Mr. Y and I signed up for a new doctor in town. With the NHS, this means visiting the GP and doing a brief physical, getting an NHS number, etc. The form is straightforward-name, age, address, last time you saw a doctor, and a list of boxes that you check yes or no to, the standard things that your pen flies over and makes a tiny mark in a box.
Do you have or have you had heart trouble? No.
Do you have or have you had kidney trouble? No.
Do you or have you had cancer? Yes.
Do you smoke? No.
And then the one that stopped my pen. The one that made me think and made me wonder how to proceed.
Do you have a mental illness?
Do I have a mental illness? Mr. Y flew through his questions ticking no, and there I was, stuck. Do I have a mental illness...
One out of four adults is struck with a mental illness at some point in their lives. Maybe it's you, maybe it's a family member, maybe it's a colleague. It's hard to think about, and even harder for society to accept.
Last June I took a series of tests, written tests that I struggled with the Swedish dictionary with as logistics and emotions are not terms that I regularly dealt with in Swedish. Upon receiving my scores, scored which indicated a million miles an hour of mental illnesses that didn't sound remotely like me, my therapist looked at me kindly and produced a mimeographed copy of a test to me, a copy in creaking and ancient English that produced a sigh of relief from me.
I took the test, the scars on my wrists bright slash marks that lit the way for my pen.
I got the answers.
And all at once my world was thrown up in the air while simultaneously making sense to me.
My entire life has been punctuated by not understanding. My childhood is completely blank, an 8MM film spinning around in my head and not getting anywhere, the images bubbly and dark. My memory kicks in around age 14, at which point it's too overwhelming, it's too much to hold. My adulthood then comes in and kicks the childhood memory's ass, ripping and pulling and tearing my feelings into little pieces.
I have hurt myself from a very young age, starting with pulling out my hair and progressing along a deadly path of eating disorders, frying pans and razors. I have played with serious alcohol addiction. I have raced my car in driving rain, hoping and praying that it would lead to a tangle of twisted metal along the guardrail and my body with it. When the going got rough, I would step out of myself and watch the horrific made-for-TV-movie of me.
My life isn't one life, but is instead 6 distinct and different lives, all of them pock-marked with me desperately changing myself into whomever I was with wanted me to be, as I throw myself on a barbed electric fence desperately seeking acceptance. I was the prodigal child. The reclusive artsy teenager. The young eager bride. The scarily angry chick that would just as soon throw something as talk. The globe-trotting smart-ass. The unemployed lost soul, sitting in a bath of depression, burning her old journals and unable to bathe or breathe.
In the early days, people would tell you that I was the angriest woman they had ever met.
Now I only rank as fucked-up.
I think I would rather be the angry chick.
And now I have abandoned all of those roles, and I live day to day in complete wonderment, wondering if I am getting any closer to Me.
I would be anyone you wanted me to be, as long as you would accept me. As long as you would love me and want me, and even more critically, as long as you would need me. As long as you would tell me I was good, as long as you would tell me what I was doing was what you wanted. I dated a parade of worthless goons, some of whom were abusive, perhaps as some way to try to continue to show myself that no matter how hard I tried, I would never be any good.
It came as no surprise then, after my suicide attempt last January, that my underlying problem was something much more significant than "I have had enough." My foundation was built on weak cement. My structure was unsound. Something had fundamentally gone awry with me, and it had done so from an early age. My psychotherapist didn't know what "prompted" it-my memories are missing, anyway, so there's likely no way to ever know if it's something from my childhood or something chemical.
I was diagnosed with Borderline Personality Disorder.
Borderline Personality Disorder, or BPD, is a big whopper of a problem. 10% of those with this disorder will meet their end by killing themselves. 20% of those in long-term mental institutions have it. It is a problem that absorbs all of you, that drives everything and makes everything hurt.
