Mental Health Month “Unipolar v. Bipolar & the great error”

After a school shooting or shopping mall attack, we nod and say; “Oh the perp was Bipolar (or schizophrenic).”

For those who are Bipolar (or Schizophrenic, discussed in a later post) this is the worst kind of association and thus, stigma imaginable.

Ironically throughout my life, I have been friends with a great number of Bipolar people and can attest that assuming all Bipolar people are gun-toting and ready to blow you away is a little like thinking all feminists want to castrate men.

Sure, mental illness can exacerbate another condition such as anger, and be part of the impetus that leads to an unacceptable outcome. However, this alone doesn’t logically mean all people with certain mental illnesses ARE going to do that. Just as the vast majority of those who are Islam would NEVER be a terrorist, the same is true of those with Bipolar (or other mental disorders)

But try telling that to the media who irresponsibly fuel this stigma.

It’s like the whisper game, you whisper to a friend and by the time you’re at the end of 20 people meaning has changed.

Ask most people and they will say that they think the majority of shooters of that kind are mentally ill and typically Bipolar or Schizophrenic. How could that not impact how they see those people?

As discussed before, stigma is the worst element of any ‘label’ and is carried even when you dismiss it, as a permanent stain in our society so fond of judging others.

Bipolar, previously known as ‘Manic Depression/Manic Depressive’ is a disorder of two parts. Typically you are either Bipolar 1 or ll or mixed-effect meaning not clearly defined by either category. The problem with categorizing is obvious, the benefit is for those trying to establish treatment protocols but like anything else, mental disorders go in swings and roundabouts of popularity, and at times, it’s almost the illness-du-jour to label a higher number of people Bipolar.

I question diagnosis for the simple reason that having seen it implemented I have seen a great many mistakes in those diagnosis. At times it can seem comforting to be ‘told’ what you ‘are’ and ‘treated’ and has saved lives. I don’t dispute that. I do however, worry that the tools by which we diagnose are faulty.

A diagnosis of Bipolar is based upon several criteria, one being that you must have had a manic episode. Bipolar ll requires a manic episode of less severity. A manic episode can be characterized by many behaviors, typically including, insomnia/wakefulness for several days, excessive impulse behavior such as spending money, making rapid and interchangeable big life changes, impulsivity and promiscuity.

Of the MANY bipolar people I know intimately, and have met throughout the years, I have yet to meet two who are alike. What that tells me is labels are usually as counter-productive as over medicating can be and Bipolars are often over-medicated. However unlike Uni-Polar (Depression and/or Dysthymia) Bipolars really respond to medication and are perhaps most likely to benefit from medication of all mental illnesses. As one who doesn’t believe in the ‘magic pill’ I would stand by anyone who has Bipolar taking medication but caution against over-medication and/or not considering other options in tangent, such as diet-change and therapy.

Many people who become Bipolar do so during puberty/late teenage years. It comes on usually as an extreme manic or depressive episode that can lead to hospitalization, suicide attempts or dangerous behavior. In the past Bipolars were characterized from depressives as being ‘delusional’ and thus, ‘clinically insane’ during manic episodes, and thus, their diagnosis was higher up on the ‘illness’ scale of mental illnesses and it was easier to declare them legally unfit.

In this I would agree. Uni-polar depression is basically that, depression. Bi-polar is a mixed cycle (of varying length, degree and frequency) of mania versus depressive symptoms. As such during the manic-period of Bi-polar, individuals can be clinically delusional and suffer delusions of grandeur, extreme expansive thinking and other exaggerated and not literal feelings. One could argue when someone is depressed they are delusional also, but ask a depressed person they will tell you they know it’s depression. Ask someone in a manic episode, they don’t know it until they ‘come down’ and thus, it’s hard to reason with someone during a manic episode. Consequently they can unintentionally do a great deal of harm to others and themselves.

What it takes to push ANYONE to the edge where they choose to shoot people, is more than any mental illness alone. It takes a CHOICE. If you are delusional you don’t have the same kind of choice system as someone sane, so to some extent you can appreciate the diagnosis of clinical insanity when a very ill person shoots other people BUT despite this, Bipolar has more consciousness than say, a full on Schizophrenic delusional episode, and as such, I would argue, most people with Bipolar can choose (not to shoot people) and are more likely to hurt themselves than others (explaining the very high rate of suicide comparatively).

Does that mean they are not capable of making some VERY bad choices? Of course not, they often will, but it is often rooted in self-destruction than destroying others. Some exceptions exist but that is true of everyone. You cannot say someone with Bipolar is more likely to kill than anyone else, because statistically more murders are committed by people without Bipolar than with. As with anything, there is a tendency to push someone over the edge if they are ostracized, shamed, judged, stigmatized and bullied. At that juncture they may act out of their norm because that’s how far they have gone down the rabbit hole.

Bipolar is a very painful disease to live with because on the one hand it can produce the highest elation and feelings of wellness, ability, skill, intellect, foresight, emotion and productivity, followed by a massive crash and the exact reverse. It is the rollercoaster of emotions that cause the higher risk of suicide, imagine feeling on top of the world followed by feeling like you want to die? How is anyone supposed to live with that? This is why medication does work because it can suppress the extent of mania and the extent of depression and level off that individual to a safer plato. But of course ask any Bipolar they will tell you it also curbs the intensity and feels a lot like castration of the mind and emotional pallet which is why periodically Bipolars will ‘go off’ their medication in an attempt to ‘feel’ authentic.

