Hello everybody! I have thought about what to write but I was actually a bit stumped! I was going to share something I had written in the grips of a nasty depression but I am just not brave enough to share it today. Instead, I thought I’d talk about the misconceptions surrounding mental illness.
As most people know, I am diagnosed with Bipolar Affective Disorder which I am fairly open and honest about, but I also have the addition of EUPD traits which I am not so honest about because of the stigma around it. I do not (yet) have a full blown diagnosis but I suspect it will come one day.
Despite finding the BP diagnosis less stigmatising there are also many misconceptions surrounding it. The most common misconception people have is that people who have it flit between feeling happy and sad. WRONG. Some people only suffer with mania, some people suffer with mania and depression and some suffer with hypomania and depression. Mania does not equal happiness. It is horrid. I suffer from a milder form of mania called hypomania. For me, this starts with me feeling very energetic to begin with and my ideas come thick and fast. At first it does feel good, especially if I have just flipped out of a horrid depression. Because of this, I tend to ignore this early warning sign because it feels good and normal. But the longer it goes on for, the worse the symptoms get. I then get racing thoughts which come thick and fast. The best way to describe it is having 300 radios turned on all at once on different channels. I start to obsess over peculiar things and I don’t sleep very much. I have sent many an embarassing email or text, started weird hobbies or think that I am the fountain of all knowledge about certain topics and like I should be educating the world. I can quite often have 2 hours sleep and then feel like I can take on the world. My speech becomes rapid and I often jumble my words up. Sleep deprivation often worsens mania. I have also spent all my money on stupid things, but thankfully I have never gotten myself into debt, which thousands of sufferers do. Because of the increase in energy combined with the racing thoughts, this is when it starts to turn nasty. I become agitated because I can’t keep up with myself or my thoughts. I can’t sit still and I find it hard to focus.
When it gets to this point it means my mood is on the turn and I am stuck in something called a “mixed episode”. This means I have both symptoms of mania and depression at the same time, which is hell on earth if you’ve ever experienced it. I get very agitated but with a lot of energy which when you mix that with a combination of suicidal ideation is a very toxic mix. I thankfully rarely suffer with psychosis during this state but I have done. I have heard voices that say very bad things, I have seen things I shouldn’t see and I become paranoid that I am being watched but the reasoning behind it can differ. But it is usually that someone is plotting against me. Thankfully, my hypomania and mixed episodes do not happen very often, but when they do, boy do I know about it!
Now depression, whether you have bipolar or or unipolar depression, on its own or comorbid with another mental health illnesses is also less than pleasant. It’s not just feeling a bit sad or a bit down. Unfortunately life sometimes happens and it is not always rosey, so to feel down in these situations is a fairly normal emotional response to an event. But when the sadness is persistant with constant low mood, tearfulness, morbid thoughts, lack of motivation, withdrawal etc. it may be early warning signs that you are becoming depressed. When I am not poorly I can look at myself and my life objectively. I am a fairly decent human being with a good job, good family, great friends, decent life etc. But when I am depressed, the inner bully comes out. Worthless, nothing, disgrace, useless, burden, better off dead are very frequent thoughts that I have even when I consider my depression fairly mild. These are fairly common day to day thoughts as my current baseline is mildly/moderately depressed but functioning. But there are days where I can just look at myself in the mirror and burst out into tears because I am ashamed of what I have become. I can lay awake all night, ruminating but not want to get out of bed because I can’t face the world. Sometimes I literally have to bully myself out of bed. Sometimes I can’t even do simple tasks. But I have a great poker face. Quite often, people don’t realise that I even have depression. I can paint on a smile and just get on with “normal” day to day activities. But sometimes, I am just screaming inside, fighting a battle against myself which drains all my energy and I burn out. I have been in that place where I have wished that I was not here. I know that place all too well as I have been there many times. I can’t always just “suck it up” or “pull myself together”.
