It’s Not Pretty

It’s not pretty. She’s not pretty. She’s not a thin, wistful girl with large tragic eyes. There’s no staring into space while smoking a cigarette and drinking Diet Coke. She’s overweight and plain. Her facial expression matches whatever situation she’s in and does not reveal how she feels. Her apartment is a disgusting mess. She doesn’t manage to still be beautiful with messy hair and circles under her eyes. Her hair is greasy and her pajamas ill-fitting. There’s no getting sent to inpatient where she has a crush (who likes her back) and leaves filled with promise and hope. There is being sent home from the ER after a few hours because she doesn’t have a specific plan for suicide, so it doesn’t matter than she can’t function. She fakes her way through work and eventually gets fired for calling off too much. She eats cereal from the box that she bought from Walgreens at 3 am since she hates leaving the house when it’s light outside. There are cuts on her thighs and sores on her scalp from compulsive picking. She doesn’t turn her misery into haunting music or captivating artwork. She can’t finish a book, watches TV without following the plot. No one notices; no one reaches out. Her friends don’t rally around her. No one wants to rescue her. It’s not a girl looking fragile and crying while indie acoustic plays in the background. It’s her slamming a cabinet door on her arm over and over after looking at photos of her cat that ran away just wishing she could cry. It is slow and heavy and terrible. It’s not like a movie. It’s not glamorous. And it’s not pretty.

Health Mystery

This post is going to be about health stuff, including some mild reproductive system stuff, so if that might be upsetting to you, you probably don’t want to read this.

I’ve gone through phases of sleeping poorly for most of my adult life. It’s milder than true insomnia and seems to be caused by physical discomfort. I lie down and can’t find a comfortable position. My legs or shoulders or neck or arms (or all of the above) are too tense or achy or stupid-feeling for me to fall asleep. This’ll go on for a couple of weeks and then I’m back to sleeping normally for a month or two.

I’ve believed I was more tired than average for the past seven years or so, too. Depression can cause fatigue, as can chronic migraines and sinus problems which I also have. I always blamed my lack of energy on those things, and I figured I was probably a little lazy, too.

This March I had a headache every single day of the month. I feel like I had a migraine that showed up and didn’t fully retreat until April. It receded a bit some days, but on a scale of 1-10, I rated my head pain 6 or higher 21 days out of 31 in March. I was tired and sad and discouraged. Being in constant pain does that.

The first week of this month (April) my headache finally let up completely, but I still felt worn out and listless. Getting out of bed for work was a huge struggle. Every day felt like a fight I wasn’t equipped for. I just didn’t have any energy. For the most part I’m very good about practicing good sleep hygiene (no caffeine close to bed, no naps during the day, put my phone away before getting into bed, etc) and made an effort to eat well. I tried exercising, but even short walks just made it worse.

One day I woke up feeling like I’d rolled down an asphalt hill and was fed up. I called out of work and made an appointment with my primary care provider. She listened to everything I had to say and took me seriously, which was great. She heard a heart murmur that wasn’t there before, so she said she wanted to order an EKG and an echocardiogram. She also asked me to come back when I hadn’t eaten to have blood drawn.

The next day I threw up on the way to work. Since I hadn’t eaten anything yet, I went to the doctor’s office and got the blood drawn. That day and the rest of the weekend, I basically just read and slept. I didn’t even feel like playing Skyrim, which I’ve been extremely into lately. My boyfriend started working on this year’s garden without me, which was a bummer, but I just didn’t have it in me.

A week ago today (April 13th) I had a follow-up appointment with my gynecologist I’d scheduled months ago. In late December and early January I’d noticed blood on the toilet paper when I wiped several times. There was never enough blood for it to actually leak onto my underwear, just an occasional streak on the toilet paper. It bugged me enough to schedule an exam, so I had one in January. Then in February I skipped my period. My March one came on schedule. The occasional blood still showed up.

I filled my gynecologist in on the other symptoms I’ve been experiencing lately: crushing fatigue, aching muscles, slight dizziness, stiffness, increased light sensitivity, constipation and diarrhea, and the new heart murmur. She did a well woman exam and a nurse drew blood to test for anemia and check my thyroid function. I also gave a urine sample, which they told me had a small amount of blood in it. The gynecologist scheduled an ultrasound for April 25.

