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’. For me, showing my self in the presence of a regulating other has helped me integrate the pieces of myself. In other words, it 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 any of these people for granted.

I'm so far from where I began with both of these searches, but it's an ongoing process. I don't expect to stop any time soon and nor do I want it too. Life and language are both in states of a constant unfolding.

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

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Since the age of about nine or ten, I've been searching for the right words and the people with whom to share them. I've written reams about how complicated this has been, and sometimes still is.

There are many faces to talking about mental health problems, even more so those with a heavier stigma. Confusion, fear, overwhelm, shame, embarrassment feature. Relief, euphoria, connection, solace are present too. Let me try to unravel some of this a little bit. I hope you will join me.

Mental health problems are often complex, shifting in nature and hard to define.

It can be easier to talk about something that's fixed and easily-defined than something fluctuating and nebulous like mental health and mental health problems.

The experiences that for me came to be labelled as BPD are, by their nature, unstable: changing feelings about myself ('I like myself/I loathe myself'), emotions that are in flux (excited in the morning/depressed in the evening) and 'impulsive' ways of responding to emotions (acting one way and then all of a sudden acting the opposite way).

It's has been hard to speak about these fluctuating experiences because of how quickly they change. In the past, my mood would have changed before I'd even found the words for it. One moment a feeling was there and then, before I even had time to gather my thoughts, it was gone and a new one had arisen.

I also used to find it extremely hard to talk retrospectively. For example, I found it hard to say 'yesterday I felt really depressed'. Once my feeling of depression had gone, it felt like it had never existed. Sometimes I even told myself I must have been inventing it. How could something change so fast?, I thought. 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.

The struggle with emotional permanence makes it feel as though whatever emotional state I am feeling in the present moment has always been there and always will be there. 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 tend to only open up in depth to people who I think can hold multiple possibilities and multiple chronologies in their mind at once. 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.

Few, or no, models for speaking about mental health. never being taught how to speak about it.

When I was a child, there were no role models for speaking about mental health or mental health problems. I never had any lessons at school on 'emotional literacy' to understand emotions or to teach me vocabulary or phrases to explain how I felt.

As chatty and verbose as I was as an older child and teenager, I felt like I 'didn't have the words' for some of the things that lived at the core of me. I felt lonely and looking back now I can understand why.

Because I had little language for what I was experiencing inside my mind, I couldn't articulate this to others in a way that they might be able to understand. I couldn't even adequately ask for help.

Not having the words, I couldn't organise my chaotic internal experiences into any kind of narrative. If I could have made a narrative for myself, maybe the wildness I felt inside my head might have felt tamed or at least contained.

I think there's an argument to made for experiences that feel 'wordless' or 'beyond words' as potentially feeling more traumatic than experiences that have been put into words— I imagine Attachment Theory and Psychodynamic Theory has something to say about this.

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I've run out of time to finish this post! I will try to finish it asap.

*I will have to unpack this idea more in another post. However, my new book is about identity when you have a diagnosis of BPD, including the strengths that are core to so many of us with this diagnosis.

*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.

***I still sometimes find it hard to feel 'held in mind' by my friends or family unless I'm physically with them or receive other communication from them frequently such as texts or look at objects they have given me. This is probably why it means so much when my friends text me; I feel a moment of recognition that they have remembered me and it comforts me.