Bipolar is also not just about switching between several emotions in a day. Bipolar episodes last weeks, not hours. You are not “feeling bipolar” today just because you feel a bit up and down. You are not “feeling depressed” because you feel a bit down in the dumps. Bipolar and depression are not feelings, they are illnesses. It is not “cool” or “trendy” to have it. It is hell. I have to take strong medication to control it. I have to see doctors and nurses regularly. I have to put in a lot of effort to self manage my condition. I have had to have years of therapy to learn how to handle my thoughts, emotions and behaviours. I used to have a really good memory up until my most recent acute episode. It is better than it was. I have trouble word finding at times and stutter at times because of the cognitive effects of the illness and medication. I have had uber shitty side effects from meds. From severe tremors, to anxiety, to agitation, to feeling sedated and putting on shit loads of weight because antipsychotics make you crave carbs and sugar 24/7 and slows down your metabolism. So yes, this is definitely not a “cool” illness to have (is any?)
Now, EUPD, which is the abbreviation for Emotionally Unstable Personality Disorder. I hate the name of the diagnosis. It was formerly known as Borderline Personality Disorder which was not great, but did not include the word “unstable” in its name. “Unstable” make you automatically think “crazy”. This is one of the worst MH illnesses to be diagnosed with. As soon as you come across a doctor, nurse, healthcare professional and they see you have that diagnosis, you are automatically labelled as a trouble maker. It is a complex illness that is difficult to manage, mainly because of the fear of abandonment, impulsivity and black and white thinking. Many label people with EUPD/BPD as attention seekers. Maybe they are, mainly because they are desperate to be understood. It is normally because they do not know how to reach out for help so they can often do things like engage in risky behaviour, self harm or lash out because what they feel can be so intense. EUPD/BPD is often a result of childhood trauma or abuse, bad past experiences and sometimes the way that you have been brought up. It is often comorbid with other illnesses such as depression, PTSD and sunstance abuse.
So what does “crazy” look like? It doesn’t have a face. Anybody can be affected by mental illness at any time in their lives. From looking at me, many people would not guess that I have a chronic mental illness. I can look at others and not guess that they suffer too. It is an invisible illness that does not discriminate.
What can you do to help? Well, for me personally, fussing and treading on eggshells doesn’t help as it makes me feel paranoid. Asking me if I am “okay” frequently drives me insane. I don’t mind once or twice, but it makes me paranoid and gives me a complex. I prefer normality as much as possible It also helps to know that you are there. A hug, a smile, a simple text can be all I need to help me get through the day. I also don’t mind people asking me questions. I would much rather someone ask me a question about something they didn’t understand rather than ignorantly jumping to conclusions. Spread awareness. Spreading awareness combats stigma. Educating people about the signs, symptoms and effects of mental illness can help you spot them in yourself and others so you can reach out and get help. “Crazy” doesn’t have a face. It is nothing to be ashamed of.
Is seeking help scary? Many people are afraid to speak out because of the consequences; hospital and sectioning. Trust me when I say, it takes an awful lot to be hospitalised and sectioned. I started suffering from mental illness when I was just 13, and in that time I have been in very bad places and have done a number of stupid things but had never been hospitalised. It wasn’t until July last year after severe and dangerous suicidal ideation (ie. I had an imminent plan) where I ended up in hospital as a voluntary patient and then subsequently sectioned later on. It was scary, but it kept me safe and it got me stabilised and functioning again. Your first port of call would be the GP who can then refer you to psychiatry or may just want to monitor you in the community for a bit. I have had very varied experiences of the system but on a whole, if you get the right help, it can be life changing. It’s nothing to be scared or ashamed of. You will not be judged and hospital is the absolutely last option as crisis teams like to keep people in their own environment and routine as much as they can, and usually because there is a severe lack of beds.
Anyway, I have rambled on a bit too much. But if this post challenges people’s perceptions or helps just one person then that would make me happy. Don’t be afraid, stay strong and keep talking!