The DSM IV Diagnostic Criteria for BPD are:
1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation
3. Identity disturbance: markedly and persistently unstable self-image or sense of self
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)
5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
7. Chronic feelings of emptiness
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)
9. Transient, stress-related paranoid ideation or severe dissociative symptoms
I do not have mutiple personalities and I am not psychotic. A doctor described a sufferer of BPD as someone having the emotional equivalent of a third-degree burn-everything hurts. Everything you say that is negative or horrible gets incorporated into who I am and becomes a medal that I wear, pinned upon my naked chest, to make myself feel worse. I have the stunning ability to twist words around in some way so that they damage me at all costs.
Everything hurts.
Sometimes even the good.
Don't think of me any differently-I am still just Helen, with still just the demons in my head. I am not in any way a danger to anyone in society. I will never hurt another person and I am not a danger to anyone....except myself.
And that's where I am a real danger.
I haven't told many people about this. My family knows about it, as well as Mr. Y, Best Friend, and Dear Mate, and two bloggers out there. It is not something that I am proud of. It is not something that I want to advertise in my real life-I can't imagine how people around me would react. Mr. Y tries hard with me-he knows that he has to remember and watch what he says in fights, since I can turn it around against myself from zero to sixty mph in 4 seconds, but it's a struggle for him sometimes, too.
I am coming out with it here on my blog since it was one of the reasons that I started my blog. I had a problem. I am fucked up. I needed to talk. So I found out why and now need to continue therapy (which I am trying to do). To be honest, my psychotherapist in Sweden was great, and I genuinely miss the work we were doing-I felt I was making progress, that things were beginning to make sense.
I will get another therapist. I will try not to be a statistic. I am not owned by BPD, but it does affect how I react to situations. I will try to remove this difficult and painful red C on my chest, I am so tired of the "Crazy" nomenclature, I just want to remove it and burn it from my clothes.
And anyway, once you move the red C, there is still the Scarlet Letter A under there to deal with next.
Do you have a mental illness?
I checked yes.
Then I scratched it out and checked no.
I can only be so honest with my problems.
-H.
Posted by Everydaystranger at June 22, 2004 05:06 AM | TrackBackBut I'd like to thank you all for discouraging me from posting. Way to push me off the cliff.
Kaetchen, don't get discouraged. My comment certainly wasn't directed at you and I seriously doubt that anybody else's were either. It's just opinions and they're bound to differ. In fact, they're fairly useless unless they do differ.
If two people are in agreement over everything, one of them is redundant.
Posted by: Jim at June 24, 2004 03:58 PMAs one from the other side of the Pond, and from the other side of the diagnosis, I find Helen really brave to admit her problem, even here. She's right, there is a huge stigma associated with mental illness, despite how commonly people have depression, for example. (One in every five, at some point in their life.) I find Mr. Y even more brave, for taking on the challenge of a woman who has been clinically diagnosed with an inability to maintain a relationship.
But, remember the good things, Helen. If you make it past your early 30s, you're more than likely not going to commit suicide, or have major problems with your BPD. You're attractive, intelligent, & well-educated - all factors leading to a positive outcome. Furthermore, and most important, you're already high functioning.
I say this in comparison to my sister-in-law, who is on SSI-Disability, because she cannot hold down a job. She has two daughters she rarely sees because she can't parent them. She has virtually no friends, because she pisses everyone off.
You're doing just fine, Helen.
Posted by: Courtney at June 23, 2004 11:03 PMThere is absolutely nothing wrong with having a mental illness, half the planet does. I hate the name personality disorder, it sounds so bad. I'm glad your getting therapy, it really does help.
Posted by: Cornelia at June 23, 2004 09:07 PMJust back after a two-day conference with Dream Job. A few issues:
-Do I believe that I do have BPD, that it is a medical condition, that it is a problem? Yes. Absolutely. My diagnosis came after some exhaustive and completely un-biased tests.
-Is it possible that BPD can be like other ailments that may get diagnosed a lot, too, perhaps incorrectly? Yes.
-The psychs in Sweden don't make a profit off of you if you are covered by the hospital system, which I was. The doctors there make paltry salaries-there's no way they're getting a BMW from treating us, they're lucky if they have a 10 year old VW.
