuroses any longer. I wasn't going to let it beat me. It was during this time that I started buying self-help and psychology books, so I could learn a different way of thinking. And it worked. When I look back at myself then (about fifteen years ago) I see an almost completely different person. I have truly changed myself. And I didn't just do it then, I have continued to change myself for the better ever since. I am a very different person now to the one I was just a year ago. And this isn't just about how I feel inside, it’s reflected in the friendships I have and in my relationship. A great deal healthier, stable and more rewarding than ever before.

I still experience a certain kind of anxiety which for me is the most deeply rooted, and that is due to issues with attachment and fear of abandonment but I am working on that, dealing with it better than ever and I am confident it too will fade eventually along with the old anxieties. I no longer have any social anxiety, I can happily walk through crowded shopping centres and sit on overflowing trains without giving it a second thought.

So, back to my problem. When it comes to writing this blog I am faced with the task of separating out my new, self-taught ways of thinking from the old me, the way I was before I started this journey. What I have learned along the way has become so integrated into my way of thinking that it is utterly unconscious. It is just who I am now. And if I can do that, anyone else can. I'm still going to be working on those book reviews for you, but I thought a little warning about how successful they can be might only be fair. 

How I might be able to help

Over the years that I have been affected by mental health issues (as long as I can remember) I have tried very hard to ‘fix myself’. Despite all the psychiatrists and other specialists I have seen and all the medications I've been given nothing has really helped. I'm a natural problem-solver – if something is wrong I have to find a solution, so I wrote about what I was experiencing in a journal so I could figure out the ‘why’ and I read as much as I could so I could find a ‘how’, how to solve the problem that was me.

Although I will not in anyway claim to be ‘fixed’, I am a lot closer to happiness than I have ever been. I am writing this blog so that I can share what I have learned with anyone who might be helped by my lessons and also in order to consolidate what I have learned. I want to go back over all the reading I have done (missing out the less helpful stuff this time) and piece together a strategy for dealing with BPD, a method out of the madness.

I am aware that are some really effective therapies for BPD out there, Dialectical Behavioural Therapy (DBT) being the most popular (I have the handbook). From what I have heard, it sounds very effective, however, where I live it is not available and I know other people are in a similar situation. I am currently receiving one-to-one Mentalisation Based Therapy (MBT), its aim is to train patients to think about the thought processes behind their feelings and behaviour and those of others. The odd thing is that my therapist says that I already seem to have this ability – it’s partly just the way I am and partly what I have learned along the way.

My plan with this blog is to discuss the particular books that I have found helpful to me, a very personalised book review I guess. I will outline the crucial points of each book and how I incorporated them into my recovery, how they were helpful to me, and hopefully will be to others. I will also share experiences from my day to day life so I can illustrate how I use the lessons I have learned to help me cope better with BPD and live a happier, more balanced life. I hope this approach will be helpful to anyone reading this and as always, I’d be delighted to receive feedback.

What made me this way

I thought a good place to start would be with my story so far, an analysis of how I've become the person I am today. As I mentioned in my previous post, I have spent a lot of time reading and writing in an attempt to figure out why I am the way I am so I can fix it - I'm a natural problem solver. I'm hoping that by writing a full explanation of why I have developed Borderline Personality Disorder it may help others recognise similar patterns in their own life, either that or just bore them to sleep.. 

It is clear that I was born with a very sensitive personality type ('The Highly Sensitive Person: How to Survive and Thrive When the World Overwhelms You' by Elaine N. Aron was particularly helpful in my understanding of this, I shall write more about the book at a later date). It takes very little to upset me and I find my emotions overwhelming and difficult to tolerate at times. I had three older siblings who didn't take too kindly to my arrival and who took every opportunity to bully and torment me that they could. I clung to my mother because she showed me abundant love and affection but my mother’s own neuroses bled into the relationship, most importantly her unbalanced view of love being based on self-sacrifice and her constant sense that something is about to go wrong at any moment. 

I had a good relationship with my dad whose open-minded and analytical approach to life encouraged my own natural leaning in that direction, however my dad came from a generation typically afraid of the expression of emotion and my temperament often met with dissaproval. My mum’s ‘no nonsense, common sense’ approach also rubbed off on me, however, her reliance on her role as mother lead to her unconsciously encouraging my clingy, needy dependence upon her, in psychological terms this is known as an 'insecure attachment' (see Bowbly's attachment theory) and is a crucial factor in the development of insecure personality types. I felt so bereft and vulnerable without the constant presence of my mother that I screamed hysterically if she even went upstairs without me.

Going to nursery and school was, frankly, traumatic for me. My very apparent sense of vulnerability made me an easy target for bullies, further reinforcing my unhealthy attachment to my mother. In one sense I only felt safe when I was with my mum – no-one could bully me then and I felt soothed by her affection, on the other hand, I unconsciously picked up from her a strong sense of impermanence, of impending catastrophe that left me feeling even more insecure and vulnerable. 