In my own experience, the vast majority of people with Bipolar are considerably above-average in intelligence, and can produce in short periods of time literally incredible outcomes be it artistic or another form. They often have an addictive intensity and are highly likable in those moods, and then quite a different person when crashed. It can be challenging being friends because even when medicated there are up and downs and these medicated shifts, are often characterized by irritability, argumentive(ness) and ‘bitchiness’ which can be difficult.

But all in all Bipolars are given an unfair ‘rap’ by society and struggle every day to achieve an equilibrium that is false to their very natures. In some ways their lives are more interesting than a uni-polar depressive who fights to ever feel that euphoria or happiness, but on the other hand, the swing and mercurial dive into darkness can be more life-threatening. Stupidly I used to envy my more manic friends who seemed to have endless energy and enthusiasm, but there is definitely a high price for this.

Diagnosis is an imperfect science and it is worth noting that more and more people are being diagnosed as suffering from Bipolar 1 or ll and I find this highly suspect. If you are diagnosed you may want to double-check by getting a second-opinion. If you asked anyone if they had a manic episode, chances are they have, be it in a fever-dream or otherwise. People can be promiscuous or manic for other reasons than Bipolar and given that the medication is often strong and has serious side-effects it’s dangerous to accept a diagnosis without being absolutely sure.

Additionally, Bipolars are often diagnosed in their 60’s and beyond which I believe is a misnomer and incorrect. Bipolar disease is a manifestation of the young, and it can worsen as you age, but rarely if ever occurs in older age. If it does this could be the result of something else and that should be treated before the symptoms of Bipolar. Bipolar without a co-morbid primary causality does not just ‘suddenly’ strike a 60-year-old or I would argue, even a 40-year-old. Yes you can go many years ‘un-diagnosed’ but to suddenly start exhibiting symptoms? That’s something else and you should not accept a doctor fobbing you off.

Some Bipolars can function without medication and if you are in that category that may save you the long-term side-effects of medication and the tendency of over-medication by medical professionals, but there is no shame if you are not able to function without some medication and many Bipolars find it helps so much to get on a regiment of medication that works for them, like anything, Bipolar is a disease of extremes and can be ‘mild’ or ‘severe’ just like depression can.

I cannot tell you the number of people I have known who were let-go, fired or forced to leave their jobs when their diagnosis was found out. Equally there are examples that concern me, of Bipolar Psychotherapists hiding their diagnosis and treating patients. I have a lot of compassion for this but from my own experience I think it’s best not to hide a diagnosis even if it means not being able to be a therapist. The same is not true of other jobs, we cannot expect most bosses to understand and we’re only increasing the likelihood of stigmatization to reveal it to them. That said, in some instances with healthcare insurance tied to employment it’s impossible not to.

Contrary to Bipolar stereotypes most with Bipolar are functioning pretty well all things considered and can be supportive to others, and often leaders in innovative, creative expression. But for every success story there are many who suffer so extremely and do not respond to medication and those people are often left feeling they have ‘failed’ where others have succeeded which only makes them feel worse. This is not the case. There is no failure there are degrees of illness. For some, Bipolar can be managed, for others, it cannot just as with varying degrees of depression. If you are not able to function ‘normally’ (whatever that is!) that’s not a personal weakness or indictment of YOU.

Try convincing someone of that … not easy especially when they are bombarded with stories of over-coming Bipolar. Bipolar cannot be eliminated but it can be dealt with. The extent to how much it can be dealt with depends entirely upon the severity of Bipolar and NOT the personal weakness/strength of the individual. It’s imperative never to compare those suffering from Bipolar unfavorably and make someone feel they are failing or not trying.

Typically Bipolars are more at risk for co-morbid diseases such as Borderline Personality Disorder (BPD) Anxiety, Attention-Deficit-Hyperactivity-Disorder (ADHD), alcohol and substance abuse. Again, this is not because they are ‘choosing’ these co-morbidities but because of the interrelationship between some mental diseases. Consequently Bipolars also report higher rates of sexual assault, and injury.

Our understanding of the facets of any mental illness is our way of being an inclusive and supportive society for those among us who suffer. What does it take to read this and learn more about a disorder that affects so many people in our society today? What does it take to become more aware of the pitfalls in hope that you could help someone in crisis in the future?

Finally, it is worthwhile considering holding off on a diagnosis of Bipolar in children unless ABSOLUTELY certain because many manifestations that ‘look like’ Bipolar are in fact not, and medication has a deleterious effect on growing-brains that is little understood. Therapy and treatment for the effects is a less dangerous way of dealing with symptoms that resemble Bipolar in children. It is uncommon to manifest as Bipolar before puberty and I personally though not a Psychiatrist, caution against diagnosis until late teen age years (17+).

Mental Health Month “Borderline”

This may offend some people.

I truly do not mean to offend but I must be honest. At this juncture I will not consciously be close friends with someone who suffers from Borderline Personality Disorder.

I realize that goes against almost EVERYTHING I have ever said about accepting people for who they are. It’s a giant screw-you to a group of people who have done nothing wrong and do not deserve exclusion of any kind.

But I’m being honest. I cannot.

I truly believe we should embrace and not judge people with mental illnesses. I believed this before I knew I had one. I believe that STIGMA is the single-most damaging phenomenon in the world virtually.

So why am I such a hypocrite?

Because I tried and tried, or maybe I just knew quite a few people who happened to be Borderline. I didn’t judge. I didn’t condemn. I didn’t ostracize. To me, a person with a mental illness is NORMAL and EQUAL to anyone else.