-Am I upset that I didn't post yes on my medical history form? Nope. My GP is not going to be treating me. I am going private and paying for it myself.
-Is there stigma for people who are mentally ill? You betcha. I think so, hands down. Which is sad, pathetic, and it fucking sucks, but I don't see any way of changing this so long as people fear what they don't understand-the human mind, the heart, and the affects of genetics and environment on growth.
-Do I think I'm crazy? I'll be honest-I'm not insane, but I definitely am a little fucked up.
Posted by: Helen at June 23, 2004 06:10 PMI am a firm believer in the truth for many reasons, but there are times when I can move that truth into a dark alley somewhere and cover it up for the sake of saving myself and my loved ones a lot of sorrow and problems.
My experiences are very similar to Helen's (even if as someone mentioned earlier here, I don't REALLY know Helen since this is only one side that we all see) and I'm 10 years older. I've lived in a lot of places, started over in different countries, been through abuses, diseases, suicide attempt and heaven knows what.
And no...if the doc I'm seeing doesn't need to know I wouldn't tell him that I've tried to end my own life, what the following test results gave away or anything about it unless a medical report would tell him.
Why?
Coz it would pass a lot of eyes on it's way to an archive somewhere and people are very fast in judging others, not to mention give away information if it can lighten up a coffee break.
Yes, I know it should be confidential information...but I don't believe that the word "confidential" isn't relevant other than when the authorities want to keep something away from you.
And starting over fresh in a new country do take some guts and a bit of difficult choices. Sometimes you have to consider what is best for you and trust yourself more than others.
Is it a terrible crime to lie indirectly to your doc? Um...not really. Not as long as it won't hurt anyone. If it will hurt yourself you are most likely self destructive. Fine.
Somehow though I think that it should be up to me to decide how I feel and if I think it's relevant to the doc to know that I didn't want to go on living. If he needs to know he will find out since my loved ones know about it and would inform him if necessary.
And if I have to tell my doc about it I want to know who the heck he is first, meet him a few times...then I MIGHT tell him if it feels ok.
But I wouldn't never check Yes on a form like that....never.
I beleive Helen medical history is already public record since she was in a hospital in her former country. Any type of clearance she is going to need is going to look back far enough to see this.
Should Helen be honest? Answer this first: Are people looked at differently in the working world if they have or are receiving medical assistance for a mental disorder they suffer from? I would say sadly yes.
However just as if you found out your suffered from a physical illiness you would seek help so to should you do the same when it comes to the mind. Maybe even more so.
Posted by: Drew at June 23, 2004 05:00 PMIt's been my experience that a GP IS the starting point for mental health care in the States. Anybody with an HMO can testify on that account.
But I'd like to thank you all for discouraging me from posting. Way to push me off the cliff.
Posted by: Kaetchen at June 23, 2004 04:58 PMNo post today? Here's a thought for anyone reading the comments. We all want to be surrounded by integrity. We want/expect it from our manager, our company, our spouse (or equivalent), our children, our banker, our cashier, the police,..., and we're outraged when they act unscrupulously.
But we so frequently act without integrity (like lying) and dismiss our behavior as acceptable. Should we expect integrity from others when we don't yield it ourselves? Think about how many times a day you do something you know isn't right and then justify it with some excuse. Anytime you have to justify something, you probably shouldn't do it.
I encouraged Helen to be objectively honest, but I'm not sure most people agree with that approach. I liked Jim's response: if you don't want them to know, don't answer. It's not lying if you don't answer. And he further made a good point by saying only answer relevant questions. That would also prevent drawing attention to one single, unanswered question.
What do y'all think?
Posted by: Solomon at June 23, 2004 04:12 PMI'd have done the same thing, Helen. It's not a question of honesty so much as a question of nobody's fucking business except yours and the people you yourself want to know about it. Medical records can be subpoenaed or reviewed by non-medical people for dozens of reasons. The entire staff has access to them to one degree or another and that receptionist might be friendly but she's also a busybody with too much down time. I worked in medicine for years - medical records are a universal joke for medical workers.