My parents did not understand my highly emotional outbursts and often told me that I shouldn't feel and react the way that I did, I was subject to 'tough love' which only had the effect of invalidating my experience, I felt that it was wrong to be me, to feel what I felt. 

To cope with this lack of security I contrived mechanisms which allowed me to ‘read’ people and adjust my behaviour in order to minimise the possibility of them rejecting me and leaving me alone and unloved. Essentially I never felt secure enough to be myself around anyone else. Due to my strong, analytical and over-active cognition I even developed fantasy scenarios that all kinds of people could see and hear what I was doing even when I was on my own, so I didn't even learn to be myself when I was alone. I also developed the habit of constantly conversing with people in my mind, second-guessing their reactions to my thoughts. I developed these behaviours as a very young child in order to protect myself from the universal fear of abandonment and rejection. Being a very young child I was unable to create strategies that effectively addressed the issues I was having. Inadvertently the part of me consumed by fear compounded the damage already done. I never felt safe, I felt uncomfortable around people and not even comfortable on my own. I withdrew; I was constantly under the influence of my mother’s negativity. I became depressed. 

Being cursed with more than my fair share of intelligence I started developing ideas about the world; I thought about all manner of things and began to form strong opinions and beliefs. Unfortunately, my rational way of seeing the world clashed rather dramatically with my emotionally immature way of coping with life’s perceived dangers. Instead of trying to reconcile the two I continued with my old strategy – deny myself, deny what I feel. I wanted to be what I was not so I told myself that I was. In essence, I developed a very strong personality but it had no firm foundations to rest on. My sense of self was dangerously fragile and evanescent. 

Inevitably, when I started having romantic relationships I transferred the unhealthy attachment from my mother to my new significant other however, I knew if I acted on my clingy, insecure impulses I would become unattractive so I played the game of emotional stability that I didn't feel. I was alone, conflicted and tormented inside and hated myself for it. I chose partners who were unsuitable for me because I was grateful to be loved and wanted – I equated sex with acceptance. I would continue to cling to men I would have been better off without because of my fear of abandonment.

This is a simplified explanation of how I developed as I did into adolescence, how my personality was constructed. A lot of my blog will be about how I am trying to undo the complex knots that I have tangled myself up in. How I can finally be at peace with myself and live a happy, balanced life. I very much hope that my insights and attempt at recovery will be useful to those with similar experiences to myself.

Why I am writing this blog

I have given a lot of thought as to whether or not to start writing a blog about my mental health problems and recovery. Unfortunately, I have a habit of starting projects, being very enthusiastic for a while and then losing interest. This lack of consistency has a negative effect on my self-esteem as I end up feeling like a failure. Of course, if I use that as a reason not to do something then I don't stand a chance of achieving anything. I find that when I write I understand more about myself and I gain a sense of  fulfillment which is very important to me. I have kept a journal for twenty-two years which has been an essential tool in my recovery process but that is a private activity, writing for an audience is a very different matter. By sharing my story I  hope to learn more about myself but also to hopefully help other people experiencing similar problems, even if it just  makes someone feel less alone. 

For as long as I can remember I have experienced periods of depression and anxiety. When I was a child I didn't have the understanding or vocabulary to ask for help although I can distinctly remember how awful it felt. I was first diagnosed with  depression when I was fifteen (after my second overdose) and have since seen numerous psychiatrists, psychologists, therapists and community  psychiatric nurses (CPN's). Of course, I have also been prescribed many different anti-depressants and other psychiatric  drugs. A few years ago I was diagnosed with Bipolar Disorder and treated for that, however this year my diagnosis has been changed to Borderline Personality Disorder (BPD) and I'm now undertaking Mentalisation Based Therapy (MBT) with a therapist  on a one to one basis.

One of my natural abilities is problem solving, I'm a very analytical person. Over the years when I have felt bad, my instinct  has been to understand the root cause of the problem and to learn more about it. I want to fix myself. As I mentioned  earlier, I have kept a journal since I was fourteen which has been crucial to this process (if somewhat embarrassing to read  back at times). I have also read widely on the subject of psychology and self-help which has provided a great deal of insight. Talking to friends and partners has also been incredibly useful (for me more than them, I suspect). I am now at the point where I have constructed a fairly comprehensive understanding of my psychological make-up - I know why I am the way I am. To me, this is the first step towards recovery. Now that I know myself I am working on trying to accept who I am - there may be some things I want to change but I am focusing on accepting who I am in the here and now, trying to eradicate the feelings of shame, inadequacy and helplessness that have prevented me from being happy in the past. I would like to share this journey with others, it would be very rewarding to get feedback from anyone who is interested in these issues, all are welcome!