But I couldn’t do it. I admit this. I couldn’t hack it.

Why?

For me, people who are severely Borderline to the point where the symptoms show (some may be mildly) have messed me up too many times. I end up realizing this. If I keep on doing something – whatever it is – again and again with the hope of the outcome being different but every time I do it, the outcome is EXACTLY THE SAME then it’s my fault and my duty to myself to stop the behavior.

Unfortunately the behavior was befriending people with Borderline Personality Disorder. If you have it, and are reading this, you can say fuck you right now.

I’m sorry. It is not a happy choice. I don’t believe it’s right but I have to. Why?

Whilst training I kept hearing about Borderline patients. Most therapists dreaded them. That’s not an exaggeration. Truthfully I didn’t know much about Borderline. I only heard about it around that time, it wasn’t properly understood. I learned Borderline is a personality disorder often characterized by the “I love you / I hate you” extremes in behavior. It is often caused by some severe trauma in childhood and is hard to treat as with any personality disorder. Often times Borderlines will turn on a person not because they are evil or wicked but out of a ‘bites the hand that feeds’ set of responses, or because they perceive the other person to be betraying them.

They are not ‘bad’ or wicked or evil people. They are hurting. They are crushed by the things that caused them to develop this disorder. It is not their fault.

So according to how I live my life, I should be inclusive and welcoming and I was. The only problem was the same thing kept happening. It went like this;

A Borderline person befriends me or I befriend them. We get on well. We are friends nothing more. At first, the Borderline friend really likes me and I really like them. We have a good friendship and things are great. At some point the Borderline perceives that I either do not mean what I say, or I am ingenuous or I am a liar or I am fickle. It could be for a perceived reason or paranoia. It could be based on some degree of reality and then amplified by 1000 percent. The outcome is they switch, they turn on me, I become the ‘enemy’ the perceived reason for bad feelings they have. The bad things that have happened in their life become my fault because I am here, and their past is not. Their response to this is extreme. It can involve a great deal of abuse verbally. We end up not being friends anymore. I am hurt, they are hurt.

If I let this keep happening, though I no longer get hurt anymore, I would be exhausted! I cannot do this. Nobody could. That doesn’t mean Borderline sufferers could never have friends. I believe certain friendships are impossible and that includes me.

I am not blaming myself. If I did I would be buying into the most common accusation a Borderline will throw at me THIS IS YOUR FAULT ENTIRELY YOU DID THIS. I know that is not true.

But .. I accept that I am a certain ‘kind’ of person just as a Borderline is a certain ‘kind’ of person and we – do – not – work.

Why? I don’t know. Maybe I’m too high on the sensitive scale, or the intensity scale, or the closeness scale, maybe I’m too affectionate, maybe I’m too effusive, maybe I’m not effusive enough. Maybe it doesn’t matter.

One thing I know. I can’t do it. And they can’t do it. So unfortunately, contrary to anything else I believe in, I shy away from making friends with someone who admits they are Borderline and that is very sad and I feel very badly about that. But there is no choice. Just as many therapists refuse to see or are reluctant to see, Borderline patients, I am basically avoiding a problem I cannot solve. I realize that is wrong on many levels I just don’t know what alternative exists besides me being a punching bag and I will not let that happen.

Classic Borderline symptoms include; Too much intensity, an extreme adoration of a person that is over-kill and too sudden, the opposite response of extreme dislike/rejection/hate of a person that is sudden also. Many times someone with Borderline is a survivor of childhood sexual or physical or emotional abuse of the worst kind. Borderline is more common among those who suffer from Bipolar Disorder 1.

I feel Borderline people have a really hard time of living in this world. They almost didn’t have a chance, and I admire them for surviving. I would like to help them, befriend them, support them. I do support them in believing them equal to every dignity and right anyone else has. They are not bad people. But the hardest part of being Borderline is that you drive people away. You don’t mean to but you do it. You end up isolating yourself when you least want to. You are lonely but cannot keep lasting relationships. You don’t want to be angry or hateful but you end up being because you perceive that’s what is being done to you.

It’s incredibly unfair.

A friend of mine who was Borderline told me a very valuable lesson. She said, when you are friends with a Borderline person you had better have immaculate boundaries. By that she meant – don’t send mixed-messages of any kind. Do not contradict yourself. Do not say one thing to a Borderline and the opposite to someone else. Do not act like a lover if you are a friend. Do not say you are a friend if you are an acquaintance. Borderline people are very literal. They will take you at your word and if you diverge from your word they will hold you to it.

That might sound like a good thing and in theory it is. Sometimes we have awful boundaries and can be real teases or send mixed-messages. So having healthy and well stated boundaries can really help any friendship. But in the case of Borderline sufferers, people who do not have well-defined boundaries or are very needy, very insecure, very anxious, may inadvertently clash with a Borderline and cause their symptoms to be exacerbated or triggered. In other words not everyone is a good match to be friends with a Borderline. This is not just on them. It’s on us.

I recognize I am not a good match for a Borderline. When I look at my friends they actually do fall into distinct categories. They are either; Very secure and confident. Very sincere, stable and compassionate or very messed up and mentally ill and lonely. The latter is the group I have struggled with the most. If I’m depressed and my friend is depressed it can often work because we can mutually support the other, and understand. A Bipolar friend may get exasperated with me because I’m never manic. A Borderline friend will find me to be imperfect.

I am. I’m imperfect and I’m not super-secure and confident.

So – note to self and note to any Borderline people – we don’t mix well.