They're also increasingly intrusive. What possible reason would a general practitioner have to know about your mental state? They have little to no reason to collect the vast majority of data that they ask for. Even if you answer every single thing they request does anybody think that the doctors actually review any of this before their HMO mandated 12 minutes or less appointment with you?
A few months ago I was curious about my cholesterol levels so I went to the family doctor. They wanted me to redo my patient history as it was over two years old. The new forms were impossibly detailed with every conceivable condition known to man noted on them. I refused to fill them out and said if they had any specific questions that actually pertained to the procedure I was there for that I would be happy to answer them. Oddly enough they didn't have any questions relevant to a single tube blood draw and cholesterol test.
Remember that the doctor is a service provider and you are the customer. You are NEVER obligated to do anything you don't want to, sign anything you aren't comfortable with or say anything you want kept private.
Posted by: Jim at June 23, 2004 12:29 PMi can understand you not wanting to admit it, or maybe not wanting to be labelled. i never told many of my friends or family that i was suffering from depression. only the very closest to me knew. many people don't 'get' illnesses like that.
helen, it took a lot for you to type that. i ache for you - for the pain you've been through, the fact that you try to hurt yourself, that you never seem to think you're good enough. i hope that you are learning who 'you' are and not to adjust for others' likes and dislikes. deep down, you are strong. you just need to let it firm up your actions a bit so you don't doubt yourself so much.
you're a survivor. you are going to make it. i so wish i could help you see that you are worth people caring for you. i'm sending a long distance hug. if your telecomm adventures ever take you to so cal, look me up.
Posted by: becky at June 23, 2004 05:16 AMThen I scratched it out and checked no.
I can only be so honest with my problems.
Ha! I wouldn't have told them either. I don't know what the person who said "here in the U.S. . . ." is talking about, either. "Here in the U.S." that would become a preexisting condition that your medical insurance would NOT pay for and oh, don't think it wouldn't be used against you in every instance possible--employment, adoption, custody, you name it.
You're a plucky one, girl. I definitely have to hand you that. Best of luck replacing the Swedish therapist.
Posted by: ilyka at June 23, 2004 01:45 AMOnce again, Helen, you have made me remember events and feelings I've long since forgotten about.
I slashed my wrists when I was 17. Not very well, though, being rather squeamish about blood. And pain. Fortunately for me. :-) (Couldn't handle my fiance deciding he wanted to fuck some little twit instead of me)
I've done the fast driving thing in the rain too, hoping to run off a cliff and die, thereby solving all my messy problems with one stroke. That was a favorite fantasy of mine before and during the breakup of my marriage.
I rather agree with Curator, based on my years of group therapy. Group taught me that there are so many people in this world who are so-called "fucked up" that I wonder where all the non-fucked-up ones are?
And I was a total lightweight compared to most of them!
Anyway, I would never check "yes" for mental illness problems. If I'm not mentally ill at the moment of checking the box, then I'm not mentally ill.
Period.
I may *have been* mentally unbalanced at one point, but if I'm not now, then I'm not checking the damn box.
Because it's who I am *now* that really counts. Not who I was then.
Thought a bit before going ahead and writing this comment because I'm positive someone will get bent out of shape.
Let's not forget that just because we read Helen's blog everyday and that just because she shares a few of her thoughts with us doesn't mean we KNOW her. We don't KNOW her. We know things about her but we do NOT KNOW her and to assume that she's "just fucked up like the rest of us" is to spit on her words.
Mental illnesses, BPD or not, are not just excuses for doctors to pay off their cars or boats or homes. Mental illnesses are real. A LOT of mental illnesses DO HAPPEN because of events that occurred in a person's childhood.
This is why I get so angry when people say, "They're adults now, they need to get over the past and move on."
Sometimes, you have been so affected by situations in your early years that you don't even understand why the hell you are acting or re-acting the way you do to certain things.
Some of you out there are living this. Some of you out there need to remember you are not doctors and to insinuate that something that is VERY REAL is utter crap made up to inflate a bank account is beyond foolish.
