Why Are Mental Health Problems Often So Hard To Talk About?

Talking About BPD is not really a blog 'about' mental health. To be honest, it's probably best described as a blog 'about' the social and relational aspects of life—my life!— with the highly stigmatised and contentious diagnosis of borderline personality disorder (BPD).

It's a corner of the internet I carved out to write about what it feels like to be me. What it feels like to be me trying to live my happiest and my most meaningful life, not just in spite of this diagnosis— but sometimes actually because of it.*

This blog became an evolving document of my search for words. Sometimes painful, sometimes ecstatic, this search is a search for language that can, as accurately as possible, represent my emotional and internal experiences. Often these have been experiences that have felt frightening and confusing, as well as exhilarating.

It's also an ever-growing archive of my search for people. People who make me feel safe enough to speak these finally-found words out loud. I'm lucky to have found many of these people, and I don't take any of them for granted.

In Understanding and Treating Chronic Shame, Pat DeYoung writes that shame is ‘the disintegration of the self in relation to a dysregulating other’. I can absolutely relate to that. As I wrote recently, if I lived in a cave alone the struggles associated with my BPD diagnosis would not exist

So if my self feels as though it's shattering into a thousand pieces when faced with 'a dysregulating other', by contrast showing my self in the presence of a regulating other has helps the pieces of my self to integrate with one another. In other words, a so-called 'regulating other' makes me feel like I can live in my own head and sit in my own skin without wanting to crawl out of either of them. This is why I don't take anyone who makes me feel safe enough to show the many parts of my self for granted.

Whilst I'm so far from where I began with both of the search for the right words and the right people, it's an ongoing process. Life and language are in a states of a constant unfolding. And I wouldn't want it any other way.

Before you go on reading, please note this post mentions suicidal thoughts and self-harm with no details (you can rest assured, I never include any details about suicide or self-harm).

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My search for the right words and people with whom I could safely share these words started in late childhood. This was the time when I started hurting myself in response to strong emotions and feelings that I didn't know how else to manage.

I found this complicated at the time and it was complicated long after childhood and adolescence ended. Whilst I've done so much talking with so many people since then, it's sometimes still complicated. Sometimes it can feel really heavy and confusing knowing what to say, how to say it, how much to say, when and to whom.

There are many faces to talking about mental health problems— and many more when the conversation features a diagnosis or a facet of mental health which bears a stronger stigma.

I've felt confusion, fear, overwhelm, shame and embarrassment when talking to someone. I've felt relief, connection, solace and euphoria too.

Mental health problems are often complex, hard to define and fluctuating by their very nature. A mental health condition can be like a shapeshifter taking on different forms on different days.

It can be easier to talk about something that's fixed and easily-defined, than something shifting and nebulous like mental health. The speaker has to work harder choosing words that capture subtlety and nuance. A listener has to be more open-minded; they may need to hold onto ambiguity and ambivalence or keep multiple possibilities and multiple chronologies in their mind simultaneously. In my experience, not everyone is open to trying to do that.

The experiences that for me came to be labelled as BPD are unstable in essence

• changing feelings about myself ('I like myself/I loathe myself')

• emotions that are in flux (excited in the morning/depressed in the evening)

• 'impulsive' ways of responding to emotions (acting one way and then all of a sudden acting the opposite way).

In the past, it was hard to speak about these experiences because of their fluctuating nature. By the time I had found the words for my feelings, they would have shifted and been replaced by new ones (imagine trying to describe an animal in front of you after it's run away and a new creature has entered the scene).

As someone who has the potential to feel many different emotions and multiple ways about myself, I owe it to myself to only share this with people who can be respectful about it. I look for people who embrace differences, stay curious when in unfamiliar emotional territory and are humble enough to not think they are an expert on someone else's life.

I used to find it hard to talk retrospectively about my emotional states. Once a feeling had faded, I doubted its realness. Sometimes I even told myself I must have been inventing it. How could I feel distressed in the morning and full of life in the afternoon. I thought. It can't be real.

Before I experienced DBT— the therapy which taught me that it was okay to feel my feelings and that they made sense in the context of my life— I was adept at invalidating and disbelieving myself.

My struggle with emotional permanence made it feel as though whatever emotion I was feeling had always been there and always would be there. As I wrote in one of my poems, 'I'm only this moment / I'm only this pain. / I relive the time lapse shot of the anemone / over and over again.'

Even today, when life is so much easier and I struggle so much less, I have to make a concerted effort to remind myself that other emotional states exist outside of the one I'm feeling. I've improved hugely with this in the last five years, but I still find it difficult.

I find objects or written words very useful such as books or other gifts people have given me next to my bed. When I see them it reminds me of their care. I also have a list in the notes app where I copy and paste any messages that would be helpful for me to re-read when I feel low or anxious.

There were few, or perhaps no, role models for speaking about mental health when I was growing up. I don't think I was ever taught how to understand emotions, what their purpose is, t the mechanics of them, useful vocabulary, possible ways of starting a sentence.

Although I was a chatty, verbose child and teenager, I still lacked the words for some of the core aspects of me. I needed a language; a language that I didn't have.

Without the words to articulate what (chaos! turbulence! confusion!) I was experiencing inside my mind, I couldn't tell others in a way that they might be able to understand. I couldn't even adequately ask for help.

Lacking the language, I couldn't organise my internal experiences into a narrative— no matter how basic or fragmented. If I had the words, maybe I could have tamed the wilderness I felt inside my head into a narrative.

Instead, it all felt unspeakable, wild. Looking back on how alone and frightened I felt, I can now understand why.

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The first time I started 'trying out' words seriously was when I was first diagnosed with BPD in my early twenties. I felt so silenced by the diagnosis, and all the stigma it bore then and still bears now, that I turned to writing anonymously on the internet. For me, writing for me was, and probably still is, a process of finding the words that I feel most effectively articulate a certain experience.

I used to describe this process of finding the words for my experiences to myself as: 'trying out words to see which ones tasted right on my tongue'. The taste/mouth metaphors also extended into my description of how it felt to speak the words 'BPD' out loud: like vomiting all over myself.

That says something about the the level of disgust I used to feel about my diagnosis, the experiences that led me to have this label and— much more than that— who I was as a person.

Through writing a blog on the internet, early iterations of this one, I started to find ways of articulating myself. I used writing on the internet to garner courage to speak in the real world.

And it worked. I'm not saying it was easy. It wasn't— and sometimes still isn't.

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This post is to be continued!

*The first time I saw someone speaking about mental health in a way that I could relate to was Stephen Fry's 'The Secret Life of the Manic Depressive' 2006 documentary which I watched secretly in my bedroom on YouTube. I must have been about 18 or 19. I didn't know how to speak to anyone about what I'd watched and how it made me feel because I was too scared of how I would be judged. It makes me sad to think of how impossible it felt for me to speak to anyone.