This is the first time in my life I have actually realized a good boundary is not being friends with or their being friends with me, a certain group of people. It feels wrong. It feels discriminatory. But it isn’t. It is the setting of those boundaries and the accepting that not everyone gets on and if we know we don’t get on with a certain kind of person then be respectful, we kind, be good, but don’t go the full hog and befriend them with the expectation your friendship will work.

That is growing up. That is experience. That is logic and ultimately, it’s more merciful than keep on doing the same thing expecting a different result.

As for those who suffer from Borderline Personality Disorder. I won’t be the one to write about you because that would be insulting and insensitive. But I will say this, in this Mental Health Month period I hope much is written about BPD people to help them and help others not stigmatize or judge them. A personality disorder is a mental disorder and requires the same level of compassion and treatment as any other.

Mental Health Month “Dying in secret”

Body Dysmorphia / Anorexia / Bulimia / Dieting / Shame / Overweight / Underweight / Orthorexic

For many, dealing with ‘real world problems’ an eating disorder or unhealthy relationship with food or self-image, is going to seem vain, unnecessary, small-minded and petty. If you’re one of those people, reading this won’t be interesting.

For the rest of us who at some point or another have experienced one or more of the above and/or been close to someone who has, this has a real world relevance and to dismiss it as a ‘rich white girls disease’ is to ignore the many people who die indirectly or directly or get sicker, every year. What good is shaming someone if you perceive their ‘problem’ not to be worthy enough for inclusion?

Let’s assume for a moment, any eating disorder or body-image issue, IS taken seriously and isn’t derided, insulted, demeaned and made fun of. Let’s assume people feel they CAN talk about it without pretending they have no idea what it is, because of fear of being judged and told; ‘Get a REAL problem rather than a made-up one!’ Tell that to the kids who die in hospital EVERY DAY from issues related to body-image.

It’s easy isn’t it? To condemn someone and say they’re petty and vain for having any type of body image disorder. Do you imagine they chose that life? That they want to be held hostage by a strange madness that seizes their otherwise rational faculties and enslaves them?

I’m not going to say vanity cannot play a part, but the vast majority of kids and adults who experience this of both genders because it affects men and trans also, feel this way because of a build up of reasons not just self-consciousness about the way they physically look. We can prove this though we should not have to, by showing the relationship between parents with eating disorders and their off-spring and the increase in likelihood their off-spring will go on to develop some kind of eating disorder. Likewise this is true even when that off-spring is adopted away from their family. In other words, it’s not just socially learned – some of it is inherited/biological.

The most recent body-issue out there is Orthorexia, and it’s trending because it has formed around a phobic over-response to the ideals of health and the fears of ‘bad’ food that dominate our society. Orthorexics will literally fear eating certain types of food because of everything written about them. For example if we took the various guidance of health gurus we would not eat; Any gluten, any fried food, any sugar, any non-organic produce, any alcohol, any dairy. We’d be left with rice-crackers, seaweed, vegetables and apple puree. Yum.

It may seem absurd, or an over-reaction but if you take health seriously it is easy to develop without intending to, a phobia of eating most foods because of this. You feel everything you eat is bad for you, so why eat it? You only want to eat things that are good for you and if you cannot then you skip eating. You may not be able to afford to eat what you want to eat and that presents problems as well as finding it hard to socialize because of your restricted diet.

More people than ever before have ‘restricted’ diets. Maybe they are gluten-intolerant, allergic to dairy, celiac, have a peanut allergy, are on a diet, have diabetes etc. Many menus calorie count, some break down the fats and ingredients. It is easy to obsess more than ever, and social media fuels this. There are sites devoted to this and other extremes as well as an increase in hard-core fitness programs that exclude many foods.

When someone has a tendency toward obsessing over this, maybe due to a pre-existing condition like body-dysmorphia, it’s not hard to become Orthorexic and fear eating a lot of food. The hard part is because it’s based upon health, it’s hard to find a healthy way of quitting being Orthorexic. How can you tell someone, eat less healthy food sometimes! The jury is still out on the ‘cure’ for this, but usually it comes to a crisis point and the sufferer realizes they are being controlled and they either embrace that and continue or let it go a bit and become less fanatical about how and what they eat. But it is not easy.

Anorexia is the fear of eating and the equating of food with weight-gain and negative feelings/experiences. Anorexics may eat but they often avoid it and limit their intake. Some purge afterward. They usually lose weight sufficiently that people will begin to notice. At first they are praised for being so ‘beach body ready’ and later on when they begin to grow hair on their skin as an extreme response to starvation they are made fun of. Anorexics have the highest risk of dying due to the lower rates of a ‘cure’ and they are often hospitalized.

Bulimia is characterized by bingeing and purging or even simply throwing up after eating. Typically a bulimic has many of the attributes of an anorexic and may starve themselves also or be an anorexic who purges. Other times they may purge but not necessarily lose sufficient weight to be seen to be anorexic although health-wise they are at great risk because of the strain throwing up does to our heart. Combined with inadequate nutrition and the strain of throwing up typical side-effects include broken veins in the face and hands, digestive disease and scarring, tooth decay and stomach problems.

Many people with eating disorders are on a ‘spectrum’ that doesn’t fit the absolute diagnosis of one specific disease, they are considered to have an eating disorder and then it is characterized individually.

