*You can read Part 1 of this article here*
* You can read Part 2 of this article here*
Starting the conversation about mental health can be so difficult.
In this series I have told some of my struggle. My struggle isn’t over, and it might not be for a long time.
Since I finished part two of this series, my quality of life has improved drastically. I am no longer a slave to a reward system activated by drugs, and not only do I wake up in the morning, but I usually wake up with a positive attitude. I have attained my first job as a cashier, and I have a plan for starting a new undergraduate degree!
I have been inspired to continue the series because it is not only important to talk about your struggles, but it is important to share the improvements that can come from proper treatments.
So, let’s back track in my story a little bit to the beginning of summer, 2015.
Before I quit my job in the bar scene, I had my two trips to the emergency room psychiatric ward.
On my second visit, I was diagnosed with borderline personality disorder. Borderline personality disorder is so named because it is thought to describe a condition that existed on the border of neurosis (being aware of reality and having emotional problems) and psychosis (unusual thoughts or experiences [ie. hallucinations] that are not based in reality) (Chapman & Gratz, 15). Psychiatrists observed that these “borderline” patients had a difficult time seeing both good and bad qualities in people simultaneously, and were often emotionally distraught (Chapman & Gratz, 16). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TYR), the criteria for BPD is:
- Frantic efforts to avoid real or imagined abandonment
- A pattern of intense and unstable interpersonal relationships characterized by alternating between extremes of idealization and devaluation
- Identity disturbance: markedly or persistently unstable self-image or sense of self
- Impulsivity in at least two areas that are self-damaging
- Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
- Affective instability due to a marked reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
- Transient, stress-related paranoid ideation or severe dissociative symptoms
Note: list is taken from The Borderline Personality Survival Guide, Alexander L. Chapman PhD, Kim L. Gratz, PhD, pg. 18, referenced from the DSM-IV-TYR. To find out more about BPD, please click here.
I am still struggling to find a psychiatrist I am comfortable with.
By October 20th, 2015 I had made 6 emergency room visits to the psychiatric ward. I remember being taken by an ambulance to the emergency room after having a major panic attack after receiving a triggering phone call. I cried, and I slept, I woke up, and I cried some more. After sleeping for some three hours, and coming to, a social worker approached me in my room. She offered to have a team check in on me in a few hours. I cried “how is that going to change anything? I don’t know how to change what is going through my head!”. Immediately I apologized for being so rude, and outspoken to which she responded “my feelings aren’t hurt, I don’t care”. She then left. Sometime later, herself and the doctor agreed it would be best if I saw a doctor in the psych ward (a psychiatrist, of course). This would take another few hours, and the hospital telephoned my work explaining I would not be able to make it in for my shift that day.
To my comfort, the psychiatrist I was speaking to was one I had seen sometime before. Before we spoke together she gave me access to the telephone in the ward to call my dentist’s office. I had received a gum graft surgery the day before, and was convinced I had ruined the work they had done. We greeted each other, and began talking.
I was bursting into tears each time I mentioned the gum graft, and how convinced I was that I had ruined it with all my crying (my mouth stretches when I cry really hard, I don’t know about you). After the call to the dentist I was told that no, it was probably not ruined unless I was bleeding excessively, which I was not. From this example, she introduced me to a new term: catastrophising. Catastrophising is your classic “making a mountain out of a mole hill situation”. She explained it would take time for me react to stressful situations without falling into hysterics, and suicidal tendencies, but for now it was time for me to start medication.
I had just been prescribed my very first medication for mental health; an anti-anxiety/anti-depressant, cipralex, which I am told is very common. It helps to slow down my thoughts. When I do not take the cipralex, my thoughts can go up to a million miles per second, and I get easily overwhelmed with all the things I [in the moment] believe I need to accomplish during the day. Most times, I end up doing nothing. I admit that it was hard to get into the habit of taking my prescription each day, and there was a time when I stopped taking it. I admitted to my roommate I hadn’t taken my pills for two weeks, and she blatantly called me an idiot; which was totally fair. She had noticed my change in positivity, and inability to look for a silver lining. Not only that, but when you stop taking pills that alter your brain chemistry, it can be really damaging. Medical professionals will tell you that they are a medication you must wean yourself off of, and cannot be stopped all at once.