Friday I called my primary care provider’s office and the only test result they had was B12, which was normal. My echocardiogram and EKG still hadn’t been scheduled. I was super frustrated, but I didn’t really know what to do. I grew up not going to the doctor for anything, and I’m not an assertive person, so I figured I just had to wait around for stuff to get done.

Sunday I got an email from my gynecologist. There is a patient portal that sends emails when lab tests come back. Everything was normal: my pap smear, my thyroid test, my CBC (complete blood count), the urine culture (there was no UTI). I was relieved that the pap smear was normal, but I burst into tears when I saw that it said “no signs of anemia.” I’d been sure anemia was my problem. It fit my symptoms so well, and I’ve been anemic in the past. It would have been such a sensible explanation with a tidy solution.

I cried for about 20 minutes, thinking I was making all this up, that I’d be stuck feeling this way forever because they’d never find a reason since there is no reason other than my being a lazy crybaby who wants attention. I couldn’t imagine how I’d get through life being this tired and sore and weak.

Later I texted my mom and she told me that I couldn’t just create a heart murmur and blood in my pee with my imagination. That made me feel a lot better. The next day I called my nurse practitioner’s office and made another appointment.

My friend M went with me to take notes and ask questions. I am having trouble focusing lately too and it really helped to have her there. She made sure nothing was forgotten. My nurse practitioner was great again. She listened patiently and was thorough. She explained the mix up with the blood tests and the delay in getting the echocardiogram. She did a 10 second EKG, which was normal, but is also referring me to a cardiologist. Blood was drawn to test a bunch of stuff, including ferratin level, lamictal level, and whatever it is they look at to aid in diagnosing lupus and another autoimmune disease.

She gave me an order for a chest X-ray so my friend took me to the hospital for that right away. They called today and said it was normal, which is great. Tomorrow afternoon I can call and see if any of the other lab tests are back yet.

So that’s where things are now. I haven’t been able to work. My job is physically and mentally demanding (I do therapy with toddlers). Even if I could force myself to push through the pain and fatigue, it’s pretty apparent that I am sick, especially because I’m getting out of breath easily. I don’t want families seeing me this way.

I am vacillating between thinking I’ve dreamed all this up and that it’s going to be humiliating when they tell me that I’m a delusional hypochondriac drama queen and worrying that something serious and life-changing is wrong with me. I’m also afraid that this is the beginning of a years long quest for a real diagnosis, that I’ll have to go from doctor to doctor before someone with the expertise to do something about it actually takes me seriously.

Uhhhhh…..I guess we’ll see.

Standing Up is Hard to Do

I really, really suck at standing up for myself. I am not assertive. I’ve been this way as long as I can remember.I don’t understand why. My parents did not have poor boundaries with me or others. My brothers and I told each other to back off when we were annoyed with each other. But when it comes to anyone else, I’ve pretty much always lacked the ability to say no.

When I was eleven, I loved the Baby-sitters Club. The week Abby’s Book showed up in the bookstore, my mom bought it for me, along with another one I was really excited about. I took them to my brother’s Little League game the next night to read. A girl whose brother was on the opposing team sat with me and told me how much she loved the Baby-sitters Club. At the end of the game she asked me if she could have the books, and I said yes. I didn’t want to, of course. But I had no idea how to say no. I felt like I couldn’t, even though I knew it wasn’t polite for her to just ask for someone else’s stuff.

My mom found out a few days later and told me that she understood that I was trying to be nice, but from that point on there was a rule against giving away presents. I loved rules that made it easy for me to say no to things I didn’t want to do anyway.

I’ve done countless things because I was too chicken to say no, from entering an unfinished class project into a school science fair (and then having to listen to several teachers tell me I should’ve given more effort) to working other people’s double shifts when they were hungover to letting a guy put his hands in my pants in 9th grade.

It’s not that I haven’t tried to fix this problem. I talked at length about it with a counselor at health services in college. I read Your Perfect Right by Robert Alberti & Michael Emmons. I’ve rehearsed assertive statements on my best friend and various therapists. I try to “know my rights” and what will make me feel taken advantage of. When I don’t want to do something or am unhappy with a situation, I come up with alternative suggestions or practice respectfully declining in my mind. But when it comes time to actually say the words (or text/email/etc) the words, I chicken out, unless I can come up with a reasonable excuse.