Over eaters / binge eaters – an eating disorder characterized by over-eating to cope with stress much like anorexia that is heightened by anxiety and stress. Over-eating can include periods of extreme denial and starvation, it can also include purging. Over-eating can cause fluctuations of weight that put pressure on vital organs, and also can be a very isolating disease with a higher risk for suicide for all types of eating disorders. Sufferers may also gain extreme amounts of weight and suffer the judgement and ridicule that many over-weight or large people suffer because of our societies obsession with lower weights and their stigmatization of ‘fat’

Working out – Sometimes people who work out to lose weight or become fit can become obsessed with it. Whilst not always connected to an eating disorder, this can relate closely to body dysmorphia and shares the ‘control’ factor crucial in all eating and body disorders because it is thought, they all seek to control their surroundings because they do not feel they are in control in other ways.

Body dysmorphia is not an eating disorder but it can lead to, cause or exacerbate an eating disorder. Body dysmorphia is the incorrect transmission of an image of oneself. You can see a photograph, a mirror reflection, a film, of your body and you will not see your body the way others do.

How is that possible?

I have no idea. It seems absolutely impossible. I would NEVER believe it IF I had not A. Experienced it directly and personally B. Known so many others who did C. Professionally worked with many who did. Just like those who are not raped cannot always understand how life-changing rape can be, we seem to struggle to empathize and understand unless we have directly experienced it, which is sad.

To some extent it seems like a delusional disorder, or type of madness. I mean if you think you look a certain way but do not, how can you see yourself physically that way? And yet you do.

People suffering from any of the above, often have other conditions such as anxiety, low self-esteem, they may be survivors of sexual abuse, they may have been raped, they may be being bullied. Depression Borderline Personality Disorder and Bipolar are other co-morbid conditions that often occur simultaneously. The secretive life of someone with this can be so secretive nobody ever knows they suffered.

Any type of eating disorder is pretty hard to ‘cure’ it was once thought Anorexia could never be cured it could be lived with. Nowadays anorexics and others, have access to treatment if they have the money for the often expensive treatment centers or if they are insured. Treatment can include hypnosis, group therapy, aversion and its opposite ‘exposure’ therapy, cognitive-behavioral and many other methods. Nobody knows the exact ‘cure’ rate but many go on to live healthy lives.

Then again like any addiction or disease, it is possible to switch one for the other. When someone who was say, formerly bulimic is ‘cured’ they may simply take their need for control and place it elsewhere. They may become obsessive-compulsive, they may generate more anxiety, they may take up smoking. It is important to look closely at this because some of the alternatives are as if not more dangerous.

Please note, this is the first time I have ever talked about my own experience in relation to eating disorders or body dysmorphia and my teeth are clenched because it’s like standing naked in public and goes against a history of being expert at hiding these things when they existed.

In my own case, I met a girl I thought was so beautiful around 14 years of age, she was bulimic and anorexic. I recall clearly that I wanted to be like her so I copied her, stupid, immature, but that’s what I did. At first it didn’t mean anything I was just copying her, until my grandmother said one day that I was thick around the waist and would never look good in 1950’s dresses (I was 14) and in the same week my dad told me I was ‘chunky’. Sometimes words have no effect, other times they do. When you are already insecure, and have had a rotten time, sometimes they have too much of an effect and it doesn’t go away.

My friend and I had a secret group where we would binge, purge, starve. Eventually we stuck with starving because we felt badly for wasting food. At 16 a gym teacher said I needed to drop a few pounds, a dance teacher said the same thing and so I entered the world of starving for the sport, which many can relate to. At 17 I began swimming four times a week and during this time of a year, I didn’t starve myself, I was simply too hungry to! It felt great, I was free of the demon.

Except that’s never what happens. The reason we know such things are mental disorders is because they are inherited (children of anorexics have a higher risk) they exist irrespective of culture or income (yes, Hispanics and Blacks have eating disorders too, they were just ignored by the main-stream who believed it to be an Anglo middle-class disease, likewise with boys and men) and it’s usually deeply hidden and never talked about and is a form of delusion-disorder, you SEE things that are NOT there. IE: You are skinny and you see fat.

I can remember being in a dance class and watching all the tan girls in their leotards with their long legs and necks, so graceful and then looking down and seeing my inner thighs all flabby and squishy. It wasn’t true, they weren’t, but that is what I SAW. I remember being at a dinner party and suddenly running to the bathroom and throwing up everything I ate, and covering it expertly with a breath mint, nobody knew and it seemed like a super-power, in fact it was a sickness, an invisible and terribly destructive sickness invading my every thought.

At 18 after my boyfriend had left me, the old demon returned (a need to control) and I began to throw up whenever I ate until I was a dangerous weight. Few people knew, including my parents because I was excellent at hiding things related to my eating disorder. I went to college and in that first year it was the worst it was ever. I realized I was going out of my mind and it controlled me completely, I sought help. I went to a therapist about it and how it related to being abused as a child and other things that had happened in my life. This helped.

The main ‘cure’ of my eating disorder though was not what the magazines would like me to say. It wasn’t that I saw the light, I got better, I’m a shining example. Oh no.

I was ‘cured’ because I was in a relationship and I had nowhere to purge, or throw up after eating and I couldn’t not eat because I lived with four people and they would have noticed. there was only one bathroom, the house was small the walls paper-thin. After a while I realized I just couldn’t hide my disorder and as I was also sharing my bed and happy in my relationship I stopped.

That seems a pretty pathetic reason huh? I thought so.