Check yourself.
Sorry if I stepped out of line Helen. That was pissing me off.
Posted by: Serenity at June 22, 2004 07:59 PMHonesty is the best policy, so I agree with Kaetchen. If you honestly and objectively believe you don't have enough of the symptoms, you should check 'no'. But if you honestly and objectively think you have BNP, you should check 'yes'.
It may be helpful info to a doctor in the event of an accident that leaves you temporarily speechless or if a doctor wants to prescribe a drug that might adversely affect someone with BNP. So I encourage you to be as objectively honest as you can. Paranoid Random Penseur:) makes a good point though, it could potentially cause problems someday; although I think Europeans are more accepting of a mental illness being cured than Americans are.
Good thing it didn't say, "Are you nuts?", or we'd all have to check 'yes'. :)
Posted by: Solomon at June 22, 2004 07:10 PMAs for the suggestion that you check the box, I'm too paranoid to agree with that. I think it's a mistake to ever put on any official form that you suffer from anything like that. If you need the therapy, pay for it yourself and keep it off your insurance and your records. Who know's when your employer is going to somehow get access to that information. Maybe, H, you will need a security clearance for the telecom work one day and this will pop up out of nowhere. Nope, you did the right thing to keep this off the official form. Rarely, if ever, are these things designed to help you. Or maybe I'm just too paranoid. Naw, that ain't it.
Posted by: Random Penseur at June 22, 2004 05:27 PMI hate to be the solo voice of dissent, but I wish you *had* checked that box, H. I'm not sure about the NHS, but with most U.S. health care systems, you'd be much more likely to get prompt access to a therapist and some regular and helpful checkups if you had ticked the box. I absolutely understand how very difficult that would have been - I've been there myself, so please don't think it's easy for me to advise you on this one. But honey, you DO need some assistance. There's nothing wrong with that, and I don't believe in telling people that there's something WRONG with them. Even you, though, recognize that things have not gone well in the past, and until you understand what happened and how it continues to affect you, it's going to be really fucking difficult to change those patterns. Whether you get the help by ticking a box or phoning a counselor is irrelevant. Getting help for your sake and the sake of those you love is as important as anything ever will be.
Wishing you lots of good things and an enormous hug.
Posted by: Kaetchen at June 22, 2004 04:46 PMI like what Croxie said best... And I'd send you my therapist if I could too! He worked wonders with me. And figuring out that blank film might just give you the key to unlock and rid yourself or what's ailing you. Don't get bogged down in labels - C's and A's don't mean shit! You are you... and I may be new here, but what I've learned of you so far... you're strong and adventurous, and loving, and kind hearted, and I could go on. You're good person!! Find you a good therapist and purge yourself of the hurt and anger... You've got a good light about you and no sense letting any of that hurt and anger get in the way of that! Mr. Y sees it and I've the feeling so many others do too! I've the feeling you're gonna be JUST FINE!
Big hugs to you from me too!!
Posted by: MH2 at June 22, 2004 02:57 PMHelen, it doesn't matter what you call it. You're you. You've shared so much, so openly, that the name for it doesn't matter. We've gotten to know, and like, and respect, you. Whatever the name.
Posted by: Jiminy at June 22, 2004 02:48 PMHelen-
You are yourself, you own your feelings and behaviour and you share love and joy with your readers. You are bold and beautiful inside and out no matter what medals you have pinned to your chest.
amelia
Whatever you were diagnosed, all that matters is that you really do seem to be doing well.
Oh, and I really liked what you said about understanding. I think people don't give the word enough credit. It's the key to so many of the problems in this world.
Posted by: Existentialwolf at June 22, 2004 02:12 PMthank you for sharing so openly of yourself once again. darlin, you are doing wonderfully. don't let labels get you down. and yes, a good therapist is important. i'd airmail mine over to you if i could!
*sending you lots of love and hugs*
Posted by: kat at June 22, 2004 02:05 PMH,
I can only imagine how hard it is for you to not only battle with your demons but to have the courage to share them with us.