Trying to stand up for myself doesn’t just make me uncomfortable. Thinking about it makes me panic. It feels like something TERRIBLE will happen if I do it. People will say stuff like, “Just tell her you can’t. Say you’re busy or too tired, because you are.” And I’ll just think, “HOW???” Finding the words isn’t the problem. It feels like I am physically incapable of doing it. Every time I get close, tears fill my eyes and I get choked up. If someone asks me to do something over text and I make up an excuse, I end up feeling anxious and crappy. So a lot of times I do things I don’t want just to avoid feeling bad even when I could give an excuse/reason.

I’m guessing that this stems from a fear of other people being displeased with me. I also am uncomfortable with the people I love being unhappy, even if it’s not directed at/because of me. So I do what other people want (and what I perceive that they want) as much as possible because I am happier when they are happy.

Obviously, though, it’s more complicated than that. If I were completely satisfied doing what other people want, then assertiveness wouldn’t be an issue. I wouldn’t need to stand up for myself because I’d be perfectly fine doing others’ bidding all the time. But I’m not happy doing that. I want to do my own stuff sometimes.

 

I don’t think there’s a quick fix for this issue. I can go through the checklists on articles about assertiveness all I want. I still fall apart when the time comes. I think it’s going to be a complex process; I have to learn to be okay with people I care about possibly being displeased with me. I also have to get used to being assertive and see that it won’t cause the world to end.

If anyone has suggestions or can relate, feel free to comment.

 

 

 

 

 

Interview with Molly McHugh (bipolar 1 survivor)!!

Recently I had the pleasure of being interviewed for a blog post on Molly McHugh’s website www.bipolar1survivor.com. Molly has lived with Bipolar 1 for many years and writes about her experiences as well as alternative treatments, scientific studies related to bipolar disorder, and tips for dealing with the disorder.

Molly interviewed me to highlight some of the differences between bipolar disorder and borderline personality disorder. I’m quite excited that I had the opportunity. Here is a link to the post on her blog.

http://www.bipolar1survivor.com/borderline-personality-disorder-explained-bpd-talks/

Make sure you check out the other information on her website, especially if you deal with bipolar disorder.

Confession: Emotional Eating

It’s been a while since I wrote. I’ve been going through that “do i really have anything significant to say” thing again. There are already so many good  blogs out there. Most of the time I feel like anything I have to say someone else has already said better.

Also, the thing I’m struggling with the most lately is pretty embarrassing. It’s harder for me to talk about than mood swings or self-injury or doing a crap job of taking care of myself.

Buuuut since being honest about mental health and BPD and myself in general is part of my whole thing, I’m going to make myself do it.

The issue I’m ashamed of is my unhealthy relationship with food. I know lots of people prefer junk food to healthy food, and I know that healthy eating isn’t something that comes easily for anyone. It takes some level of effort for everybody. It’s more than that in my case.

I haven’t been diagnosed with an eating disorder, but I think it’s safe to say I’ve got some disordered eating habits. I am an emotional eater–and not like, “Oh I ate half a gallon of ice cream after a horrible break up.” More like eating is a daily response to stress, sadness, and frustration. I’m pretty secretive about eating and will go to considerable effort to hide what I consider unacceptable eating from other people, even my boyfriend. I have certain foods I consider safe and others that are not okay, for whatever reason.

I don’t binge or purge, and I don’t restrict very often. Because of that, I generally feel like my eating problems are a matter of not having any self-discipline or willpower. I’m clearly not in the emotional hell that people with eating disorders experience, so it must just be that I’m a self-indulgent glutton. Other times I think it might be more complicated than that because I will eat normally and healthily until I get stressed/emotionally distressed and then my eating habits will fall apart.

So really I don’t know. Maybe I’m just a piece of crap with no self-control. Maybe I’ve got disordered eating because of emotional problems that food has become tied to. Either way it’s something I’m struggling with a LOT that I am going to have to work out. I hope to be posting about it in the future as I try to make sense of it and change my actions.

Better Circumstances, Better Me

I have been noticeably less symptomatic for the past few months. My mood swings are less frequent and intense, I don’t feel empty as often, and I don’t get my feelings hurt as easily. However, I don’t think this is because I have improved my DBT skills or become a master of managing my symptoms. I think my improved state is largely due to circumstances.

This makes sense since it is BPD is generally considered to be less based in neurochemistry and more based in cognitive distortions and difficulty regulating emotions and behavior based on trauma, intense fear/pain, being in an invalidating & non-nurturing environment, etc. Marsha Linehan has noted that borderlines are dependent on their environment to regulate their feelings and actions. So it’s not surprising that I am feeling and functioning better since my situation has improved.