It also wasn’t true, it was another layer of the delusion.That’s like an alcoholic not drinking in public, doesn’t mean they are not an alcoholic. People say, if it’s a disease you cannot control it, but who said that? Of course you can! You think you can anyway, but really it controls you. When I was alone, even for one night, I would stuff things in my mouth until I nearly burst and then throw up, or I would eat absolutely nothing or I would stare at myself and see something hideous. I didn’t and couldn’t talk about it because we all know what others would say. You are vain. You are shallow. You are pathetic. You cause this. You waste food. You deserve what you get. But it wasn’t vanity it was self-hatred and self-loathing, a desire to be that eight year old again, free of everything. I didn’t know why, I didn’t connect it to sexual abuse and other things that so often are the triggers and markers for at-risk youth to develop eating disorders.

But years later when I was single again I began to starve off and on. I saw that the ONLY thing keeping me from having a full-blown eating disorder again was circumstance! I wasn’t cured at all! I was simply living with the secrecy like a double-agent, patting myself on the back for my success when really it was underneath the surface controlling me. For someone who was so open and honest I was a huge liar, nobody knew, and the more they didn’t know, the more I couldn’t say.

HOW can we have so much control that if we live with someone else it may help and if we are alone we immediately fall back to it? How serious and real can it be then? I think it’s very serious and very real, imagine looking in the mirror and seeing someone who isn’t there! I still do. I cannot see the ‘real’ me in the mirror but what I try to do is surround myself with people who eat healthily but normally, and ensure that I don’t let ‘the voices’ lure me back into bad habits.

I have slipped a few times, notably in times of high stress. I realize for some it is impossible to live with the disease relatively well, for some they are so sick they really do benefit from more intensive treatment and/or hospitalization. I was never as sick as some of the girls (and one boy) whom I knew with eating disorders but that doesn’t mean I was well either. After a very serious bad experience I fell back into starving myself the denial felt redemptive, in my twenties I felt I was far too old to be doing this, and yet I was (many anorexics are over forty, everyone assumes they are 18, the age-bias means many do not ever get treatment). That year I went to visit school friends back in Europe, they all told me how unhealthy I looked, how I had no chest, no flesh, and I felt like I lived with a chimera inside of me, dictating this awful tendency to reduce everything to controlling how much I ate.

In our society if we perceive a disease to be ‘chosen’ or ‘self-selected’ and the person had a choice, then we blame the person who has that disease. We say “I’m not going to understand this disease or empathize because I blame you for causing it, therefore it’s not like a disease you didn’t cause.” What we fail to understand is, while we judge, we judge a far wider number of people who witness that judgement and thus, never seek help, we also instill a sense in the disease-sufferer that their disease is a choice, a bad habit, and their fault. In other words we compound the problem all because we condemn people for something we don’t understand. How many times have you heard someone say; “Those damn anorexic models I have no sympathy for them” We believe that kind of illness is essentially a weakness of character or worse, enviable and thus, we resent them. Would we say that if someone disclosed they had ovarian cancer?

I use my own example because I have NEVER publically talked about having an eating disorder before. I would say it’s a lot like being an alcoholic, you are ALWAYS an alcoholic just like you are always someone with a potential for eating disorders. I did go down the road of Orthorexia and left to my own devices would be merrily heading down it now (except it’s not merry, it’s ridiculous and it’s crazy) and equally I still have body dysmorphia. I can only believe that by admitting this as I have here, I encourage others to get treatment. I personally found therapy very helpful and the other thing that helped was ensuring I took the right vitamins and minerals to balance myself and become less unhinged which I was exacerbating by poor nutrition. It is a vicious circle.

It is very hard for me to recount this, I have tried to delete this several times, feeling that if it gets ‘out there’ I will lose control and I realize, that’s what I have to do and what we all have to do if we experience these feelings. For a long time I could not hang out with people with eating disorders, they triggered me. I am such an independent person ask anyone but when it comes to eating I’m not at all I’m a complete follower and that baffles me. I still struggle to eat when I’m alone or at dinner parties, there are things I will always have and need to always remind myself I have, to face them and not deny them, because then they win.

The grand irony is, I have always been genetically thin, so even if I never had this, I would have been picked on for being underweight, and that’s the farce of it, you can look any way and nobody really knows what’s going on for you, they accuse you of being anorexic when you’re not, and commend you for having a good figure when you’re starving yourself, the mixed-messages of our society increase our propensity to be sick. For some they are genetically wired to not respond to those triggers, whilst others are genetically engineered to respond to them, recent studies show there is a definitive link between DNA and the development of any type of eating disorder. Therefore it’s not all in your head and it is all in your head. But for years we were told it was the spoilt princess syndrome, would that make anyone want to admit it?

It is a form of madness I am certain of it, and as such it belongs in the mental health category almost more than anything else. Society does not help, the continual bombardment of thin bodies really doesn’t help. I have been told I was thin my entire life, and I realize, thin doesn’t even MATTER it’s not IMPORTANT and I don’t even find really thin women attractive! Sometimes it’s not about wanting to be thin, in my case it never was, it was about seeking control and having a really bad relationship with food that was very love-hate. Personally I think bigger women are far more beautiful, proof that an eating disorder or body dysmorphia is not always about weight or thinness, although for some it is.

I had a fear of letting go of being a child, of growing up, of intimacy, of body-shame due to sexual abuse, of self-hate due to low-self-esteem. Those were my triggers, those were my things that led me to develop eating and body disorders. For others it may be the same or different. The thing we all share is a need to control what we feel we do not control – a feeling of being out of control. Sometimes people cut themselves, sometimes people do drugs, sometimes people control what they eat. Equally, if you do not see yourself accurately in the mirror this can be a manifestation of self-hate that was inculcated or indoctrinated and it can lead to a skewed self-image which is at the root of body dysmorphia.