You continue to amaze me, little flame. We love you.
Posted by: Paul at June 22, 2004 01:53 PMWe love you Helen.
No was the correct answer, you just thought about it too hard. :)
Posted by: Rebecca at June 22, 2004 01:41 PMThe borderline part of the BPD name comes from the Freudian classifications normal, neurotic, and psychotic. It was noticed a large group of patients fell on the border between neuroses, and psychosis, having many symptoms of psycotic behavior, but not enough to be considered psychotic. As more research was done, a pattern of behaviors showed up very consistantly, and that is where that list comes from, if 5 or more fit you, then you have it, drop to 4, your cured.
This was discovered in the late 1930's (probably trying to pay for Packards, not BMW's) And by giving it a name, it has allowed the scientific comunity to do directed research, and find some real solutions, its for this reason I don't have a problem with classifying this sort of thing. Where people screw up is they take it as a definition of the person, instead of simply a name for an ailment the person suffers from. If you question its authenticity, I would sugest you take a glance around the web, plenty there to read, and it supports the definition of the disorder rather well. Name is kind of ambiguous, but the understanding, and treatment isn't, which is the good news because it gives our girl Helen here a direction to head.
Helen, once again, well done =)
Posted by: Dane at June 22, 2004 01:14 PMI think I'd tick No too. Even though the answer probably should be Yes.
I've wondered about that really odd spelling too, curator. It's weird.
Posted by: melanie at June 22, 2004 12:58 PMCurator, while I don't exactly have a high opinion of psychologist, psychotherapists and their like myself, you're just wrong here. Of the symptoms listed, the only thing I can reasonably claim for myself is an occasional irritability, especially when I'm stressed out. But even this normally goes away quickly when I find a way to relieve that stress, which can be as easy as going up on the balcony and staring at the nightly landscape below for half an hour. Of course, that doesn't mean I'm not fucked up in other interesting ways.
And what's it with the weird spelling? It's neither cute nor funny. In a medium that relies so much on the written word as the internet, it's just bloody irritating...
Helen, this isn't exactly a surprise for me since someone offered up that diagnosis on Plain Layne a while ago and I thought about how this fits you reasonably well, too.
I agree with Brass and croxie, and as someone else said just a few days ago in another context: And here's a hug for you from me. There never are enough hugs.
Posted by: Gudy at June 22, 2004 12:36 PMCurator, BDP does sound like a very large bag were almost everyone fits in. My sister was diagnosed BDP and as far as I can tell, there´s a huge difference between her and Helen. Nevertheless facing things and trying to understand them is very important thing. And I suspect that in Helens case even more so. My point is there’s nothing wrong with seeking help, and trying to understand yourself. Tough croxie has a point: "We're all a bunch of fuckups" :). Miguel.
Posted by: msd at June 22, 2004 12:30 PMMy ex husband "suggested" to my therapist while I was sorting out years of sexual abuse, that I would be BPD.
The doc said that there are so many different reasons for a certain group of reactions, it would be irresponsible of him to give such a diagnosis in the middle of an emotional rollercoaster.
There's a reason for that old anger...why you need acceptance and why everything hurts.
Get yourself a good therapist and begin to check that blank piece of 8mm film that is your childhood. I don't believe in blaming parens for all the bad things in life, but your childhood is blank for a reason and you might find a lot of answers in there.
Just don't forget about you. Whatever the reasons are, mental illness or not, don't let it put a label on you.
We're all a bunch of fuckups.
Rant: Pardon my French
Give me a fucking break.
BPD: NINvented by PhD's all in an effort to pay off their fucking BMW's.
Look closely at those so-called symptoms. I don't know a single NINdividual who hasn't felt alike.
The only difference between you and those supposively not afflicted is you *admit*.
That's all.
IMHO, there's nothing wrong with you whatsoever.
It's called being Human.
End of Rant.
Posted by: Curator at June 22, 2004 07:24 AMYou've got the cojones to scratch it out. You're gonna be ok.
Posted by: Brass at June 22, 2004 06:16 AM