I am fully aware that I have been very lucky, and I am so grateful. I am in a relationship with a wonderful, validating person who makes me feel secure, for the most part (meaning that I still have a lot of insecurities but they are not logically based on things he does). My hours at work went from 40 a week to 30 a week, which reduced stress. My boyfriend and I aren’t middle class or anything and we have to be careful with money but we don’t have to worry about how we’re going to pay rent and utilities from one month to the next. October to December is my favorite time of year, especially Christmastime. So that has added a huge amount of pleasure and happiness to my daily life lately.

I really think that if I were working a job I didn’t enjoy, worrying about money, and experiencing a bunch of conflict in my relationship, I would be EXTREMELY symptomatic. Even if one of those things were the case I would be pretty symptomatic. My stress tolerance is still rather low and my mood zooms up or down when too much is going on or something hurts my feelings. It’s like someone running naked through the woods and getting bitten by mosquitoes, scratched by thorns, stepping on sticks and rocks, etc. The longer they keep going and the more obstacles & irritants there are, the worse they are going to feel. But if all the aggravating stuff is removed, it’s still annoying to be in the woods naked (or a person who has so much trouble regulating themselves) but it’s much easier than it was before with the thorns and mosquitoes and such.

Right now I’m naked in the woods, but I haven’t run into any thorns or bugs or rocks yet.

BPD and Manipulation

We all know that borderlines have a reputation for being manipulative. It’s a pretty pervasive (and inaccurate) stereotype. There’s a lot to be said about it, but I don’t want this post to get too lengthy. So I’m just going to address a couple of things.

I have heard and read people say that borderlines will use suicide threats to get attention or to get what they want. For example, if they can’t get their therapist to talk to them or if a significant other talks about breaking up with them, a person with BPD might say they want to kill themselves. This is viewed as manipulative, as a tactic for getting our way.

I can’t speak for all borderlines, but that has NEVER been the case for me. What actually happens is that a situation that might not seem extreme to someone else truly does make me want to kill myself. I can remember a time several years ago when I got into an argument with my boyfriend at the time. I ended up crying and my ex-boyfriend refused to discuss the subject anymore because he thought I was upset over something stupid. Being told that I was upset over nothing caused me to escalate further. Then he said he didn’t want to be around me until I was over my crying fit. I wanted to know if he still loved me and if he forgave me. He told me those were ridiculous questions and left the apartment. His leaving while angry at me and the fact that he wouldn’t say that he loved me and forgave me sent me over the edge. While he was gone I became increasingly anxious and could not calm myself down. I was terrified of being abandoned, I hated myself for screwing everything up, I hated him for not understanding me and refusing to reassure me, and I felt completely hopeless about ever getting better. I wanted my life to be over. I was suicidal.

Of course when I texted my ex boyfriend and said I wanted to die, he said he didn’t want to talk to me and that I was just trying to get out of the situation.

I think that people just don’t understand that people with BPD truly feel things at an overwhelming intensity much of the time. If someone gets irritated at us and we burst into tears, we’re not crying to get out of accepting responsibility for our actions or to get the other person to feel sorry for us. We’re crying out of intense guilt or fear of the other person hating us or self-loathing or anger at ourselves for screwing up again.

I think part of the reason for the misunderstanding is that non-borderlines see us having big reactions to what they have decided are not big situations and they assume we have manipulative intentions. People aren’t always very good at understanding the functions of behavior. But when a kid has what we consider to be an overreaction to something, do we automatically think the kid is attempting to manipulate us? No. We just think they’re being a kid.

Sometimes, of course, kids are trying to play a situation. There’s a difference between a child throwing a tantrum when they don’t get a candy bar because they know their parent will eventually give in, and a kid crying because they are afraid of thunderstorms. Kids get upset over things that most adults don’t. Children cry more than adults; they are afraid more than adults. We might think they overreact or freak out over silly things, but we don’t think that makes them manipulative.

I don’t mean to infantilize those with borderline personality disorder, but the principle is kind of the same. Maybe the things that upset a person with BPD are trivial to non-borderlines. Maybe our reactions seem out of proportion. That doesn’t have to equal manipulation and wicked intentions. I’m not crazy about the idea of someone being dismissive of things that are important to me and cause me pain, but it’s better than being treated like I’m manipulative.

Again, I can’t speak for all borderlines. I’m sure some people with BPD are manipulative  at times. But I don’t think the stereotype is deserved.