I feel an intense embarrassment and shame at admitting this about myself. I know when I press ‘publish’ I will immediately regret this. And that’s why I’m doing it, because it’s time. Time to end the shame. If you read this and think I’m another white-middle-class-whiner who invents a disease, good day to you, but for those of you who ‘get’ what I’m saying here, I say to you, let’s talk about it, let’s get the monster out of the closet and get to the bottom of it, because the one thing that we hate most of all is admitting it and coming clean, that’s what we avoid at any cost, and that’s exactly why we must.

I’m sorry this is all about me, it was the only way I could find to truthfully tell the story.

 

Mental Health Month “Inferiority”

The next time you come across someone who has a mental illness, consider the following…

We poke fun at people calling them mentally ill (Trump) without really considering the effect such labeling may have on someone who IS mentally ill. In poking fun we are looking to someone we do not respect and saying ‘they’re mentally ill’ by implication, someone we do not respect is mentally ill – this is all bad.

Just like saying ‘he’s so gay’ or ‘that’s so gay’ you may mean nothing by it, (good grief who hasn’t said it at least once?) but it is implying a negative connotion.

White people cannot and rightfully so, use the N word, but black people can because they own the rights to that word over anyone else. Likewise if you are gay, you could say to another gay person ‘you are so gay’ and it wouldn’t be offensive because it’s about who is saying it to who. So the same applies to derogatory statements about mental health. If two people are sitting in a psych ward and say “Trump is mentally ill” that doesn’t have the same emotional fall out as if someone who is not mentally ill makes the claim.

That may be hard to undesrtand but it’s about sensisitivity and it’s just like any category of people. A Native American can make jokes about Native Americans but an Anglo person cannot. Is that Political Correctness run amock? Not really, when you consider the history behind this.

Much as I have heard some awful sexist jokes and the only person who could tell them should be a woman, and not even then. Bottom line; Don’t go there, it’s not worth it.

I would argue, black people are better off NOT using the N word, and the same applies to any group who may use derogatory jokes/statements about their group in jest, it’s probably not very funny. If that’s too PC then so be it, I don’t see it as a detriment to world humor if we reduce how many off-color jokes we tell.

Ultimately what we relate things to says a lot about what we think of them. If we compare mentally ill people to someone they know we despise, then it’s a criticism whether wrapped up in a joke or not. Next time you are tempted to joke about mental illness consider whether it’s really worth the punch line and the laughs, and whether it’s really funny or just a means of exploiting an already stigmatized group of people. If that seems too serious, so be it, mental illness IS serious just like racism is, sexism is, prejudice is.

What does the mentally ill person feel when they hear jokes and put downs related to mental illness? Inferior.

One may say, a person who suffers from a mental illness is already subject to feeling of inferiority and this is probably the case, therefore they are vulnerable to begin with, and every subsequent insult and attack adds to that feeling.

Again, I have heard people lament the ‘weakness’ and over-sensitivity, of mentally ill people. The typical taunt being; “Why do you have to be SO over-sensitive?”

I would argue, what does it take to be a little sensitive around someone you know is going through a hard time? What does it actually TAKE?

There are many people who identify or are HSP (Highly Sensitive People) and this is not always related to mental illness but the two have a relationship because of the difficulty  of being an HSP in a world of mostly harder-nosed types, proud of their ability to not be sensitive, who see any sensitivity as a weakness and are not afraid of saying so.

I’m not going to labor the point about the value of having sensitivity or the obvious detriment to compassion if we do not have any, because I know there are two sides to this, and with such extremes it is unlikely they will agree. I would only ask that less judgement and condemnation exist, permitting those who are sensitive to go about their lives unmolested.

If you are a HSP and have a mental illness, your struggle is often magnified by the accute awareness of your situation and others reactions and responses to you. If someone makes a joke at your expense that wounds you on a deeper level than those who are able to shrug it off. For some, sensitivity is perceived as a weakness of character and their attitude is one of a bully who takes pleasure in seeing the sensitive person react. If you know someone like that, maybe now is the time to call them on that.

The TV show Thirteen Reasons Why may not be a good example of mental illness, and is lacking in many ways, but one truism is the development of hurt in the main character by the insensitivity around her. This can be a determining factor that leads to the taking of your own life, as in her case. I would argue that she also hurt others, and this was not explored in the show sufficiently, nor was mental illness really examined which it should have been. But irrespective, it highlights the progression of hurt to someone with presumably a pre-existing mental condition, that acts as a trigger to take her own life.

We can be part of a reason why someone is crushed. We may not realize we have that power, and maybe knowing we do, will make us a worse tormenter, but if we want to avoid hurting others, which I hope most of you do, then considering what our words do to those who are more sensitive, doesn’t take very long, doesn’t cost anything and can literally make such a difference. It can stop someone who already is feeling inferior from feeling so inferior that they see no purpose in going on.

Everyone is equal. Nobody is inferior to someone else until they act badly and show their true colors.

 

Mental Health Month “Shame”

SHAME

“Shame on anyone who provokes unnecessary shame.”

For those who have never experienced mental health issues, it may be possible to consider a mentally ill person as wallowing lazily in their feelings of elected sadness. This may provoke a feeling of ‘isn’t it a shame?’ a sense that they are wasting their life choosing to act and behave this way.

Many times the mentally ill person will be quizzed;

Do you work out?

Do you eat right?

Do you sleep enough?