Now, being said that this was now my 6th visit to the psych ward since June, I had been brought to the attention of the Centre for Addiction and Mental Health. Within the next week I would be contacted by my first mental health worker. She asked questions about myself and my struggle, and helped me get into a dialectal behavioural therapy group through CAMH.
Dialectal behavioural therapy is therapy designed for those with borderline personality disorder to learn skills to bring balance into their lives (this is what dialectal means). It has started to help me learn skills I didn’t even know I needed, the main skill being mindfulness.
The Oxford Dictionary defines mindfulness as “the quality or state of being conscious or aware of something” as well as “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique” (Oxford Dictionary). This basically means not reacting to every thought you have. If you are still confused as to what exactly mindfulness is, please enjoy this informative animation.
Mediation is a key tool in practicing mindfulness. I only discovered this when a former friend of mine suggested meditation to me during the summer, and when I ‘YouTubed’ some titles and many had to do with mindfulness. When mindfulness was brought up as a key aspect in DBT, I decided that meditation may be a good tool for me to use on my own to practice my mindfulness (or there lack of, haha). It has really started to help me practice mindfulness, and not chase down every thought I have, overanalyzing it, and end up driving myself mad. I have not sought any further therapy for the PTSD symptoms I portray.
There are many forms of meditation including calming instrumentals, or sounds, or a guided meditation. My personal preference is to use a guided mediation in which a calming voice talks about walking along a beach, or something along those lines. One of my most used tools is an application for iPhone titled “Sleep Easily”. It generally puts me to sleep within minutes, and I think I have only made it through the entire speech less than a handful of times. It’s free, I urge you to try it out. Again, Headspace has a great video to explain the benefits of meditation.
Dealing with the post-traumatic stress disorder symptoms of my previous traumas has been a different struggle. I still struggle with keeping healthy relationships with partners, and the flashbacks are still prevalent, though I am not in as dissociative of a state during intimacy as was often the case previously – a step in the right direction. The therapy I received through Ottawa Victim Services last year unearthed many of my childhood issues (aiding in the diagnosis of BPD), and I believe I did not personally work on dealing with the PTSD enough. Though they are getting better, the fact that I was raped is something I still think about at least once a day. This year I had taken a taxi home from a friend’s house before work. I sat in the front seat, as I usually do (there are associations with the back seat I am uncomfortable with), and the driver made inappropriate comments about my physique, and, for lack of a better term, asked to take a closer look. I was raging when I got home. I got dressed for work, but was still shaking from the anxiety, and flashbacks. I spoke to my supervisor (still shaking), and ended up stress vomiting. Needless to say I had been sent home. Though this experience had been hindering at the time, it has helped me realise a new perspective on my overall recovery. Meditation has helped me to recognize when the thoughts or flashbacks become to overbearing, and I am able to recognize when I am being triggered. This helps me to pull myself out of a dissociative state, or remain calm during an anxiety attack, or full-blown panic attack. Not every time, but I am okay with that because I know I have made progress, and I am proud of myself.
Once I realised my recovery will be an on-going process, I stopped taking strides backwards, and started to focus on the baby steps forward…everything will be okay.
Sources:
Chapman, Alexander L., and Kim L. Gratz. The Borderline Personality Disorder Survival Guide: Everything You Need to Know about Living with BPD. Oakland, CA: Hew Harbinger Publications, 2007. Print. 15:16:18.
Stone, M.H. 1993. Long-term outcome in personality disorders. British Journal of Psychiatry 162:299-313.
“Borderline Personality Disorder.” NIMH RSS. N.p., n.d. Web. 09 Jan. 2016.
“Who We Are.” CAMH:. N.p., 2012. Web. 09 Jan. 2016.
“Definition of Mindfulness in English:.” Mindfulness. N.p., n.d. Web. 09 Jan. 2016.
“About CMHA.” CMHA:. N.p., 2015, Web. 12 Jan. 2016
“Our Mission, Vision, and Values.” CMHA:. N.p., 2015, Web. 12 Jan. 2016
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