Sometimes those quizzes are not kind queries but have the double-headed effect of sounding like criticisms. The implication being; If you worked out (better or more often) if you ate better (your fault) if you slept well (rather than badly, by choice) you’d not be sick.

I go back to my earlier point, barring cigarette smokers, would we say this to someone who told us they suffered from cancer? (And is it even morally right to condemn a cigarette smoker for his/her part in their disease?).

Who the hell do we think we are?

Well … we think we are the well ones, the ones who have the answers to the malady of elected depression and/or mental-illness. We think this because we have no ability to empathize with a different way of feeling, because we have no experience of it ourselves or we do and we ‘got over it’ so we assume everyone else can.

It’s worth noting, there are differing types of mental illness (no shit Sherlock!) and of those, differing degrees and/or cause/effects. By this I mean the following;

If you are raped, you may suffer depression, anxiety, flash-backs and PTSD afterward. If you don’t that doesn’t make you stronger. If you do that doesn’t make you weaker. Those symptoms may go in a short time, they may persist, they may last ages. It will depend upon a myriad of factors, mainly, whether you had a pre-existing mental illness or not.

If you are already anxious and depressed and you are raped, then it stands to reason, it will exacerbate pre-existing symptoms. If you are not anxious and depressed and you are raped, you may have fewer symptoms because you are not adding to an existing list of symptoms. Again, taht doesn’t reflect how strong you are.

See it this way … if you have an auto immune disease like thyroid, you are at higher risk of getting another auto immune disease. That’s because whatever propensity predisposes you to the development of the auto immune disease, makes you vulnerable to others because they work similarly as they have ‘auto immune’ in common.

With mental illness, people with bipolar often experience Borderline Personality Disorder at the same time, and ADHD. People with Depression often experience Anxiety at the same time.

Sounds bad?

The propensity is by no means a death sentence, it’s just like saying if you have red hair you are more likely to get skin cancer than if you have dark skin, but dark skinned people CAN get skin cancer and not every red head does. Propensity is not a certainty as there are other (epigenetic) factors at play as well as our friend CHANCE.

And chance, almost rhymes with choice – bringing us back to the point. Shame is a choice. It’s a choice we as people who experience mental illness can make, to avoid as much as possible, and it’s a choice people who know mentally ill people can make when they deal with them.

You can choose to treat others as you would wish to be treated. The law of karma let’s call it.

Or you can choose to satisify some blood lust within you and make someone else feel very, very bad. Yeah you have that power, you are almost a super hero – not.

Shame is inextricorbly linked with sexual abuse in childhood, rape, molestation, illness, rejection, certain religions, gender, sexuality and other societal conventions that often it appears, seek to remind us we are not good.

As women we are told, we are dirty if we sleep around.

As children we are told, we are perverted if we masturbate.

As loners we are told, we’re weird because we prefer a book to company.

The list goes on. It’s safe to say, it appears a fond past-time of humanity to judge and to shame. And we don’t have to be in 1600’s Salem!

Just because it’s 2017 don’t think this practice has stopped. We can find it in bullying, which incidentally, is the number one cause of teen suicide. We can find it in work-place bullying which owes a distinction because it affects older people and is growing in prevelency world-wide. We can find it in older populations who are ignored, neglected, considered less important and ‘past it’ to be contributors. We can find it in minority groups and ethnic groups, same-sex relationships, gender roles and identity or lack of, and all the shades inbetween.

My grandmother used to say; People don’t like what they can’t understand and they don’t like difference.

So I guess, if you’re left-handed, queer, red-haired, freckled, hazel-eyed and autistic you might feel left out.

Okay so that’s an extreme but how many of us don’t entirely fit in some way?

You only need to be into one thing others aren’t, or not like wearing dresses, or burn instead of tan, or have darker pigment than your other family members, to experience the feeling of shame imposed upon you by a bizzare set of ideals and rules.

In other words it’s modern society or as I like to call it, torture.

Except this didn’t start just recently, it started when we began to communicate with each other (read Vanity Fair the novel if in doubt) we use shame and shaming as a coping mechanism (attack other before we are attacked) a weapon (divide and conquer) and a tool (defeat the others first, win). Society is a battle-field. For the mentally ill they are easy targets, who among us who struggles to get out of bed in the morning can handle much more?

Even when someone doesn’t know it, they can shame others. It is very common place to say things without meaning them in a bad way. Perfectly ‘good’ and kind people can inadvertantly say something that can be taken the wrong way ‘I wish you felt better!’ and pain ensues.

Obviously you don’t want to walk around on tiptoe when talking to someone who is suffering, but at the same time, just as we should be aware of the sensitivity of other subjects we should consider the sensitivity of how we address depression and other mental diseases.

Not everyone who is bipolar is a mass murderer or school shooter

Not everyone who is schizophrenic will kill their parents

Not everyone who is depressed will jump off Golden Gate Bridge

But some may and those tiny minorities are but the extremes. Beneath those few extremes lie shades of grey. The depressed person who cuts themselves, the anorexic who develops heart problems, the BPD who alienates people and ends up alone, the bipolar or cannot read a book, and so it goes on.

Everyone has something. If we remember that, then we can treat mental disease the way it should be treated, as a disease, an illness, but not the sum of a person, only an element of their whole. Something to be conscious of, aware of, sensitive to, without stereotyping the whole.

The best technique in the world? Listen to what a person has to say. You can learn a lot. And by doing this, you afford an opportunity for your friend to speak about things without a feeling of shame or judgement. In the long run this acts much like talk therapy and can be incredibly cathartic as well as a really good way of realizing, mental illness doesn’t define you.